SOUTHDALE ALLERGY AND ASTHMA CLINIC, LLC (NPI# 1477680718) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477680718 |
| Entity Type | Organization |
| Organization Name | SOUTHDALE ALLERGY AND ASTHMA CLINIC, LLC |
| Practice Address |
4010 W 65th St #221 Minneapolis MN 55435-1721 |
| Practice Telephone | 9529267630 |
| Practice Fax Number | 9529262116 |
| Mailing Telephone | 9529267630 |
| Mailing Fax Number | 9529262116 |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. PAULINE SCHINDELDECKER (OFFICE MANAGER) |
| Authorized Official Telephone | 9529267630 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207K00000X | Allergy & Immunology | 23905 | MN | Allopathic & Osteopathic Physicians |
| Street Address |
4010 W 65TH ST #221 |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55435-1721 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518960095 | Hannelore August Brucker | Allergy & Immunology | 4010 W 65th St, Ste 221, Minneapolis, MN 55435-1706 | 2005-05-27 |
| 1427445923 | Eric Risberg | Specialist/Technologist | 4010 W 65th St, Minneapolis, MN 55435-1706 | 2015-04-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104433416 | Evy Christine Claussen | Social Worker | 6363 France Ave. S., Edina, MN 55435 | 2020-09-30 |
| 1508496621 | Samantha Jean Mcgough Lamere | Physician Assistant | 4300 Marketpointe Drive, Suite 100, Bloomington, MN 55435 | 2020-01-16 |
| 1659920460 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 3408 Galleria, Edina, MN 55435 | 2019-09-05 |
| 1730651639 | Taylor Lee Kehoe | Physician Assistant | 7400 France Ave., Suite #100, Edina, MN 55435 | 2018-12-18 |
| 1538666326 | Amanda Deangelo | Physical Therapist | 6401 Southdale Hospital, Ll3g, Edina, MN 55435 | 2018-04-09 |
| 1982107876 | Julia Seliber | Dental Hygienist | 7600 France Ave.s. Suite 1100, Edina, MN 55435 | 2018-03-16 |
| 1154840064 | Southhealth Asc, LLC | Clinic/Center | 4100 Minnesota Drive, Edina, MN 55435 | 2017-09-12 |
| 1730605528 | Edina Medical Supplies | Durable Medical Equipment & Medical Supplies | 7455 France Ave., #614 S, Edina, MN 55435 | 2017-08-14 |
| 1033565510 | Minnesota Disc Replacement and Spine Restoration Center | Clinic/Center | 4444 76 St, #700, Edina, MN 55435 | 2016-05-13 |
| 1306206321 | Barb Ryan | Mechanotherapist | 7550 France Avenue S, #220, Edina, MN 55435 | 2016-03-03 |
| Find all providers in zip 55435 | ||||
| Taxonomy Code | 207K00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Allergy & Immunology |
| An allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Selected examples of such conditions include asthma, anaphylaxis, rhinitis, eczema, and adverse reactions to drugs, foods, and insect stings as well as immune deficiency diseases (both acquired and congenital), defects in host defense, and problems related to autoimmune disease, organ transplantation, or malignancies of the immune system. |
| Notes: Source: American Board of Medical Specialties, 2007, www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Allergy and Immunology, 2007. http://www.abai.org/ No subspecialty certificates in allergy and immunology are offered by the American Board of Allergy and Immunology (ABAI). The ABAI, however, does offer formal special pathways for physicians seeking dual certification in allergy/immunology and pediatric pulmonology; allergy/immunology and pediatric rheumatology; and allergy/immunology and adult rheumatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487601316 | Jack Leon-max Mutnick | Allergy & Immunology | 1 W Lake St, Minneapolis, MN 55408-3154 | 2006-05-27 |
| 1518960095 | Hannelore August Brucker | Allergy & Immunology | 4010 W 65th St, Ste 221, Minneapolis, MN 55435-1706 | 2005-05-27 |
| 1720594500 | Paul Lorenz Bigliardi | Allergy & Immunology | 909 Fulton St Se Fl 3, Minneapolis, MN 55455-4800 | 2017-12-16 |
| 1083036222 | Gregory Paul Gilmet | Allergy & Immunology | 401 Harding St Ne # 100, Minneapolis, MN 55413-2801 | 2014-01-07 |
| 1154671873 | Manarmohammad Sharif Abdalgani | Allergy & Immunology | 2525 Chicago Ave, Minneapolis, MN 55404 | 2012-09-11 |
| 1881736544 | Eisenstadt Allergy & Asthma LLP | Allergy & Immunology | 825 Nicollet Mall, Suite 221, Minneapolis, MN 55402 | 2007-02-12 |
| 1295840783 | Nancy Lorene Ott | Allergy & Immunology | 2535 University Ave Se, Minneapolis, MN 55414-3205 | 2006-08-21 |
| 1912944489 | Malcolm Blumenthal | Allergy & Immunology | 825 S 8th St, M50, Minneapolis, MN 55404-1208 | 2006-06-01 |
| 1629031034 | Thomas Craig Eisenstadt | Allergy & Immunology | 825 Nicollet Mall, Suite 221 Eisenstadt Allergy & Asthma LLP, Minneapolis, MN 55426 | 2006-04-07 |
| 1689636482 | Ramarathinam Nagarajan | Allergy & Immunology | 825 Nicollet Mall, 221, Minneapolis, MN 55402 | 2006-04-05 |
| Find all providers in MINNEAPOLIS | ||||
| City | MINNEAPOLIS |
| Zip Code | 55435 |
Please comment or provide details below to improve the information on SOUTHDALE ALLERGY AND ASTHMA 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.