DR. ROBERT DIETZ TETIK (NPI# 1306098231) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306098231 |
| Entity Type | Individual |
| Full Name | DR. ROBERT DIETZ TETIK |
| Credential | M.D. |
| Practice Address |
2272 95th St Ste 106 Naperville IL 60564-8942 |
| Mailing Address |
24047 W Lockport St Ste 201w Plainfield IL 60544-1680 |
| Practice Telephone | 6309620474 |
| Practice Fax Number | 8667119826 |
| Mailing Telephone | 6309620474 |
| Mailing Fax Number | 8667119826 |
| Enumeration Date | 2008-10-22 |
| Last Update Date | 2020-05-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
036-44365 | IL | Allopathic & Osteopathic Physicians |
| Street Address |
2272 95TH ST STE 106 |
| City | NAPERVILLE |
| State | IL |
| Zip Code | 60564-8942 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215598842 | Jennifer A Mcgill | Speech-Language Pathologist | Sovereign Pediatric Therapy, 1315 Macom Dr #103, Naperville, IL 60564 | 2019-06-25 |
| 1083187660 | Erin Michelle Hankins | Counselor | 2132 Deep Water Lane, Suite # 240, Naperville, IL 60564 | 2019-01-07 |
| 1851873905 | Helen A Bruckner | Student in an Organized Health Care Education/Training Program | 28w154 Country View Dr., Naperville, IL 60564 | 2018-09-05 |
| 1912483074 | Kristina Kochanova | Psychologist | 3380 Lacrosse Lane, Suites 106-107, Naperville, IL 60564 | 2018-07-12 |
| 1831608397 | Courtney Srum | Speech-Language Pathologist | Graham Elementary School 2315 High Meadow Rd., Naperville, IL 60564 | 2017-09-27 |
| 1447707880 | Isabel Betancourt | Registered Nurse | 1315 Macom Dr Ste 5, Naperville, IL 60564 | 2016-09-01 |
| 1134577802 | Rosa Maria Felix-jones | Massage Therapist | 3420 Lacrosse, Suite 100, Unit 2 & 3, Naperville, IL 60564 | 2016-06-02 |
| 1245618412 | Ian E Evans | Counselor | 2948 Artesian Rd., Suite 112, Naperville, IL 60564 | 2015-05-08 |
| 1093114498 | Sovereign Rehab | Clinic/Center | 1315 Macom Dr. Suite 103, Naperville, IL 60564 | 2014-08-21 |
| 1154745891 | Antonina Rosaria Sullivan | Occupational Therapist | 10350 Brenner Ct, Naperville, IL 60564 | 2014-02-18 |
| Find all providers in zip 60564 | ||||
| Taxonomy Code | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629125661 | Scott J Padalik | Emergency Medicine | 801 S Washington St, Naperville, IL 60540-7430 | 2007-01-04 |
| 1558345967 | Martin Schutte | Emergency Medicine | 801 S Washington St, Naperville, IL 60540-7430 | 2005-11-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033760715 | Michael James Doolin | Emergency Medicine | 1338 S Clinton St, Chicago, IL 60607-5037 | 2019-09-24 |
| 1578091971 | The Board of Trustee for The University of Illinois | Emergency Medicine | 10000 West O'hare, Terminal 2, Chicago, IL 60660-0508 | 2017-05-30 |
| 1669712808 | Kathryn Theresa Pajak | Emergency Medicine | 5659 S Oak Park Ave, Chicago, IL 60638-3227 | 2013-02-26 |
| 1174832976 | Craig William Dean | Emergency Medicine | 155 N Harbor Dr Apt 309, Chicago, IL 60601-7386 | 2010-09-28 |
| 1770809881 | King, Ltd | Emergency Medicine | 9332 S Vanderpoel Ave, Chicago, IL 60643-5852 | 2010-04-14 |
| 1831384643 | Primus Trauma Care LLC | Emergency Medicine | 1304 Franklin Avenue, Normal, IL 61761 | 2007-09-14 |
| 1245355411 | Pekin Memorial Hospital | Emergency Medicine | 600 So 13th Street, Pekin, IL 61554-4969 | 2007-03-20 |
| 1396879268 | Nanci A Cherry | Emergency Medicine | 7419 Bell Harbour Dr, Rockford, IL 61114-6600 | 2007-03-15 |
| 1972609782 | Jennifer Lynn Webb | Emergency Medicine | 15730 Robert Louis Dr, Plainfield, IL 60544-2146 | 2006-09-16 |
| 1073629374 | Stuart Hickerson | Emergency Medicine | 12528 Sr 78, Havana, IL 62644-6866 | 2006-08-21 |
| Find all providers with the same taxonomy | ||||
| City | NAPERVILLE |
| Zip Code | 60564 |
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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.