NOLASCO MEDICAL GROUP, PLLC (NPI# 1184235905) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184235905 |
| Entity Type | Organization |
| Organization Name | NOLASCO MEDICAL GROUP, PLLC |
| Practice Address |
2317 S Bates Ave Springfield IL 62704-4337 |
| Practice Telephone | 3126628763 |
| Mailing Telephone | 3126628763 |
| Enumeration Date | 2020-08-14 |
| Last Update Date | 2020-08-18 |
| Authorized Official Name | DR. CARLOS NOLASCO (OWNER) |
| Authorized Official Telephone | 3126628763 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RH0005X |
Internal Medicine Specialization: Hypertension Specialist |
Allopathic & Osteopathic Physicians | ||
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities | ||
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
2317 S BATES AVE |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62704-4337 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902394901 | Hillary Haaker | Occupational Therapist | 2035 W Iles, Suite C, Springfield, ID 62704 | 2018-04-25 |
| 1871095364 | Edward Doyle Slifer Sr. | Pathology | 2117 Greenside Drive, Spring Field, IL 62704 | 2018-03-01 |
| 1598263345 | Santarelli & Feller Dental Group | Dentist | 1140 Rickard Road, Suite B, Springfield, IL 62704 | 2018-01-26 |
| 1447774757 | Lisa Ann Rogers | Developmental Therapist | 2101 Lexington Dr, Apt 3, Springfield, IL 62704 | 2017-07-28 |
| 1730611286 | Mindi Rowe | Occupational Therapist | 2508 County Rd 4 1/2 E, Springfield, IL 62704 | 2017-04-03 |
| 1366992208 | Jayme Jordan | Contractor | 2409 Westchester Blvd, Springfield, IL 62704 | 2016-10-04 |
| 1154793974 | Dina Payne | Social Worker | 917 Clocktower Drive, Suite 600, Springfield, IL 62704 | 2015-10-21 |
| 1770959819 | James R Reynolds | Hearing Instrument Specialist | 2347 W Monroe St, Springfield, IL 62704 | 2015-08-12 |
| 1336576495 | Emily Jane Dungey | Counselor | 920 S Spring St Ste 1300, Springfield, IL 62704 | 2013-10-03 |
| 1942552161 | Jeannie Marie Hundley | Specialist/Technologist, Other | 2921 Monvale Drive, Springfield, IL 62704 | 2012-10-11 |
| Find all providers in zip 62704 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639675077 | Anand Kanjolia, M.d. LLC | Internal Medicine | 222 Carew St Fl 4, Springfield, MA 01104-4109 | 2018-04-04 |
| 1376068817 | Personal Primary Care and Weight Management, LLC | Internal Medicine | 299 Carew St Ste 234, Springfield, MA 01104-2368 | 2017-08-05 |
| 1184145682 | Basma Al-bast | Internal Medicine | 701 N 1st St Ste 434, Springfield, IL 62702-3757 | 2017-07-05 |
| 1689124604 | John Duff | Internal Medicine | 2909 S Camber Ave, Springfield, MO 65809-3547 | 2016-10-13 |
| 1669834941 | Siddhi Joshi | Internal Medicine | 5501 Backlick Rd Ste 105, Springfield, VA 22151-3940 | 2016-03-24 |
| 1265898936 | Mohammad Rahimuddin | Internal Medicine | 2556 Snyder Domer Rd, Springfield, OH 45502-8161 | 2016-01-11 |
| 1376908913 | Abdul Hannan | Internal Medicine | 315 W Carpenter St # B, Springfield, IL 62702 | 2015-12-28 |
| 1033589304 | Hshs Medical Group Inc | Internal Medicine | 3215 Executive Park Dr, Springfield, IL 62703-4514 | 2015-09-30 |
| 1679992895 | Ahlam Elbadri | Internal Medicine | 2115 S Fremont Ave Ste 2300, Springfield, MO 65804-2233 | 2014-04-15 |
| 1528487543 | Barbara Vinci | Internal Medicine | 2443 Troy Rd, Springfield, OH 45504-4233 | 2014-04-08 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62704 |
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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.