CHARLES R MARIS (NPI# 1932170982) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932170982 |
| Entity Type | Individual |
| Full Name | CHARLES R MARIS |
| Credential | MD |
| Practice Address |
602 W. University Avenue Otolaryngology Urbana IL 61801 |
| Mailing Address |
P.o. Box 6002 Urbana IL 61803-6002 |
| Practice Telephone | 2173833130 |
| Practice Fax Number | 2173834451 |
| Mailing Telephone | 2173268300 |
| Mailing Fax Number | 2173834451 |
| Enumeration Date | 2006-01-29 |
| Last Update Date | 2012-06-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | 036-056584 | IL | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922433044 | Charles Stevens Maris | Ophthalmology | 230 Hilton Avenue, Suite 118, Garden City, NY 11550 | 2013-09-09 |
| Street Address |
602 W. UNIVERSITY AVENUE OTOLARYNGOLOGY |
| City | URBANA |
| State | IL |
| Zip Code | 61801 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033103197 | Suzanne M Hand | Radiology | 602 W. University Avenue, Radiology, Urbana, IL 61801 | 2005-09-06 |
| 1801127188 | Vanessa J Grafton | Advanced Practice Midwife | 602 W. University Avenue, Ob/gyn, Urbana, IL 61801 | 2010-01-26 |
| 1417182882 | Laura Browning | Physician Assistant | 602 W. University Avenue, Otolaryngology, Urbana, IL 61801 | 2009-05-28 |
| 1659528776 | Catherine L Bond | Nurse Practitioner | 602 W. University Avenue, Trauma/critical Care, Urbana, IL 61801 | 2008-08-20 |
| 1134376395 | Adam Ziegler | Nurse Anesthetist, Certified Registered | 602 W. University Avenue, Anesthesiology, Urbana, IL 61801 | 2008-08-19 |
| 1386834927 | Amy Dobrinick | Nurse Anesthetist, Certified Registered | 602 W. University Avenue, Anesthesiology, Urbana, IL 61803 | 2007-07-30 |
| 1629268669 | Lisa Diemer | Nurse Anesthetist, Certified Registered | 602 W. University Avenue, Anesthesiology, Urbana, IL 61801 | 2007-07-26 |
| 1689879314 | Rong Chen | Psychiatry & Neurology | 602 W. University Avenue, Neurology, Urbana, IL 61801 | 2007-06-21 |
| 1851508469 | Thomas Capie, IIi | Nurse Anesthetist, Certified Registered | 602 W. University Avenue, Anesthesiology, Urbana, IL 61801 | 2007-05-16 |
| 1528289089 | Janet B Dueringer | Nurse Anesthetist, Certified Registered | 602 W. University Avenue, Anesthesiology, Urbana, IL 61801 | 2007-05-01 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417566084 | Avani Sushilkumar Mohta | Internal Medicine | Carle Foundation Hospital, 611 W. Park Street, Urbana, IL 61801 | 2020-07-29 |
| 1922617133 | Recovery Concepts Urbana, LLC | Clinic/Center | 710 W. Killarney St., Urbana, IL 61801 | 2020-07-24 |
| 1447877089 | Muhammad Khalid Abbas | Internal Medicine | 611 W Park St Urbana, Urbana, IL 61801 | 2020-06-30 |
| 1003430166 | Conlan Joseph Pierce | Surgery | 601 W Park St, Urbana, IL 61801 | 2020-06-04 |
| 1568090900 | Luke Andrew Fenlon | Student in an Organized Health Care Education/Training Program | Carle Forum Lower Level, Mc-474, 611 West Park Street, Urbana, IL 61801 | 2020-03-31 |
| 1912559691 | Ali Baltaji | Internal Medicine | 101 N Busey Apt 7, Urbana, IL 61801 | 2019-07-12 |
| 1821510918 | Pallavi Pradeep | Internal Medicine | Imrp, Carle Foundation Hospital, 611 W Park Street, Urbana, IL 61801 | 2017-07-11 |
| 1093236002 | Angela Lynn Devaney | Speech-Language Pathologist | 1400 W Park, Presence Covenant Medical Center, Urbana, IL 61801 | 2017-06-29 |
| 1346775236 | Jennifer Garcia | Student in an Organized Health Care Education/Training Program | Carle Foundation Hospital, 611 W. Park Street, Urbana, IL 61801 | 2017-04-27 |
| 1467992537 | Amber Kristine Davis | Speech-Language Pathologist | 1400 W. Park, Presence Health Medical Center, Urbana, IL 61801 | 2017-03-08 |
| Find all providers in zip 61801 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154632040 | Jacob A. Stelle | Otolaryngology | 611 W. Park St., Ent, Urbana, IL 61801-2500 | 2010-06-25 |
| 1487884854 | Muhamad Amine | Otolaryngology | 611 W Park St, Ent, Urbana, IL 61801-2529 | 2009-07-20 |
| 1912160441 | Ryan G Porter Sr. | Otolaryngology | 611 W. Park St., Sc2, Urbana, IL 61801-2500 | 2008-07-03 |
| 1376642264 | Vicki Prell | Otolaryngology | 602 W University Ave, Urbana, IL 61801-2530 | 2006-09-21 |
| 1134238694 | Michael A Novak | Otolaryngology | 611 W Park St, Sc2, Urbana, IL 61801-2529 | 2006-08-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841838109 | Ryan C. Vaughn, Md Pllc | Otolaryngology | 1900 E Golf Rd Ste L125, Schaumburg, IL 60173-5831 | 2019-12-18 |
| 1265074934 | Toriumi Facial Plastics Pllc | Otolaryngology | 60 E Delaware Pl Ste 1425, Chicago, IL 60611-1998 | 2019-10-14 |
| 1184281735 | Advanced Ear Nose & Throat Specialists, Pllc | Otolaryngology | 925 N Milwaukee Ave Unit 200, Vernon Hills, IL 60061-1637 | 2019-05-20 |
| 1780144402 | Veronica Maria Drozdowski | Otolaryngology | 2160 S 1st Ave Rm 1870, Maywood, IL 60153-3328 | 2019-03-20 |
| 1205395019 | Brian Yuhan | Otolaryngology | 2160 S 1st Ave Bldg 105, Maywood, IL 60153-3328 | 2019-03-19 |
| 1285100529 | Lauren E Lesniewski | Otolaryngology | 680 N Lake Shore Dr Ste 1210, Chicago, IL 60611-4490 | 2018-10-14 |
| 1982100525 | Muyinat Yewande Osoba | Otolaryngology | 675 N. Saint Clair St, Galter Pavilion, 15th Floor, Room 200, Chicago, IL 60611-5975 | 2018-04-03 |
| 1851811343 | Peter S Dumich | Otolaryngology | 2609 S Nottingham Ct, Champaign, IL 61821-6182 | 2017-06-26 |
| 1104354414 | Sara M. Wing | Otolaryngology | 301 N 8th St Ste 5b, Springfield, IL 62701-1041 | 2017-05-31 |
| 1750734778 | Darius Bliznikas Md Sc | Otolaryngology | 7110 W 127th St Ste 210, Palos Heights, IL 60463-1580 | 2016-07-14 |
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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.