RUSH OTOLARYNGOLOGY HEAD AND NECK SURGERY (NPI# 1124101548) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1124101548 |
Entity Type | Organization |
Organization Name | RUSH OTOLARYNGOLOGY HEAD AND NECK SURGERY |
Practice Address |
1611 W Harrison St Suite 550 Chicago IL 60612-4861 |
Practice Telephone | 3129426100 |
Practice Fax Number | 3129426225 |
Mailing Telephone | 3129426100 |
Mailing Fax Number | 3129426225 |
Enumeration Date | 2006-10-21 |
Last Update Date | 2010-06-23 |
Authorized Official Name | DAVID D CALDARELLI (AUTHORIZED OFFICIAL) |
Authorized Official Telephone | 3129426100 |
Authorized Official Credential | M.D. |
Is Organization Subpart | Y |
Parent Organization Name | RUSH UNIVERSITY MEDICAL CENTER |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207Y00000X | Otolaryngology | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IL | BC PPO | 01636656 | 01 |
Street Address |
1611 W HARRISON ST SUITE 550 |
City | CHICAGO |
State | IL |
Zip Code | 60612-4861 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1235138546 | Thomas J Nielsen | Otolaryngology | 1611 W Harrison St, Suite 550, Chicago, IL 60612-4861 | 2005-07-19 |
1699376996 | Lauren Kennerly | Registered Nurse | 1611 W Harrison St, Chicago, IL 60612-4861 | 2020-11-03 |
1225677404 | Mary Kathleen Walsh | Orthopaedic Surgery | 1611 W Harrison St, Chicago, IL 60612-4861 | 2020-01-05 |
1407417900 | Megan Merritt | Specialist/Technologist | 1611 W Harrison St, Chicago, IL 60612-4861 | 2019-06-25 |
1881253292 | Ellen Rohan | Physician Assistant | 1611 W Harrison St, Chicago, IL 60612-4861 | 2019-06-10 |
1588136154 | Elle Steele | Physician Assistant | 1611 W Harrison St, Chicago, IL 60612-4861 | 2018-12-20 |
1720591704 | Tricia Jacobs | Speech-Language Pathologist | 1611 W Harrison St, Chicago, IL 60612-4861 | 2017-11-13 |
1811415227 | Emily Marie Krogel | Nurse Practitioner | 1611 W Harrison St, Chicago, IL 60612-4861 | 2017-09-06 |
1104376912 | Paige Maher | Physician Assistant | 1611 W Harrison St, Ste 300, Chicago, IL 60612-4861 | 2016-10-05 |
1902350929 | Leah Kathleen Sparker | Specialist/Technologist | 1611 W Harrison St, Orthopedic Building Suite 530, Chicago, IL 60612-4861 | 2016-08-08 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144839739 | Sandhya Shri Kannayiram | Internal Medicine | 1901w Harrison Street, Chicago, IL 60612 | 2020-07-29 |
1568080174 | Nastaran Ordoyo Haghani Rad | Student in an Organized Health Care Education/Training Program | 1950 W. Polk Street, Room 6203, Chicago, IL 60612 | 2020-07-09 |
1669090403 | Marianne Gagnon-konamna | Student in an Organized Health Care Education/Training Program | 1950 West Polk Street, Chicago, IL 60612 | 2020-07-08 |
1922625672 | Tanya Montgomery Nee Brown | Pediatrics | 1950 West Polk Street, Neonatal and Perinatal Department, Chicago, IL 60612 | 2020-06-29 |
1124643028 | Ashley Swan | Dentist | 801 S. Paulina St, Uic College of Dentistry - Endodontics Clinic, Chicago, IL 60612 | 2020-06-16 |
1831711381 | Baillie Anne Bronner | Obstetrics & Gynecology | 1653 W Congress Pkwy Chicago, Il 60612, Chicago, IL 60612 | 2020-05-07 |
1154942449 | Keisha Davell Cole | Case Manager/Care Coordinator | 612 S Western Ave Unit 1, Chicago, IL 60612 | 2020-04-28 |
1275153777 | Isac Lim | Student in an Organized Health Care Education/Training Program | 1234 S. Wells, Chicago, IL 60612 | 2020-04-24 |
1578183414 | Zachary Belden | Student in an Organized Health Care Education/Training Program | Uic Psychiatry Residency 912 S. Wood St., Rm 130b Npi-s (mc 913), Chicago, IL 60612 | 2020-04-21 |
1548880560 | Christina Nunez | Student in an Organized Health Care Education/Training Program | 801 S. Paulina Street, M/c 850, Chicago, IL 60612 | 2020-04-20 |
Find all providers in zip 60612 |
Taxonomy Code | 207Y00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Otolaryngology |
An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1265074934 | Toriumi Facial Plastics Pllc | Otolaryngology | 60 E Delaware Pl Ste 1425, Chicago, IL 60611-1998 | 2019-10-14 |
1285100529 | Lauren E Lesniewski | Otolaryngology | 680 N Lake Shore Dr Ste 1210, Chicago, IL 60611-4490 | 2018-10-14 |
1982100525 | Muyinat Yewande Osoba | Otolaryngology | 675 N. Saint Clair St, Galter Pavilion, 15th Floor, Room 200, Chicago, IL 60611-5975 | 2018-04-03 |
1366822009 | Camil Correia | Otolaryngology | 675 N Saint Clair St Fl 15, Chicago, IL 60611-5975 | 2015-06-08 |
1093104523 | Omotara Sulyman | Otolaryngology | 1855 W Taylor St Rm 242, Chicago, IL 60612-7242 | 2015-01-21 |
1497012694 | Christopher Robert Roxbury | Otolaryngology | 5841 S Maryland Ave # Mc1035, Chicago, IL 60637-1443 | 2012-04-12 |
1174899066 | Victoria S Lee | Otolaryngology | 1855 W Taylor St Ste 3, Chicago, IL 60612-7244 | 2012-03-26 |
1043508872 | Glenda Lois Montague | Otolaryngology | 5814 S Maryland Ave, U of Chicago Ent Mc 1035 Room E-102 C/o Shanna Jones, Chicago, IL 60637-1462 | 2011-07-13 |
1467773960 | Siva Kumar Elangovan | Otolaryngology | 680 N Lake Shore Dr Ste 1425, Chicago, IL 60611-4451 | 2010-06-18 |
1598085383 | Virginie Achim | Otolaryngology | 1855 W Taylor St Rm 2.42, Chicago, IL 60612-7242 | 2010-06-03 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.