ADDICTION WELLNESS SERVICES INC (NPI# 1467966853) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467966853 |
| Entity Type | Organization |
| Organization Name | ADDICTION WELLNESS SERVICES INC |
| Practice Address |
5504 N 2nd St Loves Park IL 61111-5013 |
| Mailing Address |
3824 Northern Pike Ste 600 Monroeville PA 15146-2156 |
| Practice Telephone | 8159974516 |
| Mailing Telephone | 4124570175 |
| Mailing Fax Number | 4124570179 |
| Enumeration Date | 2017-11-22 |
| Last Update Date | 2019-01-29 |
| Authorized Official Name | DR. GAGANDEEP GOYAL (PRESIDENT) |
| Authorized Official Telephone | 2672264760 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207LP3000X |
Anesthesiology Specialization: Pediatric Anesthesiology |
MD438154 | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | IL LICENSE | 036144684 | 01 |
| PA | PA LICENSE | MD438154 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 150 W Half Day Rd Ste 101, Buffalo Grove, IL 600896591 | 8478211070 | 8478211126 |
| Street Address |
5504 N 2ND ST |
| City | LOVES PARK |
| State | IL |
| Zip Code | 61111-5013 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083906382 | Gagandeep Goyal | Anesthesiology | 5504 N 2nd St, Loves Park, IL 61111 | 2011-05-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316562788 | Salli Jacobsen | Technician | 6699 Torch Lite Tr, Loves Park, IL 61111 | 2020-06-11 |
| 1003476425 | Costco Wholesale Corporation | Pharmacy | 5000 Stadium Drive, Loves Park, IL 61111 | 2019-06-18 |
| 1427541077 | Ronit Golan | Physical Therapist | 4401 Peak Dr Ste 1, Loves Park, IL 61111 | 2018-06-08 |
| 1598049025 | Sara Debelak | Developmental Therapist | 7225 Golden Eagle Drive, Loves Park, IL 61111 | 2011-10-03 |
| 1124354261 | Asap Transport, LLC | Taxi | 7117 Clinton Rd, Suite 4, Loves Park, IL 61111 | 2009-10-25 |
| 1235212275 | Roger H Hill | Optometrist | 4301 N Mulford Rd, Loves Park, IL 61111 | 2006-10-23 |
| 1831104546 | Pointcore, Inc. | Pharmacy | 9951 Rock Cut Crossing, Loves Park, IL 61111 | 2006-07-30 |
| 1629099627 | Lisa A. Breisch | Counselor | Harmony Center for Holistic Psychotherapy, 6625 N. 2nd Street, Loves Park, IL 61111 | 2006-07-22 |
| 1386670529 | Joseph L Digirolamo | Chiropractor | 116 East Riverside Blvd, Loves Park, IL 61111 | 2006-06-22 |
| 1720045859 | Metro Medical Services Inc | Ambulance | 5112 Forest Hills Ct, Loves Park, IL 61111 | 2006-05-01 |
| Find all providers in zip 61111 | ||||
| Taxonomy Code | 207LP3000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| Specialization | Pediatric Anesthesiology |
| An anesthesiologist who has had additional skill and experience in and is primarily concerned with the anesthesia, sedation, and pain management needs of infants and children. A pediatric anesthesiologist generally provides services including the evaluation of complex medical problems in infants and children when surgery is necessary, planning and care for children before and after surgery, pain control, anesthesia and sedation for any procedures out of the operating room such as MRI, CT scan, and radiation therapy. |
| Notes: Source: American Academy of Pediatrics, www.aap.org [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376751818 | Suzan H Younes | Anesthesiology | 4236 Kayla Ln, Northbrook, IL 60062-2160 | 2007-05-18 |
| 1346456324 | Ruperto Ubando Buscaino | Anesthesiology | 7350 Mimosa Dr, Orland Park, IL 60462-5129 | 2007-05-15 |
| 1326254939 | River North Anesthesia Consultants,s.c. | Anesthesiology | Same Day Surgery,one East Erie, Suite 300, Chicago, IL 60611 | 2007-05-14 |
| 1457387334 | Richard M Dsida | Anesthesiology | 225 East Chicago Ave, Department of Anesthesia, Chicago, IL 60611 | 2006-06-23 |
| 1013334499 | Jacob Ralph Heninger | Anesthesiology | 225 E Chicago Ave, Chicago, IL 60611 | 2014-03-24 |
| 1891112355 | Mitchell L Phillips Jr. | Anesthesiology | 225 E Chicago Ave, Chicago, IL 60611-2991 | 2014-03-23 |
| 1780022301 | Katherine Elizabeth Ovsevitz | Anesthesiology | 1740 W Taylor St, 3200w Uih M/c516, Chicago, IL 60612 | 2013-06-05 |
| 1932442456 | Elizabeth Quinn Starker | Anesthesiology | 180 Harvester Dr Ste 110, Burr Ridge, IL 60527-4503 | 2013-04-03 |
| 1396023412 | Dena Els | Anesthesiology | 7435 W Talcott Ave, Chicago, IL 60631-3707 | 2011-07-22 |
| 1417242314 | Michael Robert King | Anesthesiology | 225 E Chicago Ave, Box 19, Chicago, IL 60611-2991 | 2011-06-20 |
| Find all providers with the same taxonomy | ||||
| City | LOVES PARK |
| Zip Code | 61111 |
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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.