DR. AVI MAZUMDAR (NPI# 1760547889) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760547889 |
| Entity Type | Individual |
| Full Name | DR. AVI MAZUMDAR |
| Credential | MD |
| Practice Address |
25 N Winfield Rd Suite 500 Winfield IL 60190-1295 |
| Practice Telephone | 6309332113 |
| Practice Fax Number | 6309334520 |
| Mailing Telephone | 6309332113 |
| Mailing Fax Number | 6309334520 |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2018-01-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
2002021169 | MO | Allopathic & Osteopathic Physicians |
| N | 2085N0700X |
Radiology Specialization: Neuroradiology |
036113885 | IL | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
036113885 | IL | Allopathic & Osteopathic Physicians |
| Y | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
036113885 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | MEDICARE PTAN (GROUP) | 206147 | 01 |
| IL | 036113885 | 05 | |
| IL | RR MEDICARE (INDIVIDUAL) | P00762032 | 01 |
| IL | MEDICARE PTAN (INDIVIDUAL) | K35062 | 01 |
| MO | 207599606 | 05 |
| Street Address |
25 N WINFIELD RD SUITE 500 |
| 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 |
| Find all providers in the same location | ||||
| 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 |
| Find all providers in zip 60190 | ||||
| Taxonomy Code | 2085R0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Vascular & Interventional Radiology |
| A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760094130 | William Newton Memorial Hospital | Radiology | 1305 E 5th Ave, Winfield, KS 67156-2406 | 2020-08-18 |
| 1851311450 | Harish N Shownkeen | Radiology | 25 N Winfield Road, Suite 500, Winfield, IL 60190-1295 | 2006-07-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588261978 | Thorek Radiology Group Nfp | Radiology | 850 West Irving Park Road, Chicago, IL 60613 | 2020-10-08 |
| 1659930998 | Howard Simon Md PC | Radiology | 446 E Ontario St Ste 106, Chicago, IL 60611-7110 | 2019-06-11 |
| 1982119319 | Vein and Vascular Centers, Sc | Radiology | 7 N Grant St Ste 1, Hinsdale, IL 60521-3366 | 2017-12-07 |
| 1114438769 | Advanced Midwest Interventional Radiology, LLC | Radiology | 1890 Silver Cross Blvd Ste 455, New Lenox, IL 60451-9546 | 2017-10-21 |
| 1528440690 | Tarek Jazmati | Radiology | 1653 W Congress Pkwy # 181, Chicago, IL 60612-3833 | 2015-06-24 |
| 1316351232 | Smg Billing, LLC | Radiology | 1105 S. Western Ave., Chicago, IL 60612 | 2014-06-18 |
| 1013270982 | Sean David Pietrini | Radiology | 1500 W Monroe St, Apartment 118, Chicago, IL 60607 | 2012-06-16 |
| 1417240102 | Sameul Hanif | Radiology | 7808 W College Dr Ste 1se, Palos Heights, IL 60463-1095 | 2011-05-27 |
| 1649563842 | Alex Edward Heaton | Radiology | 911 N Elm St Ste 128, Hinsdale, IL 60521-3640 | 2011-05-20 |
| 1932426863 | Lifeline Vascular Access Network, LLC | Radiology | Three Hawthorn Parkway, Suite 410, Vernon Hills, IL 60061-1450 | 2010-05-03 |
| Find all providers with the same taxonomy | ||||
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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.