DR. NICHOLAS RYAN PETRE (NPI# 1699269308) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699269308 |
| Entity Type | Individual |
| Full Name | DR. NICHOLAS RYAN PETRE |
| Credential | MD |
| Practice Address |
1285 Hartrey Ave Evanston IL 60202-1056 |
| Practice Telephone | 8476663494 |
| Mailing Telephone | 8476663494 |
| Enumeration Date | 2018-06-15 |
| Last Update Date | 2019-12-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 125.072248 | IL | Allopathic & Osteopathic Physicians |
| Street Address |
1285 HARTREY AVE |
| City | EVANSTON |
| State | IL |
| Zip Code | 60202-1056 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831135102 | Avery Scott Hart | Internal Medicine | 1285 Hartrey Ave, Erie Evanston/skokie Health Center, Evanston, IL 60202-1056 | 2006-06-22 |
| 1356986624 | Laboratory Corporation of America | Clinical Medical Laboratory | 1285 Hartrey Ave, Evanston, IL 60202-1056 | 2019-11-11 |
| 1891260667 | Rebecca A Calendo | Nurse Practitioner | 1285 Hartrey Ave, Evanston, IL 60202-1056 | 2018-10-09 |
| 1962920884 | Sarah Bier | Advanced Practice Midwife | 1285 Hartrey Ave, Evanston, IL 60202-1056 | 2017-08-30 |
| 1366970279 | Nicole Lauren Potempa | Registered Nurse | 1285 Hartrey Ave, Evanston, IL 60202-1056 | 2017-05-23 |
| 1770952244 | Metropolitan Family Services | Community/Behavioral Health | 1285 Hartrey Ave, 10th Floor, Evanston, IL 60202-1056 | 2015-09-15 |
| 1366837023 | Syed Mustafa Alavi | Family Medicine | 1285 Hartrey Ave, Evanston, IL 60202-1056 | 2015-03-31 |
| 1750691002 | Judith Horwitz Glassenberg | Pediatrics | 1285 Hartrey Ave, Erie Family Health Center, Evanston, IL 60202-1056 | 2010-10-19 |
| 1992023501 | Rebecca T Lapat | Pediatrics | 1285 Hartrey Ave, Evanston, IL 60202-1056 | 2010-05-06 |
| 1588981138 | Hyo Y Lee | Internal Medicine | 1285 Hartrey Ave, Evanston, IL 60202 | 2010-04-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548889496 | Ktsmiles, Inc | Clinic/Center | 2408 Main Street, Evanston, IL 60202 | 2020-04-10 |
| 1831751163 | Dorcas Matowe | Marriage & Family Therapist | The Family Institute, 618 Library Place, Evanston, IL 60202 | 2019-07-08 |
| 1457847170 | Lilah Handler | Social Worker | 905 Forest Ave, Apt 1, Evanston, IL 60202 | 2018-07-05 |
| 1528574472 | Jessica Kubacki | Developmental Therapist | 535 Hinman Ave Apt F3, Evanston, IL 60202 | 2017-12-14 |
| 1376075853 | Lisa Meyerson Acupuncture | Acupuncturist | 1234 Sherman Avenue, Lighthouse Yoga and Acupuncture, Evanston, IL 60202 | 2017-04-03 |
| 1427597368 | Lillian Obucina Dds PC | Dentist | 111 North Wabash, Suite 1522, Chicago, IL 60202 | 2017-02-13 |
| 1184176893 | Amelia Willcox | Speech-Language Pathologist | 620 Sheridan Square, Apartment 1, Evanston, IL 60202 | 2016-10-28 |
| 1831547785 | Thomas Hagerty Jr. | Pharmacist | 2491 W Howard St, Evanston, IL 60202 | 2016-06-01 |
| 1013361948 | Autism Hope Support | In Home Supportive Care | 815 Seward Apt. 1s, Evanston, IL 60202 | 2016-04-18 |
| 1215302625 | Preferred Dentistry Associates, LLC | Dentist | 1029 Howard Street, Evanston, IL 60202 | 2015-12-10 |
| Find all providers in zip 60202 | ||||
| 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 |
|---|---|---|---|---|
| 1689207722 | South Lincoln Hospital District | Family Medicine | 195 Feather Way Stop 100, Evanston, WY 82930-9352 | 2020-02-18 |
| 1053970442 | Wade Gilman | Family Medicine | 1650 Ridge Ave, Ste 1304, Evanston, IL 60201 | 2019-06-10 |
| 1235503459 | South Lincoln Hospital District | Family Medicine | 195 Feather Way Ste 100, Evanston, WY 82930-9352 | 2015-11-26 |
| 1194094086 | Zulfikar Esmail | Family Medicine | 1616 Forest Pl, Evanston, IL 60201-4663 | 2011-12-21 |
| 1225327000 | Richard Jay Capener | Family Medicine | 196 Arrowhead Dr Ste 1, Evanston, WY 82930 | 2011-04-01 |
| 1821280256 | Humera Khan | Family Medicine | 800 Austin St Ste 505, Evanston, IL 60202-3439 | 2007-08-09 |
| 1902934532 | Michael Kevin Rakotz | Family Medicine | 1704 Maple Ave, Suite 200, Evanston, IL 60201-3134 | 2007-03-02 |
| 1497819692 | Geeta Maker-clark | Family Medicine | 909 Davis St Ste 200, Evanston, IL 60201-3664 | 2006-12-21 |
| 1982779047 | Elena Fitchev | Family Medicine | 800 Austin St Ste 502w, Evanston, IL 60202-3445 | 2006-11-22 |
| 1063528255 | Carl Elmer Hill | Family Medicine | 841 Dodge Ave, Evanston, IL 60202 | 2006-08-22 |
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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.