DR. MARK T. SHIMA (NPI# 1669789327) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669789327 |
| Entity Type | Individual |
| Full Name | DR. MARK T. SHIMA |
| Credential | D. O. |
| Practice Address |
2300 S 1st St Champaign IL 61820-7661 |
| Mailing Address |
611 W. Park St. Bwpc Urbana IL 61801-2500 |
| Practice Telephone | 2173839400 |
| Practice Fax Number | 2173839691 |
| Mailing Telephone | (217) 383-6941 |
| Enumeration Date | 2010-09-01 |
| Last Update Date | 2017-06-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0105X |
Surgery Specialization: Surgery of the Hand |
036142552 | IL | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306813787 | Mark A Shima | Internal Medicine | 311 Camden St Ste 102, San Antonio, TX 78215 | 2006-03-03 |
| Street Address |
2300 S 1ST ST |
| City | CHAMPAIGN |
| State | IL |
| Zip Code | 61820-7661 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679530836 | Cathy L Borst | Occupational Therapist | 2300 S 1st St, Champaign, IL 61820-7661 | 2006-04-28 |
| 1720619232 | Jacob Blasingame | Physician Assistant | 2300 S 1st St, Champaign, IL 61820-7661 | 2020-02-03 |
| 1578110607 | Kathleen Morrison | Specialist/Technologist | 2300 S 1st St, Champaign, IL 61820-7661 | 2019-08-22 |
| 1609423904 | Lauren A Henderson | Physical Therapist | 2300 S 1st St, Champaign, IL 61820-7661 | 2019-08-21 |
| 1689237554 | Nicholas Allen Pippin | Specialist/Technologist | 2300 S 1st St, Champaign, IL 61820-7661 | 2019-04-17 |
| 1154803351 | Christopher Nguyen | Physical Therapist | 2300 S 1st St, Champaign, IL 61820-7661 | 2018-09-04 |
| 1902310642 | Julie A Shain | Nurse Practitioner | 2300 S 1st St, Champaign, IL 61820-7661 | 2017-11-16 |
| 1851818942 | April M Shaw | Physical Therapist | 2300 S 1st St, Champaign, IL 61820-7661 | 2017-08-29 |
| 1629594825 | Adam T Carver | Physical Therapist | 2300 S 1st St, Champaign, IL 61820-7661 | 2017-08-18 |
| 1053850586 | Alger Penas | Nurse Practitioner | 2300 S 1st St, Champaign, IL 61820-7661 | 2017-02-16 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982217345 | Costco Wholesale Corporation | Pharmacy | 2002 N. Neil St., Champaign, IL 61820 | 2020-08-26 |
| 1255963583 | Jamey Richard Bailey | Social Worker | 701 Devonshire Drive, Bldg C, Suite 206, C-6, Champaign, IL 61820 | 2020-02-05 |
| 1790247443 | Jason Abrams | Counselor | 201 W Springfield Ave., Suite 1002-1003, Champaign, IL 61820 | 2019-04-02 |
| 1184100273 | Janine Rafferty | Pharmacist | 2002 N Neil St, Champaign, IL 61820 | 2018-07-12 |
| 1417475070 | Brodbeck Counseling, PC | Community/Behavioral Health | 301 N. Neil Street Suite 323, Champaign, IL 61820 | 2017-09-05 |
| 1447773726 | Quanata M Pelmore | Nurse's Aide | 508 E. Vine St, Champaign, IL 61820 | 2017-07-19 |
| 1821518127 | Molly Mclay | Social Worker | 309 W Clark St., Champaign, IL 61820 | 2017-06-27 |
| 1396265849 | Lou Echols Chambers | Audiologist | 901 South Sixth Street, Chamapign, IL 61820 | 2017-06-26 |
| 1962874495 | Luciana Angelica Guardini | Social Worker | 100 North Chestnut Street, Suite 244, Champaign, IL 61820 | 2015-10-23 |
| 1538544465 | Cpo Services, Inc. | Prosthetic/Orthotic Supplier | 410 E University Ave Ste 105, Champaign, IL 61820 | 2015-07-21 |
| Find all providers in zip 61820 | ||||
| Taxonomy Code | 2086S0105X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Surgery of the Hand |
| A surgeon with expertise in the investigation, preservation and restoration by medical, surgical and rehabilitative means, of all structures of the upper extremity directly affecting the form and function of the hand and wrist. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245442375 | Southern Illinois Hand Center, Sc | Surgery | 901 Medical Park Drive, Suite 100, Effingham, IL 62401 | 2007-05-03 |
| 1053435222 | Salvatore Antonio Fanto | Surgery | 11304 W Distinctive Drive, Orland Park, IL 60462 | 2007-03-16 |
| 1326114216 | Lim-kuy D Kho Md Sc | Surgery | 5525 S Pulaski, Chicago, IL 60629 | 2006-11-24 |
| 1174619753 | Evan T. Manolis | Surgery | 8760 W 159th St, Suite 204, Orland Park, IL 60462-5395 | 2006-10-04 |
| 1518064542 | Peter W Hui | Surgery | 493 S York St, Elmhurst, IL 60126-3944 | 2006-09-20 |
| 1992814628 | Jerome S Weiskopf | Surgery | 6533 Lexus Drive, Rockford, IL 61108-3015 | 2006-08-29 |
| 1629452073 | Justyn Lutfy | Surgery | 747 N Rutledge St, Springfield, IL 62702-6700 | 2015-07-15 |
| 1922334226 | The Chicago Center for Plastic & Reconstructive Surgery, LLC | Surgery | 845 North Michigan Avenue, Suite 980w, Chicago, IL 60611-2218 | 2009-10-22 |
| 1689878480 | Alan H Chen | Surgery | 823 129th Infantry Dr, Room 103, Joliet, IL 60435-8346 | 2007-06-14 |
| 1568682508 | Timothy Michael Bradley | Surgery | 3310 W Main St, Suite 200, St Charles, IL 60175-1000 | 2007-05-01 |
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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.