ADDISON CENTRAL PATHOLOGY SC (NPI# 1902902281) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902902281 |
| Entity Type | Organization |
| Organization Name | ADDISON CENTRAL PATHOLOGY SC |
| Practice Address |
5645 W Addison St Chicago IL 60634-4403 |
| Mailing Address |
520 E 22nd St Lombard IL 60148-6110 |
| Practice Telephone | 7732827000 |
| Mailing Telephone | 6308742542 |
| Mailing Fax Number | 6308742642 |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2016-02-09 |
| Authorized Official Name | VICKIE K REZAI (PRESIDENT) |
| Authorized Official Telephone | 7737948342 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BCBS IL | 01633170 | 01 |
| RAILROAD MEDICARE | DA0104 | 01 |
| Street Address |
5645 W ADDISON ST |
| City | CHICAGO |
| State | IL |
| Zip Code | 60634-4403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306845763 | Our Lady of The Resurrection Medical Center | Emergency Medicine | 5645 W Addison St, Chicago, IL 60634-4403 | 2005-07-19 |
| 1740809797 | Nicholas Donald Charmelo | Registered Nurse | 5645 W Addison St, Chicago, IL 60634-2881 | 2020-04-09 |
| 1528695814 | Ana Bulaja | Physician Assistant | 5645 W Addison St, Chicago, IL 60634-2881 | 2020-03-25 |
| 1669008702 | Jeremy Blauser | Physician Assistant | 5645 W Addison St, Chicago, IL 60634-4403 | 2020-03-20 |
| 1598306870 | Sss Pathology Services Pllc | Pathology | 5645 W Addison St, Chicago, IL 60634-4403 | 2019-10-08 |
| 1639737851 | Akhter U Patel | Nurse Practitioner | 5645 W Addison St, Chicago, IL 60634-4403 | 2019-06-03 |
| 1457916124 | Jaclyn Novak | Physician Assistant | 5645 W Addison St, Chicago, IL 60634-4403 | 2019-05-07 |
| 1962977421 | Ashley Fisher | Dietitian, Registered | 5645 W Addison St, Chicago, IL 60634-4403 | 2018-10-10 |
| 1093211153 | Brandee Joy Grenda | Dietitian, Registered | 5645 W Addison St, Chicago, IL 60634-4403 | 2018-04-05 |
| 1639687825 | Amy M Boettcher | Nurse Anesthetist, Certified Registered | 5645 W Addison St, Chicago, IL 60634-4403 | 2018-01-22 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356987333 | Alejandra Carrera | Student in an Organized Health Care Education/Training Program | 6417 W Irving Park Rd., Chicago, IL 60634 | 2019-11-25 |
| 1861977456 | Virtue Counseling Center | Counselor | 2904 N Parkside, Chicago, IL 60634 | 2018-09-28 |
| 1770931255 | Dynamic Transport Solutions LLC | Non-emergency Medical Transport (VAN) | 6109 W. Barry, Chicago, IL 60634 | 2016-05-25 |
| 1104284710 | Ez Dental | Dental Laboratory | 5621 W.montrose Avenue, Chicago, IL 60634 | 2016-02-10 |
| 1285075432 | Chicago Medical Transportation | Non-emergency Medical Transport (VAN) | 3033 N. Nordica Ave., Chicago, IL 60634 | 2013-07-16 |
| 1083985725 | Maria C. Rodriguez | Lactation Consultant, Non-RN | 6216 W. School St., Chicago, IL 60634 | 2012-01-25 |
| 1295066827 | Angie Harris | Occupational Therapist | 3339 N. Octavia, Chicago, IL 60634 | 2010-01-21 |
| 1205169802 | Belmont Dental P.C. | Dentist | 5611 W. Belmont Ave., Chicago, IL 60634 | 2009-09-14 |
| 1568605178 | Henry Biskup | Radiologic Technologist | 3105 N. Austin Ave., Chicago, IL 60634 | 2009-04-13 |
| 1306086624 | Highland Park Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 3615 N. Central Ave, Chicago, IL 60634 | 2009-02-26 |
| Find all providers in zip 60634 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255930145 | Uttamjot Kaur | Pathology | 2650 Ridege Avenue, Evanston Hospital, Chicago, IL 60613-6061 | 2020-10-21 |
| 1689188062 | Karina Colossi Furlan | Pathology | 1750 W Harrison St Fl 5, Chicago, IL 60612-3825 | 2017-11-21 |
| 1073967162 | Lucy Fu | Pathology | 303 East Chicago Avenue Ward 3-140 W127, Chicago, IL 60611-1059 | 2016-04-14 |
| 1053790113 | Lisa Han | Pathology | 5841 S. Maryland Ave., Rm. S323, Mc 3083, Chicago, IL 60637-1470 | 2015-05-22 |
| 1598151136 | Daiva Mattis | Pathology | Dept of Pathology, Jelke Building 579, Rush Univ Med Ct, 600 S. Paulina St., Chicago, IL 60612 | 2015-04-10 |
| 1376959981 | Aarti Sharma | Pathology | 5841 S Maryland Ave Rm P-615, Chicago, IL 60637-1447 | 2014-07-02 |
| 1831509090 | Caitlin Darrell | Pathology | 5841 S Maryland Ave # 3083, Chicago, IL 60637-1443 | 2014-04-28 |
| 1255750279 | Rebecca C Obeng | Pathology | 251 E Huron St Ste 7-132n, Chicago, IL 60611-2908 | 2014-04-08 |
| 1457790008 | Ari Scott Nowacek | Pathology | 8755 W Higgins Rd, Suite 1025, Chicago, IL 60631-2708 | 2013-06-17 |
| 1023456662 | Nora Eve Joseph | Pathology | 2016 W Race Ave, Chicago, IL 60612-1508 | 2013-06-05 |
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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.