BODY AND MIND MEDICAL (NPI# 1851843692) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851843692 |
| Entity Type | Organization |
| Organization Name | BODY AND MIND MEDICAL |
| Practice Address |
2222 W Division St Suite 130 Chicago IL 60622-2717 |
| Practice Telephone | 7732524848 |
| Practice Fax Number | 7732528484 |
| Mailing Telephone | 7732524848 |
| Mailing Fax Number | 7732528484 |
| Enumeration Date | 2016-10-27 |
| Last Update Date | 2016-10-27 |
| Authorized Official Name | DR. DOMINIC GAZIANO (PRESIDENT) |
| Authorized Official Telephone | 7739882220 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 133V00000X | Dietitian, Registered | 164006794 | IL | Dietary & Nutritional Service Providers |
| Y | 207R00000X | Internal Medicine | 036091770 | IL | Allopathic & Osteopathic Physicians |
| Street Address |
2222 W DIVISION ST SUITE 130 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60622-2717 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720086572 | Houshang Farahvar | Orthopaedic Surgery | 2222 W Division St, Suite 235, Chicago, IL 60622-2717 | 2005-07-13 |
| 1790307858 | Nwamaka Ezurike | Family Medicine | 2222 W Division St, Chicago, IL 60622-2717 | 2020-05-12 |
| 1285281386 | Francesca Pabalan | Emergency Medicine | 2222 W Division St, Chicago, IL 60622-2717 | 2019-08-22 |
| 1790344992 | Muderi Anju Aradi | Student in an Organized Health Care Education/Training Program | 2222 W Division St, Chicago, IL 60622-2717 | 2019-06-11 |
| 1538688312 | Alicia Mireya Mangano | Nurse Practitioner | 2222 W Division St, Chicago, IL 60622-2717 | 2017-09-13 |
| 1750833596 | Claudia Bueno | Dietitian, Registered | 2222 W Division St, Suite 130, Chicago, IL 60622-2717 | 2016-10-27 |
| 1407268378 | Reem Mohammad | Podiatrist | 2222 W Division St, Suite 105, Chicago, IL 60622-2717 | 2014-05-28 |
| 1457787475 | Giovanni D. Giannotti Md, S.c. | Surgery | 2222 W Division St, Suite 335, Chicago, IL 60622-2717 | 2013-09-23 |
| 1932548500 | Dominik Cornelius Meyer | Podiatrist | 2222 W Division St, #105, Chicago, IL 60622-2717 | 2013-06-17 |
| 1336447150 | Korathu Thomas, M.d. | Internal Medicine | 2222 W Division St, Suite 210, Chicago, IL 60622 | 2011-03-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447880471 | Erikson Institute | Clinic/Center | 2739 W Division St, Chicago, IL 60622 | 2020-01-17 |
| 1720620545 | Emily Claire Bonanno | Counselor | 1397 N Miwaukee Ave, Chicago, IL 60622 | 2019-10-14 |
| 1891342093 | Taylor Mallon | Speech-Language Pathologist | 8870 South Duffy Avenue, Apartment 406, Chicago, IL 60622 | 2019-08-22 |
| 1083260277 | Maggie Inman | Student in an Organized Health Care Education/Training Program | 1431 N Claremont Avenue, 2nd Floor Pavilion, Chicago, IL 60622 | 2019-08-13 |
| 1174176168 | Karol Maricel Quelal Analuisa | Internal Medicine | 1901 W Harrison, Chicago Il 60612-3714, Chicago, IL 60622 | 2019-07-19 |
| 1073076105 | Nichole Galullo | Social Worker | 1431 N Claremont 2nd Floor, Chicago, IL 60622 | 2019-04-06 |
| 1003375122 | Alfredo Delgado Perez Sr. | Psychologist | 1127 N Oakley Bvl 3 Floor, Chicago, IL 60622 | 2019-03-18 |
| 1841773439 | Abigail Hector | Counselor | 1521 N Milwaukee Ave, 3n, Chicago, IL 60622 | 2018-09-11 |
| 1164916144 | Dorothy Mitkowski | Student in an Organized Health Care Education/Training Program | 1127 N. Oakley Blvd., 2nd Floor, Chicago, IL 60622 | 2018-06-21 |
| 1255825121 | Kara Lynn Daniel | Speech-Language Pathologist | 1540 N Artesian Ave Apt 2r, Chicago, IL 60622 | 2018-06-14 |
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| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922606193 | Thatiana Carolina Schulze Goni | Internal Medicine | 5924 N Lincoln Ave Apt 205, Chicago, IL 60659-3736 | 2020-10-11 |
| 1750995742 | Eva Bartaula | Internal Medicine | 1500 S Fairfield Ave # 3, Chicago, IL 60608-1782 | 2020-09-07 |
| 1750994513 | Ranjit Babu Jasaraj | Internal Medicine | 1500 S Fairfield Ave # F-914, Chicago, IL 60608-1782 | 2020-08-30 |
| 1871106005 | Vijay Ketan Reddy | Internal Medicine | 1500 S Fairfield Ave Dept Roomf914, Chicago, IL 60608-1782 | 2020-08-27 |
| 1144839739 | Sandhya Shri Kannayiram | Internal Medicine | 1901w Harrison Street, Chicago, IL 60612 | 2020-07-29 |
| 1871119172 | Irina Komissarova | Internal Medicine | 916 S Oakley Blvd, Chicago, IL 60612-4230 | 2020-06-22 |
| 1336760719 | Arslan Zahid | Internal Medicine | 5847 S Maryland Ave, Chicago, IL 60637-1463 | 2020-04-27 |
| 1104447572 | Nirmal Desai | Internal Medicine | 5841 S Maryland Ave., M/c 7082, Chicago, IL 60637-1443 | 2020-04-27 |
| 1467072447 | Justin Edmond Sipiora | Internal Medicine | 5841 S. Maryland Ave Mc 7082, Chicago, IL 60637-1443 | 2020-04-20 |
| 1003449612 | Eoht LLC | Internal Medicine | 1718 W North Shore Ave Apt 11, Chicago, IL 60626-4030 | 2020-02-21 |
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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.