JACK ALAN KAMENSKE (NPI# 1669012837) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669012837 |
| Entity Type | Individual |
| Full Name | JACK ALAN KAMENSKE |
| Credential | MSN, RN, FNP-BC |
| Practice Address |
12251 S 80th Ave Ste 204 Palos Heights IL 60463-1256 |
| Mailing Address |
16452 Boardwalk Ter Orland Hills IL 60487-5617 |
| Practice Telephone | 7734324800 |
| Practice Fax Number | 8448054742 |
| Enumeration Date | 2020-01-15 |
| Last Update Date | 2020-02-20 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
209020706 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 16515 106th Ct, Orland Park, IL 604674545 | 7737260853 | 7737024666 |
| 4950 W 95th St, Oak Lawn, IL 604532504 | 7734324800 | |
| 1006 S Michigan Ave Ste 500, Chicago, IL 606052216 | 7734324888 | |
| 1 Ingalls Dr, Harvey, IL 604263558 | 7083332300 | |
| 17800 Kedzie Ave, Hazel Crest, IL 604290989 | 7087998000 | |
| 12251 S 80th Ave, Palos Heights, IL 604631256 | 7089234000 | |
| 4440 W 95th St, Oak Lawn, IL 604532600 | 7086848000 |
| Street Address |
12251 S 80TH AVE STE 204 |
| City | PALOS HEIGHTS |
| State | IL |
| Zip Code | 60463-1256 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932756095 | Kim Rusiecki | Technician | 25 Parliament Drive East, Palos Heights, IL 60463 | 2019-08-23 |
| 1265925218 | Sentinel Anesthesia of Illinois, PC | Anesthesiology | 7340 W College Dr Fl 1, Palos Heights, IL 60463 | 2018-06-13 |
| 1225410848 | Deborah Ann Castaneda | Skilled Nursing Facility | 12350 Natchez Ave., Palos Heights, IL 60463 | 2015-06-19 |
| 1609253160 | Tareq Ayyad | Physical Therapy Assistant | 11730 Lighthouse Ln, Palos Heights, IL 60463 | 2015-05-04 |
| 1366846503 | Ryan Teahen | Dentist | 7600 W College Dr Ste 17, Palos Heights, IL 60463 | 2014-10-17 |
| 1295140309 | Paul Park | Ophthalmology | 7600 W College Dr Ste 9, Palos Heights, IL 60463 | 2014-06-26 |
| 1275976045 | Nazim A. Khan | Physician Assistant | 6450 West College Drive, Palos Heights, IL 60463 | 2013-04-11 |
| 1619246824 | Amanda M Ejka | Psychologist | 11800 South 75th Avenue, Suite 300, Palos Heights, IL 60463 | 2011-12-16 |
| 1578832937 | Sandi Maheras | Pharmacist | 1703 Spyglass Cir, Palos Heights, IL 60463 | 2011-12-14 |
| 1043597065 | Ashraf Olwan | Pharmacist | 7660 W Sequoia Rd, Palos Heights, IL 60463 | 2011-11-04 |
| Find all providers in zip 60463 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215570247 | Monika Aneta Reyes | Nurse Practitioner | 7600 W College Dr Ste 2, Palos Heights, IL 60463-1035 | 2019-10-22 |
| 1750894952 | Matthew J Toman | Nurse Practitioner | 7270 W College Dr Ste 102, Palos Heights, IL 60463-1287 | 2017-11-09 |
| 1679653620 | Jack Evans Beaudoin Jr. | Nurse Practitioner | 13303 S Ridgeland Ave Unit C, Palos Heights, IL 60463-0020 | 2006-10-16 |
| 1730799651 | Ruby Noemi Meyer | Nurse Practitioner | 12251 S 80th Ave, Palos Heights, IL 60463-1256 | 2020-08-05 |
| 1760016547 | Ann Francis Terronez | Nurse Practitioner | 13303 S Ridgeland Ave, Palos Heights, IL 60463-1815 | 2020-03-02 |
| 1942846217 | Magdalena Landowski | Nurse Practitioner | 12820 S Ridgeland Ave, Palos Heights, IL 60463-2388 | 2019-11-21 |
| 1548829450 | Christina Gavoni | Nurse Practitioner | 12251 S 80th Ave, Palos Heights, IL 60463-1256 | 2019-06-13 |
| 1033775945 | Valerie R Giannini | Nurse Practitioner | 12251 S 80th Ave, Palos Heights, IL 60463-1256 | 2019-05-15 |
| 1073074894 | Jessica Marie Kubicki | Nurse Practitioner | 12251 S 80th Ave, Palos Heights, IL 60463-1256 | 2019-03-26 |
| 1609332188 | Maria Veronica Tarala | Nurse Practitioner | 12251 S 80th Ave, Palos Heights, IL 60463-1256 | 2019-02-20 |
| Find all providers in PALOS HEIGHTS | ||||
| City | PALOS HEIGHTS |
| Zip Code | 60463 |
Please comment or provide details below to improve the information on JACK ALAN KAMENSKE.
| 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.