ROGER EWALD (NPI# 1598908733) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598908733 |
| Entity Type | Individual |
| Full Name | ROGER EWALD |
| Credential | M.D. |
| Practice Address |
819 Bloomington Rd Champaign IL 61820-2101 |
| Practice Telephone | 2174035401 |
| Practice Fax Number | 2173660160 |
| Mailing Telephone | 2174035401 |
| Mailing Fax Number | 2173660160 |
| Enumeration Date | 2009-04-17 |
| Last Update Date | 2009-04-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | 036043360 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | LICENSEE PHYSICIAN AND SURGEON | 036043360 | 01 |
| Street Address |
819 BLOOMINGTON RD |
| City | CHAMPAIGN |
| State | IL |
| Zip Code | 61820-2101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992770192 | Community Health Improvement Center | Clinic/Center | 819 Bloomington Rd, Champaign, IL 61820-2101 | 2006-02-21 |
| 1376166264 | Carlos Rodolfo Bocanegra Cordova | Physician Assistant | 819 Bloomington Rd, Champaign, IL 61820-2101 | 2020-05-26 |
| 1992324941 | Ryan Jordan Minier | Physician Assistant | 819 Bloomington Rd, Champaign, IL 61820-2101 | 2020-04-10 |
| 1972136620 | Doug C Smith | Social Worker | 819 Bloomington Rd, Champaign, IL 61820-2101 | 2020-02-20 |
| 1316592637 | Carrie Elizabeth Keenan | Physician Assistant | 819 Bloomington Rd, Champaign, IL 61820-2101 | 2019-08-04 |
| 1093283954 | River Andres | Physician Assistant | 819 Bloomington Rd, Champaign, IL 61820-2101 | 2018-11-08 |
| 1992290449 | Kaitlyn Cornell | Social Worker | 819 Bloomington Rd, Champaign, IL 61820 | 2018-06-27 |
| 1255833695 | Marisol Chirinos Tito | Physician Assistant | 819 Bloomington Rd, Champaign, IL 61820-2101 | 2018-03-01 |
| 1841713450 | Shellane Marie Tangen | Nurse Practitioner | 819 Bloomington Rd, Champaign, IL 61820-2101 | 2017-07-25 |
| 1215387501 | John S Anderson | Dentist | 819 Bloomington Rd, Champaign, IL 61820-2101 | 2016-06-16 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982217345 | Costco Wholesale Corporation | Pharmacy | 2002 N. Neil St., Champaign, IL 61820 | 2020-08-26 |
| 1255963583 | Jamey Richard Bailey | Social Worker | 701 Devonshire Drive, Bldg C, Suite 206, C-6, Champaign, IL 61820 | 2020-02-05 |
| 1790247443 | Jason Abrams | Counselor | 201 W Springfield Ave., Suite 1002-1003, Champaign, IL 61820 | 2019-04-02 |
| 1184100273 | Janine Rafferty | Pharmacist | 2002 N Neil St, Champaign, IL 61820 | 2018-07-12 |
| 1417475070 | Brodbeck Counseling, PC | Community/Behavioral Health | 301 N. Neil Street Suite 323, Champaign, IL 61820 | 2017-09-05 |
| 1447773726 | Quanata M Pelmore | Nurse's Aide | 508 E. Vine St, Champaign, IL 61820 | 2017-07-19 |
| 1821518127 | Molly Mclay | Social Worker | 309 W Clark St., Champaign, IL 61820 | 2017-06-27 |
| 1396265849 | Lou Echols Chambers | Audiologist | 901 South Sixth Street, Chamapign, IL 61820 | 2017-06-26 |
| 1962874495 | Luciana Angelica Guardini | Social Worker | 100 North Chestnut Street, Suite 244, Champaign, IL 61820 | 2015-10-23 |
| 1538544465 | Cpo Services, Inc. | Prosthetic/Orthotic Supplier | 410 E University Ave Ste 105, Champaign, IL 61820 | 2015-07-21 |
| Find all providers in zip 61820 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073694303 | James Robert Kresca | Ophthalmology | 2011 Round Barn Rd, Champaign, IL 61821-6825 | 2006-10-17 |
| 1104918176 | Samir I. Sayegh | Ophthalmology | 2151 S Neil St, Champaign, IL 61820-7593 | 2006-09-28 |
| 1386612927 | Bette L Anderson | Ophthalmology | 3015 Village Office Pl, Champaign, IL 61822-7674 | 2006-03-09 |
| 1710321310 | Ruidi Wang | Ophthalmology | 3105 Fields South Dr, Champaign, IL 61822-3743 | 2013-04-25 |
| 1700927597 | Kresca Eye Clinic,ltd. | Ophthalmology | 2011 Round Barn Rd, Champaign, IL 61821-6825 | 2007-02-12 |
| 1760572085 | Frank Joseph Kresca | Ophthalmology | 2011 Round Barn Rd, Champaign, IL 61821-6825 | 2006-10-15 |
| 1083621544 | Douglas S. Bull | Ophthalmology | 3101 Fields South Dr, Champaign, IL 61822-3743 | 2006-08-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104433473 | Chicagoland Eye Consultants, Sc | Ophthalmology | 477 E Butterfield Rd Ste 101, Lombard, IL 60148-4880 | 2020-09-30 |
| 1649894189 | Lakeshore Ophthalmology, LLC | Ophthalmology | 2525 S Michigan Ave Fl 8, Chicago, IL 60616-2315 | 2020-06-01 |
| 1053940460 | Neil L Ross | Ophthalmology | 950 N Michigan Ave Apt 5403, Chicago, IL 60611-7535 | 2020-04-07 |
| 1932730256 | Cereesa E. Longest Md Sc | Ophthalmology | 225 Oak Knoll Rd, Barrington, IL 60010-2615 | 2020-01-27 |
| 1497314181 | Ophthalmology Surgery Center of Illinois, LLC | Ophthalmology | 1300 N Arlington Heights Rd Ste 150, Itasca, IL 60143-3128 | 2019-06-06 |
| 1770149049 | Rop Consultants LLC | Ophthalmology | 5228 N Virginia Ave, Chicago, IL 60625-4015 | 2019-05-13 |
| 1962969881 | Monique Munro | Ophthalmology | 1855 W Taylor Street. Suite 3138 Illinois Eye and Infir, Chicago, IL 60612 | 2019-02-27 |
| 1679039457 | Laser and Cataract Institute, LLC | Ophthalmology | 22200 Wolf Rd, Frankfort, IL 60423-7721 | 2019-02-15 |
| 1063987345 | Chataam Optical LLC | Ophthalmology | 8741 S Greenwood Ave Ste 108, Chicago, IL 60619-7058 | 2018-10-12 |
| 1922507474 | Dekalb Eye Consultants, LLC | Ophthalmology | 1075 Featherstone Rd Ste 10, Rockford, IL 61107-5906 | 2018-02-09 |
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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.