DR. MARK A JOHNSON (NPI# 1730383662) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730383662 |
| Entity Type | Individual |
| Full Name | DR. MARK A JOHNSON |
| Credential | M.D. |
| Practice Address |
611 W. Park St. Urbana IL 61801-2500 |
| Mailing Address |
611 W. Park St. Bwpc Urbana IL 61801-2500 |
| Practice Telephone | 2173833087 |
| Mailing Telephone | 2173836792 |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2015-01-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
036130838 | IL | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427528546 | Mark Johnson | Urology | 278 Franklin Rd Ste 150, Brentwood, TN 37027-3265 | 2018-12-01 |
| 1437692787 | Mark Johnson | Pharmacist | 500 N Claude Lord Boulevard, Pottsville, PA 17901-3868 | 2016-11-18 |
| 1902277734 | Mark Johnson Sr. | Counselor | 5310 Eagle Creek Blvd, Shakopee, MN 55379-8617 | 2015-10-20 |
| 1295175966 | Mark Johnson | Pharmacist | 418 Opal Ln, Hibbing, MN 55746-3844 | 2013-06-26 |
| 1275971988 | Mark A Johnson | Dentist | 1714 W Hunt Hwy Ste 100, Queen Creek, AZ 85143-5245 | 2013-06-05 |
| 1598009938 | Mark R Johnson | Pharmacist | 273 12th St Ne, Unit 313, Atlanta, GA 30309-3853 | 2012-11-26 |
| 1164778619 | Mark Anthony Johnson | Pharmacist | 3449 Rezanof Drive, Kodiak, AK 99615 | 2012-08-01 |
| 1881953578 | Mark Joseph Johnson | Anesthesiology | 2810 N Swan Rd Ste 1002810n, Tucson, AZ 85712-6305 | 2012-05-15 |
| 1811261662 | Mark Johnson | Physical Therapist | 3303 Sw Bond Ave Fl 1, Portland, OR 97239-4501 | 2012-02-25 |
| 1639470636 | Mark Johnson | Counselor | 4314 W Lovers Ln, Dallas, TX 75209-2804 | 2010-11-06 |
| Street Address |
611 W. PARK ST. |
| City | URBANA |
| State | IL |
| Zip Code | 61801-2500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780683391 | Marshall Blake Hay | Radiology | 611 W. Park St., Radiology, Urbana, IL 61801-2530 | 2005-07-15 |
| 1780204685 | Kaitlynn Geiger | Physical Therapist | 611 W. Park St., Fapc, Urbana, IL 61801 | 2020-04-21 |
| 1134758758 | Ellen R Leskovisek | Nurse Practitioner | 611 W. Park St., Urbana, IL 61801 | 2020-04-06 |
| 1568006542 | Whitney R Streitmatter | Dietitian, Registered | 611 W. Park St., Fapc, Urbana, IL 61801 | 2019-11-01 |
| 1174165310 | Brett A Fulks | Nurse Practitioner | 611 W. Park St., Urbana, IL 61801 | 2019-10-09 |
| 1932756194 | Carissa Cole | Nurse Practitioner | 611 W. Park St., Urbana, IL 61801 | 2019-08-22 |
| 1316593221 | Xiaoyu Zhang | Speech-Language Pathologist | 611 W. Park St., Urbana, IL 61801 | 2019-08-15 |
| 1144789264 | Hannah Dignan | Nurse Practitioner | 611 W. Park St., Urbana, IL 61801 | 2019-03-18 |
| 1639644982 | Katrina Osana | Physical Therapist | 611 W. Park St., Urbana, IL 61801 | 2018-10-12 |
| 1033684170 | Kourtney L Steinkamp | Nurse Practitioner | 611 W. Park St., Hvi, Urbana, IL 61801 | 2018-10-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417566084 | Avani Sushilkumar Mohta | Internal Medicine | Carle Foundation Hospital, 611 W. Park Street, Urbana, IL 61801 | 2020-07-29 |
| 1922617133 | Recovery Concepts Urbana, LLC | Clinic/Center | 710 W. Killarney St., Urbana, IL 61801 | 2020-07-24 |
| 1447877089 | Muhammad Khalid Abbas | Internal Medicine | 611 W Park St Urbana, Urbana, IL 61801 | 2020-06-30 |
