MARY KOMPERDA (NPI# 1881640902) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881640902 |
| Entity Type | Individual |
| Full Name | MARY KOMPERDA |
| Credential | APN |
| Practice Address |
675 W North Ave Ste-210 Melrose Park IL 60160-1634 |
| Mailing Address |
675 W North Ave Suite 210 Melrose Park IL 60160-1634 |
| Practice Telephone | 7084505094 |
| Practice Fax Number | 7083440508 |
| Mailing Telephone | 7084505094 |
| Mailing Fax Number | 7083440508 |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2018-08-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
209-004003 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | RAILROAD MEDICARE INDIVIDUAL PROVIDER ID | P00236752 | 01 |
| IL | MEDICARE GROUP NUMBER | 961280 | 01 |
| IL | MEDICARE INDIVIDUAL PTAN NUMBER | K18549 | 01 |
| IL | BLUE CROSS BLUE SHIELD GROUP PROVIDER NUMBER | 31602469 | 01 |
| IL | CONSULTANTS IN CARDIOVASCULAR MEDICINE, S.C. GROUP NPI NUMBER | 1164530713 | 01 |
| IL | MEDICARE GROUP NUMBER | 209712 | 01 |
| IL | RAILROAD MEDICARE GROUP PTAN NUMBER | CC1592 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619252103 | Mary Ann Komperda | Pharmacist | 5414 S Archer Ave, Chicago, IL 60638-3002 | 2011-10-15 |
| Street Address |
675 W NORTH AVE STE-210 |
| City | MELROSE PARK |
| State | IL |
| Zip Code | 60160-1634 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235134727 | Brad Anstadt | Ophthalmology | 675 W North Ave, Ste 107, Melrose Park, IL 60160-1622 | 2005-06-20 |
| 1578920484 | Dupage Medical Group, Ltd. | Prosthetic/Orthotic Supplier | 675 W North Ave, Melrose Park, IL 60160-1634 | 2016-01-22 |
| 1356733034 | Jessica Lynn Dye | Physician Assistant | 675 W North Ave, Suite 607, Melrose Park, IL 60160-1634 | 2015-03-04 |
| 1861893463 | Paige D Formsma | Audiologist | 675 W North Ave, Suite 110, Melrose Park, IL 60160-1634 | 2014-09-15 |
| 1083014047 | Jennifer Morales | Psychologist | 675 W North Ave, Ste 306, Melrose Park, IL 60160-1634 | 2014-08-27 |
| 1538577754 | Elizabeth Bojarskyj | Pharmacist | 675 W North Ave, Melrose Park, IL 60160-1634 | 2014-07-31 |
| 1780091538 | Bryan David Erce | Dentist | 675 W North Ave, Suite 307, Melrose Park, IL 60160-1634 | 2014-07-14 |
| 1740619246 | Merissa Mann | Physician Assistant | 675 W North Ave, Suite 402, Melrose Park, IL 60160-1634 | 2013-11-05 |
| 1770916074 | Yonatan Rosenblum | Psychologist | 675 W North Ave, Suite 306, Melrose Park, IL 60160-1634 | 2013-08-10 |
| 1538509666 | Hai Solomon M.d.s.c. | Obstetrics & Gynecology | 675 W North Ave, Suite 512, Melrose Park, IL 60160-1634 | 2013-07-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295217651 | Kairsten Thies | Registered Nurse | 1225 W. Lake St., Melrose Park, IL 60160 | 2018-09-02 |
| 1780195701 | Julia Mccann-khludenev | Nurse Practitioner | 153 1/2 Broadway Ave., Melrose Park, IL 60160 | 2017-10-17 |
| 1629595749 | Katarzyna Teresa Buksa | Speech-Language Pathologist | 906 Walton St., Melrose Park, IL 60160 | 2017-08-29 |
| 1972955102 | Erika Lazaro | Counselor | 1414 Main Street, Melrose Park, IL 60160 | 2016-07-12 |
| 1811344096 | Margaret Ann Kress | Nurse Practitioner | 675 W North Ave Ste 402, Melrose Park, IL 60160 | 2016-05-18 |
| 1942578703 | Rachna Shah Md Sc | Internal Medicine | 675 West North Ave, #310, Melrose Park, IL 60160 | 2011-12-08 |
| 1033486741 | Stephanie Lamonica | Pharmacist | 850 West North Ave, T0837, Melrose Park, IL 60160 | 2011-11-23 |
| 1285913384 | Melinda Vazquez | Social Worker | 1414 Main, Melrose Park, IL 60160 | 2011-08-08 |
| 1629373212 | Advanced Wellness Clinics | Internal Medicine | 1835 N Broadway Avenue, Suite 104, Melrose Park, IL 60160 | 2011-01-13 |
| 1508188525 | Guillermo Fernando Mora | Family Medicine | 1111 W Superior, Suite #306, Melrose Park, IL 60160 | 2010-02-17 |
| Find all providers in zip 60160 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326453713 | Michelle Garrett | Nurse Practitioner | 1111 Superior St, Suite 104, Melrose Park, IL 60160-4138 | 2014-06-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851998553 | Melissa Litwin | Nurse Practitioner | 9127 Burlington Ave, Brookfield, IL 60513-1939 | 2020-10-06 |
| 1932724200 | Tatyana Menaker | Nurse Practitioner | 2958 West Devon Ave, Chicago, IL 60659 | 2020-06-12 |
| 1518506625 | Lila Macalinga Rivera | Nurse Practitioner | 17w335 16th St, Oakbrook Terrace, IL 60181-4030 | 2020-01-06 |
| 1922642495 | Christine Nacar | Nurse Practitioner | 1232 Le Moyne Ave, Romeoville, IL 60446-4180 | 2019-10-29 |
| 1144871344 | Wensheng Tracy Wu | Nurse Practitioner | 1555 Barrington Rd Ste 1200, Hoffman Estates, IL 60169-5036 | 2019-09-27 |
| 1881245314 | Mkbb LLC | Nurse Practitioner | 1212 E Algonquin Rd, Algonquin, IL 60102-5446 | 2019-09-25 |
| 1225681455 | Jinu Joss | Nurse Practitioner | 9939 N Warren Oval, Niles, IL 60714-1044 | 2019-07-17 |
| 1659830057 | Ginger Dean | Nurse Practitioner | 2843 Chicago Rd, South Chicago Heights, IL 60411-4736 | 2019-03-15 |
| 1770048910 | Amanda K Honchell I | Nurse Practitioner | 401 W Madison St, Mount Carroll, IL 61053-9485 | 2019-02-01 |
| 1548725799 | Grace Nwaka Wabomnor | Nurse Practitioner | 17 E Grandview Dr, South Holland, IL 60473-1099 | 2019-02-01 |
| Find all providers with the same taxonomy | ||||
| City | MELROSE PARK |
| Zip Code | 60160 |
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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.