| Gottlieb Community Health Services Corporation | |
|
3249 Oak Park Ave Berwyn IL 60402-3429 | |
| (708) 783-3125 | |
| Not Available |
| Full Name | Gottlieb Community Health Services Corporation |
|---|---|
| Speciality | General Practice |
| Location | 3249 Oak Park Ave, Berwyn, Illinois |
| Authorized Official Name and Position | Adenrele Kolawole (DIRECTOR BILLING OPERATIONS) |
| Authorized Official Contact | 7082163743 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gottlieb Community Health Services Corporation 2160 S 1st Ave Bldg 102 Maywood IL 60153-3328 Ph: (708) 216-8686 | Gottlieb Community Health Services Corporation 3249 Oak Park Ave Berwyn IL 60402-3429 Ph: (708) 783-3125 |
| NPI Number | 1013415603 |
|---|---|
| Provider Enumeration Date | 01/29/2018 |
| Last Update Date | 12/16/2019 |
| Medicare PECOS PAC ID | 3375442999 |
|---|---|
| Medicare Enrollment ID | O20180420000980 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013415603 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Yesenia Yepez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063459956 PECOS PAC ID: 2365335874 Enrollment ID: I20040206000478 |
| Provider Name | Sean P Tierney |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1457315624 PECOS PAC ID: 3577558147 Enrollment ID: I20040415000135 |
| Provider Name | Robert A Iaffaldano |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1043274145 PECOS PAC ID: 7911809413 Enrollment ID: I20040429000876 |
| Provider Name | Kishin Ramani |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1932163045 PECOS PAC ID: 0749182244 Enrollment ID: I20040429001056 |
| Provider Name | Charles A Kinder |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1346204518 PECOS PAC ID: 7911994926 Enrollment ID: I20040429001153 |
| Provider Name | Hang Jin H Shin |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1689638702 PECOS PAC ID: 4385546886 Enrollment ID: I20040501000044 |
| Provider Name | Ronald E Stella |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1821052093 PECOS PAC ID: 9931001435 Enrollment ID: I20040501000089 |
| Provider Name | Kurt W Erickson |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1033173125 PECOS PAC ID: 2466364013 Enrollment ID: I20040501000104 |
| Provider Name | Dominick J Stella |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1932163623 PECOS PAC ID: 6103814066 Enrollment ID: I20040501000124 |
| Provider Name | Stavros G Maragos |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1508820184 PECOS PAC ID: 1951399823 Enrollment ID: I20040501000189 |
| Provider Name | Wayne H Franklin |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1538120472 PECOS PAC ID: 3779574884 Enrollment ID: I20040519000163 |
| Provider Name | Carolyn A Sutter |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1922084789 PECOS PAC ID: 9537140504 Enrollment ID: I20040526000353 |
| Provider Name | David A Cusick |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1093779647 PECOS PAC ID: 0648172148 Enrollment ID: I20040721001475 |
| Provider Name | Marcia J Brown |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1841398021 PECOS PAC ID: 8820064470 Enrollment ID: I20040907000215 |
| Provider Name | Julie D Porter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245226265 PECOS PAC ID: 0547238958 Enrollment ID: I20040923000392 |
| Provider Name | John Berry |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1194702795 PECOS PAC ID: 3971572041 Enrollment ID: I20040927000684 |
| Provider Name | Robert C Lichtenberg |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013972850 PECOS PAC ID: 1951370832 Enrollment ID: I20040928000452 |
| Provider Name | Edwin C Mcgee |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1972576833 PECOS PAC ID: 3971564246 Enrollment ID: I20041020000542 |
| Provider Name | Christian Q Villasenor |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1194775957 PECOS PAC ID: 8921063975 Enrollment ID: I20041201000516 |
| Provider Name | Blanca M Baldoceda |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871533703 PECOS PAC ID: 0941240873 Enrollment ID: I20050510000483 |
| Provider Name | Tuwanda Williamson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629018528 PECOS PAC ID: 6608817630 Enrollment ID: I20050519000424 |
| Provider Name | Ge Li |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1891801064 PECOS PAC ID: 4587691969 Enrollment ID: I20050719000155 |
