TIMOTHY FENDON (NPI# 1689675811) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689675811 |
| Entity Type | Individual |
| Full Name | TIMOTHY FENDON |
| Credential | MD |
| Practice Address |
2100 Glenwood Ave Joliet IL 60435-5487 |
| Mailing Address |
1860 Paysphere Cir Chicago IL 60674-0018 |
| Practice Telephone | 8159993201 |
| Mailing Telephone | 6305456016 |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2018-10-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 036-098625 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | ANTHEM | 000000365227 | 01 |
| IL | 036098625 | 05 | |
| IN | 200895510 | 05 |
| Street Address |
2100 GLENWOOD AVE |
| City | JOLIET |
| State | IL |
| Zip Code | 60435-5487 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396371811 | Leonard Kevyn Banogon Ferolin | Physical Therapist | 2100 Glenwood Ave, Joliet, IL 60435-5487 | 2020-03-16 |
| 1093370611 | Kyle Ren Barcenas Fernando | Physical Therapist | 2100 Glenwood Ave, Joliet, IL 60435-5487 | 2019-05-08 |
| 1376034918 | Kathryn Schroeder | Physical Therapist | 2100 Glenwood Ave, Joliet, IL 60435-5487 | 2018-05-18 |
| 1033609763 | Matthew Peter Lukanich | Physical Therapist | 2100 Glenwood Ave, Joliet, IL 60435-5487 | 2018-05-17 |
| 1588151260 | Du Page Medical Group Ltd | Durable Medical Equipment & Medical Supplies | 2100 Glenwood Ave, Joliet, IL 60435-5487 | 2018-04-18 |
| 1790284487 | Daniel Capparelli | Physical Therapist | 2100 Glenwood Ave, Joliet, IL 60435-5487 | 2018-02-08 |
| 1831616044 | Michael John Donovitch | Physical Therapist | 2100 Glenwood Ave, Joliet, IL 60435-5487 | 2017-08-28 |
| 1700309895 | Michael Plachy Jr. | Physical Therapy Assistant | 2100 Glenwood Ave, Joliet, IL 60435-5487 | 2017-07-20 |
| 1487189551 | Alyssa Brown | Occupational Therapist | 2100 Glenwood Ave, Suite 110, Joliet, IL 60435-5487 | 2017-04-26 |
| 1164956918 | Shanita Valentine | Nurse Practitioner | 2100 Glenwood Ave, Joliet, IL 60435 | 2017-04-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851889018 | Chime Ajiere | Nurse Practitioner | 511 Theodore St, Joliet, IL 60435 | 2018-04-24 |
| 1740791284 | Melanie Presnak | Speech-Language Pathologist | 1207 N Larkin Ave, Joliet, IL 60435 | 2017-10-23 |
| 1831618883 | Jeriel Marsena Quarles | Licensed Practical Nurse | 1617 W Jefferson Street, Joliet, IL 60435 | 2017-09-11 |
| 1053769760 | Cody Hutchinson | Physical Therapy Assistant | 2943 W Jefferson St, Joliet, IL 60435 | 2016-06-03 |
| 1659748549 | Megan Ryab | Massage Therapist | 501 Wilcox St, Joliet, IL 60435 | 2015-08-26 |
| 1922416197 | Kodo Care, Inc. | Pharmacy | 221 Springfield Avenue, Suite A, Joliet, IL 60435 | 2014-07-31 |
| 1528489739 | My Family Doc LLC | Family Medicine | 2001-03 Essington Rd, Joliet, IL 60435 | 2013-12-16 |
| 1184973869 | R A Lombardi Dds PC | Dentist | 3011 Theodore St., Joliet, IL 60435 | 2012-09-10 |
| 1245546076 | Kelly Rae Lesemann | Chiropractor | 1011 Essington Road, Joliet, IL 60435 | 2010-08-31 |
| 1932413697 | Ann E Todd | Optometrist | 1521 Essington Road, Everything In Sight, Joliet, IL 60435 | 2010-08-04 |
| Find all providers in zip 60435 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841429479 | Daniel John Bartgen | Emergency Medicine | 333 N. Madison Street, Joliet, IL 60435-8200 | 2009-07-02 |
| 1013944263 | Susan Demick | Emergency Medicine | Silver Cross Hospital, 1200 Maple Road, Joliet, IL 60432 | 2006-06-26 |
| 1144269093 | Wael Mctabi | Emergency Medicine | 1719 Glenwood Ave, Joliet, IL 60435-5835 | 2006-06-06 |
| 1497753917 | Prairie Emergency Services, Sc | Emergency Medicine | 333 Madison St, Joliet, IL 60435-8200 | 2005-07-08 |
| 1134644164 | Cepamerica Illinois LLP | Emergency Medicine | 333 Madison St, Joliet, IL 60435-8200 | 2017-08-10 |
| 1962852327 | Melvin Thomas | Emergency Medicine | 333 Madison St, Joliet, IL 60435 | 2016-06-16 |
| 1639527138 | Daewon Kim | Emergency Medicine | 333 N Madison St, Emergency Department, Joliet, IL 60435-8200 | 2016-05-25 |
| 1417343575 | Jessica Bode | Emergency Medicine | 333 Madison St, Joliet, IL 60435-8200 | 2015-04-15 |
| 1447699368 | John Paik | Emergency Medicine | 333 Madison St, Joliet, IL 60435-8200 | 2013-06-25 |
| 1528403805 | Semere Tedla | Emergency Medicine | 333 Madison St, Joliet, IL 60435-8200 | 2013-05-01 |
| Find all providers in JOLIET | ||||
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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.