CHICAGOLAND UNIVERSITY PEDIATRIC SURGERY, LLC (NPI# 1245746213) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1245746213 |
Entity Type | Organization |
Organization Name | CHICAGOLAND UNIVERSITY PEDIATRIC SURGERY, LLC |
Practice Address |
2900 N Lake Shore Dr Chicago IL 60657-5640 |
Mailing Address |
13400 S Route 59 Ste 116-208 Plainfield IL 60585-5826 |
Practice Telephone | 7736653000 |
Mailing Telephone | 6304241122 |
Mailing Fax Number | 6303962677 |
Enumeration Date | 2017-12-28 |
Last Update Date | 2017-12-28 |
Authorized Official Name | JAMES NOBLE (REVENUE MANAGER) |
Authorized Official Telephone | 6304241122 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2086S0120X |
Surgery Specialization: Pediatric Surgery |
Allopathic & Osteopathic Physicians |
Street Address |
2900 N LAKE SHORE DR |
City | CHICAGO |
State | IL |
Zip Code | 60657-5640 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1215935663 | Yongsuk - Lertratanakul | Internal Medicine | 2900 N Lake Shore Dr, Chicago, IL 60657-5640 | 2005-07-11 |
1932709847 | Ece Ozen | Student in an Organized Health Care Education/Training Program | 2900 N Lake Shore Dr, Chicago, IL 60657-5640 | 2020-10-29 |
1366041832 | Maryam Majeed | Student in an Organized Health Care Education/Training Program | 2900 N Lake Shore Dr, Chicago, IL 60657-5640 | 2020-10-25 |
1245839729 | Ahmed Abdelfattah | Internal Medicine | 2900 N Lake Shore Dr, Chicago, IL 60657-5640 | 2020-10-25 |
1467068650 | Gunjan Arora | Student in an Organized Health Care Education/Training Program | 2900 N Lake Shore Dr, Chicago, IL 60657-5640 | 2020-09-22 |
1467068502 | Zain Inam Siddiqui | Student in an Organized Health Care Education/Training Program | 2900 N Lake Shore Dr, Chicago, IL 60657-5640 | 2020-09-22 |
1659987683 | Syed Osama Ahmad | Student in an Organized Health Care Education/Training Program | 2900 N Lake Shore Dr, Chicago, IL 60657-5640 | 2020-09-15 |
1649885005 | Biniyam Teka Mohammed | Student in an Organized Health Care Education/Training Program | 2900 N Lake Shore Dr, Chicago, IL 60657-5640 | 2020-09-12 |
1982218095 | Sudha Misra | Student in an Organized Health Care Education/Training Program | 2900 N Lake Shore Dr, Chicago, IL 60657-5640 | 2020-09-04 |
1629681499 | Anamol Acharya | Student in an Organized Health Care Education/Training Program | 2900 N Lake Shore Dr, Chicago, IL 60657-5640 | 2020-08-31 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1992303887 | Simone Paes | Behavior Technician | 3141 N Sheffield Ave, Chicago, IL 60657 | 2020-10-13 |
1821613175 | Samridhi Khatri | Internal Medicine | 836 W. Wellington Ave, Advocate Illinois Masonic Medica, Suite 1312, Chigaco, IL 60657 | 2020-06-12 |
1467074617 | Dewolfe Aesthetic Services Sc | Surgery | 3357 N. Southport Aveune, Chicago, IL 60657 | 2020-05-11 |
1790304657 | Mehr Amer Mjeed | Student in an Organized Health Care Education/Training Program | Advocate Internal Medicine Clinic, Advocate Illinois Ma, 836 West Wellington Avenue, Chicago, IL 60657 | 2020-04-10 |
1457997561 | Jasleen Mohini Singh | Physician Assistant | 1645a W School Street, Suite A, Clinic Entrance, Chicago, IL 60657 | 2019-11-24 |
1306493408 | Art of Sight Eyecare, LLC | Optometrist | 2915 N. Broadway, Chicago, IL 60657 | 2019-08-22 |
1992359277 | Joseph Michael Rochford IIi | Counselor | 1358 W Belmont Ave, Unit # 202, Chicago, IL 60657 | 2019-07-25 |
1487116240 | Conrad Petersen Dermatology Sc | Dermatology | 2845 N Sheridan, Chicago, IL 60657 | 2019-04-02 |
1003388810 | Evolve Wellness S.c. | Counselor | 2845 North Sheridan Road, Suite 708, Chicago, IL 60657 | 2018-12-19 |
1639657414 | Advocate North Side Health Network | Psychiatric Unit | 836 W Wellington Ave., Chicago, IL 60657 | 2018-08-02 |
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Taxonomy Code | 2086S0120X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Surgery |
Specialization | Pediatric Surgery |
A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417141904 | Erik Ryan Barthel | Surgery | 5841 S Maryland Ave # Mc4062, University of Chicago Medicine, Chicago, IL 60637-1447 | 2007-08-28 |
1467666081 | Connie Jean Rossini | Surgery | 1725 W Harrison St Ste 708, Chicago, IL 60612-3841 | 2007-05-10 |
1356394217 | Childrens Surgical Foundation Inc | Surgery | 225 E Chicago Ave # 114, Chicago, IL 60611-2991 | 2006-05-19 |
1356822050 | Lurie Childrens Surgical Foundation Inc | Surgery | 225 E Chicago Ave, Chicago, IL 60611-2991 | 2018-08-22 |
1649774803 | Rachael Sundland | Surgery | 5841 S Maryland Ave # Mc4062, Chicago, IL 60637-1443 | 2018-03-22 |
1043655285 | Frances Chinenye Okolo | Surgery | 5841 S Maryland Ave # Mc4062, Chicago, IL 60637-1443 | 2013-05-01 |
1417226952 | Andrea Yan-sin Lo | Surgery | 5839 S Maryland Ave, Wp C-411 / Mc 4062, Chicago, IL 60637-1463 | 2011-12-28 |
1235441429 | Jennifer Rose Defazio | Surgery | 5841 S Maryland Ave, Chicago, IL 60637-1447 | 2010-07-05 |
1417198318 | Mark Slidell | Surgery | 5841 S Maryland Ave, M/c 4062 C411, Chicago, IL 60637-1447 | 2009-03-23 |
1912147349 | Yue-yung Hu | Surgery | 225 E Chicago Ave # 63, Chicago, IL 60611-2991 | 2009-02-25 |
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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.