CAMBRIDGE MEDICAL CLINIC, LLC (NPI# 1437304631) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437304631 |
| Entity Type | Organization |
| Organization Name | CAMBRIDGE MEDICAL CLINIC, LLC |
| Practice Address |
1550 N Mannheim Rd Ste C Stone Park IL 60165-1300 |
| Mailing Address |
900 S Highway Dr Ste 305 Fenton MO 63026-2042 |
| Practice Telephone | 8003331980 |
| Practice Fax Number | 6363269735 |
| Mailing Telephone | 8003331980 |
| Mailing Fax Number | 6363269735 |
| Enumeration Date | 2008-12-02 |
| Last Update Date | 2009-01-27 |
| Authorized Official Name | MR. JON P HENDRICKS (PRESIDENT) |
| Authorized Official Telephone | 8003331980 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | Allopathic & Osteopathic Physicians |
| Street Address |
1550 N MANNHEIM RD STE C |
| City | STONE PARK |
| State | IL |
| Zip Code | 60165-1300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275697914 | Syed A Ali | Chiropractor | 1813 N 38th Ave, Stone Park, IL 60165-1013 | 2006-12-20 |
| 1144766544 | Nicole Hernandez | Counselor | 1819 N 34th Ave, Stone Park, IL 60165-1023 | 2017-01-10 |
| 1679660740 | Village of Stone Park | Ambulance | 1745 N 35th Ave, Stone Park, IL 60165-1025 | 2006-10-09 |
| 1003931858 | Bellwood School Dist 88 | Local Education Agency (LEA) | 1801 N 36th Ave, Stone Park, IL 60165-1031 | 2007-03-20 |
| 1992901284 | Blanca Antonia Arenas | Developmental Therapist | 1827 N 43rd Ave, Stone Park, IL 60165-1039 | 2007-06-22 |
| 1578769840 | Carlos Rabi Arenas | Interpreter | 1827 N 43rd Ave, Stone Park, IL 60165-1039 | 2007-06-25 |
| 1689299257 | Precision Immediate Care and Medical Center, LLC | Clinic/Center | 3520 W North Ave, Stone Park, IL 60165-1042 | 2020-06-10 |
| 1174181820 | Ilene Trujillo | Behavior Technician | 1642 N 40th Ave, Stone Park, IL 60165-1112 | 2019-05-29 |
| 1609054725 | Pilsen-little Village Community Mental Health Center, Inc | Clinic/Center | 1546 N Mannheim Rd, Stone Park, IL 60165-1117 | 2008-01-31 |
| 1184846339 | Genis Enterprise Inc. | Pharmacy | 1550 N Mannheim Rd, Stone Park, IL 60165-1117 | 2007-05-03 |
| Find all providers in zip 60165 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699236612 | Behdod Katebian | Urology | 5841 S Maryland Ave Rm J-653, Chicago, IL 60637-1443 | 2019-03-31 |
| 1912436015 | Robert Ara Petrossian | Urology | 301 N 8th St # 4b143c, Springfield, IL 62701-1041 | 2017-06-12 |
| 1134657026 | Soojin Kim | Urology | 225 E. Chicago Avenue, Box 24, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL 60611 | 2017-05-23 |
| 1619337912 | George Robert Buckun | Urology | 930 Rogers St., #301, Downers Grove, IL 60515 | 2016-02-29 |
| 1275991606 | Nicole Alyssa Hamilton | Urology | 22285 N Pepper Rd Ste 201, Lake Barrington, IL 60010-2540 | 2016-01-30 |
| 1790164002 | Shay Golan | Urology | 5841 S Maryland Ave Mc6038, Chicago, IL 60637-1447 | 2015-05-20 |
| 1528453594 | Christopher Stockdale | Urology | 300 W Hill St Apt 707, Chicago, IL 60610-7537 | 2015-04-06 |
| 1639568447 | Jeremy Lai | Urology | 420 E Superior St Ste 9-900, Chicago, IL 60611-4494 | 2015-01-16 |
| 1386053759 | Ramiro Felix Prudencio | Urology | 1200 Broadmeadow Rd, Winnetka, IL 60093-3707 | 2014-08-10 |
| 1174933048 | Kyle John Ericson | Urology | 924 E 57th St, Suite 104, Chicago, IL 60637-1455 | 2014-05-01 |
| Find all providers with the same taxonomy | ||||
| City | STONE PARK |
| Zip Code | 60165 |
Please comment or provide details below to improve the information on CAMBRIDGE MEDICAL CLINIC, LLC.
| 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.