MIDWEST PEDIATRIC SURGICAL ASSOCIATES P.C. (NPI# 1912940198) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1912940198 |
Entity Type | Organization |
Organization Name | MIDWEST PEDIATRIC SURGICAL ASSOCIATES P.C. |
Practice Address |
4400 W 95th St Suite 108 Oak Lawn IL 60453-2654 |
Practice Telephone | 7084247541 |
Enumeration Date | 2006-06-14 |
Last Update Date | 2020-08-22 |
Authorized Official Name | DEBORAH LOEFF (OWNER) |
Authorized Official Telephone | 7084247541 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2086S0120X |
Surgery Specialization: Pediatric Surgery |
Allopathic & Osteopathic Physicians |
Street Address |
4400 W 95TH ST SUITE 108 |
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 |
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Taxonomy Code | 2086S0120X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Surgery |
Specialization | Pediatric Surgery |
A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1124421680 | John Wesley | Surgery | 185 S Old Creek Rd, Vernon Hills, IL 60061-3134 | 2014-09-29 |
1407089923 | Angel Bassuk | Surgery | 9655 Woods Dr, Skokie, IL 60077-4418 | 2009-09-01 |
1417141904 | Erik Ryan Barthel | Surgery | 5841 S Maryland Ave # Mc4062, University of Chicago Medicine, Chicago, IL 60637-1447 | 2007-08-28 |
1467666081 | Connie Jean Rossini | Surgery | 1725 W Harrison St Ste 708, Chicago, IL 60612-3841 | 2007-05-10 |
1356394217 | Childrens Surgical Foundation Inc | Surgery | 225 E Chicago Ave # 114, Chicago, IL 60611-2991 | 2006-05-19 |
1154309284 | Ann Oconnor | Surgery | 25 N. Winfield Road, Winfield, IL 60190 | 2006-01-09 |
1356822050 | Lurie Childrens Surgical Foundation Inc | Surgery | 225 E Chicago Ave, Chicago, IL 60611-2991 | 2018-08-22 |
1649774803 | Rachael Sundland | Surgery | 5841 S Maryland Ave # Mc4062, Chicago, IL 60637-1443 | 2018-03-22 |
1245746213 | Chicagoland University Pediatric Surgery, LLC | Surgery | 2900 N Lake Shore Dr, Chicago, IL 60657-5640 | 2017-12-28 |
1558740563 | Edward Health Ventures | Surgery | 120 Spalding Dr, Ste 200, Naperville, IL 60540-6508 | 2015-05-22 |
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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.