MOE TAKEDA (NPI# 1982068789) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982068789 |
| Entity Type | Individual |
| Full Name | MOE TAKEDA |
| Practice Address |
5841 S Maryland Ave # Mc3083 Chicago IL 60637-1443 |
| Mailing Address |
180 Harvester Dr Ste 110 Burr Ridge IL 60527-6686 |
| Practice Telephone | 7738347708 |
| Mailing Telephone | 7737021150 |
| Enumeration Date | 2016-04-07 |
| Last Update Date | 2020-04-27 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZH0000X |
Pathology Specialization: Hematology |
036151372 | IL | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1200 N State St, Clinic Tower, Room A7e, Los Angeles, CA 900331029 | 3234095126 |
| Street Address |
5841 S MARYLAND AVE # MC3083 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60637-1443 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467471813 | Carol L. Willis | Pathology | 5841 S Maryland Ave # Mc3083, Chicago, IL 60637-1447 | 2006-07-18 |
| 1063032118 | Pari Jafari | Pathology | 5841 S Maryland Ave # Mc3083, Chicago, IL 60637-1443 | 2020-04-18 |
| 1063074888 | Tanner Emerson Russell Storozuk | Pathology | 5841 S Maryland Ave # Mc3083, Chicago, IL 60637-1443 | 2019-07-02 |
| 1417419243 | Meghana Agni | Pathology | 5841 S Maryland Ave # Mc3083, Chicago, IL 60637-1443 | 2019-04-01 |
| 1124506589 | Kyle Everett Kissick | Pathology | 5841 S Maryland Ave # Mc3083, Chicago, IL 60637-1443 | 2018-07-29 |
| 1770077208 | Luke N Lauridsen | Pathology | 5841 S Maryland Ave # Mc3083, Chicago, IL 60637-1443 | 2018-06-18 |
| 1215467725 | Ellen Alexander | Pathology | 5841 S Maryland Ave # Mc3083, Chicago, IL 60637-1447 | 2017-06-16 |
| 1952831760 | Benjamin Allen Kaumeyer | Pathology | 5841 S Maryland Ave # Mc3083, Chicago, IL 60637-1447 | 2017-06-14 |
| 1710413091 | Kathleen Higgins | Dentist | 5841 S Maryland Ave # Mc3083, Chicago, IL 60637-1443 | 2017-05-05 |
| 1285173906 | Clarence Wing-chung Chan | Student in an Organized Health Care Education/Training Program | 5841 S Maryland Ave # Mc3083, Chicago, IL 60637-1443 | 2017-02-14 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386263234 | Pooja Ramnani | Pharmacist | 5841 S Maryland Ace, Chicago, IL 60637 | 2020-04-10 |
| 1780220079 | Tara Coleman | Non-emergency Medical Transport (VAN) | 808 E. 63rd Street, Suite 135, Chicago, IL 60637 | 2019-11-21 |
| 1366003501 | Valerie Silas | Case Management | 6330 S King Drive, Chicago, IL 60637 | 2019-06-27 |
| 1205391620 | Derek Joseph Fiedler | Anesthesiology | University of Chicago, 5841 S Maryland Ave, Chicago, IL 60637 | 2019-02-11 |
| 1821573072 | Ugochinyere Ohaja | Registered Nurse | 5656 South Maryland Avenue, Chicago, IL 60637 | 2018-10-03 |
| 1053899138 | Won Hee Oh | Physician Assistant | 5841 S. Maryland Ave., Mc5040, Chicago, IL 60637 | 2018-08-01 |
| 1558854695 | Rasidat Adeduntan | Internal Medicine | 5841 S. Maryland Avenue, [7082], Chicago, IL 60637 | 2018-06-13 |
| 1194235283 | Melissa Ann Arangoa | Registered Nurse | 5841 S. Maryland Ave, Mc 1083, Chicago, IL 60637 | 2017-10-03 |
| 1558880633 | Marni Harris | Optometrist | 5841 S Maryland Ave # S421, Chicago, IL 60637 | 2017-09-11 |
| 1992235105 | Vidya Mahavadi | Pediatrics | 5841 S. Maryland Avenue, Mail Code 8016, Chicago, IL 60637 | 2017-06-20 |
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| Taxonomy Code | 207ZH0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Hematology |
| A hematopathologist is expert in diseases that affect blood cells, blood clotting mechanisms, bone marrow and lymph nodes. This physician has the knowledge and technical skills essential for the laboratory diagnosis of anemias, leukemias, lymphomas, bleeding disorders and blood clotting disorders. |
| 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 Pathology, 2007. http://www.abpath.org/. American Osteopathic Board of Pathology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pathology. The Certification is NO longer provided. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336554799 | Shiraz Fidai | Pathology | 5841 S Maryland Ave Rm S-323, Chicago, IL 60637-1447 | 2014-06-24 |
| 1891075925 | Barina Aqil | Pathology | 251 E Huron St Ste 220, Chicago, IL 60611-2908 | 2011-08-21 |
| 1497978902 | Amir Behdad | Pathology | 680 N Lake Shore Dr Ste 1000, Department of Pathology and Laboratory Medicine, Chicago, IL 60611 | 2007-04-11 |
| 1053738195 | Nicolas Manuel Lopez-hisijos | Pathology | 1750 W Harrison St, Chicago, IL 60612-3825 | 2014-03-26 |
| 1215220413 | Carlos A Murga-zamalloa | Pathology | 840 S Wood St Ste 130, Chicago, IL 60612-4325 | 2011-05-20 |
| 1780901942 | Rachel Angelica Mariani | Pathology | 2900 N Lake Shore Dr, Chicago, IL 60657-5640 | 2010-04-28 |
| 1891019568 | Jason Xiaojun Cheng | Pathology | 5841 S Maryland Ave, Pathology, Tw-051d, Mc 0008, University of Chicago, Chicago, IL 60637-1447 | 2010-03-24 |
| 1811121726 | Shunyou Gong | Pathology | 225 E Chicago Ave, Chicago, IL 60611-2991 | 2009-05-06 |
| 1447400379 | Mark J Roberts | Pathology | 2900 N. Lake Shore Drive, St. Joseph Hospital Department of Pathology, Chicago, IL 60657-5640 | 2008-09-28 |
| 1417112665 | Sangeeta Mehendale | Pathology | 840 S Wood St, Chicago, IL 60612-4325 | 2008-07-26 |
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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.