CHICAGO NEUROPATHOLOGY SERVICE (NPI# 1619946993) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619946993 |
| Entity Type | Organization |
| Organization Name | CHICAGO NEUROPATHOLOGY SERVICE |
| Practice Address |
5 Revere Dr Suite 200 Northbrook IL 60062-1566 |
| Mailing Address |
Dept 77-9452 Chicago IL 60678-9452 |
| Practice Telephone | 8474987512 |
| Mailing Telephone | 8476760091 |
| Mailing Fax Number | 8476762374 |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | JAMIE JACOBSOHN (PRESIDENT) |
| Authorized Official Telephone | 8474987512 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 207ZN0500X |
Pathology Specialization: Neuropathology |
IL | Allopathic & Osteopathic Physicians | |
| X | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE CROSS BLUE SHIELD | 01623068 | 01 |
| Street Address |
5 REVERE DR SUITE 200 |
| City | NORTHBROOK |
| State | IL |
| Zip Code | 60062-1566 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366060329 | Maggie Kaiser | Behavior Technician | 5 Revere Dr, Northbrook, IL 60062-1566 | 2020-07-07 |
| 1518588664 | Amanda Danielle Ferbrache | Behavior Technician | 5 Revere Dr, Northbrook, IL 60062-1566 | 2020-04-29 |
| 1376173427 | Scot Thomas Anderson | Behavior Technician | 5 Revere Dr, Northbrook, IL 60062-1566 | 2020-01-16 |
| 1689213647 | Camryn Rose Friedman | Behavior Technician | 5 Revere Dr, Northbrook, IL 60062-1566 | 2019-12-22 |
| 1649815515 | Mirela Holic | Behavior Technician | 5 Revere Dr, Northbrook, IL 60062-1566 | 2019-11-14 |
| 1558904342 | Lauren Ann Spakausky | Behavior Technician | 5 Revere Dr, Northbrook, IL 60062-1566 | 2019-10-24 |
| 1962045260 | Sarah Lucia Reid | Behavior Technician | 5 Revere Dr, Northbrook, IL 60062-1566 | 2019-10-21 |
| 1699317347 | Melinda Mikes | Behavior Technician | 5 Revere Dr, Northbrook, IL 60062-1566 | 2019-10-15 |
| 1639727902 | Elizabeth A Flores | Behavior Technician | 5 Revere Dr, Northbrook, IL 60062-1566 | 2019-08-29 |
| 1730734393 | Rocherr Landrum | Behavior Technician | 5 Revere Dr, Northbrook, IL 60062-1566 | 2019-08-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508487067 | Cvs Aoc Services, L.L.C. | Optometrist | 936 Willow Road, Store 0141, Northbrook, IL 60062 | 2020-05-06 |
| 1386103885 | Jennifer Venegas | Behavior Technician | 5 Revere Dr Suit 120, Northbrook, IL 60062 | 2019-03-14 |
| 1720558281 | Taylor Hundley | Behavior Technician | 5 Revere Dr. Suite 120, Northbrook, IL 60062 | 2018-11-27 |
| 1609344027 | Melissa Cepeda | Behavior Technician | 5 Revere Dr Suite 120, Northbrook, IL 60062 | 2018-11-03 |
| 1235606658 | Candace Cheyenne Kaiser | Behavior Technician | 5 Revere Dr, Suite 120, Northbrook, IL 60062 | 2018-10-24 |
| 1275058745 | The Renfrew Center of Illinois | Counselor | 5 Revere Dr, Suite 100, Northbrook, IL 60062 | 2017-08-07 |
| 1467984773 | Ayzenshteyn Chiropractic | Chiropractor | 3210 Doolittle Dr., Northbrook, IL 60062 | 2017-03-28 |
| 1396282695 | Josephine Driscoll | Physician Assistant | 400 Skokie Blvd., Suite 450, Northbrook, IL 60062 | 2017-01-24 |
| 1396297842 | Lauren Raphael Lcsw LLC | Social Worker | 3050 Pheasant Creek Drive, Apt. 104, Northbrook, IL 60062 | 2016-11-01 |
| 1851847073 | Jassim Vailoces | Physical Therapist | 634 Academy Dr, Northbrook, IL 60062 | 2016-08-28 |
| Find all providers in zip 60062 | ||||
| Taxonomy Code | 207ZN0500X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Neuropathology |
| A neuropathologist is expert in the diagnosis of diseases of the nervous system and skeletal muscles and functions as a consultant primarily to neurologists and neurosurgeons. The neuropathologist is knowledgeable in the infirmities of humans as they affect the nervous and neuromuscular systems, be they degenerative, infectious, metabolic, immunologic, neoplastic, vascular or physical in nature. |
| 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 Pathology, 2007. http://www.abpath.org/. American Osteopathic Board of Pathology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pathology. The Certification is NO longer provided. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235595315 | Marc Reyes | Pathology | 3413 Summerhill Dr, Woodridge, IL 60517-1255 | 2016-01-05 |
| 1578826079 | Alexander Zane Feldman | Pathology | 3214 N Halsted St Apt 1af, Chicago, IL 60657 | 2012-06-19 |
| 1205138997 | Jan Edward Leestma | Pathology | 1440 N Kingsbury St, Suite 210, Chicago, IL 60642-2651 | 2010-12-01 |
| 1053514513 | Qinwen Mao | Pathology | 710 N Fairbanks Ct Ste 2-458, Chicago, IL 60611-3013 | 2007-06-11 |
| 1982639001 | Daniel Jay Brat | Pathology | 303 E Chicago Ave # 3140w127, Chicago, IL 60611-4296 | 2006-07-11 |
| 1639145311 | Eileen Bigio | Pathology | 710 N Fairbanks Ct, Olson 2-459, Chicago, IL 60611-3013 | 2006-02-23 |
| 1023566288 | Kwok Ling Kam | Pathology | 211 E Ohio St, Chicago, IL 60611-3262 | 2016-09-16 |
| 1598185308 | Xinhai Robert Zhang | Pathology | 1653 W Congress Pkwy, Chicago, IL 60612 | 2014-04-19 |
| 1386089977 | Missia Elizabeth Kohler-skinner | Pathology | 240 E Huron St, Chicago, IL 60611-2909 | 2013-05-08 |
| 1174810188 | Sukriti Nag | Pathology | 1653 W Congress Pkwy, Chicago, IL 60612-3833 | 2011-06-29 |
| Find all providers with the same taxonomy | ||||
| City | NORTHBROOK |
| Zip Code | 60062 |
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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.