NORTHSIDE NEUROSURGERY, LLC (NPI# 1710296934) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710296934 |
| Entity Type | Organization |
| Organization Name | NORTHSIDE NEUROSURGERY, LLC |
| Practice Address |
3000 N Halsted St Suite 605 Chicago IL 60657-5188 |
| Mailing Address |
712 S Milwaukee Ave Libertyville IL 60048-3279 |
| Practice Telephone | 7733484333 |
| Practice Fax Number | 7733482434 |
| Mailing Telephone | 8473621848 |
| Mailing Fax Number | 8473622588 |
| Enumeration Date | 2010-10-05 |
| Last Update Date | 2011-06-17 |
| Authorized Official Name | BETSY M MATTHEWS (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 8479901463 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207T00000X | Neurological Surgery | IL | Allopathic & Osteopathic Physicians |
| Street Address |
3000 N HALSTED ST SUITE 605 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60657-5188 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053310482 | Mark Pietz | Podiatrist | 3000 N Halsted St, Suite 821, Chicago, IL 60657-5188 | 2005-07-18 |
| 1740844232 | Sandra Mazzeffi | Nurse Practitioner | 3000 N Halsted St, Chicago, IL 60657-5188 | 2019-04-30 |
| 1437713930 | Molly O'brien | Physician Assistant | 3000 N Halsted St, Chicago, IL 60657-5188 | 2019-04-30 |
| 1245760081 | Carolina Coello | Nurse Practitioner | 3000 N Halsted St, Chicago, IL 60657-5188 | 2017-06-14 |
| 1417302704 | Brittany Beeg | Audiologist | 3000 N Halsted St, Suite 400, Chicago, IL 60657-5188 | 2016-04-25 |
| 1063870525 | Whitney Fritzie | Specialist | 3000 N Halsted St, Suite 320, Chicago, IL 60657-5188 | 2016-01-29 |
| 1952776445 | Alissa Roberts | Nurse Practitioner | 3000 N Halsted St, Suite 723, Chicago, IL 60657-5188 | 2015-12-09 |
| 1366815250 | Windy City Pediatrics | Clinic/Center | 3000 N Halsted St, Suite 825, Chicago, IL 60657-5188 | 2015-11-02 |
| 1346640828 | Ellen May | Audiologist | 3000 N Halsted St, Suite 400, Chicago, IL 60657-5188 | 2014-09-03 |
| 1558771543 | Anthony Lisuzzo | Physician Assistant | 3000 N Halsted St, Suite #525, Chicago, IL 60657-5188 | 2014-04-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992303887 | Simone Paes | Behavior Technician | 3141 N Sheffield Ave, Chicago, IL 60657 | 2020-10-13 |
| 1821613175 | Samridhi Khatri | Internal Medicine | 836 W. Wellington Ave, Advocate Illinois Masonic Medica, Suite 1312, Chigaco, IL 60657 | 2020-06-12 |
| 1467074617 | Dewolfe Aesthetic Services Sc | Surgery | 3357 N. Southport Aveune, Chicago, IL 60657 | 2020-05-11 |
| 1790304657 | Mehr Amer Mjeed | Student in an Organized Health Care Education/Training Program | Advocate Internal Medicine Clinic, Advocate Illinois Ma, 836 West Wellington Avenue, Chicago, IL 60657 | 2020-04-10 |
| 1457997561 | Jasleen Mohini Singh | Physician Assistant | 1645a W School Street, Suite A, Clinic Entrance, Chicago, IL 60657 | 2019-11-24 |
| 1306493408 | Art of Sight Eyecare, LLC | Optometrist | 2915 N. Broadway, Chicago, IL 60657 | 2019-08-22 |
| 1992359277 | Joseph Michael Rochford IIi | Counselor | 1358 W Belmont Ave, Unit # 202, Chicago, IL 60657 | 2019-07-25 |
| 1487116240 | Conrad Petersen Dermatology Sc | Dermatology | 2845 N Sheridan, Chicago, IL 60657 | 2019-04-02 |
| 1003388810 | Evolve Wellness S.c. | Counselor | 2845 North Sheridan Road, Suite 708, Chicago, IL 60657 | 2018-12-19 |
| 1639657414 | Advocate North Side Health Network | Psychiatric Unit | 836 W Wellington Ave., Chicago, IL 60657 | 2018-08-02 |
| Find all providers in zip 60657 | ||||
| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881124030 | Denise Brunozzi | Neurological Surgery | 912 South Wood Street, 451 N - Hc 739, Chicago, IL 60612 | 2017-06-19 |
| 1225455181 | Jehad Algharabli | Neurological Surgery | 2218 S Leavitt St, Chicago, IL 60608-4008 | 2014-03-27 |
| 1992041461 | Gursant Atwal | Neurological Surgery | University of Il Hospital & Health Science System, 1740 W Taylor St, Chicago, IL 60612 | 2013-01-02 |
| 1639445877 | Joseph R Rivas | Neurological Surgery | 511 W Belmont Ave, #32, Chicago, IL 60657-4663 | 2012-03-30 |
| 1801102322 | Karissa Marie Dunkleyshurts | Neurological Surgery | 2865 N Clybourn Ave, Number 3, Chicago, IL 60618-8269 | 2010-08-21 |
| 1326377896 | Mobile Doctors,inc | Neurological Surgery | 131 E 47th St, Chicago, IL 60653-3806 | 2009-12-13 |
| 1275762262 | Paul David Ackerman | Neurological Surgery | 7447 W Talcott Ave Ste 340, Chicago, IL 60631-3714 | 2009-07-10 |
| 1093962813 | Hideki Ogiwara | Neurological Surgery | 2300 N Childrens Plz # 28, Chicago, IL 60614-3363 | 2008-08-22 |
| 1447473426 | Richard Glenn Fessler | Neurological Surgery | 1725 W. Harrison Ave, Suite 855, Chicago, IL 60612 | 2007-04-10 |
| 1174688907 | Richard D Penn | Neurological Surgery | 4950 S Chicago Beach Dr, Chicago, IL 60615-3204 | 2006-12-22 |
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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.