KEVIN O'CONNOR (NPI# 1225407539) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225407539 |
| Entity Type | Individual |
| Full Name | KEVIN O'CONNOR |
| Credential | PA-C |
| Practice Address |
3420 Illinois St Great Lakes IL 60088-3161 |
| Practice Telephone | 8476886755 |
| Enumeration Date | 2015-09-16 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 0010-06001 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| Psc Box 20098, Hq and Service Co, 1st Bn, 6th Marine Regt, 2d Mardiv, Camp Lejeune, NC 285420098 | 9104505150 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659413219 | Kevin O'connor | Social Worker | 651 Cherry St, Santa Rosa, CA 95404-4202 | 2007-02-12 |
| 1710063557 | Kevin Francis O'connor Jr. | Physician Assistant | 1 Us Coast Guard Training Center, Tracen Yorktown Clinic, Yorktown, VA 23690 | 2006-10-27 |
| 1063418101 | Kevin M. O'connor | Emergency Medicine | 100 Saint Giles Ct, Belmont, NC 28012-4154 | 2005-06-23 |
| 1245692565 | Kevin F O'connor Jr. | Psychiatry & Neurology | University of Kentucky, 800 Rose Street, Lexington, KY 40536-0293 | 2016-03-25 |
| 1205206703 | Kevin O'connor | Counselor | 2450 S Vine St, Denver, CO 80210-5264 | 2015-09-28 |
| 1982070587 | Kevin O'connor | Physical Therapist | 30085 Comercio, Rancho Santa Margarita, CA 92688-2106 | 2015-08-18 |
| 1528313855 | Kevin Michael O'connor | Registered Nurse | 167 North Main Street, Tuba City, AZ 86045-0600 | 2012-07-24 |
| 1083996961 | Kevin O'connor | Pharmacist | 27 S Main St, Manville, NJ 08835-1801 | 2011-09-15 |
| 1124281001 | Kevin M O'connor | Radiology | 88 E Newton St, Boston, MA 02118-2308 | 2008-07-09 |
| 1831368349 | Kevin O'connor | Psychiatry & Neurology | 750 E Adams St, Syracuse, NY 13210-2342 | 2008-02-28 |
| Street Address |
3420 ILLINOIS ST |
| City | GREAT LAKES |
| State | IL |
| Zip Code | 60088-3161 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952385148 | Jason Todd Holdeman | Psychologist | 3420 Illinois St, Great Lakes, IL 60088-3161 | 2005-12-01 |
| 1750851788 | Claire Kubiesa | Psychologist | 3420 Illinois St, Great Lakes, IL 60088-3161 | 2018-12-03 |
| 1003342536 | Emily J Baker | Physical Therapist | 3420 Illinois St, Great Lakes, IL 60088-3161 | 2017-05-03 |
| 1346603594 | Laura Megan Logeman | Physician Assistant | 3420 Illinois St, Great Lakes, IL 60088-3161 | 2016-04-04 |
| 1245595776 | Alma Teresa C Molino | Psychologist | 3420 Illinois St, Great Lakes, IL 60088-3161 | 2012-07-10 |
| 1245529304 | Erin Graham | Student in an Organized Health Care Education/Training Program | 3420 Illinois St, Bldg 1007, Great Lakes, IL 60088-3161 | 2011-03-29 |
| 1588895742 | Kermit Salivia | Family Medicine | 3420 Illinois St, Great Lakes, IL 60088-3161 | 2009-08-05 |
| 1083898290 | Warren K Kennedy | Physician Assistant | 3420 Illinois St, Great Lakes, IL 60088-3120 | 2007-12-24 |
| 1346435112 | Jason Yungsup Kim | Family Medicine | 3420 Illinois St, Uss Tranquillity Clinic 1007, Great Lakes, IL 60088-3161 | 2007-09-13 |
| 1972793909 | Brett Staib | Military Health Care Provider | 3420 Illinois St, Bhc 1007, Great Lakes, IL 60088-3120 | 2007-07-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043858228 | Kathryn Ann Bird | Dentist | 3440 W Ohio St, Uss Osborne Branch Dental Clinic, Great Lakes, IL 60088 | 2019-12-18 |
| 1740775576 | Jonathan William Criter | Dentist | 3400 Ohio St, Great Lakes, IL 60088 | 2018-06-25 |
