CALEB IFEOLUWA OLUWADAMISI (NPI# 1366064560) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1366064560 |
Entity Type | Individual |
Full Name | CALEB IFEOLUWA OLUWADAMISI |
Credential | M.D |
Practice Address |
Mercy Health Javon Bea Hospital 8201 East Riverside Boulevard Rockford IL 61114 |
Mailing Address |
Javon Bea Hospital - Rockton Avenue 2400 N Rockton Avenue Rockford IL 61103 |
Practice Telephone | 8159715000 |
Mailing Telephone | 8159715000 |
Enumeration Date | 2020-05-11 |
Last Update Date | 2020-08-07 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
Street Address |
MERCY HEALTH JAVON BEA HOSPITAL 8201 EAST RIVERSIDE BOULEVARD |
City | ROCKFORD |
State | IL |
Zip Code | 61114 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1811525959 | Seifeldin Eid | Student in an Organized Health Care Education/Training Program | Mercyhealthjavon Bea Hospital, 8201, East Riversideboulevard, IL 61114 | 2020-04-01 |
1073167664 | Swedishamerican Hospital | Internal Medicine | 3505 N Bell School Road, Rockford, IL 61114 | 2019-07-31 |
1154980076 | Anurag Gill | Student in an Organized Health Care Education/Training Program | 8201 East Riverside Boulevard, Mercy Health Javon Bea Hospital, Rockford, IL 61114 | 2019-06-13 |
1578121943 | Sona Najafi | Student in an Organized Health Care Education/Training Program | Mercyhealth Javon Bea Hospital, 8201 East Riverside Blvd, Rockford, IL 61114 | 2019-05-31 |
1760045744 | Julianna Jones | Counselor | 6653 Weaver Rd Ste 115, Rockford, IL 61114 | 2019-04-16 |
1952869943 | Angela Marie Hawkins | Nurse Practitioner | 8201 E. Riverside Blvd, Pediatric Neurology, Rockford, IL 61114 | 2019-03-08 |
1376029231 | Meghan Beth Teske | Chiropractor | 3779 N. Alpine Rd., Rockfod, IL 61114 | 2018-07-13 |
1811401284 | Summit Radiology, LLC | Clinic/Center | 3849 N. Perryville Road, Rockford, IL 61114 | 2017-11-21 |
1548704299 | Rockford Orthopedic Associates, Ltd | Durable Medical Equipment & Medical Supplies | 5929 E Riverside Blvd, Rockford, IL 61114 | 2016-12-15 |
1528480241 | Dawn M Mansfield | Physical Therapist | 6451 East Riverside Blvd, Suite 103, Rockford, IL 61114 | 2014-01-15 |
Find all providers in zip 61114 |
Taxonomy Code | 390200000X |
Grouping | Student, Health Care |
Classification | Student in an Organized Health Care Education/Training Program |
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
Notes: [1/1/2005: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1871118174 | Dalton Menke | Student in an Organized Health Care Education/Training Program | 707 Woodsong Ct, Rockford, IL 61102-5625 | 2020-06-11 |
1881216729 | Dylan Jackson Dick | Student in an Organized Health Care Education/Training Program | 226 Glenview Ct Ne, Rockford, MI 49341-1198 | 2020-05-14 |
1457980138 | Alexandria Conner | Student in an Organized Health Care Education/Training Program | 9501 Sunset Ridge Dr Ne, Rockford, MI 49341-7116 | 2020-04-05 |
1679109789 | Alyssa Tunison | Student in an Organized Health Care Education/Training Program | 1722 Huffman Blvd, Rockford, IL 61103-4531 | 2020-03-20 |
1497380224 | Michael Magnuson | Student in an Organized Health Care Education/Training Program | 5268 Deer Pointe, Rockford, IL 61114-7068 | 2020-03-12 |
1467092379 | Unknown Safa Fatima | Student in an Organized Health Care Education/Training Program | Mercyhealth Mulford Clinic, 5970 Churchview Drive, Rockford, IL 61107 | 2020-01-08 |
1154980076 | Anurag Gill | Student in an Organized Health Care Education/Training Program | 8201 East Riverside Boulevard, Mercy Health Javon Bea Hospital, Rockford, IL 61114 | 2019-06-13 |
1578121943 | Sona Najafi | Student in an Organized Health Care Education/Training Program | Mercyhealth Javon Bea Hospital, 8201 East Riverside Blvd, Rockford, IL 61114 | 2019-05-31 |
1578127007 | Jose Luis Gallardo | Student in an Organized Health Care Education/Training Program | 2133 Oxford St, Rockford, IL 61103-4160 | 2019-04-30 |
1972064194 | Mahita Bellamkonda | Student in an Organized Health Care Education/Training Program | 2400 North Rockton Avenue, Rockford, IL 61103 | 2019-03-29 |
Find all providers in ROCKFORD |
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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.