MR. SAMUEL MAURICIO CORDOVA (NPI# 1326137225) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326137225 |
| Entity Type | Individual |
| Full Name | MR. SAMUEL MAURICIO CORDOVA |
| Credential | PA-C |
| Practice Address |
1259 Rickert Dr Ste 101 Naperville IL 60540-8904 |
| Mailing Address |
4300 Commerce Ct Suite 230 Lisle IL 60532-3698 |
| Practice Telephone | 6303551300 |
| Practice Fax Number | 6303553273 |
| Mailing Telephone | 6309681881 |
| Mailing Fax Number | 6309681719 |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2012-12-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 085002213 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
85002213 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | RAILROAD MEDICARE | 970023229 | 01 |
| IL | 085002213 | 05 |
| Street Address |
1259 RICKERT DR STE 101 |
| City | NAPERVILLE |
| State | IL |
| Zip Code | 60540-8904 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114913910 | Troy R. Karlsson | Orthopaedic Surgery | 1259 Rickert Dr Ste 101, Naperville, IL 60540-8904 | 2005-09-27 |
| 1548803562 | Alexandra Mai Tamayo Min-tun | Physician Assistant | 1259 Rickert Dr Ste 101, Naperville, IL 60540-8904 | 2019-10-22 |
| 1851888549 | Du Page Medical Group Ltd | Durable Medical Equipment & Medical Supplies | 1259 Rickert Dr Ste 101, Naperville, IL 60540-8904 | 2018-04-18 |
| 1306075106 | Audrey S Onyschak | Occupational Therapist | 1259 Rickert Dr Ste 101, Naperville, IL 60540-8904 | 2009-07-14 |
| 1538195995 | Robert F. Matlock | Orthopaedic Surgery | 1259 Rickert Dr Ste 101, Naperville, IL 60540-8904 | 2006-06-25 |
| 1609862325 | Brian A. Murphy | Orthopaedic Surgery | 1259 Rickert Dr Ste 101, Naperville, IL 60540-8904 | 2005-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760007678 | Mandalai Oral and Maxillofacial Surgery PC | Oral & Maxillofacial Surgery | 720 S. Brom Drive Suite 103, Naperville, IL 60540 | 2020-06-16 |
| 1316418957 | James Edward Frank | Counselor | 600 South Washington Street, Suite 302, Naperville, IL 60540 | 2018-12-07 |
| 1093208332 | Ingrid Johnson | Developmental Therapist | Right Start Pediatric Therapies, 50 S Main St Suite 200, Naperville, IL 60540 | 2018-06-12 |
| 1225528524 | Tara Rada Nieberding | Contractor | 1701 Quincy Ave Ste 12, Naperville, IL 60540 | 2018-05-14 |
| 1588182190 | Debra Xiangjun Hayes | Acupuncturist | 226 N Washington St # 2, Naperville, IL 60540 | 2017-09-03 |
| 1487197166 | Health Improvement and Preventive Services LLC | Family Medicine | 1979 Mcdowell Rd., Suite 103, Naperville, IL 60540 | 2016-11-29 |
| 1588013775 | Matthew Jacob Imber | Chiropractor | 1220 Hobson Rd Ste 220, Naperville, IL 60540 | 2016-06-08 |
| 1457711418 | Elite Pain Medical Group Inc | Physical Medicine & Rehabilitation | 720 South Brom Drive, Suite 201, Naperville, IL 60540 | 2016-03-03 |
| 1265814800 | Jenifer Lynn Mersman | Chiropractor | 475 River Bend Rd. Suite 104, Naperville, IL 60540 | 2015-06-19 |
| 1386038016 | Jonathon Martin Ruiz | Specialist/Technologist | 440 N Brainard Street, Naperville, IL 60540 | 2015-03-19 |
| Find all providers in zip 60540 | ||||
| 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 |
|---|---|---|---|---|
| 1316557770 | Brian Sautter | Physician Assistant | 1125 Wishing Well Ln, Naperville, IL 60564-8782 | 2020-07-31 |
| 1962026955 | Bridgette Lynn Caquatto | Physician Assistant | 1847 Cranshire Ln, Naperville, IL 60565-6749 | 2020-06-04 |
| 1588288286 | Megan O'hara | Physician Assistant | 416 E Chicago Ave, Naperville, IL 60540-5408 | 2020-05-29 |
| 1629619275 | Meghann Reid Vizintos | Physician Assistant | 1763 Freedom Dr Ste 117, Naperville, IL 60563 | 2019-10-04 |
| 1649831371 | Margaret Grace Rancich | Physician Assistant | 6s651 Millcreek Ln, Naperville, IL 60540-5919 | 2019-06-24 |
| 1467010884 | Madeline Simon | Physician Assistant | 1720 Frost Ln, Naperville, IL 60564-5165 | 2019-05-31 |
| 1417413543 | Vikram Singh Cheema | Physician Assistant | 1335 North Mill Street, Naperville, IL 60563 | 2019-02-13 |
| 1699259036 | Meraj Baig | Physician Assistant | 1952 Mcdowell Rd #305, Naperville, IL 60563 | 2018-09-21 |
| 1144718644 | Naperville Health Center, LLC | Physician Assistant | 3416 S Route 59 Ste 108, Naperville, IL 60564-8147 | 2018-04-30 |
| 1063919348 | Aiman Khan | Physician Assistant | 636 Raymond Dr Ste 107, Naperville, IL 60563-9789 | 2018-04-12 |
| Find all providers in NAPERVILLE | ||||
| City | NAPERVILLE |
| Zip Code | 60540 |
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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.