| Provider Name | Thomas T Kason |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1932163037 PECOS PAC ID: 2062441355 Enrollment ID: I20050808000180 |
| Provider Name | Jeffrey P Schwartz |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1114906294 PECOS PAC ID: 1052341021 Enrollment ID: I20050818000990 |
| Provider Name | Mithila Janakiram |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750313961 PECOS PAC ID: 2668494501 Enrollment ID: I20051220000756 |
| Provider Name | Wickii T Vigneswaran |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1033274873 PECOS PAC ID: 2062435985 Enrollment ID: I20060106000186 |
| Provider Name | Ruheri Perez Tamayo |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1881655397 PECOS PAC ID: 5092724377 Enrollment ID: I20060413000657 |
| Provider Name | Christopher D Bane |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1467416578 PECOS PAC ID: 9537170931 Enrollment ID: I20060524000131 |
| Provider Name | Baudelio Herrada |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366466898 PECOS PAC ID: 9335142272 Enrollment ID: I20060816000085 |
| Provider Name | Alina V Merrill |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710909890 PECOS PAC ID: 1254334733 Enrollment ID: I20060823000385 |
| Provider Name | Umashankar Subramaniam |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1487768032 PECOS PAC ID: 6608872627 Enrollment ID: I20070215000251 |
| Provider Name | Mohammad Hosseinian |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1396772380 PECOS PAC ID: 4082644554 Enrollment ID: I20070424000351 |
| Provider Name | Angelita Oquendo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669505020 PECOS PAC ID: 7911003439 Enrollment ID: I20070430000511 |
| Provider Name | Louise E Komorek |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1366577835 PECOS PAC ID: 1658479894 Enrollment ID: I20070612000128 |
| Provider Name | Tamajah M Jordan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093931198 PECOS PAC ID: 1951401256 Enrollment ID: I20070928000474 |
| Provider Name | Brian Ralston |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710917109 PECOS PAC ID: 0840370417 Enrollment ID: I20080108000871 |
| Provider Name | Danielle Erica Bass |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1790952752 PECOS PAC ID: 5890857379 Enrollment ID: I20081217000208 |
| Provider Name | Mamdouh Bakhos |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1992919914 PECOS PAC ID: 3870678477 Enrollment ID: I20090108000722 |
| Provider Name | Jill A Reda |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1215113303 PECOS PAC ID: 6709941255 Enrollment ID: I20090217000099 |
| Provider Name | Aarti J Raut |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1902813546 PECOS PAC ID: 2769488501 Enrollment ID: I20090325000507 |
| Provider Name | Timothy P Finn |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1619123031 PECOS PAC ID: 2668529058 Enrollment ID: I20090422000561 |
| Provider Name | James P Sur |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1447450788 PECOS PAC ID: 4688724909 Enrollment ID: I20090609000046 |
| Provider Name | Rupal Bhatnagar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225295504 PECOS PAC ID: 3870633167 Enrollment ID: I20091217000313 |
| Provider Name | Aaron Donald Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265690523 PECOS PAC ID: 0648314658 Enrollment ID: I20100215000219 |
| Provider Name | Quang D Pham |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1932212180 PECOS PAC ID: 5799800389 Enrollment ID: I20100920000867 |
| Provider Name | John L Bertolozzi |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1407869779 PECOS PAC ID: 1951426543 Enrollment ID: I20100920000890 |
| Provider Name | Bobby Chan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154588440 PECOS PAC ID: 6305038316 Enrollment ID: I20101008000862 |
| Provider Name | Edward C Foley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164440475 PECOS PAC ID: 1557553120 Enrollment ID: I20101014000712 |
| Provider Name | Yvonne T Murphy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801825450 PECOS PAC ID: 5890988489 Enrollment ID: I20101014001051 |
| Provider Name | Davis P Yang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659305712 PECOS PAC ID: 7315135829 Enrollment ID: I20101228000822 |
| Provider Name | Amy Harrison |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962436782 PECOS PAC ID: 3678761194 Enrollment ID: I20101228000960 |
