| Loyola Medical Group Llc | |
|
3249 Oak Park Ave Berwyn IL 60402-3429 | |
| (708) 783-3125 | |
| Not Available |
| Full Name | Loyola Medical Group Llc |
|---|---|
| Speciality | General Practice |
| Location | 3249 Oak Park Ave, Berwyn, Illinois |
| Authorized Official Name and Position | Adenrele Adekunbi 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 |
|---|---|
| Loyola Medical Group Llc 2160 S 1st Ave Maywood IL 60153-3328 Ph: () - | Loyola Medical Group Llc 3249 Oak Park Ave Berwyn IL 60402-3429 Ph: (708) 783-3125 |
| NPI Number | 1376041954 |
|---|---|
| Provider Enumeration Date | 01/29/2018 |
| Last Update Date | 11/16/2020 |
| Medicare PECOS PAC ID | 6305109547 |
|---|---|
| Medicare Enrollment ID | O20180420002063 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376041954 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Francisco Javier Espinosa-becerra |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1881646313 PECOS PAC ID: 8224930011 Enrollment ID: I20040122000755 |
| Provider Name | Yesenia Yepez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063459956 PECOS PAC ID: 2365335874 Enrollment ID: I20040206000478 |
| Provider Name | Susan H Porto |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1487643573 PECOS PAC ID: 6608767645 Enrollment ID: I20040322000328 |
| 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 | Connie E Moreland |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1346324423 PECOS PAC ID: 6103800388 Enrollment ID: I20040615001621 |
| Provider Name | Emelita C Co |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396813069 PECOS PAC ID: 1951373240 Enrollment ID: I20040810000736 |
| Provider Name | David B Levy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437101714 PECOS PAC ID: 6709859119 Enrollment ID: I20040820000819 |
| Provider Name | Jennifer Glover |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1376563742 PECOS PAC ID: 8527033232 Enrollment ID: I20040826001283 |
| Provider Name | Sandra Vega |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1760454979 PECOS PAC ID: 3476520909 Enrollment ID: I20040914001042 |
| Provider Name | Leticia Gonzalez |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1356313720 PECOS PAC ID: 3375511553 Enrollment ID: I20040924000518 |
| Provider Name | John Berry |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1194702795 PECOS PAC ID: 3971572041 Enrollment ID: I20040927000684 |
| Provider Name | Monika A Zeromska- Cancellaro |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1730111097 PECOS PAC ID: 3476514548 Enrollment ID: I20041022001143 |
| Provider Name | Kevin M Hilton |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1245348184 PECOS PAC ID: 7810950839 Enrollment ID: I20041110000291 |
| Provider Name | Ahmed Hussain |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396877767 PECOS PAC ID: 0244295756 Enrollment ID: I20041124000064 |
| 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 | Patrick T Michel |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1487639514 PECOS PAC ID: 8325099682 Enrollment ID: I20050214000341 |
| Provider Name | Alka Srivastava |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1982672663 PECOS PAC ID: 9234170424 Enrollment ID: I20050518000505 |
| Provider Name | Chong H Pak |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1003926296 PECOS PAC ID: 4284679663 Enrollment ID: I20050627000252 |
| Provider Name | Ge Li |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1891801064 PECOS PAC ID: 4587691969 Enrollment ID: I20050719000155 |
| Provider Name | Jeffrey D Branch |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1528032513 PECOS PAC ID: 3274560040 Enrollment ID: I20050722000761 |
| Provider Name | Thomas Maynard Tucker Turk |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1568436541 PECOS PAC ID: 4688602683 Enrollment ID: I20050801000506 |
| Provider Name | James A Rupp |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780658815 PECOS PAC ID: 1658301833 Enrollment ID: I20050817000505 |
| Provider Name | Douglas A Evans |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1700850005 PECOS PAC ID: 9638109416 Enrollment ID: I20050822000570 |
| Provider Name | Parag K Amin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639107667 PECOS PAC ID: 4486685872 Enrollment ID: I20050825000441 |
| Provider Name | Marcus Quek |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1457325433 PECOS PAC ID: 1254308612 Enrollment ID: I20051020000513 |
| Provider Name | Mithila Janakiram |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750313961 PECOS PAC ID: 2668494501 Enrollment ID: I20051220000756 |
| Provider Name | Rashmi C Tomur |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1770686305 PECOS PAC ID: 4486676822 Enrollment ID: I20051230000515 |
