MARY J MIKHAILOV (NPI# 1700817244) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700817244 |
| Entity Type | Individual |
| Full Name | MARY J MIKHAILOV |
| Other Name | MARY J HAUTSCH |
| Credential | MD |
| Practice Address |
25 N Winfield Rd Winfield IL 60190-1295 |
| Practice Telephone | 6302600600 |
| Practice Fax Number | 6302601370 |
| Mailing Telephone | 6302600600 |
| Mailing Fax Number | 6302601370 |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2014-11-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 036078879 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | CDPG HFS PAYEE ID | 3631498336019001 | 01 |
| IL | TAX IDENTIFICATION NUMBER | 363149833 | 01 |
| IL | BLUE CROSS GROUP NUMBER | 0222075 | 01 |
| IL | MEDICARE INDIVIDUAL PTAN | 548190001 | 01 |
| IL | 036078879 | 05 |
| Street Address |
25 N WINFIELD RD |
| City | WINFIELD |
| State | IL |
| Zip Code | 60190-1295 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861499899 | Teresa Smith | Nurse Practitioner | 25 N Winfield Rd, Winfield, IL 60190-1222 | 2005-07-05 |
| 1396358412 | Stephanie Bryan | Nurse Practitioner | 25 N Winfield Rd, Winfield, IL 60190-1379 | 2020-08-28 |
| 1629602560 | Amanda Berndt | Nurse Practitioner | 25 N Winfield Rd, Winfield, IL 60190-1222 | 2020-03-01 |
| 1003454943 | Joelle Marie Tolentino | Registered Nurse | 25 N Winfield Rd, Winfield, IL 60190-1222 | 2019-12-10 |
| 1073157582 | Haley Young | Physician Assistant | 25 N Winfield Rd, Winfield, IL 60190-1222 | 2019-10-29 |
| 1316406440 | Lisa Wehbe | Nurse Practitioner | 25 N Winfield Rd, Winfield, IL 60190-1222 | 2019-03-18 |
| 1821562281 | Julianne Reinbold | Speech-Language Pathologist | 25 N Winfield Rd, Winfield, IL 60190-1222 | 2019-01-17 |
| 1023591054 | Ekchhanak Leaders Rosenkranz | Physician Assistant | 25 N Winfield Rd, Winfield, IL 60190-1222 | 2018-09-14 |
| 1376038166 | Brittany Wienkes | Nurse Practitioner | 25 N Winfield Rd, Winfield, IL 60190-1222 | 2018-06-25 |
| 1841789583 | Sheela Bhayani | Physician Assistant | 25 N Winfield Rd, Winfield, IL 60190 | 2018-05-08 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316592256 | Kelly Marie Jung | Nurse Practitioner | 25 N Winfield Rd Ste 500, Winfield, IL 60190 | 2019-08-07 |
| 1003379660 | Genevieve Goro | Speech-Language Pathologist | In220 Pleasant Hill Rd, Winfield, IL 60190 | 2019-04-10 |
| 1730670175 | Brian J Fischer | Physical Therapist | 26w228 Geneva Road, Winfield, IL 60190 | 2018-05-22 |
| 1730625500 | Johnson Medical Services S.c. | Family Medicine | 27 W 132 Barnes Ave/, Winfield, IL 60190 | 2017-01-17 |
| 1992253843 | Dr. Roy Settergren S.c. | Chiropractor | 27w123 Redbud Lane, Winfield, IL 60190 | 2016-09-20 |
| 1952855223 | Terri Hannemann | Nurse Practitioner | 25 North Winfield Road, Central Dupage Hospital, Winfield, IL 60190 | 2016-08-04 |
| 1154730737 | Cynthia Koeppen | Registered Nurse | 27w281 Winfield Rd, Winfield, IL 60190 | 2014-08-07 |
| 1992117634 | Jonathan Wang | Internal Medicine | 25 N Winfield Rd Ste 202, Winfield, IL 60190 | 2014-05-29 |
| 1689005977 | Erin Sands | Physician Assistant | 25 N Winfield Rd Ste 519, Winfield, IL 60190 | 2013-12-11 |
| 1790120285 | Clarity Health & Wellness | Social Worker | 1 N. 121 County Farm Road, Suite 220, Winfield, IL 60190 | 2013-05-09 |
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| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861711723 | Todd Peters | Pediatrics | 1230 E 6th Ave Ste 2c, Winfield, KS 67156-3145 | 2010-05-18 |
| 1730373986 | Francisco Huidor Md PC | Pediatrics | 255 Medical Dr, Ste 1, Winfield, AL 35594 | 2007-08-30 |
| 1265896112 | Adrianne Colborg | Pediatrics | 25 N Winfield Rd, Winfield, IL 60190 | 2016-04-07 |
| 1902226640 | Katie Richards | Pediatrics | 25 N Winfield Rd, Suite 401, Winfield, IL 60190-1295 | 2014-04-21 |
| 1508192048 | Diana Sieciechowicz | Pediatrics | 25 North Winfield Road, Pediatric Outpatient Center East Clinic, Winfield, IL 60190 | 2009-10-18 |
| 1619132339 | Joy Marie Koopmans | Pediatrics | 25 N Winfield Rd, Winfield, IL 60190-1222 | 2008-07-22 |
| 1407018336 | Mujahida Baram | Pediatrics | 25 N Winfield Rd, Winfield, IL 60190-1222 | 2008-07-01 |
| 1255593638 | Winfield Children's Center | Pediatrics | 255 Medical Dr, Suite #1, Winfield, AL 35594-5005 | 2008-06-27 |
| 1851550156 | Kara Joy Carpenter | Pediatrics | 255 Medical Dr, Suite #1, Winfield, AL 35594-5005 | 2008-06-03 |
| 1699890483 | Comfortlink, Inc | Pediatrics | 25 N Winfield Rd, Winfield, IL 60190 | 2007-03-20 |
| Find all providers in WINFIELD | ||||
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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.