EDGAR E ARCHBOLD (NPI# 1801003991) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801003991 |
| Entity Type | Individual |
| Full Name | EDGAR E ARCHBOLD |
| Credential | M.D |
| Practice Address |
6917 W Cermak Rd Berwyn IL 60408 |
| Mailing Address |
6917 W Cermak Rd Berwyn IL 60402 |
| Practice Telephone | 7087498190 |
| Practice Fax Number | 7087498190 |
| Mailing Telephone | 7087498190 |
| Mailing Fax Number | 7087498190 |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2008-12-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 036-069407 | IL | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 036069407 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036068407 | 05 | |
| IL | BS | 01625394 | 01 |
| Street Address |
6917 W CERMAK RD |
| City | BERWYN |
| State | IL |
| Zip Code | 60408 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073853347 | Braidwood Fire Protection District | Ambulance | 275 W. Main St., Braidwood, IL 60408 | 2013-02-25 |
| 1346424918 | Sherri Pierce | Physical Therapy Assistant | 1130 N. Division, Braidwood, IL 60408 | 2007-12-19 |
| 1437234606 | Highland Park Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 230 Comet Drive, Braidwood, IL 60408 | 2006-10-26 |
| 1447652631 | Jeromy Lee Pellegrini | Massage Therapist | 180 Main St., Braidwood, IL 60408 | 2014-09-19 |
| 1205214749 | Kathryn Devine | Massage Therapist | 402 W 6th St, Braidwood, IL 60408-1330 | 2015-05-18 |
| 1972046639 | Christine Patterson | Counselor | 330 W Bergera Rd Unit D, Braidwood, IL 60408-1518 | 2016-11-29 |
| 1205214467 | April Crawford | Massage Therapist | 180 E Main St, Braidwood, IL 60408-1912 | 2015-05-08 |
| 1003105495 | Elite Rehabilitation Institute Braidwood LLC | Physical Therapist | 180 E Main St, Braidwood, IL 60408-1912 | 2011-04-06 |
| 1710110481 | Jason P Lamarche | Chiropractor | 180 E Main St, Braidwood, IL 60408-1912 | 2009-08-28 |
| 1801801782 | Braidwood Volunteer Fire Department | Ambulance | 275 W Main St, Braidwood, IL 60408-1919 | 2006-07-29 |
| Find all providers in zip 60408 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760910962 | Acosta and Cabrera Medical Associates, S.c. | Family Medicine | 3100 Oak Park Ave Ste 1s, Berwyn, IL 60402-4177 | 2017-06-01 |
| 1780006619 | Villasenor In-home Patient Care LLC | Family Medicine | 1639 Oak Park Ave, Berwyn, IL 60402-1782 | 2014-01-12 |
| 1881031656 | Stephanie S Kim | Family Medicine | 3231 S. Euclid Avenue, 5th Floor, Berwyn, IL 60402 | 2013-06-03 |
| 1851644942 | Lose Weight 1 LLC | Family Medicine | 901 Lancaster Ave, Suite 100, Berwyn, PA 19312-1710 | 2012-10-26 |
| 1548550262 | Mayra Gonzalez | Family Medicine | 7000 West Cermak Road, Berwyn, IL 60402 | 2011-04-14 |
| 1356586853 | Susan Marie Kennedy | Family Medicine | 1185 S Leopard Rd, Berwyn, PA 19312-2028 | 2008-12-11 |
| 1306090212 | Perez Health, Incorporated | Family Medicine | 6842 W. Cermak Road, Berwyn, IL 60402-2240 | 2008-11-06 |
| 1265690523 | Aaron D Lee | Family Medicine | 3231 S Euclid Ave, 5th Floor, Berwyn, IL 60402 | 2008-05-23 |
| 1265623540 | Charito M Delatorre | Family Medicine | 1909 Clinton Ave, Berwyn, IL 60402-1642 | 2007-08-05 |
| 1679604979 | Matthew Lewullis | Family Medicine | 1001 Chesterbrook Boulevard, Berwyn, PA 19312 | 2007-03-08 |
| Find all providers in BERWYN | ||||
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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.