| Provider Name | Walter J Wojcik |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1033104021 PECOS PAC ID: 0042214876 Enrollment ID: I20110216000160 |
| Provider Name | Jennifer M Sardone-ponnappan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851599583 PECOS PAC ID: 7618069972 Enrollment ID: I20110221000098 |
| Provider Name | Farah Diba Ciftci |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1902135668 PECOS PAC ID: 3577746254 Enrollment ID: I20110318000344 |
| Provider Name | Melissa N Toulios |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912207036 PECOS PAC ID: 4880877018 Enrollment ID: I20110325000575 |
| Provider Name | Sindhu L Joseph |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114103520 PECOS PAC ID: 6103009170 Enrollment ID: I20110329000465 |
| Provider Name | Lambros Tsonis |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1356504278 PECOS PAC ID: 8123206166 Enrollment ID: I20110622000533 |
| Provider Name | Irene Q Ma |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1710151105 PECOS PAC ID: 5991979437 Enrollment ID: I20111121000132 |
| Provider Name | Jenny R.s Handa |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1063789071 PECOS PAC ID: 5496922593 Enrollment ID: I20120112000452 |
| Provider Name | Joseph J Alioto |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1164685525 PECOS PAC ID: 2062679657 Enrollment ID: I20120209000559 |
| Provider Name | Aijaz H Walji |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1447366240 PECOS PAC ID: 4587823679 Enrollment ID: I20120308000799 |
| Provider Name | Michael R Miller |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1730470493 PECOS PAC ID: 9133306418 Enrollment ID: I20120511000332 |
| Provider Name | Komal Kaul |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962710798 PECOS PAC ID: 2466617691 Enrollment ID: I20120712000839 |
| Provider Name | Tehui M Ma |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1467618553 PECOS PAC ID: 3870742125 Enrollment ID: I20121002000771 |
| Provider Name | Amanda C Schmidgall |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1518222660 PECOS PAC ID: 4183873987 Enrollment ID: I20121011000850 |
| Provider Name | Sarah E Perkins |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1013173061 PECOS PAC ID: 3870743610 Enrollment ID: I20121101000243 |
| Provider Name | Casey G Shupe |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1982867446 PECOS PAC ID: 6608029699 Enrollment ID: I20121221000370 |
| Provider Name | Samir H Navik |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1487814695 PECOS PAC ID: 2961655105 Enrollment ID: I20130121000078 |
| Provider Name | James L Lubawski |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1679729511 PECOS PAC ID: 2860627833 Enrollment ID: I20131029000127 |
| Provider Name | Nereida Esparza |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013233006 PECOS PAC ID: 6305071051 Enrollment ID: I20131105000730 |
| Provider Name | Amit Sharma |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538479332 PECOS PAC ID: 9931336781 Enrollment ID: I20131226000626 |
| Provider Name | Eliza J Pierko |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659680015 PECOS PAC ID: 3375773914 Enrollment ID: I20140227001995 |
| Provider Name | Eilis Ryan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1487993911 PECOS PAC ID: 7416274089 Enrollment ID: I20150318002035 |
| Provider Name | Nishant Srinivasan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1649582503 PECOS PAC ID: 5890007439 Enrollment ID: I20150709002666 |
| Provider Name | Lauren N Sullivan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346503125 PECOS PAC ID: 3476866195 Enrollment ID: I20150723007776 |
| Provider Name | Maureen Wuest |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245611706 PECOS PAC ID: 5496060071 Enrollment ID: I20150811004662 |
| Provider Name | Jessica D Johnson |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1093071680 PECOS PAC ID: 1850695537 Enrollment ID: I20160825002754 |
| Provider Name | Jennifer L Dunlop |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912352089 PECOS PAC ID: 3274829791 Enrollment ID: I20160909001587 |
| Provider Name | Christine Joy C Junia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649606179 PECOS PAC ID: 3173829538 Enrollment ID: I20161006000481 |
| Provider Name | Melissa Marie Arredondo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508120981 PECOS PAC ID: 6204139256 Enrollment ID: I20161012002959 |