| Provider Name | Funmilayo A Macaulay |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1356441844 PECOS PAC ID: 3274557459 Enrollment ID: I20060116000426 |
| Provider Name | Laura Saelinger Shafer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598739633 PECOS PAC ID: 1759396633 Enrollment ID: I20060214000327 |
| Provider Name | Oliver M. Olea |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1629023635 PECOS PAC ID: 6406867571 Enrollment ID: I20060606000162 |
| Provider Name | Arlette F Brown |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1275580565 PECOS PAC ID: 8426060898 Enrollment ID: I20060629000269 |
| 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 | Madalina Ionescu |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1306878558 PECOS PAC ID: 1759359086 Enrollment ID: I20060907000446 |
| Provider Name | Raul Tamayo |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1700814183 PECOS PAC ID: 3173527694 Enrollment ID: I20060914000045 |
| Provider Name | Narges Sedighen Razavizadeh |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1164467593 PECOS PAC ID: 6709880222 Enrollment ID: I20060914000054 |
| Provider Name | Ramon Alvarez Leonardo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861425365 PECOS PAC ID: 9335144484 Enrollment ID: I20060922000282 |
| Provider Name | David Czukerberg |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1578515839 PECOS PAC ID: 7012915846 Enrollment ID: I20061110000016 |
| Provider Name | Natasha T Jenkins |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1285736736 PECOS PAC ID: 3779582218 Enrollment ID: I20061212000163 |
| Provider Name | Syed Rizvi |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1598840399 PECOS PAC ID: 4880695865 Enrollment ID: I20070117000290 |
| Provider Name | Mohammad Hosseinian |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1396772380 PECOS PAC ID: 4082644554 Enrollment ID: I20070424000351 |
| 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 | Michael Edward Woods |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1366541351 PECOS PAC ID: 8022112358 Enrollment ID: I20070713000717 |
| Provider Name | Chaiyapon Couropmitree |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073624375 PECOS PAC ID: 8426159401 Enrollment ID: I20070720000146 |
| Provider Name | Deslyn S Browne |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1083827810 PECOS PAC ID: 4082705256 Enrollment ID: I20070802000611 |
| Provider Name | Matthew J Blecha |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1518990399 PECOS PAC ID: 2769573237 Enrollment ID: I20070813000514 |
| Provider Name | Darius J Bartkus |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093836629 PECOS PAC ID: 5496849036 Enrollment ID: I20070913000438 |
| Provider Name | Michael V Gavino |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1538352539 PECOS PAC ID: 6103911797 Enrollment ID: I20070927000286 |
| Provider Name | Tamajah M Jordan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093931198 PECOS PAC ID: 1951401256 Enrollment ID: I20070928000474 |
| Provider Name | Charles J Adamczyk |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1417989468 PECOS PAC ID: 6901986223 Enrollment ID: I20071227000490 |
| Provider Name | Steve Michel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053340695 PECOS PAC ID: 6608956925 Enrollment ID: I20071227000519 |
| Provider Name | Joseph Kucera |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1699708552 PECOS PAC ID: 5294788824 Enrollment ID: I20080107000500 |
| Provider Name | Bruce T Kline |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891728747 PECOS PAC ID: 3779663331 Enrollment ID: I20080108000844 |
| Provider Name | Mark E Hroncich |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265465108 PECOS PAC ID: 9032299607 Enrollment ID: I20080108000864 |
| Provider Name | Brian Ralston |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710917109 PECOS PAC ID: 0840370417 Enrollment ID: I20080108000871 |
| Provider Name | Rajni Srivastava |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1053341248 PECOS PAC ID: 2668552043 Enrollment ID: I20080110000589 |
| Provider Name | Christopher R Thorp |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1730127739 PECOS PAC ID: 5991886293 Enrollment ID: I20080111000706 |
| Provider Name | Mohammed T Ali |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033215868 PECOS PAC ID: 1456432160 Enrollment ID: I20080121000069 |
| Provider Name | Tariq B Iftikhar |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1407963879 PECOS PAC ID: 8224112693 Enrollment ID: I20080222000607 |
| Provider Name | Janis Wiener |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750315586 PECOS PAC ID: 2567547094 Enrollment ID: I20080308000019 |
