MARIAELENA J. FAGADORE (NPI# 1861490138) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861490138 |
| Entity Type | Individual |
| Full Name | MARIAELENA J. FAGADORE |
| Credential | CNP |
| Practice Address |
4254 W 55th St Chicago IL 60632-4642 |
| Practice Telephone | 7735825200 |
| Practice Fax Number | 7735822772 |
| Mailing Telephone | 7735825200 |
| Mailing Fax Number | 7735822772 |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2017-04-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WP0200X |
Registered Nurse Specialization: Pediatrics |
R45506 | NM | Nursing Service Providers |
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
209-015320 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
9244538 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 92187315 | 05 | |
| FL | 307963500 | 05 |
| Street Address |
4254 W 55TH ST |
| City | CHICAGO |
| State | IL |
| Zip Code | 60632-4642 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114464971 | Midway Foot and Ankle PC | Podiatrist | 4254 W 55th St, Chicago, IL 60632-4642 | 2017-01-31 |
| 1417303413 | Lauren Meyers | Registered Nurse | 4254 W 55th St, Chicago, IL 60632-4642 | 2016-05-09 |
| 1215373022 | Midway Pediatrics LLC | Pediatrics | 4254 W 55th St, Chicago, IL 60632-4642 | 2013-05-20 |
| 1225338379 | Manuel O Rojas | Clinic/Center | 4254 W 55th St, Chicago, IL 60632-4642 | 2010-10-22 |
| 1972828804 | Isabel Maria Rojas | Podiatrist | 4254 W 55th St, Chicago, IL 60632-4642 | 2010-04-03 |
| 1710144944 | Erlinda B. Siwa M.d.; Sc | Family Medicine | 4254 W 55th St, Chicago, IL 60632-4642 | 2008-05-16 |
| 1629105739 | Michelle Rojas | Pediatrics | 4254 W 55th St, Chicago, IL 60632-4642 | 2007-02-27 |
| 1063577963 | Thomas E. Grudowski | Pharmacist | 4254 W 55th St, Chicago, IL 60632-4642 | 2006-12-22 |
| 1972662419 | Patricia Arroyo | Pediatrics | 4254 W 55th St, Chicago, IL 60632-4642 | 2006-12-08 |
| 1164519054 | Manuel O Rojas | Pediatrics | 4254 W 55th St, Chicago, IL 60632 | 2006-10-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104474790 | Amanda Rose Dirnberger | Nurse Practitioner | 3229-43 W. 47th Pl., Chicago, IL 60632 | 2019-08-28 |
| 1982121042 | Brown Archer Dental PC | Dentist | 4893 S Archer Ave, Chicago, IL 60632 | 2017-08-29 |
| 1538577085 | Metrosmiles - Archer Heights Dental | Dentist | 5141 S Cicero Ave, Chicago, IL 60632 | 2014-07-29 |
| 1174955173 | Thresholds | Community/Behavioral Health | 718-24 West 47th St, Chicago, IL 60632 | 2013-08-01 |
| 1659612570 | Sapex Home Healthcare, Inc. | In Home Supportive Care | 4107 West 47th Street, Chicago, IL 60632 | 2013-03-04 |
| 1912275462 | Dawn Marie Mackessy | Pharmacist | 5435 S. Kedzie Ave, Chicago, IL 60632 | 2011-12-12 |
| 1033494752 | Molly Elizabeth Mcdermott | Pharmacist | District 222-walgreens, Chicago, IL 60632 | 2011-10-13 |
| 1780908434 | Chicago Electrical Trauma Research Institute | Specialist/Technologist, Other | 4047 W. 40th Street, Chicago, IL 60632 | 2010-03-24 |
| 1265765218 | 4365 Archer Mri, LLC | Clinic/Center | 4365 South Archer Avenue, Chicago, IL 60632 | 2009-09-09 |
| 1295968121 | Smile Lee Faces | Dentist | 4197 S Archer Ave, Chicago, IL 60632 | 2009-08-26 |
| Find all providers in zip 60632 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669937231 | Colleen Ann Larkin | Nurse Practitioner | 10939 S Troy St, Chicago, IL 60655-2211 | 2019-02-07 |
| 1487160586 | Meghan Doepke Sullivan | Nurse Practitioner | 1030 N Clark St Ste 400, Chicago, IL 60610-5468 | 2017-12-27 |
| 1366955940 | Debra Chana Goldstein | Nurse Practitioner | 2732 W Chase Ave, Chicago, IL 60645-1313 | 2017-11-06 |
| 1588189260 | Larissa Marie Schulze | Nurse Practitioner | 737 N Michigan Ave Ste 820, Chicago, IL 60611-6659 | 2017-08-03 |
| 1164887295 | Meredith Murphy Mcintee | Nurse Practitioner | 5841 S Maryland Ave # Mc4065, Chicago, IL 60637-1443 | 2015-12-16 |
| 1215345442 | Tara Seider | Nurse Practitioner | 2707 W Ainslie St, Unit #3, Chicago, IL 60625-2715 | 2014-07-31 |
| 1447697982 | Emily Thurn | Nurse Practitioner | 225 E Chicago Ave Box 29, Chicago, IL 60611-2605 | 2013-05-23 |
| 1518231505 | Julianne Deschler Bertalmio | Nurse Practitioner | 1460 N. Halsted Street, Suite 402, Chicago, IL 60642 | 2012-03-08 |
| 1932478765 | Julie Elizabeth Martin | Nurse Practitioner | 225 E Chicago, 4 Ne, Chicago, IL 60611-2605 | 2011-12-22 |
| 1245532480 | Alexandra Wilson Benz | Nurse Practitioner | 225 E Chicago Ave # 93, Chicago, IL 60611-2991 | 2010-11-20 |
| Find all providers in CHICAGO | ||||
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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.