DR GURPREET S MANDER (NPI# 1932182656) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932182656 |
| Entity Type | Individual |
| Full Name | DR GURPREET S MANDER |
| Credential | M.D. |
| Practice Address |
415 N 9th St Springfield IL 62702-5317 |
| Mailing Address |
Po Box 19639 Springfield IL 62794-9639 |
| Practice Telephone | 2175446464 |
| Practice Fax Number | 2177576844 |
| Mailing Telephone | 2175457578 |
| Mailing Fax Number | 2175451884 |
| Enumeration Date | 2005-11-28 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 087739 | 05 |
| Street Address |
415 N 9TH ST |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62702-5317 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235128109 | Krishna A Rao | Internal Medicine | 415 N 9th St, Springfield, IL 62702-5317 | 2005-10-13 |
| 1821611526 | Michelle Eide | Obstetrics & Gynecology | 415 N 9th St, Springfield, IL 62702-5303 | 2020-05-28 |
| 1275156325 | Sivani Aluru | Obstetrics & Gynecology | 415 N 9th St, Springfield, IL 62702-5303 | 2020-05-23 |
| 1316560626 | Jaycee Elizabeth Housh | Obstetrics & Gynecology | 415 N 9th St, Springfield, IL 62702-5303 | 2020-05-20 |
| 1043832371 | Kerrilyn Hewell | Obstetrics & Gynecology | 415 N 9th St, Springfield, IL 62702-5303 | 2020-05-08 |
| 1386205318 | Aneesh Surya Chawla | Obstetrics & Gynecology | 415 N 9th St, Springfield, IL 62702-5303 | 2019-06-20 |
| 1144889965 | Maggie Lynn Sevrin | Obstetrics & Gynecology | 415 N 9th St, Springfield, IL 62702-5303 | 2019-06-06 |
| 1063070597 | Emma Victoria James | Obstetrics & Gynecology | 415 N 9th St, Springfield, IL 62702-5303 | 2019-05-30 |
| 1083272520 | Haylee Elizabeth Elvendahl-rumley | Obstetrics & Gynecology | 415 N 9th St, Springfield, IL 62702-5303 | 2019-05-30 |
| 1962996769 | Erika Alejandra Gonzalez Osorio | Obstetrics & Gynecology | 415 N 9th St, Springfield, IL 62702-5303 | 2018-06-15 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457866519 | Mohammad Jamal Uddin Ansari | Internal Medicine | 751 N Rutledge St Ste 400, Springfield, IL 62702 | 2017-12-11 |
| 1588105811 | Mickey Graphia | Surgery | 701 N 1st St # D346, Springfield, IL 62702 | 2017-03-20 |
| 1376908913 | Abdul Hannan | Internal Medicine | 315 W Carpenter St # B, Springfield, IL 62702 | 2015-12-28 |
| 1871986414 | Rachel Hoselton | Nurse Practitioner | 400 N 9th St Fl 4, Springfield, IL 62702 | 2015-03-06 |
| 1548697774 | Alyssa Wilson | Behavioral Analyst | 232 Bruns Lane, One Sparcenter Plaza, Springfield, IL 62702 | 2013-10-02 |
| 1174965446 | Amy Wilson | Speech-Language Pathologist | 2120 West Washington Street, Springfield, IL 62702 | 2013-07-26 |
| 1275898116 | Pele Boutrous Dina | Pediatrics | 415 N 9th St # 4w16, Springfield, IL 62702 | 2012-07-06 |
| 1427327733 | Brook D Croke | Genetic Counselor, MS | 400 N. 9th Street, 3rd Floor Clinic B, Springfield, IL 62702 | 2011-12-16 |
| 1629352604 | Renae M Sanchez | Pharmacist | 3216 East Clearlake Ave, Springfield, IL 62702 | 2011-10-07 |
| 1982915302 | William Leland Zelkovich | Radiology | 701 N 1st, Springfield, IL 62702 | 2010-06-30 |
| Find all providers in zip 62702 | ||||
| Taxonomy Code | 2080P0203X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Critical Care Medicine |
| A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. ACGME Accredited Residency Program Requirements: 2 years of training with 3 years Pediatrics plus 1 year Pediatric Critical Care for certification for a total of 6 years. ABMS Approved Subspecialty Certificate (Pediatrics) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396144259 | Danyal Thaver | Pediatrics | 1235 E Cherokee St, Springfield, MO 65804-2203 | 2014-08-17 |
| 1669896775 | Pallav Bhattarai | Pediatrics | 759 Chestnut Street, Springfield, MA 01107-1619 | 2014-02-10 |
| 1124223029 | Kimberly Lynn Marohn | Pediatrics | 759 Chestnut St, Springfield, MA 01199-1619 | 2007-06-19 |
| 1578684718 | Michael F Canarie | Pediatrics | 759 Chestnut St, W2810, Springfield, MA 01199-1619 | 2007-04-03 |
| 1497898118 | Dean R Rising | Pediatrics | 1235 E Cherokee St, Springfield, MO 65804-2203 | 2007-02-14 |
| 1336228808 | Kathleen M Ventre | Pediatrics | 759 Chestnut St, W2810, Springfield, MA 01199-1619 | 2006-11-03 |
| 1013011592 | Stephen A Lieberman | Pediatrics | 759 Chestnut St, Springfield, MA 01107-1619 | 2006-09-12 |
| 1336243823 | Christine A Mckiernan | Pediatrics | 759 Chestnut St, Springfield, MA 01107-1619 | 2006-09-12 |
| 1780677732 | Diane C Lipscomb | Pediatrics | 1235 E Cherokee St, Springfield, MO 65804-2203 | 2005-08-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982150702 | Kayla Duvall | Pediatrics | 5841 S Maryland Ave # 1145, Chicago, IL 60637-1443 | 2016-08-31 |
| 1215304258 | Huda Adam | Pediatrics | 5706 S Blackstone Ave, Unit 1, Chicago, IL 60637-1824 | 2015-08-25 |
| 1699916932 | Deanna Marie Behrens | Pediatrics | 840 S. Wood, Department of Pediatrics, Uic, Chicago, IL 60612 | 2009-03-17 |
| 1326207663 | Lauren Elizabeth Marsillio | Pediatrics | 225 E Chicago Ave # 15-119d, Chicago, IL 60611-2991 | 2008-06-02 |
| 1376606491 | Pallavi P. Patwari | Pediatrics | 1620 W Harrison St, Suite 7 Kellogg, Chicago, IL 60612-3801 | 2006-12-19 |
| 1972665974 | Denise M. Goodman | Pediatrics | 2300 N Childrens Plz # 73, Chicago, IL 60614-3363 | 2006-12-15 |
| 1447267497 | Enrique Guillermo Cifuentes | Pediatrics | 4440 W. 95th Street, Oak Lawn, IL 60453 | 2006-08-02 |
| 1386659415 | Bharat K Kotadia | Pediatrics | 1822 Arlington Ln, Glendale Heights, IL 60139-1309 | 2006-07-29 |
| 1447271911 | Mary Christine Baldauf | Pediatrics | 2400 N Rockten Ave, Rockford Health Physicians, Rockford, IL 61103-3619 | 2006-07-21 |
| 1407897887 | Rachel K Wolfson | Pediatrics | 5839 S Maryland Ave, Mc 4064, Chicago, IL 60637-1463 | 2006-06-09 |
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| City | SPRINGFIELD |
| Zip Code | 62702 |
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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.