MS. LIDIA S POMAVILLE (NPI# 1144595174) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144595174 |
| Entity Type | Individual |
| Full Name | MS. LIDIA S POMAVILLE |
| Other Name | LIDIA SCHETTLE |
| Credential | PA-C |
| Practice Address |
3253 S Harlem Ave Suite 1a Berwyn IL 60402-3073 |
| Mailing Address |
801 York St Manitowoc WI 54220-4630 |
| Practice Telephone | 2628984400 |
| Practice Fax Number | 7087886884 |
| Mailing Telephone | 8666309882 |
| Mailing Fax Number | 9206825810 |
| Enumeration Date | 2012-03-08 |
| Last Update Date | 2016-11-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 085-004255 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3253 S HARLEM AVE SUITE 1A |
| City | BERWYN |
| State | IL |
| Zip Code | 60402-3073 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013983618 | David H Whitney | Dermatology | 3253 S Harlem Ave, Suite 1a, Berwyn, IL 60402-3073 | 2006-02-24 |
| 1629524632 | Forefront Dermatology, S.c. | Dermatology | 3253 S Harlem Ave, Suite 1a, Berwyn, IL 60402 | 2016-08-30 |
| 1992086029 | Berwyn Surgical Center LLC | Clinic/Center | 3253 S Harlem Ave, Ste. 1b, Berwyn, IL 60402-2996 | 2011-09-02 |
| 1184935611 | Elizabeth Marie Damstetter | Dermatology | 3253 S Harlem Ave, Suite 1a, Berwyn, IL 60402-3073 | 2010-06-30 |
| 1700110699 | Sue H Bedi | Chiropractor | 3253 S Harlem Ave, Suite 1b, Berwyn, IL 60402-2996 | 2009-09-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619586518 | Lisa K Anderson-shaw | Clinical Ethicist | Macneal Trinity Medical Cetner, 3249 Oak Park Avenue, Berwyn, IL 60402 | 2020-07-27 |
| 1922622380 | Ayesha Ikram | Internal Medicine | Macneal Hospital 3249 S. Oak Park Ave, Brewyn, IL 60402 | 2020-06-02 |
| 1598329146 | Eleanor Teoh | Student in an Organized Health Care Education/Training Program | Family Medicine, Macneal Family Medicine Center, 3231 Eucild Ave, 5th Floor, Berwyn, IL 60402 | 2019-04-30 |
| 1376013920 | Virginia Mireles | Behavior Technician | 2317 S. Home, Berwyn, IL 60402 | 2018-11-27 |
| 1245709047 | Saraswati Koirala | Dentist | 1227 S Harlem Ave Apt414, Berwyn, IL 60402 | 2018-11-21 |
| 1295204220 | Dental Town Ltd | Dentist | 7106 W Cermak Rd, Berwyn, IL 60402 | 2018-11-20 |
| 1396231684 | Toya M Gildart | Counselor | Pillars, 6415 Stanley Avenue, Berwyn, IL 60402 | 2018-07-10 |
| 1437655685 | Ana Luisa Desantiago | Social Worker | 3245 Grove Ave Ste 201, Berwyn, IL 60402 | 2018-04-04 |
| 1821520198 | Chetan Velagapudi | Student in an Organized Health Care Education/Training Program | 3231 S Euclid Avenue, Suite 203, Berwyn, IL 60402 | 2017-03-28 |
| 1174976567 | Sydney Talavera | Counselor | 6415 Stanley Ave., Berwyn, IL 60402 | 2016-07-20 |
| Find all providers in zip 60402 | ||||
| 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 |
|---|---|---|---|---|
| 1164497087 | Heather Tenbrock Kern | Physician Assistant | 552a Lancaster Ave, Berwyn, PA 19312-1635 | 2006-02-22 |
| 1063409035 | Frank R Perez | Physician Assistant | 7000 Cermak Rd, Berwyn, IL 60402-2112 | 2005-10-04 |
| 1609878370 | Celesia Leonard | Physician Assistant | 3249 S. Oak Park Ave, Macneal Hospital, Berwyn, IL 60402 | 2005-08-12 |
| 1740808633 | Brigette Chelchowski | Physician Assistant | 6447 Cermak Rd, Berwyn, IL 60402-2311 | 2020-07-08 |
| 1386279677 | Jennifer K Yang | Physician Assistant | 3249 Oak Park Ave, Berwyn, IL 60402-0715 | 2020-03-06 |
| 1780214528 | Michelle Adler Silver | Physician Assistant | 3249 Oak Park Ave, Berwyn, IL 60402-3429 | 2020-01-21 |
| 1710405899 | Kanyada Suvittayasiri | Physician Assistant | 3249 Oak Park Ave, Berwyn, IL 60402-3429 | 2017-09-08 |
| 1316319247 | Amber Yow | Physician Assistant | 3249 Oak Park Ave, 1st Floor, Berwyn, IL 60402-3429 | 2015-10-30 |
| 1356712558 | Mustafa Zakaria | Physician Assistant | 3249 Oak Park Ave, Berwyn, IL 60402-3429 | 2015-10-13 |
| 1376913574 | Emily Maine | Physician Assistant | 3249 Oak Park Ave, Berwyn, IL 60402-3429 | 2015-09-30 |
| Find all providers in BERWYN | ||||
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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.