| Provider Name | Kathleen D Mahoney |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1952329369 PECOS PAC ID: 3476632365 Enrollment ID: I20080502000601 |
| Provider Name | Elsa Valero |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033383088 PECOS PAC ID: 4587733688 Enrollment ID: I20080515000249 |
| Provider Name | Hong S Lee |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1023289444 PECOS PAC ID: 7113098039 Enrollment ID: I20080620000375 |
| Provider Name | Kristina Aleksoniene |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1659545002 PECOS PAC ID: 6901978139 Enrollment ID: I20080703000507 |
| Provider Name | Dinas Aleksonis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255505608 PECOS PAC ID: 4284708801 Enrollment ID: I20080730000820 |
| Provider Name | Kendra Marie Hammond |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1417134883 PECOS PAC ID: 9537236427 Enrollment ID: I20080918000151 |
| Provider Name | Syed Waliuddin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104046630 PECOS PAC ID: 1658463534 Enrollment ID: I20080924000549 |
| Provider Name | Manohar L Jethani |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366529505 PECOS PAC ID: 6406923648 Enrollment ID: I20080930000317 |
| Provider Name | Stefanie A Allen |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1114192416 PECOS PAC ID: 6800964404 Enrollment ID: I20081009000459 |
| Provider Name | Taratip Thupvong |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1457500993 PECOS PAC ID: 6204995798 Enrollment ID: I20081113000169 |
| Provider Name | James G Martin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235382011 PECOS PAC ID: 7214091966 Enrollment ID: I20090126000348 |
| Provider Name | Kelly A Dewolfe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265525760 PECOS PAC ID: 7416012224 Enrollment ID: I20090211000363 |
| 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 | 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 | Gregory J Ozark |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558337840 PECOS PAC ID: 3476602301 Enrollment ID: I20090522000261 |
| Provider Name | Michael S Dewolfe |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1538307566 PECOS PAC ID: 7618027962 Enrollment ID: I20090625000357 |
| Provider Name | Louis E De La Garza |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740448323 PECOS PAC ID: 6002968575 Enrollment ID: I20090714000422 |
| Provider Name | Mary Alice Horan |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1639252737 PECOS PAC ID: 2365588159 Enrollment ID: I20091008000249 |
| Provider Name | Nadia Haider |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1508954678 PECOS PAC ID: 3072650373 Enrollment ID: I20091019000433 |
| Provider Name | Yongsun L Ra Hurka |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821062944 PECOS PAC ID: 6305988114 Enrollment ID: I20100116000077 |
| Provider Name | Aaron Donald Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265690523 PECOS PAC ID: 0648314658 Enrollment ID: I20100215000219 |
| Provider Name | Kevin Thomas Mcvary |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1356369185 PECOS PAC ID: 5890825772 Enrollment ID: I20100621000320 |
| Provider Name | Andrea D Jones |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1861487423 PECOS PAC ID: 7911021191 Enrollment ID: I20100824001165 |
| 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 | Sarkis Morales Vidal |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1811211899 PECOS PAC ID: 4587858592 Enrollment ID: I20101103001363 |
| Provider Name | Alex Gorbonos |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1538341060 PECOS PAC ID: 0941353908 Enrollment ID: I20101112000451 |
| Provider Name | Haris Aleem |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1063409795 PECOS PAC ID: 1850472374 Enrollment ID: I20101213000715 |
| Provider Name | Davis P Yang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659305712 PECOS PAC ID: 7315135829 Enrollment ID: I20101228000822 |
| Provider Name | Lawrence E Schilder |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1962439398 PECOS PAC ID: 0547458747 Enrollment ID: I20110103000327 |
| Provider Name | May Hashimi |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1154342293 PECOS PAC ID: 8022297233 Enrollment ID: I20110120000317 |
| 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 | John A Mcgann |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1326018334 PECOS PAC ID: 0941484497 Enrollment ID: I20110407000927 |
| Provider Name | Thythy T Pham |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1285880757 PECOS PAC ID: 8527245992 Enrollment ID: I20110613000205 |
