DR. SHADI LATTA (NPI# 1427255447) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427255447 |
| Entity Type | Individual |
| Full Name | DR. SHADI LATTA |
| Credential | M.D. |
| Practice Address |
17333 La Grange Rd Ste 200 Tinley Park IL 60487-7510 |
| Practice Telephone | 7083421900 |
| Practice Fax Number | 7087459993 |
| Mailing Telephone | 7083421900 |
| Mailing Fax Number | 7087459993 |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
036121973 | IL | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 12150 S Harlem Ave, Palos Heights, IL 604631435 | 7008745998 | 7087459993 |
| 1775 W Dempster St, Advocate Lutheran General Hospital, Park Ridge, IL 600681143 | 8477232210 |
| Street Address |
17333 LA GRANGE RD STE 200 |
| City | TINLEY PARK |
| State | IL |
| Zip Code | 60487-7510 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992797047 | Vasia A Ahmed | Internal Medicine | 17333 La Grange Rd Ste 200, Tinley Park, IL 60487-7510 | 2005-08-16 |
| 1770944571 | Jessica Duffin | Nurse Practitioner | 17333 La Grange Rd Ste 200, Tinley Park, IL 60487-7510 | 2016-03-08 |
| 1821482928 | Megan Jones | Nurse Practitioner | 17333 La Grange Rd Ste 200, Tinley Park, IL 60487-7510 | 2015-03-26 |
| 1316236524 | Mylene Hernandez Remo | Internal Medicine | 17333 La Grange Rd Ste 200, Tinley Park, IL 60487-7510 | 2011-03-29 |
| 1740256783 | Subramanya Rao | Internal Medicine | 17333 La Grange Rd Ste 200, Tinley Park, IL 60487-7510 | 2006-02-28 |
| 1558336149 | Wasif Shirazi | Internal Medicine | 17333 La Grange Rd Ste 200, Tinley Park, IL 60487-7510 | 2006-02-17 |
| 1609868819 | Jose M Paredes | Internal Medicine | 17333 La Grange Rd Ste 200, Tinley Park, IL 60487-7510 | 2005-08-16 |
| 1598757718 | Mufaddal M Hamadeh | Internal Medicine | 17333 La Grange Rd Ste 200, Tinley Park, IL 60487-7510 | 2005-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346850492 | Essential Counseling Group LLC | Social Worker | 17550 W Quail Trail, Tinley Park, IL 60487 | 2020-08-04 |
| 1457972705 | Michelle E Estand | Speech-Language Pathologist | 8200 185th, Tinley Park, Il 60487, Suite A/b, Suite A/b, Suite A/b, Tinley Park, IL 60487 | 2020-04-28 |
| 1659839108 | Jasmine Mccloskey | Behavioral Analyst | Cards, 8505 183rd Suite D, IL 60487 | 2019-03-04 |
| 1669951158 | Christine Marie Cavanaugh | Developmental Therapist | 8384 Dunmore Dr, Tinley Park, IL 60487 | 2018-08-07 |
| 1851810998 | Jeffrey Beck | Counselor | 16243 Haven Ave., Orland Hills, IL 60487 | 2017-09-09 |
| 1730634700 | Liyun Huang | Internal Medicine | 17495 South La Grange Rd, Tinley Park, IL 60487 | 2016-08-19 |
| 1780016162 | Kristin Ann Strausbaugh | Nurse Practitioner | 7300 191st Street, Tinley Park, IL 60487 | 2013-08-07 |
| 1679855597 | Florence Delavega | Pharmacist | 9151 Mansfield Dr, Tinley Park, IL 60487 | 2011-09-16 |
| 1912285685 | Michelle Vansetten | Behavioral Analyst | 8200 W. 185th Street, Suite A/b, Tinley Park, IL 60487 | 2011-07-29 |
| 1417283938 | Haley Ranae Goulson | Physician Assistant | 17495 South Lagrange Road, Tinley Park, IL 60487 | 2009-10-19 |
| Find all providers in zip 60487 | ||||
| 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 |
|---|---|---|---|---|
| 1730634700 | Liyun Huang | Internal Medicine | 17495 South La Grange Rd, Tinley Park, IL 60487 | 2016-08-19 |
| 1659461010 | John Michael Mckeown | Internal Medicine | 16532 S. Oak Park Ave, Suite 102, Tinley Park, IL 60477-2280 | 2006-10-13 |
| 1598750101 | Saoud Loutfi | Internal Medicine | 17495 La Grange Rd, Tinley Park, IL 60487-7581 | 2005-09-20 |
| 1992797047 | Vasia A Ahmed | Internal Medicine | 17333 La Grange Rd Ste 200, Tinley Park, IL 60487-7510 | 2005-08-16 |
| 1316236524 | Mylene Hernandez Remo | Internal Medicine | 17333 La Grange Rd Ste 200, Tinley Park, IL 60487-7510 | 2011-03-29 |
| 1255656948 | Surekha Boddipalli | Internal Medicine | 17495 La Grange Rd, Tinley Park, IL 60487-7581 | 2010-04-06 |
| 1760625867 | Alpha Med Physicians Group, LLC | Internal Medicine | 17333 La Grange Rd, Suite 200, Tinley Park, IL 60487-7502 | 2009-04-20 |
| 1427218452 | Vasantha Kumaraiah,md,sc | Internal Medicine | 17732 Oak Park Ave, Suite E, Tinley Park, IL 60477-3934 | 2008-06-12 |
| 1083704449 | Cancer Care Specialists, Ltd. | Internal Medicine | 16532 S. Oak Park Ave, Suite 102, Tinley Park, IL 60477-2280 | 2006-10-13 |
| 1588607923 | Monroe Medical Associates, Sc | Internal Medicine | 6701 159th St, Suite 1, Tinley Park, IL 60477-1758 | 2006-06-14 |
| Find all providers in TINLEY PARK | ||||
| City | TINLEY PARK |
| Zip Code | 60487 |
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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.