SHAWN B KHADEMI (NPI# 1124412184) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124412184 |
| Entity Type | Individual |
| Full Name | SHAWN B KHADEMI |
| Credential | DPM |
| Practice Address |
750 E Terra Cotta Ave Ste C Crystal Lake IL 60014-3621 |
| Practice Telephone | 8476395800 |
| Practice Fax Number | 8155263467 |
| Mailing Telephone | 8476395800 |
| Mailing Fax Number | 8155263467 |
| Enumeration Date | 2015-03-26 |
| Last Update Date | 2020-08-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
016005850 | IL | Podiatric Medicine & Surgery Service Providers |
| N | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
1348 | MA | Podiatric Medicine & Surgery Service Providers |
| Street Address |
750 E TERRA COTTA AVE STE C |
| City | CRYSTAL LAKE |
| State | IL |
| Zip Code | 60014-3621 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386296887 | Nataliia Steshenko | Specialist/Technologist, Other | 750 E Terra Cotta Ave Ste C, Crystal Lake, IL 60014-3621 | 2019-07-15 |
| 1073083770 | Northern Illinois Foot & Ankle Specialists, Ltd | Podiatrist | 750 E Terra Cotta Ave Ste C, Crystal Lake, IL 60014-3621 | 2018-11-26 |
| 1386165389 | John Michael Thometz | Podiatrist | 750 E Terra Cotta Ave Ste C, Crystal Lake, IL 60014-3621 | 2017-06-29 |
| 1467972497 | Joseph George Wilson | Podiatrist | 750 E Terra Cotta Ave Ste C, Crystal Lake, IL 60014-3621 | 2017-06-21 |
| 1396197604 | Adam Buffington | Podiatrist | 750 E Terra Cotta Ave Ste C, Crystal Lake, IL 60014 | 2016-07-11 |
| 1538510656 | Rimvydas Statkus | Podiatrist | 750 E Terra Cotta Ave Ste C, Crystal Lake, IL 60014-3621 | 2016-06-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497394720 | Lorelei Mariano | Physical Therapist | 350 E Congress Parkway Ste A, Crystal Lake, IL 60014 | 2020-01-03 |
| 1396227070 | Behavioral Services for Autism, Inc | Behavioral Analyst | 1095 Pingree Road, Suite 204, Crystal Lake, IL 60014 | 2018-08-30 |
| 1831635564 | Isis Mendoza-garnica | Counselor | 6803 Rose Ave, Crystal Lake, IL 60014 | 2017-01-19 |
| 1134664402 | Derick Dermatology, LLC | Non-Pharmacy Dispensing Site | 525 E Congress Parkway, Suite 200, Crystal Lake, IL 60014 | 2016-12-22 |
| 1306394051 | Highland Park Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 177 W Virginia Street, Crystal Lake, IL 60014 | 2016-09-12 |
| 1124492830 | Align Spine & Orthopaedics | Durable Medical Equipment & Medical Supplies | 60 B West Terra Cotta Ave, #265, Crystal Lake, IL 60014 | 2015-11-18 |
| 1558747428 | Shabana Nawaz | Optometrist | 4777 Northwest Highway, Crystal Lake, IL 60014 | 2015-08-03 |
| 1548649205 | Daniel Okon | Social Worker | 304 Charllote Ave, Crystal Lake, IL 60014 | 2015-05-27 |
| 1154729838 | Crystal Lake Center for Chronic Pain Sc | Nurse Practitioner | 1 South Northwest Highway, Crystal Lake, IL 60014 | 2014-12-12 |
| 1558763581 | Brooke Nicole Grandt | Occupational Therapist | 394 Heisler Ct, Crystal Lake, IL 60014 | 2014-09-22 |
| Find all providers in zip 60014 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275770844 | Godfrey V. Viegas Dpm, Foot and Ankle Center, Inc. | Podiatrist | 280 Memorial Ct, Suite C, Crystal Lake, IL 60014-6233 | 2009-01-19 |
| 1902873904 | Cheryl R Brown-cook | Podiatrist | 1520 Carlemont Dr Ste M, Crystal Lake, IL 60014-1836 | 2006-03-08 |
| 1073083770 | Northern Illinois Foot & Ankle Specialists, Ltd | Podiatrist | 750 E Terra Cotta Ave Ste C, Crystal Lake, IL 60014-3621 | 2018-11-26 |
| 1386165389 | John Michael Thometz | Podiatrist | 750 E Terra Cotta Ave Ste C, Crystal Lake, IL 60014-3621 | 2017-06-29 |
| 1396197604 | Adam Buffington | Podiatrist | 750 E Terra Cotta Ave Ste C, Crystal Lake, IL 60014 | 2016-07-11 |
| 1538510656 | Rimvydas Statkus | Podiatrist | 750 E Terra Cotta Ave Ste C, Crystal Lake, IL 60014-3621 | 2016-06-29 |
| 1891840203 | Foot First Podiatry Cl PC | Podiatrist | 39 S Virginia St, Crystal Lake, IL 60014-5826 | 2007-01-24 |
| 1548315021 | Ronald Jay Leib | Podiatrist | 39 S Virginia St, Crystal Lake, IL 60014-5826 | 2007-01-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154930485 | Mid America Foot & Ankle Specialist Illinois LLC | Podiatrist | 2003 Montgomery Rd Ste 108109, Aurora, IL 60504-9078 | 2020-07-22 |
| 1265040026 | Northern Illinois Foot & Ankle Specialists, Ltd | Podiatrist | 4121 Fairview Ave Ste 102, Downers Grove, IL 60515-2266 | 2020-07-17 |
| 1316563612 | Jacob Tilsley | Podiatrist | 610 S Maple Ave Ste 2250, Oak Park, IL 60304-1093 | 2020-06-22 |
| 1033738547 | C James Anderson Dpm LLC | Podiatrist | 1000 Eleven S Ste 3a, Columbia, IL 62236-1077 | 2020-04-14 |
| 1386263895 | C James Anderson Dpm LLC | Podiatrist | 717 Insight Ave Ste 100, O Fallon, IL 62269-2193 | 2020-04-14 |
| 1821631367 | Dr Christine Heck PC | Podiatrist | 111 N Wabash Ave Ste 1914, Chicago, IL 60602-2968 | 2019-10-28 |
| 1013562578 | Bishoy Atef Botros | Podiatrist | 820 S Damen Ave Fl 7, Chicago, IL 60612-3728 | 2019-08-01 |
| 1538623947 | Steven B Overpeck Dpm PC | Podiatrist | 25520 S Pheasant Ln Unit K, Channahon, IL 60410-8808 | 2019-01-30 |
| 1366916355 | Center for Foot and Ankle Surgery Ltd | Podiatrist | 654 W Veterans Pkwy Ste D, Yorkville, IL 60560-2510 | 2019-01-14 |
| 1497224950 | Northern Illinois Foot & Ankle Specialists, Ltd | Podiatrist | 1288 S Us Highway 12, Fox Lake, IL 60020-1950 | 2018-11-14 |
| Find all providers with the same taxonomy | ||||
| City | CRYSTAL LAKE |
| Zip Code | 60014 |
Please comment or provide details below to improve the information on SHAWN B KHADEMI.
| 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.