JENNIFER MICKELSON (NPI# 1558518761) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558518761 |
| Entity Type | Individual |
| Full Name | JENNIFER MICKELSON |
| Credential | M.D. |
| Practice Address |
2300 N Childrens Plz # 24 Division of Urology - Childrens Memorial Hospital Chicago IL 60614-3363 |
| Mailing Address |
1730 N Clark St Apt 3610 Chicago IL 60614-5395 |
| Practice Telephone | 7738804000 |
| Mailing Telephone | 3129293865 |
| Enumeration Date | 2008-08-19 |
| Last Update Date | 2008-08-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2088P0231X |
Urology Specialization: Pediatric Urology |
036.117785 | IL | Allopathic & Osteopathic Physicians |
| Street Address |
2300 N CHILDRENS PLZ # 24 DIVISION OF UROLOGY - CHILDRENS MEMORIAL HOSPITAL |
| City | CHICAGO |
| State | IL |
| Zip Code | 60614-3363 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578752739 | Kids Urology. S.c. | Urology | 2300 N Childrens Plz # 24, Chicago, IL 60614-3363 | 2007-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487266516 | Taylor Connington | Pharmacist | 843 W Armitage Ave, Chicago, IL 60614 | 2020-08-19 |
| 1356975692 | Amarilis Diaz | Social Worker | Terry Hefter Associates, LLC, 1731 N. Marcey Suite 535, Chicago, IL 60614 | 2020-02-25 |
| 1457902975 | Michele Waggoner | Physical Therapist | 2515 N. Clark St, Chicago, IL 60614 | 2019-09-25 |
| 1669031936 | Justin Pomeroy | Acupuncturist | 1350 W. Schubert Ave., Chicago, IL 60614 | 2019-06-11 |
| 1801451547 | Amanda Harris | Counselor | 2451 N Lincoln Ave # 206, Chicago, IL 60614 | 2019-05-08 |
| 1780164574 | Danielle Trokey | Psychiatry & Neurology | 2515 N Clark St Ste 801, Chicago, IL 60614 | 2018-08-21 |
| 1841707353 | Madison Counseling Solutions LLC | Social Worker | 2502 N. Clark St., Chicago, IL 60614 | 2018-01-05 |
| 1386154011 | Allison Cooper Boyan | Occupational Therapist | 1640 N. Wells St., Unit 103, Chicago, IL 60614 | 2017-10-09 |
| 1245759653 | Eileen Davidson Siegel | Physician Assistant | 2073 N. Clybourn Ave., Chicago, IL 60614 | 2017-09-18 |
| 1447779814 | Elizabeth Hobart | Psychologist | 1800 W. Diversey Pkwy, Unit H, Chicago, IL 60614 | 2017-09-16 |
| Find all providers in zip 60614 | ||||
| Taxonomy Code | 2088P0231X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| Specialization | Pediatric Urology |
| Surgeons who can diagnose, treat, and manage children’s urinary and genital problems. A pediatric urologist devotes a minimum of 50% of his or her practice to the urologic problems of infants, children, and adolescents. Pediatric urologists generally provide the following services: the evaluation and management of voiding disorders; vesicoureteral reflux, and urinary tract infections that require surgery; surgical reconstruction of the urinary tract (kidneys, ureters, and bladder) including genital abnormalities, hypospadias, and intersex conditions; surgery for groin conditions in childhood and adolescence (undescended testes, hydrocele/hernia, varicocele). |
| Notes: Source: American Academy of Pediatrics [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578752739 | Kids Urology. S.c. | Urology | 2300 N Childrens Plz # 24, Chicago, IL 60614-3363 | 2007-10-23 |
| 1093892143 | John Houston | Urology | 2308 N Lincoln Ave, Chicago, IL 60614-3676 | 2006-11-01 |
| 1205126257 | Deborah Lynn Jacobson | Urology | 225 E Chicago Ave, Chicago, IL 60611-2991 | 2011-04-12 |
| 1457675233 | Edward Ming-luan Gong | Urology | 225 E Chicago Ave, Box 24, Chicago, IL 60611-2991 | 2010-03-23 |
| 1891962148 | David I-wang Chu | Urology | 225 E Chicago Ave, Chicago, IL 60611-2991 | 2008-05-14 |
| 1790968147 | Mohan Saheb Gundeti | Urology | 5841 S Maryland Ave, Mc 6038, Chicago, IL 60637-1447 | 2007-12-07 |
| 1366568784 | Emilie Johnson | Urology | 225 E Chicago Ave, Box 24, Chicago, IL 60611-2991 | 2007-03-21 |
| 1710973763 | Elizabeth Yerkes | Urology | 225 E Chicago Ave, Chicago, IL 60611-2991 | 2005-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528109006 | Associated Urological Specialists LLC | Urology | 16632 107th St, Orland Park, IL 60467-8898 | 2007-02-09 |
| 1326189895 | Associated Urological Specialists | Urology | 4440 W 95th St Ste 109-112, Oak Lawn, IL 60453-2600 | 2007-02-09 |
| 1518983998 | Pediatric Urology Partners | Urology | 1440 Renaissance Dr, Suite 220, Park Ridge, IL 60068-1356 | 2006-07-15 |
| 1841844917 | Blair Mack | Urology | 1775 Dempster St, Park Ridge, IL 60068-1174 | 2019-07-28 |
| 1316193824 | Derek John Matoka | Urology | 2160 S 1st Ave, Building 54, Maywood, IL 60153-3328 | 2008-08-15 |
| 1437311479 | Children's Urology Health Partners | Urology | 1440 Renaissance Dr, Suite 220, Park Ridge, IL 60068-1356 | 2008-07-01 |
| 1114952256 | L. Suzanne Flom | Urology | 8901 Golf Rd, Suite 301, Des Plaines, IL 60016-6850 | 2006-07-11 |
| 1447200357 | Ranjiv Ignatius Mathews | Urology | 301 N 8th St, Suite Pav 4b, Springfield, IL 62701-1041 | 2006-05-11 |
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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.