MISS TAMARA A. PRIDE (NPI# 1649494691) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649494691 |
| Entity Type | Individual |
| Full Name | MISS TAMARA A. PRIDE |
| Credential | PA-C |
| Practice Address |
820 E Terra Cotta Ave Ste 125 Crystal Lake IL 60014 |
| Mailing Address |
820 E Terra Cotta Ave Ste 125 Crystal Lake IL 60014-3650 |
| Practice Telephone | 8154554434 |
| Practice Fax Number | 8154554593 |
| Mailing Telephone | 8478428839 |
| Mailing Fax Number | 8473928439 |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2018-05-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 085001795 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1100 W Central Rd Ste 200, Arlington Heights, IL 600052465 | 8473925440 | 8473928439 |
| Street Address |
820 E TERRA COTTA AVE STE 125 |
| City | CRYSTAL LAKE |
| State | IL |
| Zip Code | 60014 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497394720 | Lorelei Mariano | Physical Therapist | 350 E Congress Parkway Ste A, Crystal Lake, IL 60014 | 2020-01-03 |
| 1396227070 | Behavioral Services for Autism, Inc | Behavioral Analyst | 1095 Pingree Road, Suite 204, Crystal Lake, IL 60014 | 2018-08-30 |
| 1831635564 | Isis Mendoza-garnica | Counselor | 6803 Rose Ave, Crystal Lake, IL 60014 | 2017-01-19 |
| 1134664402 | Derick Dermatology, LLC | Non-Pharmacy Dispensing Site | 525 E Congress Parkway, Suite 200, Crystal Lake, IL 60014 | 2016-12-22 |
| 1306394051 | Highland Park Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 177 W Virginia Street, Crystal Lake, IL 60014 | 2016-09-12 |
| 1124492830 | Align Spine & Orthopaedics | Durable Medical Equipment & Medical Supplies | 60 B West Terra Cotta Ave, #265, Crystal Lake, IL 60014 | 2015-11-18 |
| 1558747428 | Shabana Nawaz | Optometrist | 4777 Northwest Highway, Crystal Lake, IL 60014 | 2015-08-03 |
| 1548649205 | Daniel Okon | Social Worker | 304 Charllote Ave, Crystal Lake, IL 60014 | 2015-05-27 |
| 1154729838 | Crystal Lake Center for Chronic Pain Sc | Nurse Practitioner | 1 South Northwest Highway, Crystal Lake, IL 60014 | 2014-12-12 |
| 1558763581 | Brooke Nicole Grandt | Occupational Therapist | 394 Heisler Ct, Crystal Lake, IL 60014 | 2014-09-22 |
| Find all providers in zip 60014 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982210654 | Brittany Michelle Weber | Physician Assistant | 525 E Congress Pkwy Ste 200, Crystal Lake, IL 60014-6271 | 2020-09-18 |
| 1851865257 | Julia Kocemba | Physician Assistant | 1761 Queensport Dr, Crystal Lake, IL 60014-2978 | 2019-01-18 |
| 1245752856 | Christine A. Potter | Physician Assistant | 420 N State Route 31, Crystal Lake, IL 60012-3709 | 2017-07-14 |
| 1124449558 | Robin K Pond | Physician Assistant | 5911 Northwest Highway, Suite 205, Crystal Lake, IL 60014 | 2014-01-03 |
| 1134121965 | Makiko Ogino-mcelligott | Physician Assistant | 525 E Congress Pkwy, 100, Crystal Lake, IL 60014-6245 | 2005-08-11 |
| 1134648389 | Ryan Miguel Colon | Physician Assistant | 420 N Il Route 31, Crystal Lake, IL 60012 | 2017-09-19 |
| 1225406499 | Eric Torres | Physician Assistant | 750 E Terra Cotta Ave, Crystal Lake, IL 60014-3621 | 2015-09-04 |
| 1679963821 | Kelly A Muscavitch | Physician Assistant | 750 E Terra Cotta Ave, Suite C, Crystal Lake, IL 60014-3621 | 2015-01-27 |
| 1265718993 | Ralph Andrew Seymoure | Physician Assistant | 6119 Northwest Hwy, Crystal Lake, IL 60014-7911 | 2011-10-26 |
| 1003147406 | Amanda Marie Diamond | Physician Assistant | 360 Station Drive, Suite 201, Crystal Lake, IL 60014-7978 | 2010-01-25 |
| Find all providers in CRYSTAL LAKE | ||||
| City | CRYSTAL LAKE |
| Zip Code | 60014 |
Please comment or provide details below to improve the information on MISS TAMARA A. PRIDE.
| 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.