| 1134598733 | True Xiong | Dentist | Zachary & Elizabeth Fisher Medical & Dental Clinic, 2470 Sampson Street, Apo, AA 60088 | 2015-09-24 |
| 1447685771 | Lisa Carol Perrone | Dentist | Fhcc Lovell Bldg 237 Dental, Navsta Great Lakes, North Chicago, IL 60088 | 2013-09-05 |
| 1437438421 | David Lawrence Green | Dentist | 2410 Samson St., Bldg 237, Great Lakes, IL 60088 | 2011-08-09 |
| 1164730602 | James A Lovell Federal Health Care Center | Military/U.S. Coast Guard Pharmacy | 2430 Illinois Street, Great Lakes, IL 60088 | 2010-09-17 |
| 1598073439 | James A Lovell Federal Health Care Center | Military/U.S. Coast Guard Pharmacy | 2430 Illinois St, Bldg 1007, Great Lakes, IL 60088 | 2010-09-14 |
| 1164736302 | Clinton Lariscy | Military Health Care Provider | 3355 Illinois St, Recruit Training Command Great Lakes, Great Lakes, IL 60088 | 2010-07-29 |
| 1083943906 | James Doll | Dentist | 2608 Paul Jones St, Great Lakes, IL 60088 | 2009-12-24 |
| 1396996823 | Kelly Robert Lanning | Dentist | 3001 A 6th St Bhc 237, Naval Hospital Great Lakes- Dental Dept., Great Lakes, IL 60088 | 2008-10-02 |
| Find all providers in zip 60088 | ||||
| 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 |
|---|---|---|---|---|
| 1932723467 | Amanda Christine Perlinski | Physician Assistant | 3697 Great Lakes Dr Apt A, Great Lakes, IL 60088-1741 | 2020-06-01 |
| 1346603594 | Laura Megan Logeman | Physician Assistant | 3420 Illinois St, Great Lakes, IL 60088-3161 | 2016-04-04 |
| 1669725644 | Benjamin Keith Mattox | Physician Assistant | 2410 Sampson St, Great Lakes, IL 60088-2942 | 2012-10-16 |
| 1184904757 | Ashley R Deriemacker | Physician Assistant | 2410 Sampson St, Great Lakes, IL 60088-2942 | 2011-08-26 |
| 1396860334 | Carlos Julio Albarracin | Physician Assistant | 3001a Sixth Street, Great Lakes, IL 60088-5230 | 2007-03-20 |
| 1184773012 | Orlando Lopez | Physician Assistant | 3001 6th St, Great Lakes, IL 60088-2833 | 2007-01-09 |
| 1164482212 | William Harreld Peterson | Physician Assistant | 3420 Illinois St, Uss Tranquility Medical Clinic 1007, Great Lakes, IL 60088-5230 | 2006-03-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063010924 | Mckenzie Youngblood | Physician Assistant | 28653 Wren Ln, Jerseyville, IL 62052-6501 | 2020-10-13 |
| 1548877400 | Shawn Milhauser | Physician Assistant | 1014 N Mill St, Pontiac, IL 61764-1332 | 2020-09-25 |
| 1982210654 | Brittany Michelle Weber | Physician Assistant | 525 E Congress Pkwy Ste 200, Crystal Lake, IL 60014-6271 | 2020-09-18 |
| 1003421603 | Logan M Barkley | Physician Assistant | 2560 24th St Ste 201, Rock Island, IL 61201-5390 | 2020-09-10 |
| 1336753342 | Navneet Kaur Bamrah | Physician Assistant | 11316 S Highland Dr, Plainfield, IL 60585-1581 | 2020-09-07 |
| 1306450424 | Annie Mannancheril | Physician Assistant | 9114 Waukegan Rd, Morton Grove, IL 60053-2135 | 2020-09-04 |
| 1508470709 | Bryan Ying Wong | Physician Assistant | 3420 S Morgan St Apt 2e, Chicago, IL 60608-6904 | 2020-09-04 |
| 1386256402 | Emma Schmidt | Physician Assistant | 20 Haverton Ct, Streamwood, IL 60107-1682 | 2020-08-19 |
| 1063024388 | Alyson Dyck | Physician Assistant | 2540 Health Services, Ssb Student Services Building, Normal, IL 61790-2540 | 2020-08-18 |
| 1649882192 | Anna Marie Phillips | Physician Assistant | 5337 Main St, Skokie, IL 60077-2029 | 2020-08-17 |
| Find all providers with the same taxonomy | ||||
| City | GREAT LAKES |
| Zip Code | 60088 |
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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.