SIDNEY DREYER (NPI# 1639530603) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1639530603 |
Entity Type | Individual |
Full Name | SIDNEY DREYER |
Credential | MS, ATC |
Practice Address |
1920 Football Dr Lake Forest IL 60045-4829 |
Mailing Address |
1601 S Candlestick Way Waukegan IL 60085-8670 |
Practice Telephone | 8477395403 |
Mailing Telephone | 6057595373 |
Enumeration Date | 2016-03-17 |
Last Update Date | 2016-12-08 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2083S0010X |
Preventive Medicine Specialization: Sports Medicine |
096004152 | IL | Allopathic & Osteopathic Physicians |
N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
096.004152 | IL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Street Address |
1920 FOOTBALL DR |
City | LAKE FOREST |
State | IL |
Zip Code | 60045-4829 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1184830812 | Jeremy Smith | Physical Therapist | 1920 Football Dr, Lake Forest, IL 60045-4829 | 2007-05-16 |
1447764550 | Elizabeth Ariel Garcia | Specialist/Technologist | 1920 Football Dr, Lake Forest, IL 60045-4829 | 2017-11-28 |
1588906721 | William Temple Newing Rogers | Specialist/Technologist | 1920 Football Dr, Halas Hall At Conway Park, Lake Forest, IL 60045-4829 | 2013-03-26 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851931109 | Spine & Wellness Clinic, Inc. | Chiropractor | 775 N Bank Lane Suite 101, Lake Forest, IL 60045 | 2020-01-14 |
1184278640 | Mary Belluomini Dipietro | Dietitian, Registered | 1000 North Westmoreland Rd., Lake Forest, IL 60045 | 2019-08-01 |
1336621747 | Brook Elizabeth Orvis | Physical Therapist | 1000 N Westmoreland Road, 2nd Floor, Pavilion B, Lake Forest, IL 60045 | 2018-08-31 |
1336621028 | Michelle Nebel | Audiologist | 225 East Deerpath, Suite 223, Lake Forest, IL 60045 | 2018-08-30 |
1467951731 | Devan Keesling | Audiologist | 800 N Westmoreland Rd Ste Ll30, Lake Forest, IL 60045 | 2018-02-01 |
1023516796 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1000 N Westmoreland Rd Ste A, Lake Forest, IL 60045 | 2018-01-29 |
1275056780 | Karen Elizabeth Cohen | Counselor | 1331 S. Estate Lane, Lake Forest, IL 60045 | 2017-07-18 |
1497281711 | Caroline Connors | Speech-Language Pathologist | 660 Westmoreland Road, Lake Forest, IL 60045 | 2017-05-05 |
1013453406 | Katie L Konopacz | Nurse Practitioner | 1000 N Westmoreland Rd # B, Lake Forest, IL 60045 | 2017-01-10 |
1225424575 | Sean Robert Wessel | Internal Medicine | 1000 N Westmoreland Rd Ste 3556, Lake Forest, IL 60045 | 2015-04-14 |
Find all providers in zip 60045 |
Taxonomy Code | 2083S0010X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Preventive Medicine |
Specialization | Sports Medicine |
A preventive medicine physician who specializes in the diagnosis and treatment of sports related conditions and injuries. |
Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Preventive Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1760987515 | Eric Raul Simental | Preventive Medicine | 1014 Claim St, Aurora, IL 60505 | 2018-03-26 |
1750998704 | Jacob Quinn | Preventive Medicine | 1009 Wellington Dr, Washington, IL 61571-1378 | 2020-09-24 |
1043715899 | Ryan Lee Basden | Preventive Medicine | 347 S Gladstone Ave, Aurora, IL 60506-4877 | 2018-03-26 |
1861445256 | Robert J Strugala | Preventive Medicine | 2850 S Wabash Ave, Suite 100, Chicago, IL 60616-2955 | 2006-05-18 |
City | LAKE FOREST |
Zip Code | 60045 |
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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.