ADAM JAMES MAYBERRY (NPI# 1902437296) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1902437296 |
Entity Type | Individual |
Full Name | ADAM JAMES MAYBERRY |
Credential | PA |
Practice Address |
1500 S Fairfield Ave Chicago IL 60608-1782 |
Mailing Address |
3051 W Lyndale St Chicago IL 60647-2811 |
Practice Telephone | 3124986037 |
Mailing Telephone | 3124986037 |
Enumeration Date | 2020-01-27 |
Last Update Date | 2020-01-27 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AM0700X |
Physician Assistant Specialization: Medical |
085007405 | IL | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
1500 S FAIRFIELD AVE |
City | CHICAGO |
State | IL |
Zip Code | 60608-1782 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275564197 | Paul M. Berkowitz | Psychiatry & Neurology | 1500 S Fairfield Ave, Chicago, IL 60608-1782 | 2006-07-06 |
1528668274 | Mount Sinai Hospital Medical Center | Clinic/Center | 1500 S Fairfield Ave, Chicago, IL 60608-1782 | 2020-10-30 |
1669089306 | Sabin Gajurel | Internal Medicine | 1500 S Fairfield Ave, Chicago, IL 60608-1782 | 2020-09-27 |
1710591854 | Trisha May Homan | Nurse Practitioner | 1500 S Fairfield Ave, Chicago, IL 60608-1782 | 2020-09-05 |
1861005134 | Elizaveta Vitkovskaya | Internal Medicine | 1500 S Fairfield Ave, Chicago, IL 60608-1782 | 2020-08-26 |
1104439751 | Vishal Kwatra | Internal Medicine | 1500 S Fairfield Ave, Chicago, IL 60608-1782 | 2020-08-24 |
1265044226 | Temitayo Kafisanwo | Nurse Practitioner | 1500 S Fairfield Ave, Chicago, IL 60608-1782 | 2020-08-20 |
1891306577 | Nardeen Morkos | Family Medicine | 1500 S Fairfield Ave, Chicago, IL 60608-1782 | 2020-08-14 |
1659981983 | Anuradha Sakhuja | Internal Medicine | 1500 S Fairfield Ave, Chicago, IL 60608-1782 | 2020-08-02 |
1508474818 | Anthony Adly Messiha | Family Medicine | 1500 S Fairfield Ave, Chicago, IL 60608-1782 | 2020-07-22 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1699390047 | Bethuna Shields | Occupational Therapist | 1401 South California Ave, Chicago, IL 60608 | 2020-06-11 |
1861024176 | Mount Sinai Community Foundation | Clinic/Center | 1414 S Fairfield, Chicago, IL 60608 | 2020-02-05 |
1205481058 | Joshua Hartman | Pharmacist | 345 Csb Mc 884, 840 S. Wood St, Chicago, IL 60608 | 2019-08-08 |
1194386706 | Mount Sinai Hospital, Chicago | Internal Medicine | Mount Sinai Hospital, 1500 S Fairfield Ave, Chicago, IL 60608 | 2019-06-25 |
1841754256 | Julia Bates | Occupational Therapist | 1640 W. Roosevelt Rd., 415 Dhsp (mc 726), Chicago, IL 60608 | 2019-01-30 |
1194205781 | Anais J Robles | Contractor | 1626 S Allport St, Chicago, IL 60608 | 2018-08-14 |
1114412970 | Dmitri Zbarsky | Internal Medicine | 1500 South Fairfield Ave., F-914, Chicago, IL 60608 | 2018-06-25 |
1740773050 | Alexia Ilian Derma Salazar | Speech-Language Pathologist | 2301 W 19th St - 3rd Floor Rear, Chicago, IL 60608 | 2018-06-11 |
1912424730 | Pareen Modi | Pharmacist | 2539 South Western Avenue, Chicago, IL 60608 | 2017-08-23 |
1952824302 | Raquel Gonzalez Heredia | Surgery | 1500 South Fairfield Ave, Chicago, IL 60608 | 2017-07-18 |
Find all providers in zip 60608 |
Taxonomy Code | 363AM0700X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Medical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518591759 | Julie Jenkot | Physician Assistant | 333 N Michigan Ave Fl 14, Chicago, IL 60601-3901 | 2020-02-26 |
1457997561 | Jasleen Mohini Singh | Physician Assistant | 1645a W School Street, Suite A, Clinic Entrance, Chicago, IL 60657 | 2019-11-24 |
1598238883 | Andrea Budzon | Physician Assistant | 2940 N Kimball Ave Apt 2, Chicago, IL 60618-6846 | 2019-01-09 |
1760995161 | Leena Abed Hamdan | Physician Assistant | 251 E Huron St Fl 1, Chicago, IL 60611-2908 | 2017-11-08 |
1134580079 | Joseph Smith II | Physician Assistant | 654 E 84th St, Chicago, IL 60619-5802 | 2016-03-18 |
1679950232 | Alexis Davidman | Physician Assistant | 20 S Clark St Ste, Chicago, IL 60603-1802 | 2015-05-04 |
1669861589 | Stewart David Harsant | Physician Assistant | 1702 N Milwaukee Ave, Chicago, IL 60647-5424 | 2015-01-15 |
1063817013 | Jenna Lynn Sniegowski | Physician Assistant | 675 N Saint Clair St Fl 21, Chicago, IL 60611-5975 | 2014-11-01 |
1851700066 | Lauren Lew | Physician Assistant | 555 West Madison St. Apt 4903, Chicago, IL 60661 | 2014-08-13 |
1306270137 | Brianne Patricia Randall | Physician Assistant | California Blvd. At 15th St., Chicago, IL 60608 | 2013-08-28 |
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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.