KELLY A MUSCAVITCH (NPI# 1679963821) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679963821 |
| Entity Type | Individual |
| Full Name | KELLY A MUSCAVITCH |
| Practice Address |
750 E Terra Cotta Ave Suite C Crystal Lake IL 60014-3621 |
| Mailing Address |
5875 E Riverside Blvd Rockford IL 61114-4937 |
| Practice Telephone | 8153989491 |
| Practice Fax Number | 8153817498 |
| Mailing Telephone | 8153989491 |
| Mailing Fax Number | 8153817498 |
| Enumeration Date | 2015-01-27 |
| Last Update Date | 2019-10-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
750 E TERRA COTTA AVE SUITE C |
| City | CRYSTAL LAKE |
| State | IL |
| Zip Code | 60014-3621 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710984638 | Virginia B Hemelt | Psychiatry & Neurology | 750 E Terra Cotta Ave, Crystal Lake, IL 60014-3621 | 2005-07-07 |
| 1700239639 | Rockford Orthopedic Associates, Ltd. | Durable Medical Equipment & Medical Supplies | 750 E Terra Cotta Ave, Suite C, Crystal Lake, IL 60014-3621 | 2016-07-15 |
| 1225406499 | Eric Torres | Physician Assistant | 750 E Terra Cotta Ave, Crystal Lake, IL 60014-3621 | 2015-09-04 |
| 1306235882 | Rebecca E Cheski | Specialist/Technologist | 750 E Terra Cotta Ave, Suite C, Crystal Lake, IL 60014-3621 | 2015-01-21 |
| 1205024668 | Kara C. Joyner | Physician Assistant | 750 E Terra Cotta Ave, Suite C, Crystal Lake, IL 60014-3621 | 2007-10-11 |
| 1902092109 | Jeremy A Houtakker | Physician Assistant | 750 E Terra Cotta Ave, Suite C, Crystal Lake, IL 60014-3621 | 2007-09-20 |
| 1508983784 | Mercy Health System Corporation | Durable Medical Equipment & Medical Supplies | 750 E Terra Cotta Ave, Ste B, Crystal Lake, IL 60014-3621 | 2007-03-23 |
| 1679628374 | Michelle Lee Sanfilippo | Physician Assistant | 750 E Terra Cotta Ave, Centegra Neurology, Crystal Lake, IL 60014 | 2007-01-24 |
| 1346394236 | Kevin Franklin Barnes | Specialist/Technologist | 750 E Terra Cotta Ave, Crystal Lake, IL 60014-3621 | 2007-01-22 |
| 1710034400 | Crystal Lake Orthopaedic Surgery & Sports Medicine, Ltd | Specialist | 750 E Terra Cotta Ave, Suite C, Crystal Lake, IL 60014-3621 | 2007-01-04 |
| Find all providers in the same location | ||||
| 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 |
| 1649494691 | Tamara A. Pride | Physician Assistant | 820 E Terra Cotta Ave Ste 125, Crystal Lake, IL 60014 | 2007-04-12 |
| 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 |
| 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 KELLY A MUSCAVITCH.
| 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.