DR. BENNETT LUM (NPI# 1497774459) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497774459 |
| Entity Type | Individual |
| Full Name | DR. BENNETT LUM |
| Credential | MD |
| Practice Address |
2800 W 95th Street Little Company of Mary Hospital Evergreen IL 60805 |
| Mailing Address |
6910 So Madison Willowbrook IL 60527 |
| Practice Telephone | 7082295104 |
| Practice Fax Number | 6303231699 |
| Mailing Telephone | 6303212715 |
| Mailing Fax Number | 6303231699 |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BCBS | 0221524519 | 01 |
| Street Address |
2800 W 95TH STREET LITTLE COMPANY OF MARY HOSPITAL |
| City | EVERGREEN |
| State | IL |
| Zip Code | 60805 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215956271 | Danilo Martinez | Radiology | 2800 W 95th Street, Little Company of Mary Hospital, Evergreen, IL 60805 | 2006-07-19 |
| 1124047188 | Gene Quirini | Radiology | 2800 W 95th Street, Little Company of Mary Hospital, Evergreen, IL 60805 | 2006-07-19 |
| 1659390615 | Dharma Alagaratam | Radiology | 2800 W 95th Street, Little Company of Mary Hospital, Evergreen, IL 60805 | 2006-07-19 |
| 1508885567 | Irving Fuld | Radiology | 2800 W 95th Street, Little Company of Mary Hospital, Evergreen, IL 60805 | 2006-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487254603 | Cynthia Nicole Bucio | Pharmacist | 9400 S. Western, Evergreen Park, N/A 60805 | 2020-10-27 |
| 1124530456 | Foundations Counseling, LLC | Social Worker | 9730 S Western Ave Ste 215, Evergreen Park, IL 60805 | 2017-10-26 |
| 1184147886 | Luke Blaeser | Specialist/Technologist | 2856 W. 97th Pl., Evergreen Park, IL 60805 | 2017-07-25 |
| 1396193322 | Daniel Joseph Bierbaum Howard | Emergency Medicine | 2800 95th St, Emergency Department, Evergreen Park, IL 60805 | 2016-05-31 |
| 1588037873 | Lcr Primary Care LLC | Exclusive Provider Organization | 9237 S.pulaski, Ste. 2s, Evergreen Park, IL 60805 | 2015-11-09 |
| 1447639091 | Nancy Sanchez | Social Worker | 9832 S Utica Ave, Evergreen Park, IL 60805 | 2015-05-28 |
| 1629334743 | Harshad M. Mehta Md Sc | Psychiatry & Neurology | 2850 W. 95th Street, Suite 206, Evergreen Park, IL 60805 | 2012-04-03 |
| 1235407305 | Victoria T Adesina | Pharmacist | 8700 South Kedzie Ave, Evergreen Park, IL 60805 | 2011-12-05 |
| 1891072922 | Zahia-lena Refat Hussien | Pharmacist | 8700 S. Kedzie Ave, Evergreen Park, IL 60805 | 2011-11-03 |
| 1891079091 | Denise Adams | Occupational Therapy Assistant | 9217 S. Kedzie, Evergreen Park, IL 60805 | 2011-10-06 |
| Find all providers in zip 60805 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790022853 | John Price Witwer | Radiology | 3111 Interlocken Dr, Evergreen, CO 80439-8846 | 2013-01-09 |
| 1548243165 | Mark A Mcgehee | Radiology | 31022 Troutdale Ridge Rd, Evergreen, CO 80439-7734 | 2005-11-29 |
| 1215956271 | Danilo Martinez | Radiology | 2800 W 95th Street, Little Company of Mary Hospital, Evergreen, IL 60805 | 2006-07-19 |
| 1124047188 | Gene Quirini | Radiology | 2800 W 95th Street, Little Company of Mary Hospital, Evergreen, IL 60805 | 2006-07-19 |
| 1659390615 | Dharma Alagaratam | Radiology | 2800 W 95th Street, Little Company of Mary Hospital, Evergreen, IL 60805 | 2006-07-19 |
| 1578582532 | Steven Domiano | Radiology | 2800 W 95th St, Evergreen, IL 60805 | 2006-07-19 |
| 1508885567 | Irving Fuld | Radiology | 2800 W 95th Street, Little Company of Mary Hospital, Evergreen, IL 60805 | 2006-07-19 |
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|---|---|---|---|---|
| 1376196220 | Parvathamma Imaging Services, LLC | Radiology | 7431 S East End Ave Ste 2, Chicago, IL 60649-3611 | 2019-07-19 |
| 1730652017 | Diaspora Radiology, Sc | Radiology | 2602 Mulberry Ln, Northbrook, IL 60062-5937 | 2019-01-09 |
| 1225516842 | Tyler Jonathan Hinkel | Radiology | 33 W Ontario St Apt 46f, Chicago, IL 60654 | 2018-08-06 |
| 1043796543 | Quantum Medical Radiology of California, P.C. | Radiology | 374 W Seminary Ave, Wheaton, IL 60187-5002 | 2018-07-17 |
| 1215429501 | The Open Mri Center | Radiology | 3123 Williamson County Pkwy, Marion, IL 62959-5235 | 2018-06-01 |
| 1649769746 | Envision Medical Imaging, LLC | Radiology | 915 National Pkwy Ste 915-20, Schaumburg, IL 60173-5160 | 2018-05-03 |
| 1831687250 | Michael Patrick Murphy | Radiology | 807 Davis St. Unit 707, Evanston, IL 60201 | 2018-05-01 |
| 1366976631 | Ali Mostafa Serhal | Radiology | 240 E. Huron St, Suite 1-203, Chicago, IL 60617 | 2017-04-13 |
| 1710427737 | Dorothea A Nazos | Radiology | 1810 Parkside Dr, Shorewood, IL 60404-0684 | 2017-02-24 |
| 1194275941 | Florida United Radiology, Lc | Radiology | 7 Pear Tree Ct, Charleston, IL 61920-4415 | 2016-10-05 |
| 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.