DR. CAROL WITCRAFT BOOTH (NPI# 1225072598) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225072598 |
| Entity Type | Individual |
| Full Name | DR. CAROL WITCRAFT BOOTH |
| Credential | M.D. |
| Practice Address |
1875 Dempster St Suite 310 Park Ridge IL 60068-1186 |
| Practice Telephone | 8477237705 |
| Practice Fax Number | 8477238675 |
| Mailing Telephone | 8477237705 |
| Mailing Fax Number | 8477238675 |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2009-03-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207SG0201X |
Medical Genetics Specialization: Clinical Genetics (M.D.) |
036042710 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036042710 | 05 | |
| RR MED GROUP | C19354 | 01 | |
| RR MED PIN | 460002585 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275882375 | Carol Booth | Speech-Language Pathologist | 1025 Euclid Avenue, Paintsville, KY 41240 | 2012-09-05 |
| 1154629574 | Carol Lynn Booth | Dietitian, Registered | 415 Margaret Ave, Johnstown, PA 15905-3865 | 2011-03-09 |
| 1407303738 | Carol Ann Booth | Psychologist | 4515 Yoakum Blvd, Houston, TX 77006-5821 | 2016-09-02 |
| 1629331566 | Carol Blood Booth | Specialist | 1001 W Seneca St, Ithaca, NY 14850-3342 | 2012-06-15 |
| 1104835438 | Carol W. Booth | Chiropractor | 1621 W Park Row Dr, Arlington, TX 76013-3502 | 2006-08-05 |
| Street Address |
1875 DEMPSTER ST SUITE 310 |
| City | PARK RIDGE |
| State | IL |
| Zip Code | 60068-1186 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952307092 | The Spine Center, S.c | Orthopaedic Surgery | 1875 Dempster St, Ste 425, Park Ridge, IL 60068-1129 | 2005-06-23 |
| 1124680640 | Heather Ann-marie Owens | Physical Therapist | 1875 Dempster St, Park Ridge, IL 60068-1186 | 2019-07-04 |
| 1467012187 | Eric Joseph Leadley | Nurse Practitioner | 1875 Dempster St, Park Ridge, IL 60068-1186 | 2019-06-14 |
| 1619495868 | Kelly Ryan Warf | Audiologist | 1875 Dempster St, Park Ridge, IL 60068-1186 | 2017-09-07 |
| 1164946919 | Olga Gilman | Nurse Practitioner | 1875 Dempster St, Park Ridge, IL 60068-1186 | 2017-08-02 |
| 1275060972 | Anne Frances Wright | Nurse Practitioner | 1875 Dempster St, Park Ridge, IL 60068-1186 | 2017-05-12 |
| 1558892166 | Maricar A Virina | Obstetrics & Gynecology | 1875 Dempster St, Ste. 330, Park Ridge, IL 60068 | 2017-03-24 |
| 1649711995 | Brian Saliba | Obstetrics & Gynecology | 1875 Dempster St, Suite 330, Park Ridge, IL 60068-1186 | 2017-03-19 |
| 1174069363 | Laura Hunnell | Physician Assistant | 1875 Dempster St, Suite 410, Park Ridge, IL 60068-1186 | 2017-01-11 |
| 1871035121 | Rosina Hannilora Victor | Nurse Practitioner | 1875 Dempster St, #465, Park Ridge, IL 60068-1186 | 2016-11-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861010720 | Caitlin Marie Kompanowski | Dentist | 412 W. Talcott, Park Ridge, IL 60068 | 2020-07-08 |
| 1972142198 | Center for Authentic Living, Inc. | Counselor | 120 Main Street Suite 200, Park Ridge, IL 60068 | 2020-01-06 |
| 1306312152 | Maryann Almores Devilla | Physical Medicine & Rehabilitation | Sunrise Assisted Living, 1725 Ballard Road, Park Ridge, IL 60068 | 2018-10-19 |
| 1053808857 | Landon Ginsberg | Student in an Organized Health Care Education/Training Program | 1775 Ballard, Park Ridge, IL 60068 | 2018-04-17 |
| 1255828448 | Vera W Brink | Obstetrics & Gynecology | Parkside Professional Center, 1875 Dempster St., Ste. 330, Park Ridge, IL 60068 | 2018-04-13 |
| 1205367448 | Courtney Heim | Psychiatry & Neurology | 1875 W.dempster Street - Park Side Professional Center, Ste 470, Park Ridge, IL 60068 | 2017-03-21 |
| 1720521362 | Alexander Mylonas | Psychologist | 1400 Renaissance Dr Ste 401, Park Ridge, IL 60068 | 2016-11-30 |
| 1376090878 | Rebecca Rajasekhar | Audiologist | 1030 W. Higgins Rd., Audiology Room 6, Park Ridge, IL 60068 | 2016-09-01 |
| 1164818449 | Mohammad Taha Mustaf Taha Mustafa Sheikh | Student in an Organized Health Care Education/Training Program | 1550 North Northwest Highway Suite 107, L.m. Prasad, Md, Sc, Park Ridge, IL 60068 | 2015-04-13 |
| 1518397918 | Megan Roberts | Speech-Language Pathologist | 2240 Campus Dr., Evanston, IL 60068 | 2013-11-21 |
| Find all providers in zip 60068 | ||||
| Taxonomy Code | 207SG0201X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Medical Genetics |
| Specialization | Clinical Genetics (M.D.) |
| A clinical geneticist demonstrates competence in providing comprehensive diagnostic, management and counseling services for genetic disorders. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Medical Genetics, 2007. http://www.abmg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Medical Genetics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427026897 | Brad Angle | Medical Genetics | 1875 Dempster St Ste 285, Park Ridge, IL 60068-1157 | 2006-03-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043474893 | Serendestiny Enterprise LLC | Medical Genetics | 3555 Vanilla Grass Dr, Naperville, IL 60564-8331 | 2008-07-10 |
| 1164447413 | Lee Shulman | Medical Genetics | 675 N St Clair Street, Galter Suite 14-200, Chicago, IL 60611-5966 | 2006-07-13 |
| 1962466375 | Joel Martin Charrow | Medical Genetics | Ann& Robert H. Lurie Children's Hospital of Chicago #59, 225 E Chicago Ave, Chicago, IL 60611-2991 | 2006-04-13 |
| 1629051289 | Rhonda Spiro | Medical Genetics | 1801 W Taylor St Ste 2e, Chicago, IL 60612-4795 | 2005-11-28 |
| 1134534597 | Joshua Baker | Medical Genetics | 225 E Chicago Ave, Chicago, IL 60611-2991 | 2014-06-24 |
| 1306108105 | Josue Flores Daboub | Medical Genetics | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2012-06-08 |
| 1972883254 | Gifty Bhat | Medical Genetics | 1801 W Taylor St Ste 2e, Ui Health Occ, Chicago, IL 60612-4795 | 2011-08-18 |
| 1043410772 | Neuromed Clinic LLC | Medical Genetics | 25 N Winfield Rd, Ste 500, Winfield, IL 60190-1222 | 2007-07-20 |
| 1669595872 | Darrel Waggoner | Medical Genetics | 5841 S Maryland Ave, Mc 0077 Room O-500, Chicago, IL 60637-1447 | 2007-04-10 |
| 1538282736 | William Brian Dobyns | Medical Genetics | 5841 S Maryland Ave, Mc 0077, Chicago, IL 60637-1447 | 2007-04-10 |
| Find all providers with the same taxonomy | ||||
| City | PARK RIDGE |
| Zip Code | 60068 |
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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.