KEITH J CERMAK (NPI# 1609200971) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1609200971 |
Entity Type | Individual |
Full Name | KEITH J CERMAK |
Credential | NP |
Practice Address |
5198 Reliable Pkwy Chicago IL 60686-0051 |
Mailing Address |
2013 Woodhavens Dr Bloomington IL 61701-7802 |
Practice Telephone | 8476152200 |
Practice Fax Number | 8476152828 |
Mailing Telephone | 8476152200 |
Mailing Fax Number | 8476152828 |
Enumeration Date | 2013-08-22 |
Last Update Date | 2013-09-04 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
209010665 | IL | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
5198 RELIABLE PKWY |
City | CHICAGO |
State | IL |
Zip Code | 60686-0051 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1174765945 | Mclaren Oakland | Clinic/Center | 8172 Reliable Pkwy, Chicago, IL 60686-0001 | 2009-03-25 |
1053566182 | Kathryn A Davidson | Counselor | 2683 Reliable Pkwy, Chicago, IL 60686-0001 | 2008-11-17 |
1356590525 | Keith A Roberts | Optometrist | 5855 Reliable Pkwy, Chicago, IL 60686-0001 | 2008-09-12 |
1194775858 | Mandar A Pattekar | Radiology | 5200 Reliable Parkway, Chicago, IL 60686-0001 | 2006-05-11 |
1467447268 | Mark B Austin | Pathology | 6810 Reliable Pkwy, Chicago, IL 60686-0001 | 2005-09-19 |
1326042235 | Wayne Macomb Diagnostic Imaging Center Inc | Radiology | 8690 Reliable, Chicago, IL 60686-0001 | 2005-06-09 |
1235133141 | Macomb Magnetic Resonance Imaging Center Inc | Radiology | 8956 Reliable Parkway, Chicago, IL 60686-0001 | 2005-06-09 |
1528019437 | Craig A Fenton | Radiology | 5200 Reliable Parkway, Chicago, IL 60686-0001 | 2006-05-15 |
1578514543 | Stephen M Smith | Radiology | 5200 Reliable Parkway, Chicago, IL 60686-0001 | 2006-05-15 |
1134170004 | James A Mcgee | Radiology | 5200 Reliable Parkway, Chicago, IL 60686-0001 | 2006-05-15 |
Find all providers in zip 60686 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932700911 | Laura Ivette Portillo | Nurse Practitioner | 2727 N Marmora Ave, Chicago, IL 60639-1219 | 2020-11-05 |
1265033385 | Carolle M Derradji | Nurse Practitioner | 3256 W Potomac Ave, Chicago, IL 60651-2411 | 2020-11-04 |
1104427293 | Katie Michelle O'halloran | Nurse Practitioner | 5841 S Maryland Ave # E500, Chicago, IL 60637-1443 | 2020-11-04 |
1578163515 | Deanna Bassette | Nurse Practitioner | 243 E 31st St Apt 401, Chicago, IL 60616-5212 | 2020-10-29 |
1891395745 | Vrunda Shah Patel | Nurse Practitioner | 933 W Van Buren St Apt 502, Chicago, IL 60607-3583 | 2020-10-29 |
1881291706 | Rita Elue | Nurse Practitioner | 6241 N Winthrop Ave Apt 307, Chicago, IL 60660-2071 | 2020-10-04 |
1558976514 | Janice Nicole Kinney | Nurse Practitioner | 10127 S Harding Ave, Chicago, IL 60655-3748 | 2020-09-15 |
1881209278 | Monique Graves | Nurse Practitioner | 4912 W Adams St Apt 2, Chicago, IL 60644-4445 | 2020-09-11 |
1194339721 | Maureen Iyesogie Diji | Nurse Practitioner | 4658 S Ellis Ave, Chicago, IL 60653-3625 | 2020-09-01 |
1669085395 | Emily Calderon | Nurse Practitioner | 5556 N Sheridan Rd Apt 506, Chicago, IL 60640-1677 | 2020-08-24 |
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.