MARTA E BANEGAS (NPI# 1477542926) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477542926 |
| Entity Type | Individual |
| Full Name | MARTA E BANEGAS |
| Credential | M.D. |
| Practice Address |
3000 N Halsted St Suite# 505 Chicago IL 60657-5188 |
| Practice Telephone | 7732811044 |
| Practice Fax Number | 7732811049 |
| Mailing Telephone | 7732811044 |
| Mailing Fax Number | 7732811049 |
| Enumeration Date | 2005-10-18 |
| Last Update Date | 2012-08-20 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
036056450 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE SHIELD | 0001618837 | 01 |
| IL | 036056450 | 05 | |
| IL | IL BLUE SHIELD | 0001617631 | 01 |
| RAILROAD MEDICARE | 260048416 | 01 |
| Street Address |
3000 N HALSTED ST SUITE# 505 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60657-5188 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053310482 | Mark Pietz | Podiatrist | 3000 N Halsted St, Suite 821, Chicago, IL 60657-5188 | 2005-07-18 |
| 1740844232 | Sandra Mazzeffi | Nurse Practitioner | 3000 N Halsted St, Chicago, IL 60657-5188 | 2019-04-30 |
| 1437713930 | Molly O'brien | Physician Assistant | 3000 N Halsted St, Chicago, IL 60657-5188 | 2019-04-30 |
| 1245760081 | Carolina Coello | Nurse Practitioner | 3000 N Halsted St, Chicago, IL 60657-5188 | 2017-06-14 |
| 1417302704 | Brittany Beeg | Audiologist | 3000 N Halsted St, Suite 400, Chicago, IL 60657-5188 | 2016-04-25 |
| 1063870525 | Whitney Fritzie | Specialist | 3000 N Halsted St, Suite 320, Chicago, IL 60657-5188 | 2016-01-29 |
| 1952776445 | Alissa Roberts | Nurse Practitioner | 3000 N Halsted St, Suite 723, Chicago, IL 60657-5188 | 2015-12-09 |
| 1366815250 | Windy City Pediatrics | Clinic/Center | 3000 N Halsted St, Suite 825, Chicago, IL 60657-5188 | 2015-11-02 |
| 1346640828 | Ellen May | Audiologist | 3000 N Halsted St, Suite 400, Chicago, IL 60657-5188 | 2014-09-03 |
| 1558771543 | Anthony Lisuzzo | Physician Assistant | 3000 N Halsted St, Suite #525, Chicago, IL 60657-5188 | 2014-04-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992303887 | Simone Paes | Behavior Technician | 3141 N Sheffield Ave, Chicago, IL 60657 | 2020-10-13 |
| 1821613175 | Samridhi Khatri | Internal Medicine | 836 W. Wellington Ave, Advocate Illinois Masonic Medica, Suite 1312, Chigaco, IL 60657 | 2020-06-12 |
| 1467074617 | Dewolfe Aesthetic Services Sc | Surgery | 3357 N. Southport Aveune, Chicago, IL 60657 | 2020-05-11 |
| 1790304657 | Mehr Amer Mjeed | Student in an Organized Health Care Education/Training Program | Advocate Internal Medicine Clinic, Advocate Illinois Ma, 836 West Wellington Avenue, Chicago, IL 60657 | 2020-04-10 |
| 1457997561 | Jasleen Mohini Singh | Physician Assistant | 1645a W School Street, Suite A, Clinic Entrance, Chicago, IL 60657 | 2019-11-24 |
| 1306493408 | Art of Sight Eyecare, LLC | Optometrist | 2915 N. Broadway, Chicago, IL 60657 | 2019-08-22 |
| 1992359277 | Joseph Michael Rochford IIi | Counselor | 1358 W Belmont Ave, Unit # 202, Chicago, IL 60657 | 2019-07-25 |
| 1487116240 | Conrad Petersen Dermatology Sc | Dermatology | 2845 N Sheridan, Chicago, IL 60657 | 2019-04-02 |
| 1003388810 | Evolve Wellness S.c. | Counselor | 2845 North Sheridan Road, Suite 708, Chicago, IL 60657 | 2018-12-19 |
| 1639657414 | Advocate North Side Health Network | Psychiatric Unit | 836 W Wellington Ave., Chicago, IL 60657 | 2018-08-02 |
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| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144851684 | Greywood Health Center LLC | Psychiatry & Neurology | 303 W Institute Pl Fl 3, Chicago, IL 60610-3080 | 2020-02-03 |
| 1942702386 | Brain and Wellness Institute LLC | Psychiatry & Neurology | 30 W Oak St Apt 14a, Chicago, IL 60610-8724 | 2018-03-01 |
| 1598278749 | Elemental Treatment Center Ltd | Psychiatry & Neurology | 612 S Western Ave Apt 1, Chicago, IL 60612-4682 | 2017-11-09 |
| 1487032082 | Jerry Francisco Benzl | Psychiatry & Neurology | 1740 Taylor St., Chicago, IL 60612 | 2015-05-14 |
| 1326372780 | Syiha Ltd | Psychiatry & Neurology | 6321 N Leavitt, Apt 1n, Chicago, IL 60659 | 2009-10-01 |
| 1568514263 | Robert Elliot Blaik | Psychiatry & Neurology | 1642 E. 56th St., #505, Chicago, IL 60637-1973 | 2007-01-16 |
| 1891865515 | Mina K. Dulcan | Psychiatry & Neurology | 225 East Chicago Ave. Box 10, Ann & Robert H. Lurie Childrens Hospital of Chicago, Chicago, IL 60611-2605 | 2006-11-09 |
| 1124198239 | Thomas K. Cummins | Psychiatry & Neurology | 225 E Chicago Ave # 10, Chicago, IL 60611-2605 | 2006-11-08 |
| 1801994769 | Peter D Nierman | Psychiatry & Neurology | 3730 North Lake Shore Drive, #15a, Chicago, IL 60613 | 2006-09-21 |
| 1578661781 | Adrienne L. Adams | Psychiatry & Neurology | 1720 W Polk St, Mfiv- Child Psychiatry, Chicago, IL 60612-4328 | 2006-09-20 |
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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.