| Provider Name | Erika Ethel Gleeson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821448077 PECOS PAC ID: 0941588313 Enrollment ID: I20161107000479 |
| Provider Name | Janardhan Mydam |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1396024972 PECOS PAC ID: 0143502484 Enrollment ID: I20170123001391 |
| Provider Name | Dennis A Peacock |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023223021 PECOS PAC ID: 6901973932 Enrollment ID: I20170206001786 |
| Provider Name | Michelle Adichithara |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174069512 PECOS PAC ID: 4587948542 Enrollment ID: I20170313000143 |
| Provider Name | Patricia G Mankowski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720528474 PECOS PAC ID: 0345137188 Enrollment ID: I20170315000433 |
| Provider Name | Kathleen Masella |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043752918 PECOS PAC ID: 5092090647 Enrollment ID: I20170321002636 |
| Provider Name | Syed Ali |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1518113562 PECOS PAC ID: 9032367248 Enrollment ID: I20170322001606 |
| Provider Name | Grant T Balbarin |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1891237095 PECOS PAC ID: 4486930021 Enrollment ID: I20170413000776 |
| Provider Name | Aditi Puri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578882221 PECOS PAC ID: 2769622265 Enrollment ID: I20170526000060 |
| Provider Name | Sheila B Atendido |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1609308139 PECOS PAC ID: 1052680592 Enrollment ID: I20170627001544 |
| Provider Name | Ann S Bunyan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174935274 PECOS PAC ID: 9032334826 Enrollment ID: I20170629001064 |
| Provider Name | Claire A Gross |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1144664681 PECOS PAC ID: 0345545190 Enrollment ID: I20170706002223 |
| Provider Name | Saurabhkumar Chandrakant Patel |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1295152155 PECOS PAC ID: 6002126349 Enrollment ID: I20170803000665 |
| Provider Name | Maryana Yevtukh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609281989 PECOS PAC ID: 2264738780 Enrollment ID: I20170808000083 |
| Provider Name | Eugene Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770841678 PECOS PAC ID: 2961713953 Enrollment ID: I20170818002595 |
| Provider Name | Samira Sihabdeen |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1366885444 PECOS PAC ID: 2062715808 Enrollment ID: I20171018001471 |
| Provider Name | Danielle Farrington |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578976445 PECOS PAC ID: 5193940906 Enrollment ID: I20171027000433 |
| Provider Name | Melanie Ann Ripley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275948630 PECOS PAC ID: 5092011940 Enrollment ID: I20171129001420 |
| Provider Name | Katelyn Ladd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891200176 PECOS PAC ID: 1355603176 Enrollment ID: I20180314002277 |
| Provider Name | Elizabeth Marie Zuelke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245756113 PECOS PAC ID: 5991067605 Enrollment ID: I20180316001055 |
| Provider Name | Shameeta Vinod Thanki |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1437491834 PECOS PAC ID: 7911297577 Enrollment ID: I20180521000527 |
| Provider Name | Naveed S Iqbal |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1346458189 PECOS PAC ID: 2769539220 Enrollment ID: I20180620000026 |
| Provider Name | Krzysztof Malewicz |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1609383496 PECOS PAC ID: 1052669652 Enrollment ID: I20180730001138 |
| Provider Name | Pratixa Patel |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1891210647 PECOS PAC ID: 0840548053 Enrollment ID: I20180803002467 |
| Provider Name | Linda Lee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043691447 PECOS PAC ID: 6204140817 Enrollment ID: I20180815000836 |
| Provider Name | Shantay Danielle Thomas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558756452 PECOS PAC ID: 9032412135 Enrollment ID: I20180817000597 |
| Provider Name | Lauren A Gustafson |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1881107787 PECOS PAC ID: 9830448208 Enrollment ID: I20180817001023 |
| Provider Name | Michael Quien |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043604952 PECOS PAC ID: 4486915915 Enrollment ID: I20180905003206 |
