FAMILY MEDICINE FOR MCHENRY COUNTY (NPI# 1174503510) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174503510 |
| Entity Type | Organization |
| Organization Name | FAMILY MEDICINE FOR MCHENRY COUNTY |
| Practice Address |
1095 Pingree Rd Suite 108 Crystal Lake IL 60014-1725 |
| Mailing Address |
Po Box 1588 Crystal Lake IL 60039-1588 |
| Practice Telephone | 8476582400 |
| Practice Fax Number | 8476587755 |
| Mailing Telephone | 8476582400 |
| Mailing Fax Number | 8476587755 |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2007-10-18 |
| Authorized Official Name | DR. MICHAEL LESSER (PRESIDENT) |
| Authorized Official Telephone | 8476582400 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BCBS PROVIDER NUMBER | 5615119 | 01 |
| Street Address |
1095 PINGREE RD SUITE 108 |
| City | CRYSTAL LAKE |
| State | IL |
| Zip Code | 60014-1725 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528610268 | Jenna Lee | Physical Therapist | 1095 Pingree Rd, Crystal Lake, IL 60014-1725 | 2019-07-12 |
| 1265951883 | Lakeview Counseling Services | Counselor | 1095 Pingree Rd, Crystal Lake, IL 60014-1725 | 2017-09-14 |
| 1962935213 | Julia Tansor | Physical Therapist | 1095 Pingree Rd, Suite 209, Crystal Lake, IL 60014-1725 | 2017-04-04 |
| 1255786950 | Margaret Yuk | Speech-Language Pathologist | 1095 Pingree Rd, Suite #209, Crystal Lake, IL 60014-1725 | 2016-05-01 |
| 1386099208 | Roseann C Iverson | Nurse Practitioner | 1095 Pingree Rd, Suite 108, Crystal Lake, IL 60014-1725 | 2016-04-28 |
| 1053718445 | Companian Animal Specialty and Emergency Hospital | Veterinarian | 1095 Pingree Rd, Suite 120, Crystal Lake, IL 60014-1725 | 2014-12-01 |
| 1902223290 | Rachel Lynne Linden | Speech-Language Pathologist | 1095 Pingree Rd, #119, Crystal Lake, IL 60014-1725 | 2014-03-25 |
| 1063769487 | Siddhi Virendra Bavishi | Physical Therapist | 1095 Pingree Rd, Suite 119, Crystal Lake, IL 60014-1725 | 2012-08-06 |
| 1831325299 | William Peter Birong | Social Worker | 1095 Pingree Rd, Suite 204, Crystal Lake, IL 60014-1725 | 2009-05-29 |
| 1497998702 | Kelli Marie Reynolds | Speech-Language Pathologist | 1095 Pingree Rd, Ste 119, Crystal Lake, IL 60014-1725 | 2009-04-16 |
| Find all providers in the same location | ||||
| 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 | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265917876 | Global Med Pro LLC | Family Medicine | 741 S Mchenry Ave Ste C&d, Crystal Lake, IL 60014-7445 | 2018-09-28 |
| 1588921951 | Khyldoon Selim Bajwa | Family Medicine | 2813 Stonegate Dr, Crystal Lake, IL 60012-1033 | 2012-04-23 |
| 1356653570 | Anthony J Weston | Family Medicine | 525 E Congress Pkwy Ste 350, Crystal Lake, IL 60014-6271 | 2010-07-02 |
| 1700106028 | Sumaira Jabeen | Family Medicine | 741 S Mchenry Ave Ste C, Crystal Lake, IL 60014 | 2010-06-09 |
| 1801856117 | John S Balocki | Family Medicine | 185 Heritage Drive, Suite 3, Crystal Lake, IL 60014 | 2006-03-23 |
| 1356905194 | Illinois Primary & Immediate Care Inc | Family Medicine | 741 S Mchenry Ave Ste C, Crystal Lake, IL 60014-7445 | 2019-04-26 |
| 1356883599 | Centegra Primary Care LLC | Family Medicine | 420 N Il Route 31, Crystal Lake, IL 60012-3709 | 2016-11-04 |
| 1972814267 | Krishanthi Dilrukshi Seneviratne | Family Medicine | 415 E Congress Pkwy Ste A, Crystal Lake, IL 60014-6248 | 2010-07-01 |
| 1508035304 | Shruti Bahadur | Family Medicine | 650 Dakota St Ste A, Crystal Lake, IL 60012 | 2008-02-26 |
| 1871779744 | Emily Shen | Family Medicine | 350 E Congress Pkwy, Crystal Lake, IL 60014-6284 | 2008-01-10 |
| Find all providers in CRYSTAL LAKE | ||||
| City | CRYSTAL LAKE |
| Zip Code | 60014 |
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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.