JANE GRACE MERCADO MANALO (NPI# 1407813470) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407813470 |
| Entity Type | Individual |
| Full Name | JANE GRACE MERCADO MANALO |
| Credential | M.D. |
| Practice Address |
905 Medical Park Dr Effingham IL 62401-2190 |
| Practice Telephone | 2173422066 |
| Practice Fax Number | 2173422074 |
| Mailing Telephone | 2173422066 |
| Mailing Fax Number | 2173422074 |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2014-02-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
036122145 | IL | Allopathic & Osteopathic Physicians |
| N | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
84859581-1205 | UT | Allopathic & Osteopathic Physicians |
| N | 207RX0202X |
Internal Medicine Specialization: Medical Oncology |
036122145 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | 88847357001 | 05 |
| Street Address |
905 MEDICAL PARK DR |
| City | EFFINGHAM |
| State | IL |
| Zip Code | 62401-2190 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720070386 | Hanna M Saba | Internal Medicine | 905 Medical Park Dr, Effingham, IL 62401 | 2005-08-19 |
| 1487720942 | Casey Ellis Duncan | Radiology | 905 Medical Park Dr, Department of Radiation Oncology, Effingham, IL 62401-2190 | 2006-11-28 |
| 1710076567 | Philip A Dy | Internal Medicine | 905 Medical Park Dr, Effingham, IL 62401 | 2006-10-12 |
| 1720173438 | Bassam N Maalouf | Emergency Medicine | 905 Medical Park Dr, Effingham, IL 62401-2190 | 2006-10-04 |
| 1770597940 | David J Obrien | Pharmacist | 905 Medical Park Dr, Effingham, IL 62401-2190 | 2006-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568021269 | Rhodes To Health, LLC | Chiropractor | 200 E. Fayette Ave, Effingham, IL 62401 | 2019-06-07 |
| 1467951699 | Sarah Bush Lincoln Health Center | Durable Medical Equipment & Medical Supplies | 903 N Maple St, Effingham, IL 62401 | 2018-02-02 |
| 1033632187 | Diel Counseling Inc. | Counselor | 444 S. Willow #7, Effingham, IL 62401 | 2017-07-20 |
| 1770930968 | Community Support Systems | Intermediate Care Facility, Mentally Retarded | 2311 Veterans Drive, Effingham, IL 62401 | 2016-05-18 |
| 1194107102 | Radhika Annam | Internal Medicine | 500 N. Maple St., Joslin Diabetes Center Affiliate At Hshs Medical Group, Effingham, IL 62401 | 2015-06-25 |
| 1912334558 | Ruben Boyajian, Md | Surgery | 904 Medical Park Drive, Suite 2, Effingham, IL 62401 | 2013-09-27 |
| 1427483502 | Daniel E Czajkowski | Physical Therapist | 2611 S Banker St, Effingham, Il, Effingham, IL 62401 | 2013-09-09 |
| 1093140501 | Lifetime Dental Care of Maryland, Badger, P.C. | Dentist | 1200 Network Centre Drive, Suite #2, Effingham, IL 62401 | 2013-09-04 |
| 1689926487 | Wellness Loft Inc. | Counselor | 408 South 4th St., Effingham, IL 62401 | 2012-10-04 |
| 1598011470 | Patricia R. Diel | Social Worker | 444 S. Willow, Suite 7, Effingham, IL 62401 | 2012-07-30 |
| Find all providers in zip 62401 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720070386 | Hanna M Saba | Internal Medicine | 905 Medical Park Dr, Effingham, IL 62401 | 2005-08-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649831124 | Elena Vagia | Internal Medicine | 233 E Superior St Ste 1-061, Chicago, IL 60611-2913 | 2019-06-25 |
| 1194206367 | Illinois Cancer Specialists | Internal Medicine | 360 Station Dr Ste 201, Crystal Lake, IL 60014-7978 | 2018-08-27 |
| 1861986549 | Quincy Physicians & Surgeons Clinic, Sc | Internal Medicine | 3347 Broadway St, Quincy, IL 62301 | 2018-06-18 |
| 1730634700 | Liyun Huang | Internal Medicine | 17495 South La Grange Rd, Tinley Park, IL 60487 | 2016-08-19 |
| 1578017596 | Mercy Clinic Specialists Services-illinois LLC | Internal Medicine | 2227 Vadalabene Dr Ste 200, Maryville, IL 62062-5824 | 2016-08-08 |
| 1356793319 | Glenda Maria Delgado Ramos | Internal Medicine | 2160 S 1st Ave Ste 167, Maywood, IL 60153-3328 | 2016-07-01 |
| 1023403516 | Meghan Rebecca Steiner | Internal Medicine | 5841 S Maryland Ave # Mc-2115, Chicago, IL 60637 | 2015-04-01 |
| 1700270154 | Joseph Heng | Internal Medicine | 5841 S Maryland Ave # Mc1152, Chicago, IL 60637-1443 | 2015-03-24 |
| 1497148118 | Pinal Chokshi | Internal Medicine | 525 E Congress Pkwy Ste 300, Crystal Lake, IL 60014-6258 | 2015-03-05 |
| 1770998262 | Adventist Bolingbrook Hospital | Internal Medicine | 420 S Schmidt, Ste 230, Bolingbrook, IL 60440 | 2014-06-24 |
| Find all providers with the same taxonomy | ||||
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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.