PETRA JOSEPH (NPI# 1679685234) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679685234 |
| Entity Type | Individual |
| Full Name | PETRA JOSEPH |
| Other Name | PETRA NOVOTNY-JOSEPH |
| Credential | MD |
| Practice Address |
1030 N Clark St Chicago IL 60610-5467 |
| Mailing Address |
36912 Eagle Way Chicago IL 60678-0001 |
| Practice Telephone | 3122387800 |
| Mailing Telephone | 4076812241 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2008-02-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207L00000X | Anesthesiology | 036-061158 | IL | Allopathic & Osteopathic Physicians |
| N | 208100000X | Physical Medicine & Rehabilitation | 036-061158 | IL | Allopathic & Osteopathic Physicians |
| Y | 2081P2900X |
Physical Medicine & Rehabilitation Specialization: Pain Medicine |
036-061158 | IL | Allopathic & Osteopathic Physicians |
| N | 208VP0000X |
Pain Medicine Specialization: Pain Medicine |
036-061158 | IL | Allopathic & Osteopathic Physicians |
| N | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
036-061158 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036061158 | 05 | |
| IL | RAILROAD MEDICARE | 250011935 | 01 |
| IL | RAILROAD MEDICARE | 250011936 | 01 |
| Street Address |
1030 N CLARK ST |
| City | CHICAGO |
| State | IL |
| Zip Code | 60610-5467 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447259759 | Kimberly A. Koval | Pediatrics | 1030 N Clark St, Suite 400, Chicago, IL 60610-5467 | 2005-07-19 |
| 1922667278 | Casey Gray | Physical Therapist | 1030 N Clark St, Suite #610, 6th Floor, Chicago, IL 60610 | 2019-06-11 |
| 1457887648 | Jennifer L. Fockler, L.ac. LLC | Clinic/Center | 1030 N Clark St, Suite 610, Chicago, IL 60610-5467 | 2017-05-07 |
| 1215306394 | Andrea Lieberman, Psy.d., LLC | Psychologist | 1030 N Clark St, Suite 303, Chicago, IL 60610-5467 | 2015-09-18 |
| 1790161305 | Nneka E. Onyezia Phd, LLC | Psychologist | 1030 N Clark St, Suite 300, Chicago, IL 60610-5467 | 2015-08-05 |
| 1487036992 | Jennifer Louise Fockler | Acupuncturist | 1030 N Clark St, #610, Chicago, IL 60610-5467 | 2015-06-19 |
| 1265812002 | Christopher Balmaceda | Social Worker | 1030 N Clark St, Suite 303, Chicago, IL 60610-5467 | 2015-06-07 |
| 1033502570 | Jeremiah Yoo | Physical Therapist | 1030 N Clark St, #500, Chicago, IL 60610-5467 | 2015-03-09 |
| 1750702890 | Inner Life Psychological Services | Psychologist | 1030 N Clark St, Suite 303, Chicago, IL 60610-5467 | 2013-12-16 |
| 1750646469 | Colleen Marian Napleton | Counselor | 1030 N Clark St, Suite 303, Chicago, IL 60610-5467 | 2012-07-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326683145 | Roslyn M Jordan | Counselor | 860 N. Lasalle, Chicago, IL 60610 | 2019-11-15 |
| 1992278196 | Deangela Roberson | Specialist/Technologist, Other | 1212 N. Lasalle, Ste 100/ Surgery Center, Chicago, IL 60610 | 2019-01-10 |
| 1477053205 | Terri Lynn Tyson | Counselor | 1250 N. Dearborn St., 18b, Chicago, IL 60610 | 2018-02-19 |
| 1487153797 | Jennifer Quinn | Social Worker | 1200 N. Lasalle Street, Chicago, IL 60610 | 2018-02-02 |
| 1811415334 | Erin Conroy | Behavioral Analyst | 1400 North Lake Shore Drive Apt 8a, Chicago, IL 60610 | 2017-09-05 |
| 1659898674 | Courtney Jane Busing | Speech-Language Pathologist | 1211 N Lasalle, 903, Chicago, IL 60610 | 2017-08-30 |
| 1528503042 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 908 North State Street, Chicago, IL 60610 | 2016-12-20 |
| 1548702814 | Melissa Snyder | Counselor | 1820 N Lasalle Blvd, Counseling- Sweeting, Chicago, IL 60610 | 2016-11-17 |
| 1982146908 | Samantha Ruth Slagh | Physical Therapist | 1100 N Lasalle Street, Apt 1018, Chicago, IL 60610 | 2016-11-08 |
| 1891242426 | Stephanie Pinsler | Counselor | 100 W Chestnut, #1907, Chicago, IL 60610 | 2016-09-01 |
| Find all providers in zip 60610 | ||||
| Taxonomy Code | 2081P2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Pain Medicine |
| A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed] Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. A subspecialty certificate was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Proposal under development. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285256982 | Prm of Illinois | Physical Medicine & Rehabilitation | 625 N Michigan Ave Ste 810, Chicago, IL 60611-3110 | 2020-05-15 |
| 1376007757 | Jose Angel Munoz Jr. | Physical Medicine & Rehabilitation | 5035 W Parker Ave, Chicago, IL 60639-1603 | 2019-01-30 |
| 1629315312 | Chinatown Integrated Medicine Ltd | Physical Medicine & Rehabilitation | 2134b S Archer Ave Fl 2, Chicago, IL 60616-1514 | 2013-01-15 |
| 1730236928 | Linda T Stewart | Physical Medicine & Rehabilitation | 4926 S Champlain Ave, Chicago, IL 60615-2541 | 2007-01-03 |
| 1275186033 | Chicago Regenerative Medical Center Corporation | Physical Medicine & Rehabilitation | 4149 W 26th St, Chicago, IL 60623-4314 | 2019-07-22 |
| 1972013530 | Armitage Orthopedics and Pain Ltd | Physical Medicine & Rehabilitation | 3055 W Armitage Ave, Chicago, IL 60647-3862 | 2017-10-09 |
| 1134541568 | Express Healthcare Inc | Physical Medicine & Rehabilitation | 1502 W Chicago Ave, Chicago, IL 60642-5236 | 2014-01-21 |
| 1386806115 | Divya Agrawal | Physical Medicine & Rehabilitation | 1611 W Harrison St Ste 400, Chicago, IL 60612 | 2008-07-02 |
| 1871752881 | Shivani Shah Batra | Physical Medicine & Rehabilitation | 3000 N Halsted St Ste 525, Chicago, IL 60657-9269 | 2008-06-04 |
| 1154510311 | Baljinder Singh Bathla | Physical Medicine & Rehabilitation | 1550 S Indiana Ave, Suite 100, Chicago, IL 60605-2857 | 2007-10-23 |
| Find all providers in CHICAGO | ||||
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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.