MICHIGAN AVENUE INTERNISTS (NPI# 1922066588) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922066588 |
| Entity Type | Organization |
| Organization Name | MICHIGAN AVENUE INTERNISTS |
| Practice Address |
200 S Michigan Ave Suite 805 Chicago IL 60604-2402 |
| Practice Telephone | 3129223815 |
| Practice Fax Number | 3129223789 |
| Mailing Telephone | 3129223815 |
| Mailing Fax Number | 3129223789 |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. GREG DONALD EWERT (PRESIDENT) |
| Authorized Official Telephone | 3129223815 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 207N00000X | Dermatology | ========= | IL | Allopathic & Osteopathic Physicians |
| X | 207R00000X | Internal Medicine | ========= | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BC/BS OF ILLINOIS # | 01605414 | 01 |
| Street Address |
200 S MICHIGAN AVE SUITE 805 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60604-2402 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083608343 | Cynthia Ann Levin | Psychologist | 200 S Michigan Ave, #710, Chicago, IL 60604-2402 | 2005-09-01 |
| 1679969182 | Greg D Ewert Md Sc | Internal Medicine | 200 S Michigan Ave, Suite 805, Chicago, IL 60604-2402 | 2015-04-10 |
| 1912310319 | Angelo A Costas Md Sc | Internal Medicine | 200 S Michigan Ave, Suite 805, Chicago, IL 60604-2402 | 2014-06-04 |
| 1750724464 | David K. Zich, Md, Sc | Emergency Medicine | 200 S Michigan Ave, Suite 830, Chicago, IL 60604-2402 | 2013-04-11 |
| 1467794859 | Sheila Downey Ballintine | Internal Medicine | 200 S Michigan Ave, Suite 805, Chicago, IL 60604-2402 | 2013-03-23 |
| 1932444312 | Joy Georgiana Economos | Physician Assistant | 200 S Michigan Ave, Suite 805, Chicago, IL 60604-2402 | 2012-12-11 |
| 1427304724 | Theresa Wang | Dentist | 200 S Michigan Ave, Suite 1400, Chicago, IL 60604-2402 | 2012-07-24 |
| 1467773986 | David Alan Vermylen | Internal Medicine | 200 S Michigan Ave, Suite 805, Chicago, IL 60604-2402 | 2010-06-18 |
| 1114186038 | Wendy Carolyn Goodall Mcdonald | Obstetrics & Gynecology | 200 S Michigan Ave, Suite 1550, Chicago, IL 60604-2402 | 2008-06-05 |
| 1790944064 | Women's Health Consulting Il, LLC | Obstetrics & Gynecology | 200 S Michigan Ave, Suite 1550, Chicago, IL 60604-2402 | 2008-06-03 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750853719 | Michael Cramer | Nurse Practitioner | 322 S. Michigan Ave, Suite 1100, Chicago, IL 60604 | 2018-12-31 |
| 1174079883 | Cardinal Technical Sc | Specialist | 208 Lasalle Street, Suite 214, Chicago, IL 60604 | 2016-09-01 |
| 1427412436 | Your Choice Homecare, Inc. | Home Health | 332 S. Michigan Ave., Suite 1032-y43, Chicago, IL 60604 | 2016-04-06 |
| 1548634843 | Catherine Ranieri | Counselor | 53 W Jackson Blvd Ste 1625, Chicago, IL 60604 | 2015-11-24 |
| 1356710701 | Otis Peeples | Counselor | 134 N Lasalle Suite 400, Chicago, IL 60604 | 2015-09-16 |
| 1124495916 | Te You Moore | Counselor | 53 W Jackson Blvd Ste 1360, Chicago, IL 60604 | 2015-08-27 |
| 1992187686 | Kathryn Weaver | Psychiatry & Neurology | 343 South Dearborn Street Apt # 304, Chicago, IL 60604 | 2015-06-18 |
| 1700162583 | Tracy Bisterfeldt | Psychologist | 53 W. Jackson Blvd., Unit 635, Chicago, IL 60604 | 2011-10-25 |
| 1619201084 | Jennifer Gurski | Social Worker | 53 W. Jackson Blvd, Chicago, IL 60604 | 2009-10-01 |
| 1578736252 | Richard A Reschke | Naprapath | 141 W. Jackson Boulevard, Suite 2170, Chicago, IL 60604 | 2008-04-02 |
| Find all providers in zip 60604 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114551983 | Katherine Janezic | Dermatology | 7447 W Talcott Ave Ste 425, Chicago, IL 60631-3704 | 2020-03-02 |
| 1487116240 | Conrad Petersen Dermatology Sc | Dermatology | 2845 N Sheridan, Chicago, IL 60657 | 2019-04-02 |
| 1891257853 | Maria Estela Martinez Escala | Dermatology | 5841 S Maryland Ave Ste Mc5067, Chicago, IL 60637-1443 | 2019-04-01 |
| 1275013450 | Advanced Dermatology and Aesthetic Medicine | Dermatology | 850 S Wabash Ave Ste 200, Chicago, IL 60605-3642 | 2018-08-17 |
| 1346784543 | Dermio, LLC | Dermatology | 3023 N Clark St, Suite 861, Chicago, IL 60657-5200 | 2016-12-07 |
| 1366823544 | Oyinade Aderibigbe | Dermatology | 111 W Washington St Ste 1801, Chicago, IL 60602-3430 | 2015-06-14 |
| 1073909032 | Julia Dai | Dermatology | 5758 S Maryland Ave Fl 3, Chicago, IL 60637 | 2015-04-07 |
| 1437544582 | Nicholas Blickenstaff | Dermatology | 30 N Michigan Ave Ste 1429, Chicago, IL 60602-3698 | 2015-04-04 |
| 1801285929 | Medical Dermatology Associates of Chicago, Ltd | Dermatology | 363 W Erie St, Suite 350, Chicago, IL 60654-6903 | 2015-01-13 |
| 1366857286 | Noor Tazudeen | Dermatology | 4700 N Marine Dr Ste 220, Chicago, IL 60640-7972 | 2014-06-30 |
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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.