TOTAL CARE MEDICAL CLINIC (NPI# 1548447956) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1548447956 |
Entity Type | Organization |
Organization Name | TOTAL CARE MEDICAL CLINIC |
Other Organization Name | TOTAL CARE MEDICAL GROUP |
Practice Address |
6929 Ogden Ave Berwyn IL 60402-3649 |
Practice Telephone | 7084849472 |
Practice Fax Number | 7084849473 |
Mailing Telephone | 7084849472 |
Mailing Fax Number | 7084849473 |
Enumeration Date | 2008-01-28 |
Last Update Date | 2011-04-13 |
Authorized Official Name | DR. LEONARD M SPISHAKOFF (PHYSICIAN) |
Authorized Official Telephone | 7084849506 |
Authorized Official Credential | MD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207QA0401X |
Family Medicine Specialization: Addiction Medicine |
036091578 | IL | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IL | 036091578 | 05 |
Other Name | Type Code |
---|---|
total care medical group | Former Legal Business Name - Organization |
Street Address |
6929 OGDEN AVE |
City | BERWYN |
State | IL |
Zip Code | 60402-3649 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619586518 | Lisa K Anderson-shaw | Clinical Ethicist | Macneal Trinity Medical Cetner, 3249 Oak Park Avenue, Berwyn, IL 60402 | 2020-07-27 |
1922622380 | Ayesha Ikram | Internal Medicine | Macneal Hospital 3249 S. Oak Park Ave, Brewyn, IL 60402 | 2020-06-02 |
1598329146 | Eleanor Teoh | Student in an Organized Health Care Education/Training Program | Family Medicine, Macneal Family Medicine Center, 3231 Eucild Ave, 5th Floor, Berwyn, IL 60402 | 2019-04-30 |
1376013920 | Virginia Mireles | Behavior Technician | 2317 S. Home, Berwyn, IL 60402 | 2018-11-27 |
1245709047 | Saraswati Koirala | Dentist | 1227 S Harlem Ave Apt414, Berwyn, IL 60402 | 2018-11-21 |
1295204220 | Dental Town Ltd | Dentist | 7106 W Cermak Rd, Berwyn, IL 60402 | 2018-11-20 |
1396231684 | Toya M Gildart | Counselor | Pillars, 6415 Stanley Avenue, Berwyn, IL 60402 | 2018-07-10 |
1437655685 | Ana Luisa Desantiago | Social Worker | 3245 Grove Ave Ste 201, Berwyn, IL 60402 | 2018-04-04 |
1821520198 | Chetan Velagapudi | Student in an Organized Health Care Education/Training Program | 3231 S Euclid Avenue, Suite 203, Berwyn, IL 60402 | 2017-03-28 |
1174976567 | Sydney Talavera | Counselor | 6415 Stanley Ave., Berwyn, IL 60402 | 2016-07-20 |
Find all providers in zip 60402 |
Taxonomy Code | 207QA0401X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Family Medicine |
Specialization | Addiction Medicine |
A family medicine physician who specializes in the diagnosis and treatment of addictions. |
Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) was, but is no longer issued by the American Osteopathic Board of Family Physicians. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609303320 | Brianne C Brown | Family Medicine | 1111 N Milwaukee Ave Unit 242, Vernon Hills, IL 60061-1658 | 2017-05-11 |
1649553892 | Physicians Community Medical Center North, S.c. | Family Medicine | 5320 159th St # 2n, Oak Forest, IL 60452-4705 | 2011-09-23 |
1538469739 | John Thomas Johns Jr. | Family Medicine | 210 N. Ashland, Chicago, IL 60607-1402 | 2010-10-22 |
1205979028 | Gloria J Mouzon | Family Medicine | 140 N Ashland Ave, Chicago, IL 60607-1802 | 2007-02-14 |
1760448674 | Richard J Ready | Family Medicine | 999 Oakmont Plaza Dr Ste 100, Westmont, IL 60559-1381 | 2006-04-21 |
1841251378 | Britt Michael Borden | Family Medicine | 180 N Stetson Ave, Chicago, IL 60601-6710 | 2006-04-02 |
1992704381 | James Edward Beckett | Family Medicine | 326 W 64th St, St Bernard Hospital Dept Radiology, Chicago, IL 60621-3114 | 2005-07-18 |
1912519786 | Shark Addiction Treatment | Family Medicine | 1111 N Milwaukee Ave Unit 242, Vernon Hills, IL 60061-1658 | 2020-08-21 |
1831748573 | Recoveruscenters-carbondale LLC | Family Medicine | 2250 Reed Station Pkwy Ste 204, Carbondale, IL 62901-8104 | 2019-09-05 |
1609303940 | Great Heights Medical Ltd. | Family Medicine | 315 E Mckinley Rd, Ottawa, IL 61350-4805 | 2017-05-17 |
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.