| 1003430166 | Conlan Joseph Pierce | Surgery | 601 W Park St, Urbana, IL 61801 | 2020-06-04 |
| 1568090900 | Luke Andrew Fenlon | Student in an Organized Health Care Education/Training Program | Carle Forum Lower Level, Mc-474, 611 West Park Street, Urbana, IL 61801 | 2020-03-31 |
| 1912559691 | Ali Baltaji | Internal Medicine | 101 N Busey Apt 7, Urbana, IL 61801 | 2019-07-12 |
| 1821510918 | Pallavi Pradeep | Internal Medicine | Imrp, Carle Foundation Hospital, 611 W Park Street, Urbana, IL 61801 | 2017-07-11 |
| 1093236002 | Angela Lynn Devaney | Speech-Language Pathologist | 1400 W Park, Presence Covenant Medical Center, Urbana, IL 61801 | 2017-06-29 |
| 1346775236 | Jennifer Garcia | Student in an Organized Health Care Education/Training Program | Carle Foundation Hospital, 611 W. Park Street, Urbana, IL 61801 | 2017-04-27 |
| 1467992537 | Amber Kristine Davis | Speech-Language Pathologist | 1400 W. Park, Presence Health Medical Center, Urbana, IL 61801 | 2017-03-08 |
| Find all providers in zip 61801 | ||||
| Taxonomy Code | 207RC0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Critical Care Medicine |
| An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053427252 | Karen C White | Internal Medicine | 611 West Park, Urbana, IL 61801-2500 | 2006-08-21 |
| 1750310553 | Ismail Bobat | Internal Medicine | 1400 West Park St, Suite D2248, Urbana, IL 61801-2396 | 2006-07-02 |
| 1720345085 | Melinda Dorottya Miller | Internal Medicine | 611 W. Park St., Critical Care, Urbana, IL 61801-2500 | 2012-04-11 |
| 1144517707 | Temitope Shodunke | Internal Medicine | 611 W. Park St., Critical Care, Urbana, IL 61801-2500 | 2011-07-05 |
| 1174548234 | John F Hill | Internal Medicine | 611 W. Park Street, Trauma/critical Care, Urbana, IL 61801-2530 | 2006-07-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861970626 | Suburban Pulmonary & Critical Care Assoc, Inc | Internal Medicine | 3 Erie Ct Ste 7010, Oak Park, IL 60302-2519 | 2018-08-03 |
| 1265883441 | Kunal H. Patel | Internal Medicine | 9600 Gross Point Rd. Im/icu Hospitalists, Skokie, IL 60076-1900 | 2016-06-28 |
| 1760896633 | Zohaib Akhtar | Internal Medicine | 301 S Park Ave, Herrin, IL 62948-3603 | 2014-06-18 |
| 1699187344 | Said Abuhasna | Internal Medicine | 800 Biesterfield Rd Ste 105, Elk Grove Village, IL 60007-3372 | 2014-05-29 |
| 1053678755 | Nida Junaid | Internal Medicine | 305 W Jackson St Ste 301, Carbondale, IL 62901-1474 | 2012-04-18 |
| 1730446998 | Steven Jay Quinn | Internal Medicine | 11900 Southwest Hwy Ste 101, Palos Park, IL 60464 | 2012-04-12 |
| 1588970933 | Farbod Ghods | Internal Medicine | 5841 S Maryland Ave # Mc6026, Chicago, IL 60637-1447 | 2010-08-24 |
| 1225340045 | Praveen R. Anegondhi Sudhindra | Internal Medicine | 5401 N Knoxville Ave Ste 412b, Peoria, IL 61614-5082 | 2010-07-09 |
| 1588984454 | James M Walter | Internal Medicine | 240 East Huron, Mcgaw M-300, Chicago, IL 60611 | 2010-06-02 |
| 1568789485 | Suleman A Umar | Internal Medicine | 4440 W 95th St Rm 190s, Oak Lawn, IL 60453-2600 | 2010-05-03 |
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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.