| Provider Name | Abid K Nazeer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114129921 PECOS PAC ID: 0547307126 Enrollment ID: I20110729000139 |
| Provider Name | Nicole M Sprawka |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1659534055 PECOS PAC ID: 1052581436 Enrollment ID: I20110822000180 |
| Provider Name | Gopal Gupta |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1326182015 PECOS PAC ID: 4587835111 Enrollment ID: I20110912000550 |
| Provider Name | Margaret Liotta |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1841454303 PECOS PAC ID: 3476605494 Enrollment ID: I20110914000286 |
| Provider Name | Ahmer V Farooq |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1326201666 PECOS PAC ID: 3375714728 Enrollment ID: I20110915000722 |
| Provider Name | Christina Arellano |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396907796 PECOS PAC ID: 9638341233 Enrollment ID: I20111003000758 |
| Provider Name | Nina Yedavalli |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1306094842 PECOS PAC ID: 0749200541 Enrollment ID: I20111109000701 |
| Provider Name | Kalki Bommaraju |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1609029511 PECOS PAC ID: 9638347032 Enrollment ID: I20111115000226 |
| 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 | Michael Haske |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1982632725 PECOS PAC ID: 1052317401 Enrollment ID: I20120201000067 |
| Provider Name | Joseph J Alioto |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1164685525 PECOS PAC ID: 2062679657 Enrollment ID: I20120209000559 |
| Provider Name | Olivier Louis Marie Curet |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740519198 PECOS PAC ID: 4486813557 Enrollment ID: I20120308000566 |
| Provider Name | Aijaz H Walji |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1447366240 PECOS PAC ID: 4587823679 Enrollment ID: I20120308000799 |
| Provider Name | Ann K Lal |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1518163401 PECOS PAC ID: 4284792094 Enrollment ID: I20120404000972 |
| Provider Name | Sameer M A Qazi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1083842868 PECOS PAC ID: 8820259351 Enrollment ID: I20120410000703 |
| 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 | Brent Cutro |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346479474 PECOS PAC ID: 1658535919 Enrollment ID: I20120618000236 |
| Provider Name | Andrei V Pankov |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225285703 PECOS PAC ID: 8022273770 Enrollment ID: I20120629000528 |
| Provider Name | Komal Kaul |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962710798 PECOS PAC ID: 2466617691 Enrollment ID: I20120712000839 |
| Provider Name | Janet M Nielsen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679773980 PECOS PAC ID: 9830254473 Enrollment ID: I20120823000632 |
| Provider Name | Joann Harano |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1710144233 PECOS PAC ID: 7618125220 Enrollment ID: I20120924000129 |
| 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 | Gabriela I Ferrera |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992002711 PECOS PAC ID: 9537311303 Enrollment ID: I20121203000111 |
| Provider Name | Jude Dumfeh |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1700048022 PECOS PAC ID: 6901058387 Enrollment ID: I20121211000241 |
| 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 | Candace R Blank |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1194056564 PECOS PAC ID: 1951555010 Enrollment ID: I20130126000019 |
| Provider Name | Diorella C Guloy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477782597 PECOS PAC ID: 2961640305 Enrollment ID: I20130524000400 |
| Provider Name | Jolene M Quinones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750624581 PECOS PAC ID: 5395985162 Enrollment ID: I20130628000457 |
| Provider Name | Jason Rice |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093036931 PECOS PAC ID: 4082855838 Enrollment ID: I20130722000188 |
| Provider Name | Shuja M Uddin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871832790 PECOS PAC ID: 0840425831 Enrollment ID: I20131029000596 |
| Provider Name | Summers Michelle Stacks |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710206784 PECOS PAC ID: 0042445801 Enrollment ID: I20131101001117 |
| 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 | Farnaz Almasganj |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1568672160 PECOS PAC ID: 7517195209 Enrollment ID: I20131231000712 |
| Provider Name | Youshay Humayun |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1093010423 PECOS PAC ID: 6709015621 Enrollment ID: I20140218001193 |
| Provider Name | Eliza J Pierko |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659680015 PECOS PAC ID: 3375773914 Enrollment ID: I20140227001995 |
