DR. THEODORE G JAMES (NPI# 1598741050) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598741050 |
| Entity Type | Individual |
| Full Name | DR. THEODORE G JAMES |
| Credential | MD |
| Practice Address |
2310 York St Ste 2c Blue Island IL 60406-2411 |
| Mailing Address |
10660 W 143rd St Ste B Orland Park IL 60462-1982 |
| Practice Telephone | 7083884903 |
| Practice Fax Number | 7083880043 |
| Mailing Telephone | 7084604499 |
| Mailing Fax Number | 7084608031 |
| Enumeration Date | 2005-12-16 |
| Last Update Date | 2015-04-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 036039906 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036039906 | 05 | |
| RR MEDICARE | 080178217 | 01 | |
| IL | BLUE SHIELD | 1626986 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841726593 | Theodore James | Student in an Organized Health Care Education/Training Program | Geisinger Medical Ctr, 100 North Academy Avenue, Danville, PA 17822-0001 | 2017-05-01 |
| 1003159559 | Theodore William James | Internal Medicine | 200 1st St Sw, Rochester, MN 55905-0001 | 2013-04-03 |
| Street Address |
2310 YORK ST STE 2C |
| City | BLUE ISLAND |
| State | IL |
| Zip Code | 60406-2411 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477553188 | Robert Ethan Applebaum | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2310 York St, Suite 3a, Blue Island, IL 60406-2411 | 2005-07-22 |
| 1013292457 | Rafiq Ahmed M.d., S.c. | Clinic/Center | 2310 York St, Suite 2b, Blue Island, IL 60406-2411 | 2011-10-17 |
| 1396074753 | Sa Padua Medical Center, LLC | Family Medicine | 2310 York St, Suite 2c, Blue Island, IL 60406-2411 | 2009-12-15 |
| 1457546848 | Laurie Sue Gordon | Dentist | 2310 York St, 4b, Blue Island, IL 60406-2411 | 2007-09-10 |
| 1528079977 | Neurodiagnostic Services Ltd | Psychiatry & Neurology | 2310 York St, #2c, Blue Island, IL 60406-2411 | 2006-08-11 |
| 1154343408 | Rafiq Ahmed | Internal Medicine | 2310 York St, Suite 2b, Blue Island, IL 60406-2411 | 2006-07-24 |
| 1851330302 | William W Ashley | Internal Medicine | 2310 York St, Blue Island, IL 60406-2411 | 2006-06-06 |
| 1831145325 | Newport Medical Associates, Ltd | Internal Medicine | 2310 York St, Blue Island, IL 60406-2411 | 2006-05-26 |
| 1972558757 | Hope Medical Sc | Internal Medicine | 2310 York St, Suite 3c, Blue Island, IL 60406-2411 | 2006-05-23 |
| 1336120807 | Gregorio M Tolentino Jr. | Radiology | 2310 York St, Suite M, Blue Island, IL 60406-2411 | 2005-11-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780205708 | Cook County | Family Medicine | 12757 S. Western Ave, Blue Island, IL 60406 | 2020-04-30 |
| 1942842810 | Blue Island Smiles PC | Dentist | 12059 Western Avenue, Blue Island, IL 60406 | 2019-10-12 |
| 1609438738 | Maisha Safford | Developmental Therapist | 2262 W. 120th Place, Blue Island, IL 60406 | 2019-06-28 |
| 1891279709 | Renjith Thomas | Physical Therapy Assistant | Therapy Department, 1546 W Water Stret, Blue Island, IL 60406 | 2018-09-18 |
| 1982182994 | Lifehouse Health Group,llc | Clinic/Center | 14127 Levitt Ave, Dixmoor, IL 60406 | 2018-08-01 |
| 1063923159 | Sarah Lynn Presser | Speech-Language Pathologist | 2975 W Broadway, Blue Island, IL 60406 | 2017-10-17 |
| 1174070676 | Aunt Martha's Youth Service Center | Clinic/Center | 12139 S. Western Ave, Blue Island, IL 60406 | 2016-09-01 |
| 1427429141 | Pamela Kilcrease | Case Manager/Care Coordinator | 2247 119th Street, Apt 6, Blue Island, IL 60406 | 2015-10-08 |
| 1639587025 | D2 Dental At Oak Street, P.C. | Dentist | 3046 West 127th Street, Blue Island, IL 60406 | 2014-07-29 |
| 1700299658 | Daniel Ahrens | Optometrist | 13114 S Western Ave, Blue Island, IL 60406 | 2014-06-09 |
| Find all providers in zip 60406 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, 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 Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811174105 | Humaira Khan | Family Medicine | 2310 York Street, 2a Pavilion, Blue Island, IL 60406-2428 | 2008-01-29 |
| 1700400744 | Cook County | Family Medicine | 12757 South Western Avenue, Blue Island, IL 60406 | 2020-06-05 |
| 1023549821 | Patrick Hines | Family Medicine | 3046 127th St, Blue Island, IL 60406-1827 | 2017-03-23 |
| 1801273362 | Jaydeep Khudai | Family Medicine | 2320 High St, Blue Island, IL 60406-2426 | 2015-05-04 |
| 1275952731 | Avinash Mantha | Family Medicine | 3046 127th St, Blue Island, IL 60406-1827 | 2014-04-14 |
| 1609148139 | Blue Island Clinic Company LLC | Family Medicine | 12935 Gregory St, Blue Island, IL 60406-2428 | 2012-01-30 |
| 1093007221 | Daniel James Fitzgerald | Family Medicine | 12935 Gregory St, Blue Island, IL 60406 | 2011-05-05 |
| 1396074753 | Sa Padua Medical Center, LLC | Family Medicine | 2310 York St, Suite 2c, Blue Island, IL 60406-2411 | 2009-12-15 |
| 1932349040 | Francisco Pereiro | Family Medicine | 2320 High St, Blue Island, IL 60406-2426 | 2009-03-02 |
| 1225286412 | Msmc Investors, LLC | Family Medicine | 12935 Gregory St, Blue Island, IL 60406-2428 | 2008-09-03 |
| Find all providers in BLUE ISLAND | ||||
| City | BLUE ISLAND |
| Zip Code | 60406 |
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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.