KENNETH DAVID ILLINGWORTH (NPI# 1851646566) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851646566 |
| Entity Type | Individual |
| Full Name | KENNETH DAVID ILLINGWORTH |
| Credential | M.D. |
| Practice Address |
301 N 8th St Pav 3a158 Springfield IL 62794 |
| Mailing Address |
Po Box 19000 Springfield IL 62794 |
| Practice Telephone | 2175458853 |
| Practice Fax Number | 2175450828 |
| Mailing Telephone | 2175458853 |
| Mailing Fax Number | 2175450828 |
| Enumeration Date | 2012-07-18 |
| Last Update Date | 2012-07-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | 125.061286 | IL | Allopathic & Osteopathic Physicians |
| Street Address |
301 N 8TH ST PAV 3A158 |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62794 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750941639 | Ammar Tarabichi | Psychiatry & Neurology | 751 N Rutledge, Springfield, Il, Springfield, IL 62794 | 2019-06-13 |
| 1255623997 | Venkata Sasidhar Majjiga | Pediatrics | 301 N 8th Street, Siu School of Medicine, Pediatrics, Room 3a169, Springfield, IL 62794 | 2011-05-13 |
| 1205810082 | Michael R Pranzatelli | Psychiatry & Neurology | Southern Illinois University Healthcare Administration, Springfield, IL 62794 | 2005-12-05 |
| 1346735065 | Pooja Sheth-dutt | Family Medicine | 520 N 4th St, Springfield, IL 62794 | 2018-06-25 |
| 1558511519 | John Wang | Emergency Medicine | 520 North Fourth Street, Springfield, IL 62794 | 2008-09-26 |
| 1659431351 | University of Illinois | Public Health or Welfare | 2815 W Washington, Suite 300, Springfield, IL 62794-9481 | 2006-12-11 |
| 1750645263 | Schuyler Whitney Stone | Internal Medicine | 701 North 1st Street, Springfield, IL 62794-9636 | 2012-06-28 |
| 1083695811 | John Mark Ruscin | Pharmacist | 701 N. First Street, Springfield, IL 62794-9636 | 2005-11-09 |
| 1053750851 | Ashley Patricia Macdonald | Family Medicine | 520 N Fourth St, Springfield, IL 62794-9670 | 2013-06-14 |
| 1386759264 | David Buoy Graham | Family Medicine | 520 North 4th Street, Springfield, IL 62794-9670 | 2006-08-20 |
| Find all providers in zip 62794 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| 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 Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104440049 | Elliot M Johns | Orthopaedic Surgery | 301 N 8th St Ste 3a158, Springfield, IL 62701-1085 | 2020-06-06 |
| 1740804764 | David Alan Forgas | Orthopaedic Surgery | 901 N 1st St # D252, Springfield, IL 62702-3759 | 2020-06-05 |
| 1063849719 | Effingham Hospital, Inc. | Orthopaedic Surgery | 459 Highway 119 S Ste A, Springfield, GA 31329-3021 | 2013-09-26 |
| 1760792329 | Lasante Inc | Orthopaedic Surgery | 4936 Laverna Road, Springfield, IL 62707-9797 | 2010-10-18 |
| 1902134638 | Optim Orthopedics, LLC | Orthopaedic Surgery | 459 Highway 119 South, Springfield, GA 31329 | 2009-11-18 |
| 1861630113 | Acustep Diabetic Foot Center, LLC | Orthopaedic Surgery | 2139 W Republic Rd, Springfield, MO 65807-5705 | 2009-01-24 |
| 1902066491 | Charles Joseph Ash | Orthopaedic Surgery | 3433 I S Campbell, Springfield, MO 65807 | 2008-06-10 |
| 1366616849 | Jennie Garver | Orthopaedic Surgery | 300 Birnie Ave Ste 301, Springfield, MA 01107 | 2008-04-16 |
| 1841487733 | Maplegate Rehab Inc. Dba Medical Associates | Orthopaedic Surgery | 181 State St, Springfield, MA 01103-1719 | 2007-09-25 |
| 1669681003 | Samuel A Finck | Orthopaedic Surgery | 2600 N Limestone St Ste 150, Springfield, OH 45503 | 2007-05-22 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62794 |
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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.