MICHAEL JAKE PETERSEN (NPI# 1780248146) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780248146 |
| Entity Type | Individual |
| Full Name | MICHAEL JAKE PETERSEN |
| Practice Address |
600 S Paulina St Ste 403 Chicago IL 60612-3806 |
| Practice Telephone | 3129427100 |
| Enumeration Date | 2019-04-30 |
| Last Update Date | 2019-04-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740602960 | Michael Petersen | Veterinarian | 5754 Nicollet Ave, Minneapolis, MN 55419-2415 | 2014-01-07 |
| 1407902307 | Michael James Petersen | Dentist | 3101 Old Highway 8, Suite #303, Roseville, MN 55113-1072 | 2007-01-25 |
| 1881798379 | Michael Charles Petersen | Pediatrics | 12356 Riata Trace Pkwy # 6006-b, Austin, TX 78727-6417 | 2006-09-12 |
| 1629005160 | Michael R Petersen | Ophthalmology | 2000 N Huron River Dr Ste 100, Ypsilanti, MI 48197 | 2006-06-28 |
| 1467428656 | Michael S Petersen | Orthopaedic Surgery | 2020 Sutter Pl, Suite 104, Davis, CA 95616-6213 | 2006-02-27 |
| 1609849736 | Michael T Petersen | Anesthesiology | 25 Main Pl, Suite 425, Council Bluffs, IA 51503-0792 | 2006-02-09 |
| 1639785579 | Michael Lee Petersen | Pharmacist | 900 W Clairemont Ave, Eau Claire, WI 54701-6122 | 2020-09-16 |
| 1093182552 | Michael Petersen | Counselor | 1067 E Tabernacle St, Suite 7, Saint George, UT 84770-3163 | 2015-08-31 |
| 1972746931 | Michael G Petersen | Physician Assistant | 7201 Manchaca Rd, Ste B, Austin, TX 78745-5283 | 2009-04-07 |
| 1518974153 | Michael J Petersen | Podiatrist | 3922 Mercy Dr, Mchenry, IL 60050-3151 | 2006-08-02 |
| Street Address |
600 S PAULINA ST STE 403 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60612-3806 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720060072 | Ruchi Mishra Fitzgerald | Family Medicine | 600 S Paulina St Ste 403, Chicago, IL 60612-3806 | 2005-11-14 |
| 1891394524 | Pokhraj Prakashchandra Suthar | Nuclear Medicine | 600 S Paulina St Ste 403, Chicago, IL 60612-3806 | 2020-10-23 |
| 1497371488 | Paz Abergel | Podiatrist | 600 S Paulina St Ste 403, Chicago, IL 60612-3806 | 2020-06-25 |
| 1346866670 | Mira Adly Mahmoud Ayoub | Radiology | 600 S Paulina St Ste 403, Chicago, IL 60612-3806 | 2020-06-23 |
| 1780200121 | Daniel Francis Roadman | Urology | 600 S Paulina St Ste 403, Chicago, IL 60612-3806 | 2020-06-22 |
| 1528684982 | Carol Lynn Feng | Urology | 600 S Paulina St Ste 403, Chicago, IL 60612-3806 | 2020-06-22 |
| 1225654874 | Rahim Shakoor | Psychiatry & Neurology | 600 S Paulina St Ste 403, Chicago, IL 60612-3806 | 2020-06-19 |
| 1437775327 | Pei-ning Hsu | Psychiatry & Neurology | 600 S Paulina St Ste 403, Chicago, IL 60612-3806 | 2020-06-17 |
| 1316562200 | Jeanette Marie Lorme | Emergency Medicine | 600 S Paulina St Ste 403, Chicago, IL 60612-3806 | 2020-06-16 |
| 1669097812 | Jayne Slocum | Anesthesiology | 600 S Paulina St Ste 403, Chicago, IL 60612-3806 | 2020-06-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144839739 | Sandhya Shri Kannayiram | Internal Medicine | 1901w Harrison Street, Chicago, IL 60612 | 2020-07-29 |
| 1568080174 | Nastaran Ordoyo Haghani Rad | Student in an Organized Health Care Education/Training Program | 1950 W. Polk Street, Room 6203, Chicago, IL 60612 | 2020-07-09 |
