MS. KATHARYN DESA LUPO (NPI# 1295979300) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295979300 |
| Entity Type | Individual |
| Full Name | MS. KATHARYN DESA LUPO |
| Other Name | KATHARYN DESA FREUND |
| Credential | M.D. |
| Practice Address |
636 Raymond Dr Naperville IL 60563-9789 |
| Practice Telephone | 6309222350 |
| Practice Fax Number | 6309222070 |
| Mailing Telephone | 6309222350 |
| Mailing Fax Number | 6309222070 |
| Enumeration Date | 2009-04-21 |
| Last Update Date | 2018-02-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 036138404 | IL | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | 036138404 | IL | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | MD448210 | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | MEDICARE PTAN GROUP | 920540 | 01 |
| IL | 036138404 | 05 | |
| IL | MEDICARE PTAN INDIVIDUAL | F400228991 | 01 |
| Street Address |
636 RAYMOND DR |
| City | NAPERVILLE |
| State | IL |
| Zip Code | 60563-9789 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447250642 | Sean Patrick Mccormick | Pediatrics | 636 Raymond Dr, Suite 205, Naperville, IL 60563-9789 | 2005-07-28 |
| 1528465614 | Melissa Mandra | Audiologist | 636 Raymond Dr, Suite 203, Naperville, IL 60563-9789 | 2014-12-04 |
| 1407269939 | Lauren Marie Panner | Registered Nurse | 636 Raymond Dr, Naperville, IL 60563-9791 | 2014-06-02 |
| 1740523539 | Jill Katherine Cotseones | Dermatology | 636 Raymond Dr, Naperville, IL 60563 | 2013-04-01 |
| 1285981167 | Elizabeth J Delass | Physical Therapist | 636 Raymond Dr, Suite 305, Naperville, IL 60563-9789 | 2012-08-09 |
| 1386991552 | Michaela Campagnolo | Physical Therapist | 636 Raymond Dr, Suite 305, Naperville, IL 60563-9789 | 2012-08-07 |
| 1720366636 | Lauren Nicole Taglia | Dermatology | 636 Raymond Dr, Naperville, IL 60563-9791 | 2011-07-26 |
| 1881972990 | Karen L Camporese | Physical Therapist | 636 Raymond Dr, Suite 104a, Naperville, IL 60563-9789 | 2011-07-25 |
| 1023304862 | Molly Purkart | Physical Therapist | 636 Raymond Dr, Suite 200, Naperville, IL 60563-9789 | 2011-06-20 |
| 1659675601 | Kimberly Anne Gubbins | Nurse Practitioner | 636 Raymond Dr, Suite 205, Naperville, IL 60563-9789 | 2011-01-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952902884 | Julia Ann Gottschalk | Nurse Practitioner | 1979 Mcdowell Rd, Unit 103, Naperville, IL 60563 | 2020-11-06 |
| 1700484847 | Lee Michael Harms I | Social Worker | 1952 Mcdowell Road, Suite 305, Naperville, IL 60563 | 2020-10-12 |
| 1881208478 | Poornima Swamy Gangaji | Dentist | 760 N, Illinois Rte 59, Ste100, Naperville, IL 60563 | 2020-09-01 |
| 1851901219 | Adiana Lebron | Social Worker | 2948 Artestian Road, Naperville, IL 60563 | 2020-07-31 |
| 1194342014 | Ingrid Lara | Behavioral Analyst | 1975 Mcdowell Rd #101, Naperville, IL 60563 | 2020-06-26 |
| 1396383030 | Jack Kelly | Assistant Behavior Analyst | 1975 Mcdowell Rd. #101, Naperville, IL 60563 | 2019-12-12 |
| 1316583529 | Arvind Ramakrishnan | Behavioral Analyst | 1975 Mcdowell Rd., Naperville, IL 60563 | 2019-11-22 |
| 1679115778 | Melissa Macias | Behavioral Analyst | 1975 Mcdowell Road, #101, Naperville, IL 60563 | 2019-10-10 |
| 1629619275 | Meghann Reid Vizintos | Physician Assistant | 1763 Freedom Dr Ste 117, Naperville, IL 60563 | 2019-10-04 |
| 1417413543 | Vikram Singh Cheema | Physician Assistant | 1335 North Mill Street, Naperville, IL 60563 | 2019-02-13 |
| Find all providers in zip 60563 | ||||
| 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 |
|---|---|---|---|---|
| 1467800961 | Ishtiaq Ahmed Habib | Internal Medicine | 1804 N Naper Blvd Ste 103, Naperville, IL 60563-8831 | 2016-05-25 |
| 1871977892 | Edward Health Ventures | Internal Medicine | 2308 N Route 59, Naperville, IL 60563-2061 | 2015-07-20 |
| 1639489057 | Naperville Medical Group Corporation | Internal Medicine | 1020 E Ogden Ave Ste 314, Naperville, IL 60563-8611 | 2010-10-19 |
| 1861710733 | Neha Shah | Internal Medicine | 1331 W 75th St Ste 201, Naperville, IL 60540-9311 | 2010-05-17 |
| 1336373356 | Praveen V Parvathala Md LLC | Internal Medicine | 3555 Sweet Maggie Ln, Naperville, IL 60564-8303 | 2009-05-05 |
| 1255573622 | Adventist Health Partners, Inc | Internal Medicine | 1012 95th St Ste 3, Naperville, IL 60564-5040 | 2009-04-01 |
| 1972759298 | Kevin K Pandya | Internal Medicine | 120 Spalding Dr Ste 410, Nephrology Associates of Northern Illinois, Naperville, IL 60540-6558 | 2008-08-18 |
| 1639340029 | Jobby Mampilly | Internal Medicine | 100 Spalding Dr Ste 102, Naperville, IL 60540 | 2008-03-13 |
| 1205016086 | Prime Health Associates Inc | Internal Medicine | 519 W 87th St, Naperville, IL 60565-3128 | 2007-11-08 |
| 1588853113 | Matthew Michael Dunne | Internal Medicine | 801 S. Washington St, 3rd Floor, Naperville, IL 60540-7430 | 2007-10-19 |
| Find all providers in NAPERVILLE | ||||
| City | NAPERVILLE |
| Zip Code | 60563 |
Please comment or provide details below to improve the information on MS. KATHARYN DESA LUPO.
| 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.