MARK S MUSSELMAN (NPI# 1336256825) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336256825 |
| Entity Type | Individual |
| Full Name | MARK S MUSSELMAN |
| Credential | M.D. |
| Practice Address |
1701 W. Curtis Road Pediatrics Champaign IL 61822 |
| Mailing Address |
611 W Park St Bwpc Urbana IL 61801-2529 |
| Practice Telephone | 2173656202 |
| Practice Fax Number | 2173261234 |
| Mailing Telephone | 2173836792 |
| Mailing Fax Number | 2173834752 |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2014-05-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0207X |
Pediatrics Specialization: Pediatric Hematology-Oncology |
036104715 | IL | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336201060 | Mark Musselman | Physical Therapist | 8114 Sandpiper Cir, Suite 114, Baltimore, MD 21236-4934 | 2006-12-16 |
| Street Address |
1701 W. CURTIS ROAD PEDIATRICS |
| City | CHAMPAIGN |
| State | IL |
| Zip Code | 61822 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205866415 | Ines O Baquero | Obstetrics & Gynecology | 1701 W. Curtis Road, Ob/gyn, Champaign, IL 61822 | 2006-07-04 |
| 1669791166 | Sean Patrick Fullan | Pediatrics | 1701 W. Curtis Road, Champaign, IL 61822-9678 | 2010-05-24 |
| 1518195155 | William D. Holmes | Dermatology | 1701 W. Curtis Road, Champaign, IL 61822-9678 | 2009-06-22 |
| 1457590408 | Tina Yi-ting Yang | Family Medicine | 1701 W. Curtis Road, Champaign, IL 61822-9678 | 2009-02-16 |
| 1518158914 | Jody K Gurtler | Registered Nurse | 1701 W. Curtis Road, Pediatrics, Champaign, IL 61822 | 2007-08-09 |
| 1922159110 | Jeremy Medler | Physician Assistant | 1701 W. Curtis Road, Dermatology, Champaign, IL 61822 | 2007-01-15 |
| 1649347550 | Joyce S Rhee | Internal Medicine | 1701 W. Curtis Road, Adult Medicine, Champaign, IL 61822 | 2006-11-29 |
| 1518067743 | Gretchen B Sperka | Internal Medicine | 1701 W. Curtis Road, Adult Medicine, Champaign, IL 61822 | 2006-09-25 |
| 1710084124 | Paul R Wilson | Internal Medicine | 1701 W. Curtis Road, Adult Medicine, Champaign, IL 61822 | 2006-09-20 |
| 1891898110 | Janet W Welch | Internal Medicine | 1701 W. Curtis Road, Adult Medicine, Champaign, IL 61822 | 2006-09-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083180830 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 2718 N Prospect Avenue, Champaign, IL 61822 | 2018-10-19 |
| 1487129730 | Siegfred T. Celis | Occupational Therapy Assistant | 1820 Oak Park Drive, Champaign, IL 61822 | 2018-10-12 |
| 1134633746 | Osf Healthcare System | Home Health | 1501 Interstate Dr Ste C, Champaign, IL 61822 | 2017-11-20 |
| 1386164200 | Carlo Sandico | Physical Therapist | 612 Corey Lane, Champagne, IL 61822 | 2017-06-21 |
| 1295270288 | Jennifer Lee Lugo | Registered Nurse | 3101 Fields South Dr., Champaign, IL 61822 | 2016-12-29 |
| 1902341209 | Jala Simmons | Behavioral Analyst | 4112 Fieldstone Rd, Suite B, Champaign, IL 61822 | 2016-12-22 |
| 1639552433 | Muhammad Ajmal | Internal Medicine | 1701 Curtis Road, Carle Clinic, Champaign, IL 61822 | 2015-06-30 |
| 1518363761 | Margaret A. Hallden | Hearing Instrument Specialist | 3354 Big Pine Trail #c, Audibel Hearing Aids, Champaign, IL 61822 | 2014-11-17 |
| 1801291638 | Kristen Karlsen | Pharmacist | 3114 Village Office Place, Champaign, IL 61822 | 2014-10-22 |
| 1649601543 | Jeff Chu | Optometrist | 507 W. Town Center Blvd, Champaign, IL 61822 | 2013-12-03 |
| Find all providers in zip 61822 | ||||
| Taxonomy Code | 2080P0207X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Hematology-Oncology |
| A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265720510 | Reuben Antony | Pediatrics | 530 Ne Glen Oak Ave., C/o Ms Suzy Lewellen, Peoria, IL 61637 | 2011-07-20 |
| 1780829911 | Richard Moldwin | Pediatrics | 9017 Ewing Ave, Evanston, IL 60203-1908 | 2008-12-02 |
| 1801005848 | Marie-ellen Tubal Sarvida | Pediatrics | 4440 West 95th Street, Oak Lawn, IL 60453 | 2007-05-22 |
| 1639395304 | Lenore Evans Gonzalez | Pediatrics | 236 S 5th St, Apt C, Springfield, IL 62701-1431 | 2007-04-18 |
| 1700948643 | Astrid K. Mack | Pediatrics | 2300 N Childrens Plz # 30, Chicago, IL 60614-3363 | 2006-12-15 |
| 1659449163 | Pediatric Cancer Institute | Pediatrics | 4440 W.95th Street, Oak Lawn, IL 60453 | 2006-12-01 |
| 1699724385 | Joanna Lynn Weinstein | Pediatrics | 2300 Childrens Plaza Box 30, Childrens Memorial Hospital Hem Onc, Chicago, IL 60614 | 2006-05-09 |
| 1568433050 | University of Illinois | Pediatrics | St Jude Midwest Affiliate, 530 Ne Glen Oak, Peoria, IL 61637-0001 | 2006-02-01 |
| 1396731063 | Michael D Tarantino | Pediatrics | 9128 N Lindbergh Dr, Peoria, IL 61615-1422 | 2005-09-27 |
| 1427051622 | John M Cunningham | Pediatrics | 5841 South Maryland Ave, University of Chicago Rm N-112 Mc 4060, Chicago, IL 60637 | 2005-05-23 |
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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.