| Provider Name | Shilpa V Desai |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063552412 PECOS PAC ID: 4284772294 Enrollment ID: I20140502001180 |
| Provider Name | Anne E Groves |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1699948786 PECOS PAC ID: 8921222043 Enrollment ID: I20140611001780 |
| Provider Name | Maria J Ferrera |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285955476 PECOS PAC ID: 3678797388 Enrollment ID: I20140620000341 |
| Provider Name | Meghan Cox-pedota |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1144541657 PECOS PAC ID: 2668694969 Enrollment ID: I20141120001083 |
| Provider Name | Courtney Lockhart |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1952689259 PECOS PAC ID: 0547582017 Enrollment ID: I20141211001972 |
| Provider Name | Allyson M Lucero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043617087 PECOS PAC ID: 6103141163 Enrollment ID: I20150213001657 |
| Provider Name | Eilis Ryan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1487993911 PECOS PAC ID: 7416274089 Enrollment ID: I20150318002035 |
| Provider Name | Mirtha Raigoza Ramirez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295080372 PECOS PAC ID: 6002133923 Enrollment ID: I20150402000091 |
| Provider Name | Robert Dons |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1508905928 PECOS PAC ID: 4183765431 Enrollment ID: I20150708002450 |
| Provider Name | Jacquelyn N Skerrett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457611683 PECOS PAC ID: 0042433906 Enrollment ID: I20150723006712 |
| Provider Name | Lauren N Sullivan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346503125 PECOS PAC ID: 3476866195 Enrollment ID: I20150723007776 |
| Provider Name | Amelia M Merz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770637399 PECOS PAC ID: 7012005689 Enrollment ID: I20150729007154 |
| Provider Name | Jasmin P Ulit |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316321359 PECOS PAC ID: 8628383247 Enrollment ID: I20150811005846 |
| Provider Name | Allen Tung |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730444852 PECOS PAC ID: 3779716436 Enrollment ID: I20151005003250 |
| Provider Name | Grace Delos Santos |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1255569323 PECOS PAC ID: 9830499342 Enrollment ID: I20151204000773 |
| Provider Name | Uroosa Kamran |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821353707 PECOS PAC ID: 1052534252 Enrollment ID: I20160105002464 |
| Provider Name | Neel B Patel |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1700102332 PECOS PAC ID: 1557675741 Enrollment ID: I20160608000147 |
| Provider Name | Lauren Matteini |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1922261346 PECOS PAC ID: 6608018643 Enrollment ID: I20160707001959 |
| Provider Name | Caitlin Marie Dore |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1619231396 PECOS PAC ID: 6305142365 Enrollment ID: I20160816001643 |
| Provider Name | Abigail Winder |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1740423623 PECOS PAC ID: 8921250507 Enrollment ID: I20160816001800 |
| 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 | Viraj Dharmraj Chauhan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1962835884 PECOS PAC ID: 9931497849 Enrollment ID: I20161010000696 |
| Provider Name | Melissa Marie Arredondo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508120981 PECOS PAC ID: 6204139256 Enrollment ID: I20161012002959 |
| Provider Name | Sneha P Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598212110 PECOS PAC ID: 7113205790 Enrollment ID: I20161102001287 |
| Provider Name | Erika Ethel Gleeson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821448077 PECOS PAC ID: 0941588313 Enrollment ID: I20161107000479 |
| Provider Name | Jocelyn Tolentino |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1609267095 PECOS PAC ID: 8729367289 Enrollment ID: I20161128001719 |
| Provider Name | Jennifer Holland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366573495 PECOS PAC ID: 9032357140 Enrollment ID: I20161202000417 |
| Provider Name | Magdaline V Piatek |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588899454 PECOS PAC ID: 9133342371 Enrollment ID: I20161209000133 |
| Provider Name | Tushar Murli Advani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881918415 PECOS PAC ID: 9739461484 Enrollment ID: I20170113000145 |
| Provider Name | Samer Totonchi |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1467689281 PECOS PAC ID: 5092948570 Enrollment ID: I20170119002247 |
| Provider Name | Kara Linn Totonchi |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1366701989 PECOS PAC ID: 9931405701 Enrollment ID: I20170123000391 |
