AMIT DATE (NPI# 1831311984) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831311984 |
| Entity Type | Individual |
| Full Name | AMIT DATE |
| Credential | MD, MBA |
| Practice Address |
3101 Fields South Dr Champaign IL 61822-3743 |
| Mailing Address |
101 W University Ave Champaign IL 61820-3909 |
| Practice Telephone | 2173661243 |
| Practice Fax Number | 2173666106 |
| Mailing Telephone | 2173668107 |
| Mailing Fax Number | 2173666106 |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2020-10-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | 036126212 | IL | Allopathic & Osteopathic Physicians |
| N | 207Y00000X | Otolaryngology | 125-049364 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | MEDICARE INDIVIDUAL PTAN | IL2613057 | 01 |
| IL | MEDICARE GROUP PTAN | IL2613 | 01 |
| Street Address |
3101 FIELDS SOUTH DR |
| City | CHAMPAIGN |
| State | IL |
| Zip Code | 61822-3743 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750386215 | Nathan A Crouch | Optometrist | 3101 Fields South Dr, Champaign, IL 61822-3743 | 2005-06-20 |
| 1255961470 | Kyle Kappes | Student in an Organized Health Care Education/Training Program | 3101 Fields South Dr, Champaign, IL 61822-3743 | 2020-01-16 |
| 1356897003 | Emily Foertsch | Nurse Practitioner | 3101 Fields South Dr, Champaign, IL 61822-3743 | 2016-08-31 |
| 1467858308 | Kelly Mae Guzlas | Registered Nurse | 3101 Fields South Dr, Champaign, IL 61822-3743 | 2014-11-04 |
| 1811257348 | Samantha Herriott | Physical Therapist | 3101 Fields South Dr, Champaign, IL 61822-3743 | 2012-05-17 |
| 1861791261 | Karen Valerie Draper | Internal Medicine | 3101 Fields South Dr, Champaign, IL 61822-3743 | 2011-03-24 |
| 1841517679 | Lisa Ryan Hobbs | Podiatrist | 3101 Fields South Dr, Champaign, IL 61822-3743 | 2010-05-04 |
| 1497940993 | Dara Naomi Catron | Occupational Therapist | 3101 Fields South Dr, Champaign, IL 61822-3743 | 2007-09-09 |
| 1356560353 | Christine Benway | Physical Therapist | 3101 Fields South Dr, Champaign, IL 61822-3743 | 2007-04-25 |
| 1518064062 | Eric P Helfer | Urology | 3101 Fields South Dr, Champaign, IL 61822-3743 | 2006-09-19 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083180830 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 2718 N Prospect Avenue, Champaign, IL 61822 | 2018-10-19 |
| 1487129730 | Siegfred T. Celis | Occupational Therapy Assistant | 1820 Oak Park Drive, Champaign, IL 61822 | 2018-10-12 |
| 1134633746 | Osf Healthcare System | Home Health | 1501 Interstate Dr Ste C, Champaign, IL 61822 | 2017-11-20 |
| 1386164200 | Carlo Sandico | Physical Therapist | 612 Corey Lane, Champagne, IL 61822 | 2017-06-21 |
| 1295270288 | Jennifer Lee Lugo | Registered Nurse | 3101 Fields South Dr., Champaign, IL 61822 | 2016-12-29 |
| 1902341209 | Jala Simmons | Behavioral Analyst | 4112 Fieldstone Rd, Suite B, Champaign, IL 61822 | 2016-12-22 |
| 1639552433 | Muhammad Ajmal | Internal Medicine | 1701 Curtis Road, Carle Clinic, Champaign, IL 61822 | 2015-06-30 |
| 1518363761 | Margaret A. Hallden | Hearing Instrument Specialist | 3354 Big Pine Trail #c, Audibel Hearing Aids, Champaign, IL 61822 | 2014-11-17 |
| 1801291638 | Kristen Karlsen | Pharmacist | 3114 Village Office Place, Champaign, IL 61822 | 2014-10-22 |
| 1649601543 | Jeff Chu | Optometrist | 507 W. Town Center Blvd, Champaign, IL 61822 | 2013-12-03 |
| Find all providers in zip 61822 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851811343 | Peter S Dumich | Otolaryngology | 2609 S Nottingham Ct, Champaign, IL 61821-6182 | 2017-06-26 |
| 1528077195 | William D. Youngerman | Otolaryngology | 101 W University Ave, Champaign, IL 61820-3909 | 2006-08-05 |
| 1447278676 | Ashok A Jagasia | Otolaryngology | 3101 Fields South Dr, Champaign, IL 61822-3743 | 2006-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841838109 | Ryan C. Vaughn, Md Pllc | Otolaryngology | 1900 E Golf Rd Ste L125, Schaumburg, IL 60173-5831 | 2019-12-18 |
| 1265074934 | Toriumi Facial Plastics Pllc | Otolaryngology | 60 E Delaware Pl Ste 1425, Chicago, IL 60611-1998 | 2019-10-14 |
| 1184281735 | Advanced Ear Nose & Throat Specialists, Pllc | Otolaryngology | 925 N Milwaukee Ave Unit 200, Vernon Hills, IL 60061-1637 | 2019-05-20 |
| 1780144402 | Veronica Maria Drozdowski | Otolaryngology | 2160 S 1st Ave Rm 1870, Maywood, IL 60153-3328 | 2019-03-20 |
| 1205395019 | Brian Yuhan | Otolaryngology | 2160 S 1st Ave Bldg 105, Maywood, IL 60153-3328 | 2019-03-19 |
| 1285100529 | Lauren E Lesniewski | Otolaryngology | 680 N Lake Shore Dr Ste 1210, Chicago, IL 60611-4490 | 2018-10-14 |
| 1982100525 | Muyinat Yewande Osoba | Otolaryngology | 675 N. Saint Clair St, Galter Pavilion, 15th Floor, Room 200, Chicago, IL 60611-5975 | 2018-04-03 |
| 1104354414 | Sara M. Wing | Otolaryngology | 301 N 8th St Ste 5b, Springfield, IL 62701-1041 | 2017-05-31 |
| 1750734778 | Darius Bliznikas Md Sc | Otolaryngology | 7110 W 127th St Ste 210, Palos Heights, IL 60463-1580 | 2016-07-14 |
| 1366822009 | Camil Correia | Otolaryngology | 675 N Saint Clair St Fl 15, Chicago, IL 60611-5975 | 2015-06-08 |
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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.