DR. K. JOD TAYWADITEP (NPI# 1629171749) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629171749 |
| Entity Type | Individual |
| Full Name | DR. K. JOD TAYWADITEP |
| Other Name | DR. KITTIWUT J. TAYWADITEP |
| Credential | PH.D. |
| Practice Address |
633 Emerson St Evanston IL 60208-0844 |
| Practice Telephone | 8474912151 |
| Mailing Telephone | 8474912151 |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2009-07-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
71006528 | IL | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE CROSS BLUE SHIELD | 01634395 | 01 |
| Street Address |
633 EMERSON ST |
| City | EVANSTON |
| State | IL |
| Zip Code | 60208-0844 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952395659 | Lisa Reeder | Internal Medicine | 633 Emerson St, Evanston, IL 60208-0844 | 2005-09-08 |
| 1891321188 | Meghan Mckeever | Registered Nurse | 633 Emerson St, Evanston, IL 60208-0844 | 2020-03-18 |
| 1376010678 | Teresa Michelle Kikugawa | Specialist/Technologist | 633 Emerson St, Evanston, IL 60208-0844 | 2018-10-25 |
| 1962911131 | Rebecca Heneghan | Pharmacist | 633 Emerson St, Evanston, IL 60208-0844 | 2017-09-20 |
| 1619378940 | Amber Marie Parish | Pharmacist | 633 Emerson St, Evanston, IL 60208-0844 | 2014-09-05 |
| 1265798813 | Tony Purkal | Emergency Medical Technician, Basic | 633 Emerson St, Evanston, IL 60208-0844 | 2012-04-09 |
| 1225303712 | Natalie Kramer | Specialist/Technologist | 633 Emerson St, Evanston, IL 60208-0844 | 2012-03-15 |
| 1710276696 | Bettina Ute Bohle-frankel | Psychiatry & Neurology | 633 Emerson St, Caps, Evanston, IL 60208-0844 | 2011-03-31 |
| 1447557723 | Northwestern University | Clinic/Center | 633 Emerson St, Evanston, IL 60208-4000 | 2011-02-22 |
| 1245536192 | Pamela W Hazard | Psychiatry & Neurology | 633 Emerson St, Evanston, IL 60208-4000 | 2011-02-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437128089 | Courtney Jones | Specialist/Technologist | 1501 Central St., Evanston, IL 60208 | 2006-03-16 |
| 1467456004 | Bridget A Hannum | Nurse Practitioner | Northwestern University 633 Emerson, Evanston, IL 60208 | 2005-06-10 |
| 1891947727 | Catherine Anne Fabian | Audiologist | 2315 Campus Dr, Evanston, IL 60208 | 2008-10-22 |
| 1417487471 | Jack Scott | Audiologist | 2315 Campus Drive Nucasll, Evanston, IL 60208-0001 | 2017-06-13 |
| 1588038699 | Robin Lynn Dodds | Developmental Therapist | Center for Audiology Speech Language And, Northwestern University 2315 Campus Drive, Evanston, IL 60208-0001 | 2015-12-01 |
| 1831565936 | Natalie Morales | Specialist/Technologist | 2255 Campus Drive, Evanston, IL 60208-0001 | 2015-08-12 |
| 1750612115 | Northwestern University Intercollegiate Sports Medicine | Clinic/Center | 2703 Ashland Ave, Northwestern University Sports Medicine, Evanston, IL 60208-0001 | 2010-01-26 |
| 1609927417 | Kimberly A Seipel-carrow | Pediatrics | Northwestern University Health Services, 633 Emerson, Evanston, IL 60208-0001 | 2007-01-16 |
| 1114551793 | Peter Ritz | 2255 Campus Drive, Evanston, IL 60208-0001 | 2020-02-24 | |
| 1912395336 | Susan Taber Mulhern | Speech-Language Pathologist | 2315 Campus Dr, Evanston, IL 60208-0001 | 2015-01-07 |
| Find all providers in zip 60208 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861007049 | Heloisa Garman | Psychologist | 800 Elgin Rd Apt 1611, Evanston, IL 60201-5632 | 2020-09-14 |
| 1992346233 | Kiran Ramesh Mirchandani | Psychologist | 1740 Ridge Ave Ste 22, Evanston, IL 60201-5918 | 2019-10-07 |
| 1982181533 | Melissa Perrin | Psychologist | 2530 Crawford Ave Ste 203, Evanston, IL 60201-4959 | 2018-07-26 |
| 1689165250 | Mona Sue Weissmark | Psychologist | 737 Clinton Pl, Evanston, IL 60201-1765 | 2018-05-19 |
| 1063920957 | Tamara Miriam Claman | Psychologist | 1718 Sherman Ave Ste 210, Evanston, IL 60201-5610 | 2018-01-13 |
| 1619480720 | Kaelin Emery | Psychologist | 820 Davis St Ste 455, Evanston, IL 60201-4447 | 2017-11-10 |
| 1861905051 | Dr. Tari Mack, Inc. | Psychologist | 636 Church St Ste 415, Evanston, IL 60201-4580 | 2017-11-09 |
| 1639535396 | Alissa Levy Chung, Ph.d., Inc. | Psychologist | 704 South Blvd, Evanston, IL 60202-2908 | 2016-01-12 |
| 1114359213 | Dr Savage Psychological Services PC | Psychologist | 2550 Crawford Ave Ste 12, Evanston, IL 60201-4987 | 2013-07-31 |
| 1710320080 | Marni B Rosen | Psychologist | 2130 Green Bay Rd, Evanston, IL 60201-3026 | 2013-04-16 |
| Find all providers in EVANSTON | ||||
Please comment or provide details below to improve the information on DR. K. JOD TAYWADITEP.
| 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.