MAHVEEN ETHEZAZ (NPI# 1699193268) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699193268 |
| Entity Type | Individual |
| Full Name | MAHVEEN ETHEZAZ |
| Credential | M.D. |
| Practice Address |
40 S Clay St Ste 210 Hinsdale IL 60521-3257 |
| Mailing Address |
1860 Paysphere Cir Chicago IL 60674-0018 |
| Practice Telephone | 6307898890 |
| Mailing Telephone | 6304699200 |
| Enumeration Date | 2014-04-01 |
| Last Update Date | 2020-08-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 036-151954 | IL | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 61445 | MN | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 9055 Springbrook Dr., Allina Health Coon Rapids Clinic, Coon Rapids, MN 55433 | 7637809155 |
| Street Address |
40 S CLAY ST STE 210 |
| City | HINSDALE |
| State | IL |
| Zip Code | 60521-3257 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497046304 | Rebecca Meyers-tomecki | Counselor | 40 S Clay St Ste 210, Hinsdale, IL 60521-3257 | 2011-04-26 |
| 1164877882 | Steven Broderick | Family Medicine | 40 S Clay St Ste 210, Hinsdale, IL 60521 | 2016-05-01 |
| 1336527654 | Tingting Zhou | Internal Medicine | 40 S Clay St Ste 210, Hinsdale, IL 60521 | 2015-05-07 |
| 1023376191 | Asma Halim | Social Worker | 40 S Clay St Ste 210, Hinsdale, IL 60521-3257 | 2012-04-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386256170 | Infinity Yoga LLC | Counselor | 702 Mills St, Hinsdale, IL 60521 | 2020-08-21 |
| 1427696855 | Anne Didier | Nurse Practitioner | 40 South Clay St., Suite 200, West Building, Hinsdale, IL 60521 | 2019-12-16 |
| 1619469244 | Rush Oak Brook Surgery Center, LLC | Clinic/Center | 2011 York Road, Suite 3000, Oak Brook, IL 60521 | 2018-05-30 |
| 1639680275 | Kelly M Lyell | Psychologist | 950 S Oak St, Hinsdale, IL 60521 | 2017-10-23 |
| 1386169720 | Elizabeth Ann Thorsness | Counselor | 412 East Fourth St., Hinsdale, IL 60521 | 2017-08-07 |
| 1275057424 | Bryndal Nicole Chervinko | Audiologist | 908 North Elm Street, Suite 306, Hinsdale, IL 60521 | 2017-07-31 |
| 1972038990 | Carolyn M Ball | Counselor | 19 N Grant St Ste 2c, Hinsdale, IL 60521 | 2017-04-27 |
| 1710429964 | Smiling Star Speech & Language | Speech-Language Pathologist | 120 E Odgen Avenue, Suite 110, Hinsdale, IL 60521 | 2016-11-04 |
| 1972964773 | Sharon Grob Murphy | Psychologist | 728 S. Park Ave., Hinsdale, IL 60521 | 2016-03-08 |
| 1992187074 | Matthew Destefani | Emergency Medicine | 109 Symonds Dr # 578, Hinsdale, IL 60521 | 2015-06-24 |
| Find all providers in zip 60521 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467828970 | Adventist Health Partners, Inc. | Family Medicine | 222 E Ogden Ave, Hinsdale, IL 60521-2458 | 2015-08-19 |
| 1881074599 | Zoheb Osman | Family Medicine | 911 N Elm St Ste 301, Hinsdale, IL 60521 | 2015-06-08 |
| 1023160488 | Aleea Gupta | Family Medicine | 211 W Chicago Ave Ste 210, Hinsdale, IL 60521 | 2007-01-17 |
| 1467498618 | Joseph Reda | Family Medicine | 11 Salt Creek Ln Ste 125, Hinsdale, IL 60521-3041 | 2006-06-22 |
| 1871550798 | Lisa Holmes | Family Medicine | 911 N Elm St, Ste 123, Hinsdale, IL 60521-3634 | 2006-04-26 |
| 1033102744 | Ingrid Y Liu | Family Medicine | 907 N Elm St, Hinsdale, IL 60521-3630 | 2005-08-26 |
| 1356790653 | Sheena Aleena Eettickal | Family Medicine | 135 N Oak St, Hinsdale, IL 60521-3860 | 2016-06-07 |
| 1164877882 | Steven Broderick | Family Medicine | 40 S Clay St Ste 210, Hinsdale, IL 60521 | 2016-05-01 |
| 1487034195 | Farahnaz Amina Ali | Family Medicine | 135 N Oak St, Hinsdale, IL 60521 | 2015-06-08 |
| 1922433051 | Adventist Health Partners, Inc | Family Medicine | 12 Salt Creek Ln, Suite 106, Hinsdale, IL 60521-8605 | 2013-09-09 |
| Find all providers in HINSDALE | ||||
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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.