MICHAEL DEVISSER (NPI# 1215317599) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215317599 |
| Entity Type | Individual |
| Full Name | MICHAEL DEVISSER |
| Credential | M.D. |
| Practice Address |
1 Kish Hospital Dr Dekalb IL 60115-9602 |
| Practice Telephone | 8157667334 |
| Practice Fax Number | 8157669768 |
| Mailing Telephone | 8157667334 |
| Mailing Fax Number | 8157669768 |
| Enumeration Date | 2015-06-02 |
| Last Update Date | 2020-08-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 036149046 | IL | Allopathic & Osteopathic Physicians |
| N | 207P00000X | Emergency Medicine | 01081653A | IN | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1901 W Harrison St, Chicago, IL 606123714 | 3128646000 |
| Street Address |
1 KISH HOSPITAL DR |
| City | DEKALB |
| State | IL |
| Zip Code | 60115-9602 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184626194 | Connie M Bruch-harrison | Anesthesiology | 1 Kish Hospital Dr, Dekalb, IL 60115-9602 | 2005-08-10 |
| 1891394417 | Olivia Burton | Nurse Practitioner | 1 Kish Hospital Dr, Dekalb, IL 60115-9602 | 2020-10-23 |
| 1962019687 | Helen Elizabeth Rayburn | Registered Nurse | 1 Kish Hospital Dr, Dekalb, IL 60115-9602 | 2020-09-27 |
| 1932715570 | Julie Renee Long | Nurse Practitioner | 1 Kish Hospital Dr, Dekalb, IL 60115-9602 | 2020-09-18 |
| 1346878451 | Allison Smith | Nurse Anesthetist, Certified Registered | 1 Kish Hospital Dr, Dekalb, IL 60115-9602 | 2020-04-01 |
| 1679118301 | Kelly P Lopez | Nurse Practitioner | 1 Kish Hospital Dr, Dekalb, IL 60115-9602 | 2019-11-18 |
| 1366095333 | Godwin Roy Esquillo Flores | Nurse Practitioner | 1 Kish Hospital Dr, Dekalb, IL 60115-9602 | 2019-07-18 |
| 1275186330 | Melissa Romano | Dietitian, Registered | 1 Kish Hospital Dr, Dekalb, IL 60115-9602 | 2019-07-18 |
| 1932666385 | Rebecca Andrews | Dietitian, Registered | 1 Kish Hospital Dr, Dekalb, IL 60115-9602 | 2019-02-21 |
| 1093214249 | Cassandra Katzenberger | Registered Nurse | 1 Kish Hospital Dr, Dekalb, IL 60115-9602 | 2018-02-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598372179 | Megan Erhart | Counselor | 304 N. 6th Street, Dekalb, IL 60115 | 2020-09-28 |
| 1689141616 | Stephanie Klewin | Psychologist | 631 S 1st Street, Dekalb, IL 60115 | 2018-10-29 |
| 1164902219 | Kimberly Ann Hart | Counselor | 290 N. Annie Glidden Drive, Gh 416, Niu, Dekalb, IL 60115 | 2018-08-17 |
| 1497235824 | Cory David Michael Hayden | Specialist/Technologist | 175 Yordon Center (niu Athletic Training), Dekalb, IL 60115 | 2018-08-15 |
| 1154807808 | Michael John Borak | Pharmacist | 975 S Annie Glidden Road, Schnucks Market Inc, Dekalb, IL 60115 | 2018-07-16 |
| 1184125841 | Candace Schroeffel | Student in an Organized Health Care Education/Training Program | 520 Garden Rd, Dekalb, IL 60115 | 2018-02-27 |
| 1033627583 | Hannah M Studebaker | Massage Therapist | 3266 Sycamore Road, Dekalb, IL 60115 | 2018-01-18 |
| 1649700238 | Jennifer Mangino | Behavioral Analyst | 138 Berkshire Dr, Dekalb, IL 60115 | 2017-06-15 |
| 1003346628 | Victoria Tullock | Counselor | 631 South First St., Dekalb, IL 60115 | 2017-06-15 |
| 1194263848 | Brianna Kraft | Specialist/Technologist | 900 Crane Dr, Dekalb, IL 60115 | 2017-02-02 |
| Find all providers in zip 60115 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891010591 | Ted Samawi | Emergency Medicine | 1 Kish Drive, Dekalb, IL 60115 | 2010-04-06 |
| 1003973728 | Nina L Taylor | Emergency Medicine | 1425 W Lincoln Hwy, Northern Illinois University / Health Services, Dekalb, IL 60115-2828 | 2007-01-02 |
| 1912439654 | Amanda Renee Ross | Emergency Medicine | 1 Kish Hospital Dr, Dekalb, IL 60115-9602 | 2017-03-31 |
| 1396191359 | Michael Hagstrom | Emergency Medicine | 1 Kish Hospital Dr, Dekalb, IL 60115-9602 | 2016-05-09 |
| 1215391099 | Grace Ortman | Emergency Medicine | 1 Kish Hospital Dr, Dekalb, IL 60115-9602 | 2016-04-07 |
| 1427312727 | Sweta K Shah | Emergency Medicine | 1 Kish Hospital Dr, Dekalb, IL 60115-9602 | 2012-07-02 |
| 1548575855 | Clayborn Morris | Emergency Medicine | 1 Kish Hospital Dr, Dekalb, IL 60115 | 2010-08-11 |
| 1376743914 | Michael S Hohlastos | Emergency Medicine | 1 Kish Hospital Dr, Dekalb, IL 60115-9602 | 2007-07-23 |
| 1396899431 | Gregg A Kling | Emergency Medicine | One Kish Hospital Dr, Dekalb, IL 60115-4939 | 2007-01-23 |
| 1437203528 | Bruce Brantman | Emergency Medicine | 626 Bethany Rd, Dekalb, IL 60115-4939 | 2007-01-23 |
| Find all providers in DEKALB | ||||
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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.