MR. SUSHILKUMAR MAHABIRPRASAD TIBREWALA (NPI# 1457366858) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457366858 |
| Entity Type | Individual |
| Full Name | MR. SUSHILKUMAR MAHABIRPRASAD TIBREWALA |
| Other Name | SUSHIL TIBREWALA |
| Credential | M.D. |
| Practice Address |
3301 Patriot Ct Herrin IL 62948-3782 |
| Mailing Address |
24 Pine Lake Dr Carbondale IL 62901-5410 |
| Practice Telephone | 6189988885 |
| Practice Fax Number | 6189988886 |
| Mailing Telephone | 6189988885 |
| Mailing Fax Number | 6189988886 |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2018-09-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
036-073571 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | AETNA | 833199720 | 01 |
| IL | BLUE CROSS/BLUE SHIELD | 0010023397 | 01 |
| IL | 036073571 | 05 |
| Street Address |
3301 PATRIOT CT |
| City | HERRIN |
| State | IL |
| Zip Code | 62948-3782 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609914183 | Gastroenterology Care of Southern Illinois, LLC | Internal Medicine | 3301 Patriot Ct, Herrin, IL 62948-3782 | 2007-02-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215307590 | Carmelito Miralles Caronongan | Pediatrics | 120 S. 11th St., Herrin, IL 62948 | 2015-09-30 |
| 1073995684 | Motaz R Wraikat | Preventive Medicine | 315 S 13th St Ste 3, Herrin, IL 62948 | 2015-06-19 |
| 1639427933 | Salim Hosein | Surgery | 317 S 14th St Ste 1, Herrin, IL 62948 | 2012-08-17 |
| 1962780288 | Pooja Sareen | Internal Medicine | 3024 S Park Avenue, Herrin, IL 62948 | 2011-08-03 |
| 1235459918 | Timoteo Castro Md & Josefina D. Castro Md Ltd | Family Medicine | 321 South 13st St., Herrin, IL 62948 | 2010-06-04 |
| 1457501926 | Don Cassidy Arnold II | Urology | 220 S Park Ave Fl 2, Herrin, IL 62948 | 2008-09-22 |
| 1306094560 | Karl Keith Mitchener | Speech-Language Pathologist | 1901 N 13th Street, Herrin, IL 62948 | 2008-08-29 |
| 1457509705 | Kathryn Marie Bordenet-jines | Occupational Therapy Assistant | 1901 N. 13th, Herrin, IL 62948 | 2008-08-28 |
| 1417105776 | Cheryl Lynn Matic | Occupational Therapy Assistant | 1901 N. 13th St., Herrin, IL 62948 | 2008-08-28 |
| 1174771422 | Mary Frances Graham | Physical Therapy Assistant | 1901 N. 13th Street, Herrin, IL 62948 | 2008-08-28 |
| Find all providers in zip 62948 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558321190 | Mack E Mccain | Internal Medicine | 404 Lincoln Dr, Herrin, IL 62948 | 2006-03-27 |
| 1174524136 | Jeffrey Mark Jacobs | Internal Medicine | 201 S 14th St, Herrin, IL 62948-3631 | 2005-08-02 |
| 1609914183 | Gastroenterology Care of Southern Illinois, LLC | Internal Medicine | 3301 Patriot Ct, Herrin, IL 62948-3782 | 2007-02-04 |
| 1881782654 | Jimmy J Morrison | Internal Medicine | 3314 Patriot Ct, Herrin, IL 62948-3782 | 2006-10-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013487388 | Endoscopy Center of The North Shore, LLC | Internal Medicine | 1100 Central Ave Ste H, Wilmette, IL 60091-2666 | 2018-11-29 |
| 1104303296 | Amanda Israel | Internal Medicine | 5841 S Maryland Ave # 4076m410, Chicago, IL 60637-1443 | 2018-07-23 |
| 1861999559 | Kiba, Inc. | Internal Medicine | 3845 Mccoy Dr Ste 101, Aurora, IL 60504-4429 | 2018-04-09 |
| 1447765888 | David Henoch Barch | Internal Medicine | 3431 N Leavitt St, Chicago, IL 60618-6013 | 2017-12-07 |
| 1861861403 | Belleville Endoscopy LLC | Internal Medicine | 311 West Lincoln St, Suite 101, Belleville, IL 62220 | 2015-09-24 |
| 1205218658 | Ye Eun Kwak | Internal Medicine | 5841 S Maryland Ave Rm J-517, Chicago, IL 60637 | 2015-06-22 |
| 1699186890 | Laura Hamad | Internal Medicine | 1717 Midwest Club Pkwy, Oak Brook, IL 60523-2586 | 2014-05-11 |
| 1154749042 | Joshua Michael Steinberg | Internal Medicine | 5841 S Maryland Ave # 4076, Chicago, IL 60637-1443 | 2014-03-28 |
| 1841533254 | Danish Shahab | Internal Medicine | 133 E Brush Hill Rd Ste 100&400, Elmhurst, IL 60126-5659 | 2013-04-03 |
| 1447599311 | Seymour Marshall Sabesin | Internal Medicine | 630 S Hermitage Ave, Suite 802, Chicago, IL 60612-3874 | 2013-02-12 |
| 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.