MARK AMDUR (NPI# 1346277274) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346277274 |
| Entity Type | Individual |
| Full Name | MARK AMDUR |
| Credential | MD |
| Practice Address |
6201 Roosevelt Rd Berwyn IL 60402-1108 |
| Mailing Address |
4250 N Marine Dr Suite 236 Chicago IL 60613-1744 |
| Practice Telephone | 7083860845 |
| Mailing Telephone | 7734040160 |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2019-12-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
036044305 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036044305 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4250 N Marine Dr, Suite 236, Chicago, IL 606131744 | 7734040160 |
| Street Address |
6201 ROOSEVELT RD |
| City | BERWYN |
| State | IL |
| Zip Code | 60402-1108 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932141637 | Cecelia B Bacom | Advanced Practice Midwife | 6201 Roosevelt Rd, Berwyn, IL 60402-1108 | 2006-06-10 |
| 1659978179 | Katherine Elizabeth Jaynes | Nurse Practitioner | 6201 Roosevelt Rd, Berwyn, IL 60402-1108 | 2020-10-07 |
| 1477190411 | Simone Bonde | Advanced Practice Midwife | 6201 Roosevelt Rd, Berwyn, IL 60402-1108 | 2019-12-10 |
| 1396389342 | Patricia Billingsley | Registered Nurse | 6201 Roosevelt Rd, Berwyn, IL 60402-1108 | 2019-11-03 |
| 1902336266 | Lindsey K Kurdi Wood | Family Medicine | 6201 Roosevelt Rd, Berwyn, IL 60402-1108 | 2017-06-19 |
| 1255786430 | Christine Elaine Schultheiss | Family Medicine | 6201 Roosevelt Rd, Berwyn, IL 60402-1108 | 2016-04-26 |
| 1003277500 | Damaris Velazquez | Social Worker | 6201 Roosevelt Rd, Berwyn, IL 60402 | 2016-03-10 |
| 1750769352 | Eliza Claire Miller Harper | Advanced Practice Midwife | 6201 Roosevelt Rd, Berwyn, IL 60402-1108 | 2015-05-14 |
| 1700275930 | Edith Zamudio | Social Worker | 6201 Roosevelt Rd, Berwyn, IL 60402-1108 | 2015-01-12 |
| 1417350612 | Jennifer Jaume | Advanced Practice Midwife | 6201 Roosevelt Rd, Berwyn, IL 60402-1108 | 2014-10-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619586518 | Lisa K Anderson-shaw | Clinical Ethicist | Macneal Trinity Medical Cetner, 3249 Oak Park Avenue, Berwyn, IL 60402 | 2020-07-27 |
| 1922622380 | Ayesha Ikram | Internal Medicine | Macneal Hospital 3249 S. Oak Park Ave, Brewyn, IL 60402 | 2020-06-02 |
| 1598329146 | Eleanor Teoh | Student in an Organized Health Care Education/Training Program | Family Medicine, Macneal Family Medicine Center, 3231 Eucild Ave, 5th Floor, Berwyn, IL 60402 | 2019-04-30 |
| 1376013920 | Virginia Mireles | Behavior Technician | 2317 S. Home, Berwyn, IL 60402 | 2018-11-27 |
| 1245709047 | Saraswati Koirala | Dentist | 1227 S Harlem Ave Apt414, Berwyn, IL 60402 | 2018-11-21 |
| 1295204220 | Dental Town Ltd | Dentist | 7106 W Cermak Rd, Berwyn, IL 60402 | 2018-11-20 |
| 1396231684 | Toya M Gildart | Counselor | Pillars, 6415 Stanley Avenue, Berwyn, IL 60402 | 2018-07-10 |
| 1437655685 | Ana Luisa Desantiago | Social Worker | 3245 Grove Ave Ste 201, Berwyn, IL 60402 | 2018-04-04 |
| 1821520198 | Chetan Velagapudi | Student in an Organized Health Care Education/Training Program | 3231 S Euclid Avenue, Suite 203, Berwyn, IL 60402 | 2017-03-28 |
| 1174976567 | Sydney Talavera | Counselor | 6415 Stanley Ave., Berwyn, IL 60402 | 2016-07-20 |
| Find all providers in zip 60402 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366674376 | Lauren Wylonis | Psychiatry & Neurology | 1035 Sugartown Rd, Berwyn, PA 19312-1883 | 2009-08-10 |
| 1215087747 | Brooklyn Health, LLC | Psychiatry & Neurology | 3303 Grove Ave, Unit 504, Berwyn, IL 60402-3432 | 2007-01-10 |
| 1275586901 | John V Lim | Psychiatry & Neurology | 1405 Harlem Ave, Berwyn, IL 60402-4832 | 2006-05-17 |
| 1992754550 | Jacqueline E Deutsch | Psychiatry & Neurology | 2114 Kenilworth Ave, Suite 1, Berwyn, IL 60402-1660 | 2006-05-09 |
| 1013452168 | Prosalud6238 Inc | Psychiatry & Neurology | 6238 Cermak Rd, Berwyn, IL 60402-2319 | 2016-12-28 |
| 1598922957 | Kalyan Naraharisetty Rao | Psychiatry & Neurology | 3249 Oak Park Ave, Berwyn, IL 60402-3429 | 2008-05-21 |
| 1376761080 | Elizabeth Wilma Canelas | Psychiatry & Neurology | 6238 Cermak Rd, Berwyn, IL 60402-2319 | 2007-04-20 |
| 1457485567 | Maria Teresa Ponton | Psychiatry & Neurology | 6918 Windsor Ave, Berwyn, IL 60402-3334 | 2007-03-14 |
| 1770637399 | Amelia M Merz | Psychiatry & Neurology | 3249 Oak Park Ave, Berwyn, IL 60402-3429 | 2007-01-22 |
| 1932205481 | William Egan | Psychiatry & Neurology | 3231 Euclid Ave, 404, Berwyn, IL 60402-3471 | 2006-09-15 |
| Find all providers in BERWYN | ||||
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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.