MR. SEBASTIAN KO (NPI# 1902367642) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902367642 |
| Entity Type | Individual |
| Full Name | MR. SEBASTIAN KO |
| Credential | M.D. |
| Practice Address |
4646 N Marine Dr Chicago IL 60640-5759 |
| Practice Telephone | 7735645219 |
| Mailing Telephone | 7735645219 |
| Enumeration Date | 2019-03-26 |
| Last Update Date | 2020-09-17 |
| NPI Deactivation Date | 11/04/2019 |
| NPI Reactivation Date | 2019-11-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
036.148139 | IL | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 259 E Erie, 13th Floor, Chicago, IL 60611 | 3124726488 |
| Street Address |
4646 N MARINE DR |
| City | CHICAGO |
| State | IL |
| Zip Code | 60640-5759 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407850969 | Peter A Hancock | Podiatrist | 4646 N Marine Dr, Ste C-6500, Chicago, IL 60640-5759 | 2005-06-11 |
| 1881200368 | Chandan Singh Sapkota | Internal Medicine | 4646 N Marine Dr, Chicago, IL 60640-5759 | 2020-09-19 |
| 1538771316 | Ayesha Saleem | Student in an Organized Health Care Education/Training Program | 4646 N Marine Dr, Chicago, IL 60640-5759 | 2020-08-21 |
| 1831701978 | Allina Ghimire | Internal Medicine | 4646 N Marine Dr, Chicago, IL 60640-5759 | 2020-08-19 |
| 1154932291 | Ayomide Ireti Sotomi-foluso | Internal Medicine | 4646 N Marine Dr, Chicago, IL 60640-5759 | 2020-08-12 |
| 1427669860 | Yadana Oo | Internal Medicine | 4646 N Marine Dr, Chicago, IL 60640-5759 | 2020-08-10 |
| 1467062190 | Seyma Eroglu | Internal Medicine | 4646 N Marine Dr, Chicago, IL 60640-5759 | 2020-08-07 |
| 1003426743 | Carlos Andres Rueda Mantilla | Internal Medicine | 4646 N Marine Dr, Chicago, IL 60640-5759 | 2020-08-07 |
| 1609486968 | Ahmet Ersin Yassa | Internal Medicine | 4646 N Marine Dr, Chicago, IL 60640-5759 | 2020-08-03 |
| 1861000630 | Mustafa Ali Samejo | Internal Medicine | 4646 N Marine Dr, Chicago, IL 60640-5759 | 2020-07-17 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336754233 | Rci (wrs), LLC. | Clinic/Center | 5221-23 North Broadway, Chicago, IL 60640 | 2020-09-09 |
| 1548871916 | Borici Counseling LLC | Counselor | 4731 N Paulina St, Chicago, IL 60640 | 2020-08-11 |
| 1306319173 | Gerardo Garcia | Physician Assistant | Medical Staff Office, Weiss Memorial Hospital, 4646 N Marine Drive, Chicago, IL 60640 | 2019-01-04 |
| 1386121283 | Aea Optical Ventures, LLC | Clinic/Center | 4814 N Clark St, Chicago, IL 60640 | 2018-07-24 |
| 1023503885 | Lauren Vassiliades | Internal Medicine | Weiss Memorial Hospital, Medical Education Dpt., 4646 N. Marine Drive, C Elevators, 7th Flr. # 7100, Chicago, IL 60640 | 2018-06-25 |
| 1477061620 | Yesenia Vargas | Nurse Practitioner | 1025 W Sunnyside, Chicago, IL 60640 | 2018-01-22 |
| 1932622206 | Jasleen Kaur Brar | Internal Medicine | 4646 N. Marine Dr., Chicago, IL 60640 | 2017-07-19 |
| 1750802849 | Umer Mukhtar | Internal Medicine | 4646 N. Marine Dr. Med Ed Dept. C Elevators., Weiss Memorial Hospital. 7 Floor. #7100, Chicago, IL 60640 | 2017-06-29 |
| 1184144081 | Ellie Navidson | Registered Nurse | 1015 W Lawrence, 2nd Floor, Chicago, IL 60640 | 2017-06-21 |
| 1962932558 | Jennifer Stridh | Marriage & Family Therapist | 5125 N. Winthrop Ave, 1f, Chicago, IL 60640 | 2017-06-15 |
| Find all providers in zip 60640 | ||||
| Taxonomy Code | 207XX0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Sports Medicine |
| An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063048395 | Dr Ouilife LLC | Orthopaedic Surgery | 640 S Federal St Apt 410, Chicago, IL 60605-1800 | 2020-03-18 |
| 1568851251 | Benjamin Scott Kester | Orthopaedic Surgery | 1725 W Harrison St Ste Rush, Chicago, IL 60612-3841 | 2015-01-18 |
| 1568419463 | Mark K. Bowen | Orthopaedic Surgery | 680 N Lake Shore Dr Ste 924, Chicago, IL 60611 | 2006-05-27 |
| 1225677404 | Mary Kathleen Walsh | Orthopaedic Surgery | 1611 W Harrison St, Chicago, IL 60612-4861 | 2020-01-05 |
| 1073080909 | Kierra La Shawn Bruno-rodgers | Orthopaedic Surgery | 712 N Dearborn St, Chicago, IL 60654-3846 | 2018-10-29 |
| 1124505508 | Robert Morris University Illinois | Orthopaedic Surgery | 401 S State St, Chicago, IL 60605-1229 | 2018-07-27 |
| 1992220404 | Chicago Sports Medicine Institute | Orthopaedic Surgery | 875 N Dearborn St, Chicago, IL 60610-7377 | 2017-08-04 |
| 1417330242 | Nicholas Anthony Trasolini | Orthopaedic Surgery | 1611 W Harrison St Ste 400, Chicago, IL 60612-4861 | 2015-06-29 |
| 1679960843 | John Lloyd Fritch | Orthopaedic Surgery | 5841 S Maryland Ave # Mc3079, Chicago, IL 60637-1443 | 2015-04-24 |
| 1083000905 | Blake Michael Bodendorfer | Orthopaedic Surgery | 1611 W Harrison St Ste 400, Chicago, IL 60612-4861 | 2015-04-07 |
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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.