MR. ANDREW J DONOFRIO (NPI# 1124546221) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124546221 |
| Entity Type | Individual |
| Full Name | MR. ANDREW J DONOFRIO |
| Credential | PA-C |
| Practice Address |
500 N Wall St Kankakee IL 60901-2942 |
| Practice Telephone | 8444044787 |
| Practice Fax Number | 8159363243 |
| Mailing Telephone | 8444044787 |
| Mailing Fax Number | 8159363243 |
| Enumeration Date | 2017-09-08 |
| Last Update Date | 2019-08-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 085006333 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 515 Ne Glen Oak Ave, Peoria, IL 616033136 | (309) 674-2002 | 3096248949 |
| Street Address |
500 N WALL ST |
| City | KANKAKEE |
| State | IL |
| Zip Code | 60901-2942 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649265026 | Lambros C Chrones | Psychiatry & Neurology | 500 N Wall St, Suite 200, Kankakee, IL 60901-2942 | 2005-09-13 |
| 1477062172 | Cheryl D Rogers | Nurse Practitioner | 500 N Wall St, Kankakee, IL 60901-2942 | 2017-09-25 |
| 1245758416 | Elizabeth Ann Wirth | Clinical Nurse Specialist | 500 N Wall St, Kankakee, IL 60901-2942 | 2017-09-07 |
| 1568708667 | Karla Schweigert | Nurse Practitioner | 500 N Wall St, Kankakee, IL 60901-2942 | 2012-12-17 |
| 1588911333 | Shiva Prasad Shashidharan | Internal Medicine | 500 N Wall St, Kankakee, IL 60901 | 2012-08-11 |
| 1295964872 | Amit Zachariah | Internal Medicine | 500 N Wall St, Kankakee, IL 60901-2942 | 2009-07-05 |
| 1992959555 | Dawit Amare | Psychiatry & Neurology | 500 N Wall St, Ste. 200, Kankakee, IL 60901-2942 | 2008-11-10 |
| 1376709758 | Nha T Huynh | Internal Medicine | 500 N Wall St, Kankakee, IL 60901-2942 | 2008-08-05 |
| 1316111693 | Alaa E Abdel-meguid, M.d., S.c. | Internal Medicine | 500 N Wall St, Suite 501, Kankakee, IL 60901-2942 | 2008-04-17 |
| 1336339381 | Abhimanyu Beri | Internal Medicine | 500 N Wall St, Kankakee, IL 60901-2942 | 2007-07-26 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558978841 | William Mitsos Dds | Dentist | 1291 S. 7th Ave, Kankakee, IL 60901 | 2020-09-30 |
| 1922653682 | Jody Mcguyer, Lcpc, Cadc Counseling Services, LLC | Counselor | 315 W. Court St., Kankakee, IL 60901 | 2019-08-08 |
| 1700346327 | Sarah Elizabeth Toma | Speech-Language Pathologist | 200 E Court St #708, Kankakee, IL 60901 | 2019-03-20 |
| 1710473160 | Small Talk Speech Services, LLC | Clinic/Center | 1439 W Vanmeter St, Kankakee, IL 60901 | 2018-07-09 |
| 1124538004 | Amy J Green | Physical Therapist | 350 N. Wall Street, Kankakee, IL 60901 | 2017-10-05 |
| 1013457514 | Elizabeth Ann Smith | Registered Nurse | 292 Charlton Lane, Kankakee, IL 60901 | 2017-03-02 |
| 1861931461 | Stacey E. Brown | Nurse Practitioner | 207 N. Schuyler Ave., Kankakee, IL 60901 | 2017-02-15 |
| 1417352105 | Provider Healthcare Services, Inc | Home Health | 555 South Schuyler, Suite 275, Kankakee, IL 60901 | 2014-10-24 |
| 1265850655 | Ronald George Testa | Dentist | 202 N. Schuyler Ave, Kankakee, IL 60901 | 2014-04-02 |
| 1245587898 | Mary Beth Wertz | Registered Nurse | 100 N Jeffery Street, Kankakee, IL 60901 | 2012-08-13 |
| Find all providers in zip 60901 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164722955 | Stephanie E Grosso | Physician Assistant | 375 N Wall St, Suite P620, Kankakee, IL 60901 | 2010-10-26 |
| 1265930127 | Olga Banys | Physician Assistant | 350 N Wall St, Kankakee, IL 60901-2901 | 2018-01-25 |
| 1154798189 | Kimberly Ann Simon | Physician Assistant | 375 N Wall St Ste P420, Kankakee, IL 60901-3406 | 2015-08-25 |
| 1881090124 | Sarah Guastalli | Physician Assistant | 350 N Wall St, Kankakee, IL 60901-2901 | 2014-11-14 |
| 1922417625 | Catherine Helen Topor Diaz | Physician Assistant | 350 N Wall St, Kankakee, IL 60901-2901 | 2014-08-06 |
| 1780969634 | Karim H Bouferrache | Physician Assistant | 375 N Wall St Ste P530, Kankakee, IL 60901-3486 | 2011-10-11 |
| 1487941738 | Kaitlyn Marie Chiero | Physician Assistant | 350 N Wall St, Kankakee, IL 60901-2901 | 2011-07-07 |
| 1982928917 | Adam M Weaver | Physician Assistant | 400 N Wall St, Suite 402, Kankakee, IL 60901-2940 | 2010-03-19 |
| 1649422619 | Kristin Marie Balthazor | Physician Assistant | 375 N Wall St, Ste P530, Kankakee, IL 60901 | 2008-10-21 |
| 1306093356 | Brent Ray Huffines | Physician Assistant | 350 N Wall St, Kankakee, IL 60901-2901 | 2008-08-21 |
| Find all providers in KANKAKEE | ||||
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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.