| Provider Name | Spencer Paul Cooperman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033596432 PECOS PAC ID: 3779891403 Enrollment ID: I20180913000012 |
| Provider Name | Asma Asif |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1437425857 PECOS PAC ID: 1658503685 Enrollment ID: I20180913002400 |
| Provider Name | Arvind K. Maheshwari |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1659767903 PECOS PAC ID: 0749598241 Enrollment ID: I20181004001997 |
| Provider Name | Rebecca Harris |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356723969 PECOS PAC ID: 5092018093 Enrollment ID: I20181009003199 |
| Provider Name | Madeline S Lubenow |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1265996631 PECOS PAC ID: 6204176860 Enrollment ID: I20190318001082 |
| Provider Name | Grace Koo |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1255788659 PECOS PAC ID: 3375834989 Enrollment ID: I20190607001615 |
| Provider Name | Natalie Tapaskar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477902302 PECOS PAC ID: 2769774231 Enrollment ID: I20190613003258 |
| Provider Name | Caitlin Canton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093164972 PECOS PAC ID: 0143502518 Enrollment ID: I20190718000022 |
| Provider Name | Ann Hulme |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1124402920 PECOS PAC ID: 6103133632 Enrollment ID: I20190718000247 |
| Provider Name | Michael Kimes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548616857 PECOS PAC ID: 0840588489 Enrollment ID: I20190815002002 |
| Provider Name | Jennifer Thai Andersen |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1336569557 PECOS PAC ID: 5496058000 Enrollment ID: I20190830000607 |
| Provider Name | Charles E Umunna |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1922325661 PECOS PAC ID: 2264738111 Enrollment ID: I20191101002382 |
| Provider Name | Priyanka Sultania Dudani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316255847 PECOS PAC ID: 5890922678 Enrollment ID: I20191216000245 |
| Provider Name | Rosa M Navarro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417478009 PECOS PAC ID: 1557790318 Enrollment ID: I20200331001859 |
| Provider Name | Elizabeth M Stranges |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912438482 PECOS PAC ID: 3971869918 Enrollment ID: I20200715003599 |
| Provider Name | Lucas Chan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578094710 PECOS PAC ID: 5294006706 Enrollment ID: I20200818002264 |
| Provider Name | Lindsay Zehra Ozgunay |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1679107908 PECOS PAC ID: 5294155867 Enrollment ID: I20201028001246 |
| Provider Name | Sean P Jastillano |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1497385082 PECOS PAC ID: 3779911243 Enrollment ID: I20210316002893 |
| Provider Name | David B White |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1407310717 PECOS PAC ID: 1557601887 Enrollment ID: I20210319001421 |
| Provider Name | Cindy Vy. Huynh |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1912596297 PECOS PAC ID: 6507274602 Enrollment ID: I20210408002035 |
| Provider Name | Taysir Walid Awad |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1225415102 PECOS PAC ID: 2163831702 Enrollment ID: I20210511001475 |
| Provider Name | Ashley Smith Nunez |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1083107122 PECOS PAC ID: 3274880026 Enrollment ID: I20210713000576 |
| Provider Name | Deyger Navarrete |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1023513025 PECOS PAC ID: 1254689672 Enrollment ID: I20210713002532 |
| Provider Name | Kelly Mae Atassi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871026856 PECOS PAC ID: 1951670637 Enrollment ID: I20210720001244 |
| Provider Name | Seethal Motamarri |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245729128 PECOS PAC ID: 5597168054 Enrollment ID: I20210722000290 |
| Provider Name | Amit K Singh |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1669913836 PECOS PAC ID: 4688924533 Enrollment ID: I20210907000685 |
| Provider Name | Sirisha Yellayi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619473519 PECOS PAC ID: 3375894462 Enrollment ID: I20210915001139 |
| Provider Name | Ruta Cepaitis |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1568993426 PECOS PAC ID: 1557633963 Enrollment ID: I20210924002493 |
| Provider Name | Arshnoor Qamaruddin |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1649841339 PECOS PAC ID: 8527457407 Enrollment ID: I20211115002223 |
