KEDZIE MEDICAL CLINIC INC (NPI# 1558593947) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558593947 |
| Entity Type | Organization |
| Organization Name | KEDZIE MEDICAL CLINIC INC |
| Practice Address |
262 N Kedzie Ave Chicago IL 60612-1869 |
| Practice Telephone | 8479047500 |
| Enumeration Date | 2009-08-18 |
| Last Update Date | 2009-08-18 |
| Authorized Official Name | GOHAR AKOPYAN (CMM) |
| Authorized Official Telephone | 8479047500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0000X |
Family Medicine Specialization: Adolescent Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
262 N KEDZIE AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60612-1869 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538202692 | Kedzie Drugs Inc | Pharmacy | 262 N Kedzie Ave, Chicago, IL 60612-1869 | 2007-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144839739 | Sandhya Shri Kannayiram | Internal Medicine | 1901w Harrison Street, Chicago, IL 60612 | 2020-07-29 |
| 1568080174 | Nastaran Ordoyo Haghani Rad | Student in an Organized Health Care Education/Training Program | 1950 W. Polk Street, Room 6203, Chicago, IL 60612 | 2020-07-09 |
| 1669090403 | Marianne Gagnon-konamna | Student in an Organized Health Care Education/Training Program | 1950 West Polk Street, Chicago, IL 60612 | 2020-07-08 |
| 1922625672 | Tanya Montgomery Nee Brown | Pediatrics | 1950 West Polk Street, Neonatal and Perinatal Department, Chicago, IL 60612 | 2020-06-29 |
| 1124643028 | Ashley Swan | Dentist | 801 S. Paulina St, Uic College of Dentistry - Endodontics Clinic, Chicago, IL 60612 | 2020-06-16 |
| 1831711381 | Baillie Anne Bronner | Obstetrics & Gynecology | 1653 W Congress Pkwy Chicago, Il 60612, Chicago, IL 60612 | 2020-05-07 |
| 1154942449 | Keisha Davell Cole | Case Manager/Care Coordinator | 612 S Western Ave Unit 1, Chicago, IL 60612 | 2020-04-28 |
| 1275153777 | Isac Lim | Student in an Organized Health Care Education/Training Program | 1234 S. Wells, Chicago, IL 60612 | 2020-04-24 |
| 1578183414 | Zachary Belden | Student in an Organized Health Care Education/Training Program | Uic Psychiatry Residency 912 S. Wood St., Rm 130b Npi-s (mc 913), Chicago, IL 60612 | 2020-04-21 |
| 1548880560 | Christina Nunez | Student in an Organized Health Care Education/Training Program | 801 S. Paulina Street, M/c 850, Chicago, IL 60612 | 2020-04-20 |
| Find all providers in zip 60612 | ||||
| Taxonomy Code | 207QA0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Adolescent Medicine |
| A family medicine physician with multidisciplinary training in the unique physical, psychological and social characteristics of adolescents and their health care problems and needs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023517331 | Chicago Medical Healthcare Group, S.c. | Family Medicine | 3648 W Armitage Avenue, Chicago, IL 60647 | 2018-02-02 |
| 1548492234 | 63rd Advanced Health Clinic Inc | Family Medicine | 1249 W 63rd St, Chicago, IL 60636-1947 | 2009-08-14 |
| 1518969518 | Ghousia Begum Ali | Family Medicine | 2136 W Devon Ave, Chicago, IL 60659-2127 | 2005-08-10 |
| 1568099380 | Bianca Jenkins | Family Medicine | 251 E Huron St, Chicago, IL 60611-2908 | 2020-03-23 |
| 1740779024 | Karen Batty | Family Medicine | 3000 S King Dr, Chicago, IL 60616-3452 | 2018-05-02 |
| 1629204961 | Sarah Jahns Kidder | Family Medicine | 800 E 55th St, Chicago, IL 60615 | 2009-06-01 |
| 1548404031 | Ebony R Copeland | Family Medicine | 836 W Wellington Ave, Chicago, IL 60657-5147 | 2009-04-28 |
| 1386770642 | Rosa Subero | Family Medicine | 3600 W Fullerton Ave, Chicago, IL 60647-2319 | 2007-02-23 |
| 1649325929 | Nela Rodriguez Cordero | Family Medicine | 2002 N Damen Ave, Chicago, IL 60647-4527 | 2007-01-24 |
| 1992811178 | Trv - Family Medicine, Ltd. | Family Medicine | 2740 W Foster Ave, Suite 214, Chicago, IL 60625-3500 | 2006-08-21 |
| Find all providers in CHICAGO | ||||
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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.