MATTHEW JOSEPH RUDOLPH (NPI# 1942791702) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942791702 |
| Entity Type | Individual |
| Full Name | MATTHEW JOSEPH RUDOLPH |
| Credential | MD |
| Practice Address |
5425 W Lake St Chicago IL 60644-2342 |
| Practice Telephone | 7733783347 |
| Practice Fax Number | 7733784028 |
| Mailing Telephone | 7733783347 |
| Mailing Fax Number | 7733784028 |
| Enumeration Date | 2018-05-28 |
| Last Update Date | 2018-05-28 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487682720 | Matthew Seth Rudolph | Dentist | 903 Dublin Way, Chester Springs, PA 19425-3833 | 2006-06-28 |
| 1629200308 | Matthew Brian Rudolph | Orthopaedic Surgery | 1123 S Palestine St, Athens, TX 75751-3646 | 2009-08-14 |
| Street Address |
5425 W LAKE ST |
| City | CHICAGO |
| State | IL |
| Zip Code | 60644-2342 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871575233 | Lisa Kozinski | Family Medicine | 5425 W Lake St, Chicago, IL 60644-2342 | 2005-11-18 |
| 1588288773 | Bridget Mary Doyle | Student in an Organized Health Care Education/Training Program | 5425 W Lake St, Chicago, IL 60644-2342 | 2020-06-03 |
| 1023677051 | Alvie Bender | Social Worker | 5425 W Lake St, Chicago, IL 60644-2342 | 2019-06-12 |
| 1699333476 | Reema Yogesh Patel | Student in an Organized Health Care Education/Training Program | 5425 W Lake St, Chicago, IL 60644-2342 | 2019-06-05 |
| 1013574136 | Michelle Behrens | Social Worker | 5425 W Lake St, Chicago, IL 60644-2342 | 2019-05-23 |
| 1578120770 | Joanna Trask | Counselor | 5425 W Lake St, Chicago, IL 60644-2342 | 2019-05-22 |
| 1568920171 | Erick Woodrow Skaff | Student in an Organized Health Care Education/Training Program | 5425 W Lake St, Chicago, IL 60644 | 2019-03-04 |
| 1356805386 | Kathleen Escalona | Nurse Practitioner | 5425 W Lake St, Chicago, IL 60644-2342 | 2019-01-23 |
| 1306337233 | Sarah Neugarten | Nurse Practitioner | 5425 W Lake St, Chicago, IL 60644-2342 | 2018-05-26 |
| 1245721174 | Nathan Lee Lin | Student in an Organized Health Care Education/Training Program | 5425 W Lake St, Chicago, IL 60644-2342 | 2018-05-26 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710535638 | Marta Yvonne Palmer | Technician | 5008 W Adams, Chicago, IL 60644 | 2019-09-04 |
| 1861056848 | B U I L D Incorporated | Social Worker | 5100 W Harrison St., Chicago, IL 60644 | 2019-04-25 |
| 1851806269 | Habilitative Systems, Inc. | Case Management | 4732 W Ohio St, Chicago, IL 60644 | 2017-12-07 |
| 1336408665 | Meghan Nancy Daw | Dietitian, Registered | 646 S Central Ave, Chicago, IL 60644 | 2012-05-07 |
| 1164790515 | Elizabeth Eleanor Reid-tate | Pharmacist | 5222 W. Madison Avenue, Chicago, IL 60644 | 2011-12-13 |
| 1134458466 | Power Teen Program | Psychologist | 300 N Central Ave, Chicago, IL 60644 | 2009-12-16 |
| 1417198342 | Betty Jean Lofton | Counselor | 5938 W. Midway Park, Chicago, IL 60644 | 2009-03-24 |
| 1881856094 | Sanjay M. Patel M.d. S.c. | Psychiatry & Neurology | 5730 W. Roosevelt Road, Chicago, IL 60644 | 2008-06-29 |
| 1639348691 | Ysl Care, Inc | Community Based Residential Treatment Facility, Mental Illness | 5107-21 West Jackson Blvd, Chicago, IL 60644 | 2008-02-25 |
| 1073795845 | Maryanne Rakidzioski | Occupational Therapist | 5103 W Jackson Blvd, Chicago, IL 60644 | 2007-12-03 |
| Find all providers in zip 60644 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205443975 | Nickolas Armstrong | Student in an Organized Health Care Education/Training Program | 2828 N Pine Grove Ave Apt 618, Chicago, IL 60657-6137 | 2020-09-28 |
| 1134735962 | Kalvin Cheuk Hang Lung | Student in an Organized Health Care Education/Training Program | 675 N St Clair St 17th Floor, Chicago, IL 60611 | 2020-09-17 |
| 1487267845 | Ashley Marie Sablich | Student in an Organized Health Care Education/Training Program | 250 E Huron Street, Suite 1-200, Chicago, IL 60611 | 2020-08-26 |
| 1275146599 | Ryan Mather | Student in an Organized Health Care Education/Training Program | 155 N Michigan Ave Ste 566, Chicago, IL 60601-7799 | 2020-08-26 |
| 1831701010 | Alexandra Klonis | Student in an Organized Health Care Education/Training Program | 676 N Saint Clair St Ste 6-108, Chicago, IL 60611-2927 | 2020-08-19 |
| 1851903389 | Brittney Christine Evans | Student in an Organized Health Care Education/Training Program | 1901 N Clybourn Ave Ste 302&304, Chicago, IL 60614-5090 | 2020-08-17 |
| 1205446358 | Kai Lai Chu | Student in an Organized Health Care Education/Training Program | 600 N Fairbanks Ct Unit 3505, Chicago, IL 60611-5869 | 2020-08-04 |
| 1568080174 | Nastaran Ordoyo Haghani Rad | Student in an Organized Health Care Education/Training Program | 1950 W. Polk Street, Room 6203, Chicago, IL 60612 | 2020-07-09 |
| 1669090403 | Marianne Gagnon-konamna | Student in an Organized Health Care Education/Training Program | 1950 West Polk Street, Chicago, IL 60612 | 2020-07-08 |
| 1407474463 | Madison Nicole Schulenberg | Student in an Organized Health Care Education/Training Program | 1111 W 14th Pl Unit 119, Chicago, IL 60608-2796 | 2020-07-07 |
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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.