| Provider Name | Steve Fankam |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1255910014 PECOS PAC ID: 8628468667 Enrollment ID: I20211206000806 |
| Provider Name | Tianyi Swartz |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1912402405 PECOS PAC ID: 8527317270 Enrollment ID: I20220602001397 |
| Provider Name | Neal K Shah |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1356872576 PECOS PAC ID: 2769759414 Enrollment ID: I20220625000286 |
| Provider Name | Tonia Gooden |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1962065623 PECOS PAC ID: 4789915042 Enrollment ID: I20220715000211 |
| Provider Name | Maria Khalil |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770143893 PECOS PAC ID: 1658753868 Enrollment ID: I20220804002777 |
| Provider Name | Kayla Janine Dmytruk |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1467974402 PECOS PAC ID: 8921371618 Enrollment ID: I20221025000621 |
| Provider Name | Sawyer C Henderson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1487309175 PECOS PAC ID: 9739556978 Enrollment ID: I20221101002321 |
| Provider Name | Avais Sunny Ahmed |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1770087918 PECOS PAC ID: 6305196262 Enrollment ID: I20221116000794 |
| Provider Name | Anna Lebiedzinski |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1801535356 PECOS PAC ID: 2668840745 Enrollment ID: I20221121002427 |
| Provider Name | Rebecca J Burkhart |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1962124347 PECOS PAC ID: 7911376959 Enrollment ID: I20221213002694 |
| Provider Name | Evin Koleini |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1215422084 PECOS PAC ID: 6002299708 Enrollment ID: I20230214003223 |
| Provider Name | Verna L Auge |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1255430039 PECOS PAC ID: 7113943168 Enrollment ID: I20230215001782 |
| Provider Name | Feroz A Osmani |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1780180190 PECOS PAC ID: 4082946637 Enrollment ID: I20230320000160 |
| Provider Name | Stanley A Kristiansen |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1205984366 PECOS PAC ID: 6608972088 Enrollment ID: I20230512001631 |
| Provider Name | Aaron M Gish |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1063971844 PECOS PAC ID: 2264897107 Enrollment ID: I20230623002846 |
| Provider Name | Adeel A Yaseen |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1841759735 PECOS PAC ID: 0941543599 Enrollment ID: I20230714001551 |
| Provider Name | Jorge Romo |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1689179301 PECOS PAC ID: 6507113354 Enrollment ID: I20230727001285 |
| Provider Name | Wali Sajjad Khan |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1891465225 PECOS PAC ID: 2163883703 Enrollment ID: I20230731001307 |
| Provider Name | Kyle Mieszcak |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1417624206 PECOS PAC ID: 2365803533 Enrollment ID: I20230803003344 |
| Provider Name | Yoojung Kang |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1346705316 PECOS PAC ID: 3476893785 Enrollment ID: I20230810000055 |
| Provider Name | Udochukwu O Asonye |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1114964673 PECOS PAC ID: 5294639803 Enrollment ID: I20231010001141 |
| Provider Name | Joseph Torre |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1528000361 PECOS PAC ID: 0648625640 Enrollment ID: I20231011002182 |
| Provider Name | Telma Karerakattil |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1205612173 PECOS PAC ID: 0143677278 Enrollment ID: I20231113000256 |
Healthy Hearts Doctors Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6920 Ogden Ave, Berwyn, IL 60402 Phone: 630-847-9795 Fax: 630-780-2991 | |
Berwyn Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3245 S. Grove Avenue, Ste 105 & 106, Berwyn, IL 60402 Phone: 708-795-0383 Fax: 708-484-9545 | |
Macneal Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3249 South Oak Park Ave, Berwyn, IL 60402 Phone: 708-783-3222 Fax: 708-783-3489 | |
South Family Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6201 Roosevelt Rd, Berwyn, IL 60402 Phone: 708-386-0845 Fax: 708-386-8472 | |
Vanguard Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3249 Oak Park Ave, Berwyn, IL 60402 Phone: 708-783-3222 Fax: 708-783-3489 | |
7 Hills Healthcare Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6925 Cermak Rd, Berwyn, IL 60402 Phone: 708-484-9903 |