DAVID L DELOSO (NPI# 1912002882) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912002882 |
| Entity Type | Individual |
| Full Name | DAVID L DELOSO |
| Credential | MD |
| Practice Address |
2920 Veterans Memorial Dr Mount Vernon IL 62864-5924 |
| Mailing Address |
Po Box 155 Christopher IL 62822-0155 |
| Practice Telephone | 6182446544 |
| Practice Fax Number | 6182446577 |
| Mailing Telephone | 6187241624 |
| Mailing Fax Number | 6187244628 |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2019-06-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 036089974 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036089974 | 05 | |
| BCBS | 4106916 | 01 |
| Street Address |
2920 VETERANS MEMORIAL DR |
| City | MOUNT VERNON |
| State | IL |
| Zip Code | 62864-5924 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326093493 | Sandra Tate | Nurse Practitioner | 2920 Veterans Memorial Dr, Mount Vernon, IL 62864-5924 | 2006-05-24 |
| 1154965218 | Stacy Withrow | Registered Nurse | 2920 Veterans Memorial Dr, Mount Vernon, IL 62864-5924 | 2019-11-01 |
| 1003467341 | Erica Renee Escue | Physician Assistant | 2920 Veterans Memorial Dr, Mount Vernon, IL 62864-5924 | 2019-09-27 |
| 1629536685 | Tiffany L Alms | Registered Nurse | 2920 Veterans Memorial Dr, Mount Vernon, IL 62864-5924 | 2019-03-08 |
| 1760940720 | Melissa Havrilka | Registered Nurse | 2920 Veterans Memorial Dr, Mount Vernon, IL 62864-5924 | 2019-03-08 |
| 1346719630 | Amanda Ratcliff | Licensed Practical Nurse | 2920 Veterans Memorial Dr, Mount Vernon, IL 62864-5924 | 2018-11-16 |
| 1548738057 | Amanda Lynn Hays | Licensed Practical Nurse | 2920 Veterans Memorial Dr, Mount Vernon, IL 62864-5924 | 2018-11-02 |
| 1184125874 | Naomi D Easley | Licensed Practical Nurse | 2920 Veterans Memorial Dr, Mount Vernon, IL 62864-5924 | 2018-02-27 |
| 1558869412 | Bonnie Smith | Registered Nurse | 2920 Veterans Memorial Dr, Mount Vernon, IL 62864-5924 | 2018-01-25 |
| 1700304847 | Elesha Wilson | Licensed Practical Nurse | 2920 Veterans Memorial Dr, Mount Vernon, IL 62864-5924 | 2017-09-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619438892 | Melissa Pryer | Dietitian, Registered | 2020 Broadway, Suite 1, Mt. Vernon, IL 62864 | 2019-03-28 |
| 1487145454 | Chiropractic Wellness Center of Mt Vernon, LLC. | Chiropractor | 1009 S 42nd St Ste 5, Mount Vernon, IL 62864 | 2018-05-24 |
| 1851889208 | Kimberly Tate | Counselor | 4110 North Water Place, Mt. Vernon, IL 62864 | 2018-05-01 |
| 1871907790 | University Hematology Oncology Inc | Specialist | #11 Cusumano Professional Plaza, Mount Vernon, IL 62864 | 2014-06-18 |
| 1457771677 | Dynamic Counseling and Consultation Services | Social Worker | 3600 S Water Tower Pl, Mt Vernon, IL 62864 | 2014-04-27 |
| 1619239431 | Judith C Morgan | Counselor | 16338 N Illinois Hwy 37, Mount Vernon, IL 62864 | 2012-06-08 |
| 1073888624 | James Brian Verges | Counselor | 16338 N. Illinois Hwy 37, Mount Vernon, IL 62864 | 2012-03-15 |
| 1720352271 | Lucinda M. Holdren | Counselor | 16338 North Illinois Highway 37, Mount Vernon, IL 62864 | 2012-03-01 |
| 1780978627 | Jamie M Orange | Physical Therapy Assistant | 19958 Fairfield Rd, Mt. Vernon, IL 62864 | 2011-06-08 |
| 1780978791 | Wendy Marie Claytor | Speech-Language Pathologist | 600 E Il Hwy 15, Mount Vernon, IL 62864 | 2011-06-07 |
| Find all providers in zip 62864 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487290615 | Pediatric Group, LLC | Pediatrics | 1007 S 42nd St Ste 1, Mount Vernon, IL 62864-6217 | 2019-11-22 |
| 1659785400 | Andrea Michelle Weiner | Pediatrics | 54 Parkway S, Mount Vernon, NY 10552-2227 | 2014-06-19 |
| 1023375433 | Hayley Harris Martins | Pediatrics | 4103 S Water Tower Pl, Mount Vernon, IL 62864-6293 | 2012-04-23 |
| 1538326582 | Kaushal Pediatric Services Ltd | Pediatrics | 4107 North Water Tower Place, Mount Vernon, IL 62864 | 2008-05-19 |
| 1467511618 | Beth L Bernstein | Pediatrics | 107 West 4th St, Mount Vernon, NY 10550 | 2006-12-06 |
| 1023128824 | Cheryl Esen Zentner | Pediatrics | 2101 Little Mountain Ln, Mount Vernon, WA 98274-8752 | 2006-08-30 |
| 1932164951 | Marjorie Mabong Nwosu | Pediatrics | 3505 Broadway, Mount Vernon, IL 62864 | 2006-04-20 |
| 1003878703 | Neeta B Kaushal | Pediatrics | 4107 N Water Tower Pl, Mount Vernon, IL 62864-6296 | 2006-04-06 |
| 1013992288 | Marie-micheline Lominy | Pediatrics | 559 Gramatan Ave, Suite 203, Mount Vernon, NY 10552-2155 | 2005-12-10 |
| 1407218969 | Mari Hammerquist Oathes | Pediatrics | 2320 Freeway Dr, Mount Vernon, WA 98273-5445 | 2016-03-24 |
| Find all providers in MOUNT VERNON | ||||
| City | MOUNT VERNON |
| Zip Code | 62864 |
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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.