MRS. NANCY ALICE WAHLSTROM (NPI# 1578837746) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578837746 |
| Entity Type | Individual |
| Full Name | MRS. NANCY ALICE WAHLSTROM |
| Credential | CSFA/CST |
| Practice Address |
2730 Brassie Ave Flossmoor IL 60422-1822 |
| Practice Telephone | 7083631317 |
| Mailing Telephone | 7083631317 |
| Enumeration Date | 2012-03-05 |
| Last Update Date | 2012-03-05 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 246ZC0007X |
Specialist/Technologist, Other Specialization: Surgical Assistant |
Technologists, Technicians & Other Technical Service Providers |
| Street Address |
2730 BRASSIE AVE |
| City | FLOSSMOOR |
| State | IL |
| Zip Code | 60422-1822 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588274310 | Miranda Home Health Care Inc | Nursing Care | 19150 S. Kedzie Ave, 203, Flossmoor, IL 60422 | 2020-08-06 |
| 1285256172 | Bp Behavioral Services, LLC | Behavioral Analyst | 2222 Marston Lane, Flossmoor, IL 60422 | 2020-05-13 |
| 1891164133 | Lauren Simpson | Behavioral Analyst | 19530 Kezie Avenue, Flossmoor, IL 60422 | 2015-09-16 |
| 1437541190 | Keshawn Gardner | Specialist/Technologist, Other | 1248 Berry Ln, Flossmoor, IL 60422 | 2015-03-04 |
| 1770989717 | Naomi Kelly | Behavioral Analyst | 1930 Kedzie Avenue, Flossmoor, IL 60422 | 2014-11-18 |
| 1093059453 | Miranda Home Health Care Inc | In Home Supportive Care | 19150 S Kedzie Ave, 203, Flossmoor, IL 60422 | 2012-11-23 |
| 1285981506 | Restorative Life Services, LLC | Social Worker | 169624 Governors Highway, Flossmoor, IL 60422 | 2012-08-06 |
| 1063786457 | Gwyneeda Carter-sidberry | Pharmacist | 1443 Selkirk Street, Flossmoor, IL 60422 | 2012-03-02 |
| 1053682021 | Alfonso Javier Medina Sr. | Anesthesiology | 3141 Stonegate Ct., Flossmoor, IL 60422 | 2012-01-23 |
| 1912121161 | Anthony J Maoloni | Dentist | 19815 Governors Highway, Orthodontic Associates Ltd Suite 1, Flossmoor, IL 60422 | 2007-04-12 |
| Find all providers in zip 60422 | ||||
| Taxonomy Code | 246ZC0007X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Specialist/Technologist, Other |
| Specialization | Surgical Assistant |
| A surgical assistant is a skilled practitioner who has undergone formalized education and training as a surgical assistant. The surgical assistant performs surgical functions that include, but are not limited to: retracting, manipulating, suturing, clamping, cauterizing, litigating, and tying tissue; suctioning, irrigating and sponging; positioning the patient; closure of body planes and skin; and participating in hemostasis and volume replacement. Surgical assistants are certified and registered or licensed by the state, or, in states without licensure, certified as surgical assistants by completing appropriate education and training. |
| Notes: Source: Association of Surgical Assistants, 2014. [7/1/2014: title modified, definition modified] http://www.surgicalassistant.org/index.php/surgical-assisting Additional Resources: National Surgical Assistant Association, www.nsaa.net. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437541190 | Keshawn Gardner | Specialist/Technologist, Other | 1248 Berry Ln, Flossmoor, IL 60422 | 2015-03-04 |
| 1245744515 | Chief Surgical Assistants | Specialist/Technologist, Other | 1248 Berry Ln, Flossmoor, IL 60422 | 2017-11-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568072288 | Jaime Viramontes Jr. | Specialist/Technologist, Other | 2725 Technology Dr, Lombard, IL 60148-5675 | 2020-08-06 |
| 1215545660 | Ghirri Health Care Inc | Specialist/Technologist, Other | 9101 Falcon Ridge Dr, Bridgeview, IL 60455-2608 | 2020-07-21 |
| 1649896606 | Eric Dupaya | Specialist/Technologist, Other | 6432 S Eberhart Ave, Chicago, IL 60637-3325 | 2020-06-24 |
| 1508482027 | Juan Carlos Diaz | Specialist/Technologist, Other | 1433 W Flournoy St Apt 3f, Chicago, IL 60607-3213 | 2020-06-20 |
| 1528682275 | Alan George | Specialist/Technologist, Other | 606 N Van Auken St, Elmhurst, IL 60126-1947 | 2020-05-28 |
| 1881215416 | Brianne O'leary | Specialist/Technologist, Other | 2413 Sunrise Cir, Aurora, IL 60503-6757 | 2020-05-05 |
| 1669006433 | Michael Howard Keller | Specialist/Technologist, Other | 414 Chapel St, Marengo, IL 60152-3016 | 2020-03-02 |
| 1205487543 | Muneif Abusaleh | Specialist/Technologist, Other | 10536 Forest Ln, Chicago Ridge, IL 60415-1820 | 2019-09-27 |
| 1831752773 | Bienvenido Camacho | Specialist/Technologist, Other | 7900 W Deerwood Dr, Palos Park, IL 60464-2155 | 2019-04-16 |
| 1992278196 | Deangela Roberson | Specialist/Technologist, Other | 1212 N. Lasalle, Ste 100/ Surgery Center, Chicago, IL 60610 | 2019-01-10 |
| 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.