DR. MICHAEL CHRISTOPHER CICCOTTI (NPI# 1528487436) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528487436 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL CHRISTOPHER CICCOTTI |
| Credential | M.D. |
| Practice Address |
420 N Il Route 31 Crystal Lake IL 60012-3709 |
| Practice Telephone | 8153565200 |
| Practice Fax Number | 8153565262 |
| Mailing Telephone | 8153565200 |
| Mailing Fax Number | 8153565262 |
| Enumeration Date | 2014-04-08 |
| Last Update Date | 2020-10-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207X00000X | Orthopaedic Surgery | 036153327 | IL | Allopathic & Osteopathic Physicians |
| Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
036153327 | IL | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 10370 Haligus Rd Ste 201, Huntley, IL 601429582 | 8153565200 | 8153565262 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245287556 | Michael Girard Ciccotti | Orthopaedic Surgery | 925 Chestnut St, 5th Floor, Philadelphia, PA 19107-4216 | 2006-05-30 |
| Street Address |
420 N IL ROUTE 31 |
| City | CRYSTAL LAKE |
| State | IL |
| Zip Code | 60012-3709 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467485128 | Gordon D Husby | Physical Therapist | 420 N Il Route 31, Crystal Lake, IL 60012-3711 | 2006-07-08 |
| 1134648389 | Ryan Miguel Colon | Physician Assistant | 420 N Il Route 31, Crystal Lake, IL 60012 | 2017-09-19 |
| 1497295125 | Alexander J Hembrey | Physician Assistant | 420 N Il Route 31, Crystal Lake, IL 60012 | 2017-02-28 |
| 1316486459 | Nicole M Trittschuh | Physician Assistant | 420 N Il Route 31, Crystal Lake, IL 60012 | 2017-02-22 |
| 1356883599 | Centegra Primary Care LLC | Family Medicine | 420 N Il Route 31, Crystal Lake, IL 60012-3709 | 2016-11-04 |
| 1770954125 | Lisa Zemaitis | Physical Therapy Assistant | 420 N Il Route 31, Crystal Lake, IL 60012-3709 | 2015-10-12 |
| 1336552199 | Nicole Ashley Fox | Physical Therapist | 420 N Il Route 31, Crystal Lake, IL 60012-3711 | 2014-06-09 |
| 1497168355 | Heather Michelle Murnane | Occupational Therapist | 420 N Il Route 31, Crystal Lake, IL 60012-3711 | 2014-06-09 |
| 1326483280 | Mark Andrew Rotert | Nurse Practitioner | 420 N Il Route 31, Crystal Lake, IL 60012 | 2013-05-06 |
| 1548519986 | Stephanie H Goede | Physician Assistant | 420 N Il Route 31, Crystal Lake, IL 60012 | 2012-08-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033574629 | Joan M Ryan | Counselor | 610 N Route 31, Suite E, Crystal Lake, IL 60012 | 2015-12-23 |
| 1285972331 | Lauren Elyse Westerman | Physical Therapist | 1000 Brighton Ln, Crystal Lake, IL 60012 | 2013-01-24 |
| 1447537469 | Sean Gale | Pharmacist | 135 Carmella Dr, Crystal Lake, IL 60012 | 2011-11-04 |
| 1477836625 | Judy Meekyung Fakhouri | Pharmacist | 315 N. Route 31, Crystal Lake, IL 60012 | 2011-09-23 |
| 1730462136 | Leslie Dawn Weckerlin | Pharmacist | 315 N Route 31, Crystal Lake, IL 60012 | 2011-09-21 |
| 1639452188 | Laura Jean Galles | Pharmacist | 315 N. Routet 31, Crystal Lake, IL 60012 | 2011-09-21 |
| 1326320516 | Stacey Jean Knuth | Pharmacist | 315 North Route 31, Crystal Lake, IL 60012 | 2011-09-13 |
| 1356469803 | Donn Orien Humphries | Chiropractor | 690 N Route 31, Suite F, Crystal Lake, IL 60012 | 2007-03-26 |
| 1538204508 | Midwest Physical Therapy Ctr | Clinic/Center | 630 N Rt 31, Suite 103, Crystal Lake, IL 60012 | 2007-02-20 |
| 1356488415 | Charlotte Joy Parcels | Social Worker | 8600 Route 14, Suite 110, Crystal Lake, IL 60012 | 2007-01-30 |
| Find all providers in zip 60012 | ||||
| Taxonomy Code | 207XX0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Sports Medicine |
| An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033422209 | Savan Dixit Patel | Orthopaedic Surgery | 420 N Il Route 31, Crystal Lake, IL 60012 | 2010-07-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063048395 | Dr Ouilife LLC | Orthopaedic Surgery | 640 S Federal St Apt 410, Chicago, IL 60605-1800 | 2020-03-18 |
| 1316437890 | Darcy L Marr | Orthopaedic Surgery | 3030 Salt Creek Lane, Suite 100, Arlington Heights, IL 60005 | 2018-05-10 |
| 1568851251 | Benjamin Scott Kester | Orthopaedic Surgery | 1725 W Harrison St Ste Rush, Chicago, IL 60612-3841 | 2015-01-18 |
| 1609041565 | Sheryl Lynn Lipnick | Orthopaedic Surgery | 1585 N. Barrington Rd Ste 101, Drs. Bldg. 2, Hoffman Estates, IL 60169-5019 | 2008-04-22 |
| 1295937555 | Gregory Lamar Primus | Orthopaedic Surgery | 7543 183rd St, Tinley Park, IL 60477-6208 | 2007-05-31 |
| 1154454635 | Benjamin Domb | Orthopaedic Surgery | 999 E Touhy Ave Ste 450, Des Plaines, IL 60018-2748 | 2007-03-13 |
| 1518981612 | Sean Daniel Odell | Orthopaedic Surgery | 375 S Roselle Rd, Schaumburg, IL 60193-5544 | 2006-07-26 |
| 1568419463 | Mark K. Bowen | Orthopaedic Surgery | 680 N Lake Shore Dr Ste 924, Chicago, IL 60611 | 2006-05-27 |
| 1639146103 | Jean Benoit Houle | Orthopaedic Surgery | 4121 Veterans Memorial Dr, Mount Vernon, IL 62864-6262 | 2006-03-03 |
| 1093792277 | Scott Eric Urch | Orthopaedic Surgery | 503 E Grant St, Macomb, IL 61455-3313 | 2005-12-28 |
| Find all providers with the same taxonomy | ||||
| City | CRYSTAL LAKE |
| Zip Code | 60012 |
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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.