DR. HARESH K MOTWANI (NPI# 1598841025) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598841025 |
| Entity Type | Individual |
| Full Name | DR. HARESH K MOTWANI |
| Credential | MD. |
| Practice Address |
2133 Vadalabene Dr Suite # 5b Maryville IL 62062-5839 |
| Practice Telephone | 6182887605 |
| Practice Fax Number | 6182887644 |
| Mailing Telephone | 6182887605 |
| Mailing Fax Number | 6182887644 |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2015-07-20 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | 036117061 | IL | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | 036.117061 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE CROSS BLUE SHIELD | 08232204 | 01 |
| IL | 036117061 5 | 05 | |
| IL | 036117061 | 05 | |
| IL | BLUE CROSS BLUE SHIELD | 08232205 | 01 |
| MO | 1598841025 | 05 |
| Street Address |
2133 VADALABENE DR SUITE # 5B |
| City | MARYVILLE |
| State | IL |
| Zip Code | 62062-5839 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457870131 | Tayler Rae Fazil | Audiologist | 2133 Vadalabene Dr, Maryville, IL 62062-5839 | 2017-09-14 |
| 1881075661 | Chelsea Jackson | Physician Assistant | 2133 Vadalabene Dr, Suite 1, Maryville, IL 62062-5839 | 2015-06-17 |
| 1013397967 | Katherine Anne Burnley | Nurse Practitioner | 2133 Vadalabene Dr, Suite 5b, Maryville, IL 62062-5839 | 2015-06-05 |
| 1053711895 | Msa Alliance, LLC | Surgery | 2133 Vadalabene Dr, Suite 2, Maryville, IL 62062-5839 | 2014-08-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104325091 | Jennifer M Oyler | Physician Assistant | 6812 State Route 162 Suite 120, Maryville, IL 62062 | 2018-02-06 |
| 1710495965 | Sarah Elizabeth Barto | Family Medicine | 2133 Vadalabene Drive, Suite Sb, Maryville, IL 62062 | 2018-01-22 |
| 1104348085 | Lindsey Nicole Langendorf | Chiropractor | 62 Executive Plaza Ct, Maryville, IL 62062 | 2017-07-12 |
| 1043750540 | Gina Saal | Nurse Anesthetist, Certified Registered | 6800 Rt 162, Maryville, IL 62062 | 2017-03-02 |
| 1548657737 | Karen Michelle Bertels | Emergency Medicine | 6800 Il - 162, Maryville, IL 62062 | 2015-04-25 |
| 1811258148 | Debra Ann Hoelscher | Internal Medicine | 2102 Vadalabene, Maryville, IL 62062 | 2012-06-04 |
| 1538438445 | Casey Elizabeth Wiesemeyer | Speech-Language Pathologist | 2201 Copper Creek Rd, Maryville, IL 62062 | 2011-12-21 |
| 1407144819 | Norah Claire Farley Baker | Family Medicine | 10 Professional Park Dr., Maryville, IL 62062 | 2011-07-19 |
| 1891092474 | Kimberly M Schneider | Physician Assistant | 20b Professional Park Drive, Maryville, IL 62062 | 2011-02-17 |
| 1669782397 | Purandhri Patel | Physical Therapist | 6820 State Route 162, Maryville, IL 62062 | 2010-10-15 |
| Find all providers in zip 62062 | ||||
| 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 |
|---|---|---|---|---|
| 1124633995 | Continuum Family Care LLC | Family Medicine | 2336 S Main St, Maryville, MO 64468-3622 | 2020-09-09 |
| 1619530029 | Pamela Gail Byrd | Family Medicine | 934 Dunkirk Dr, Maryville, TN 37801-8990 | 2019-04-22 |
| 1710495965 | Sarah Elizabeth Barto | Family Medicine | 2133 Vadalabene Drive, Suite Sb, Maryville, IL 62062 | 2018-01-22 |
| 1134504012 | Dallas Mullock | Family Medicine | 2332 S Main St, Maryville, MO 64468-3622 | 2015-07-21 |
| 1649538802 | Easterly Family Medicine | Family Medicine | 104 Parliament Drive, Maryville, TN 37804-6209 | 2012-04-25 |
| 1407144819 | Norah Claire Farley Baker | Family Medicine | 10 Professional Park Dr., Maryville, IL 62062 | 2011-07-19 |
| 1275854465 | Charles S Fillingane II | Family Medicine | 2336 S Main St Lowr Level, Maryville, MO 64468-3622 | 2010-06-22 |
| 1083767479 | Metro East Healthcare Limited | Family Medicine | 2133 Vadalabene Dr Ste 5b, Maryville, IL 62062-5839 | 2007-01-19 |
| 1356368310 | Blount Memorial Hospital, Inc. | Family Medicine | 116 Chantilly Ln, Maryville, TN 37803-6102 | 2006-07-16 |
| 1821032285 | Jonathan F Greene | Family Medicine | 720 Foothills Mall Dr, Maryville, TN 37801-3519 | 2006-06-16 |
| Find all providers in MARYVILLE | ||||
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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.