| 1669090403 | Marianne Gagnon-konamna | Student in an Organized Health Care Education/Training Program | 1950 West Polk Street, Chicago, IL 60612 | 2020-07-08 |
| 1922625672 | Tanya Montgomery Nee Brown | Pediatrics | 1950 West Polk Street, Neonatal and Perinatal Department, Chicago, IL 60612 | 2020-06-29 |
| 1124643028 | Ashley Swan | Dentist | 801 S. Paulina St, Uic College of Dentistry - Endodontics Clinic, Chicago, IL 60612 | 2020-06-16 |
| 1831711381 | Baillie Anne Bronner | Obstetrics & Gynecology | 1653 W Congress Pkwy Chicago, Il 60612, Chicago, IL 60612 | 2020-05-07 |
| 1154942449 | Keisha Davell Cole | Case Manager/Care Coordinator | 612 S Western Ave Unit 1, Chicago, IL 60612 | 2020-04-28 |
| 1275153777 | Isac Lim | Student in an Organized Health Care Education/Training Program | 1234 S. Wells, Chicago, IL 60612 | 2020-04-24 |
| 1578183414 | Zachary Belden | Student in an Organized Health Care Education/Training Program | Uic Psychiatry Residency 912 S. Wood St., Rm 130b Npi-s (mc 913), Chicago, IL 60612 | 2020-04-21 |
| 1548880560 | Christina Nunez | Student in an Organized Health Care Education/Training Program | 801 S. Paulina Street, M/c 850, Chicago, IL 60612 | 2020-04-20 |
| Find all providers in zip 60612 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205443975 | Nickolas Armstrong | Student in an Organized Health Care Education/Training Program | 2828 N Pine Grove Ave Apt 618, Chicago, IL 60657-6137 | 2020-09-28 |
| 1134735962 | Kalvin Cheuk Hang Lung | Student in an Organized Health Care Education/Training Program | 675 N St Clair St 17th Floor, Chicago, IL 60611 | 2020-09-17 |
| 1487267845 | Ashley Marie Sablich | Student in an Organized Health Care Education/Training Program | 250 E Huron Street, Suite 1-200, Chicago, IL 60611 | 2020-08-26 |
| 1275146599 | Ryan Mather | Student in an Organized Health Care Education/Training Program | 155 N Michigan Ave Ste 566, Chicago, IL 60601-7799 | 2020-08-26 |
| 1831701010 | Alexandra Klonis | Student in an Organized Health Care Education/Training Program | 676 N Saint Clair St Ste 6-108, Chicago, IL 60611-2927 | 2020-08-19 |
| 1851903389 | Brittney Christine Evans | Student in an Organized Health Care Education/Training Program | 1901 N Clybourn Ave Ste 302&304, Chicago, IL 60614-5090 | 2020-08-17 |
| 1205446358 | Kai Lai Chu | Student in an Organized Health Care Education/Training Program | 600 N Fairbanks Ct Unit 3505, Chicago, IL 60611-5869 | 2020-08-04 |
| 1568080174 | Nastaran Ordoyo Haghani Rad | Student in an Organized Health Care Education/Training Program | 1950 W. Polk Street, Room 6203, Chicago, IL 60612 | 2020-07-09 |
| 1669090403 | Marianne Gagnon-konamna | Student in an Organized Health Care Education/Training Program | 1950 West Polk Street, Chicago, IL 60612 | 2020-07-08 |
| 1407474463 | Madison Nicole Schulenberg | Student in an Organized Health Care Education/Training Program | 1111 W 14th Pl Unit 119, Chicago, IL 60608-2796 | 2020-07-07 |
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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.