DR. JACK CARTER ROBERTS (NPI# 1881680213) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881680213 |
| Entity Type | Individual |
| Full Name | DR. JACK CARTER ROBERTS |
| Credential | M.D. |
| Practice Address |
4400 W 95th St Suite 205 Oak Lawn IL 60453-2654 |
| Practice Telephone | 7083464040 |
| Practice Fax Number | 7083463287 |
| Mailing Telephone | 7083464040 |
| Mailing Fax Number | 7083463287 |
| Enumeration Date | 2005-09-21 |
| Last Update Date | 2012-02-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | 036042020 | IL | Allopathic & Osteopathic Physicians |
| Y | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 036042020 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200123430B | 05 | |
| IN | 200123430C | 05 | |
| IL | 036042020 | 05 | |
| IL | BCBS | 01618941 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932311164 | Jack Roberts | Dentist | 4409 Pack Saddle Pass, Austin, TX 78745-1623 | 2007-05-03 |
| 1376592667 | Jack T. Roberts | Audiologist | 1680 Cooper Foster Park Rd W, Suite A, Lorain, OH 44053-3657 | 2006-05-06 |
| 1518525542 | Jack A Roberts | Physical Therapist | 4621 W Park Blvd Ste 102, Plano, TX 75093-2318 | 2019-06-04 |
| 1013958917 | Jack T Roberts Jr. | Internal Medicine | 907 E Lamar Alexander Pkwy, Maryville, TN 37804-5015 | 2006-06-10 |
| Street Address |
4400 W 95TH ST SUITE 205 |
| City | OAK LAWN |
| State | IL |
| Zip Code | 60453-2654 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366445678 | Richard Z Belch | Specialist | 4400 W 95th St, Suite 207, Oak Lawn, IL 60453-2654 | 2005-05-31 |
| 1629683289 | Allison Gilbert | Nurse Practitioner | 4400 W 95th St, Oak Lawn, IL 60453-2654 | 2020-09-10 |
| 1164054011 | Elizabeth Gawne | Nurse Practitioner | 4400 W 95th St, Oak Lawn, IL 60453-2654 | 2020-02-09 |
| 1770128175 | Brittany Snyder | Physician Assistant | 4400 W 95th St, Oak Lawn, IL 60453-2654 | 2019-11-10 |
| 1730723446 | Christina M Tortorici | Physician Assistant | 4400 W 95th St, Oak Lawn, IL 60453-2654 | 2019-11-06 |
| 1437610805 | Duhah Hamayel | Pediatrics | 4400 W 95th St, Oak Lawn, IL 60453-2654 | 2019-03-28 |
| 1790246205 | Shawn Buxton | Pediatrics | 4400 W 95th St, Oak Lawn, IL 60453-2654 | 2019-03-27 |
| 1619456506 | Betty Joechle | Registered Nurse | 4400 W 95th St, Oak Lawn, IL 60453-2654 | 2018-08-10 |
| 1700372174 | Amy Elizabeth Calandriello | Registered Nurse | 4400 W 95th St, Oak Lawn, IL 60453-2654 | 2018-07-09 |
| 1801380563 | Corissa Nicole Culichia | Pediatrics | 4400 W 95th St, Oak Lawn, IL 60453-2654 | 2018-06-18 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659995231 | Natalia Zero | Student in an Organized Health Care Education/Training Program | 4440 W 95th St, Rm 131 North, Oak Lawn, IL 60453 | 2020-05-30 |
| 1114554300 | Sylvia Maria Chlebek | Student in an Organized Health Care Education/Training Program | Advocate Christ Medical Center 4440 W. 95th St., Rm 131 North, Oak Lawn, IL 60453 | 2020-03-26 |
| 1972066751 | Amanda Mroczek | Family Medicine | 9555 52nd Avenue, Suite F, Oak Lawn, IL 60453 | 2019-04-09 |
| 1013479955 | Leah Rae Prager | Physician Assistant | 4400 W. 95th St., Attn: Pediatric General Surgery, Oak Lawn, IL 60453 | 2019-04-01 |
| 1659833473 | Chelsea Sumida Gipson | Family Medicine | 9555 South 52nd Avenue, Suite F, Oak Lawn, IL 60453 | 2019-04-01 |
| 1518427418 | Robert Lindgren | Family Medicine | 9555 S. 52nd Ave., Suite F, Oak Lawn, IL 60453 | 2019-03-25 |
| 1154886695 | Stephanie Anne Comer | Social Worker | 10102 South Cicero Avenue, Suite C, Oak Lawn, IL 60453 | 2019-02-08 |
| 1700360070 | Brian L Lee | Counselor | 8938 S Ridgeland Avenue Suite 100, Oak Lawn, IL 60453 | 2018-09-21 |
| 1679085245 | International Dental of Oak Lawn | Clinic/Center | 9539 S Cicero Ave, Oak Lawn, IL 60453 | 2017-11-03 |
| 1124538301 | Kavitha Rajendran | Physician Assistant | 5851 W. 95th Street, Suite 300, Oak Lawn, IL 60453 | 2017-10-02 |
| Find all providers in zip 60453 | ||||
| Taxonomy Code | 208G00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Thoracic Surgery, 2007. http://www.abts.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Thoracic Surgery. Thoracic surgeons have the knowledge, experience and technical skills to accurately diagnose, operate upon safely, and effectively manage patients with thoracic diseases of the chest. This requires substantial knowledge of cardiorespiratory physiology and oncology, as well as capability in the use of heart assist devices, management of abnormal heart rhythms and drainage of the chest cavity, respiratory support systems, endoscopy and invasive and noninvasive diagnostic techniques. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437159142 | Philip Joseph Alexander | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4400 W 95th St Ste 308, Oak Lawn, IL 60453-2660 | 2005-07-22 |
| 1043582158 | Joel Roy Guillory Jr. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4400 W 95th St, Ste 205, Oak Lawn, IL 60453-2654 | 2012-02-04 |
| 1790074912 | Deborah R Tabachnick | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4400 W 95th St Ste 308, Oak Lawn, IL 60453 | 2011-03-29 |
| 1477871705 | Asif K Mustafa | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4400 W 95th St Ste 308, Oak Lawn, IL 60453-2660 | 2010-05-11 |
| 1942533070 | Chadrick Antony Cross | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4400 W 95th St Ste 308, Oak Lawn, IL 60453-2660 | 2009-09-08 |
| 1073690186 | Cardiovascular Surgeons Ltd | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4440 W 95th St, Oak Lawn, IL 60453-2600 | 2006-11-01 |
| 1831157999 | Henry James Sullivan | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4400 W 95th St Ste 308, Oak Lawn, IL 60453-2660 | 2006-05-01 |
| 1437115342 | Michel N Ilbawi | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4440 W 95th St, Oak Lawn, IL 60453-2600 | 2006-04-21 |
| 1497711394 | Chawki F El Zein | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4440 W 95th St, Oak Lawn, IL 60453-2600 | 2006-04-21 |
| 1740278217 | Francis J Podbielski | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4400 W 95th St Ste 205, Oak Lawn, IL 60453-2658 | 2005-10-10 |
| Find all providers in OAK LAWN | ||||
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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.