| Provider Name | Dennis A Peacock |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023223021 PECOS PAC ID: 6901973932 Enrollment ID: I20170206001786 |
| 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 | Kellie Vaidya |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346781879 PECOS PAC ID: 5597042754 Enrollment ID: I20170426001273 |
| Provider Name | Jacqueline N Horst |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003158254 PECOS PAC ID: 1557653912 Enrollment ID: I20170522001263 |
| Provider Name | Aditi Puri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578882221 PECOS PAC ID: 2769622265 Enrollment ID: I20170526000060 |
| Provider Name | Christopher Ochoa |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1952690182 PECOS PAC ID: 5193028314 Enrollment ID: I20170619000444 |
| 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 | Nicholas Brown |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1972899748 PECOS PAC ID: 9537452180 Enrollment ID: I20170808000326 |
| Provider Name | Madonna Fabian |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1124438411 PECOS PAC ID: 9931470754 Enrollment ID: I20170811001996 |
| 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 | Elie J Zayyat |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1760429930 PECOS PAC ID: 0345131546 Enrollment ID: I20171018002702 |
| Provider Name | John Robert Miller |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1528367836 PECOS PAC ID: 3072814946 Enrollment ID: I20171026003277 |
| Provider Name | Danielle Farrington |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578976445 PECOS PAC ID: 5193940906 Enrollment ID: I20171027000433 |
| Provider Name | Antonio Hernando Iglesias |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1003142704 PECOS PAC ID: 8921228834 Enrollment ID: I20171113001999 |
| Provider Name | Melanie Ann Ripley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275948630 PECOS PAC ID: 5092011940 Enrollment ID: I20171129001420 |
| Provider Name | Elizabeth Clay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235411695 PECOS PAC ID: 0840559464 Enrollment ID: I20180105000066 |
| Provider Name | Gregory Hall Sams |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1881956936 PECOS PAC ID: 9638310410 Enrollment ID: I20180214002932 |
| Provider Name | Kaylea M Reeves |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1881101350 PECOS PAC ID: 1658633474 Enrollment ID: I20180314002123 |
| Provider Name | Katelyn Ladd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891200176 PECOS PAC ID: 1355603176 Enrollment ID: I20180314002277 |
| Provider Name | Shameeta Vinod Thanki |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1437491834 PECOS PAC ID: 7911297577 Enrollment ID: I20180521000527 |
| Provider Name | Lilyana Kalinova Nezirova |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1407246697 PECOS PAC ID: 8729385711 Enrollment ID: I20180717000786 |
| Provider Name | Zachary T Lonjers |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104205491 PECOS PAC ID: 0446562953 Enrollment ID: I20180725003204 |
| 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 | Elizabeth Torres |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1194806711 PECOS PAC ID: 1052461084 Enrollment ID: I20180815003371 |
| Provider Name | Shantay Danielle Thomas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558756452 PECOS PAC ID: 9032412135 Enrollment ID: I20180817000597 |
| Provider Name | Kathleen Patricia Medici |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104315571 PECOS PAC ID: 4183974991 Enrollment ID: I20180828004213 |
| Provider Name | Michael Quien |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043604952 PECOS PAC ID: 4486915915 Enrollment ID: I20180905003206 |
| Provider Name | Alexander P Soneru |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1558656033 PECOS PAC ID: 9638446388 Enrollment ID: I20180910002090 |
| 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 | Jay Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538553177 PECOS PAC ID: 4082922554 Enrollment ID: I20180918003423 |
| Provider Name | Marian Giselle Acevedo Alvarez |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1710271341 PECOS PAC ID: 1456649045 Enrollment ID: I20180919001916 |
| Provider Name | Virginia Dunsmore |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1396996518 PECOS PAC ID: 0840541306 Enrollment ID: I20180921001250 |
| 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 | Mark D Alter |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1730263617 PECOS PAC ID: 5991855330 Enrollment ID: I20181113000752 |
| 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 | Stasia Rouse |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1699193847 PECOS PAC ID: 6002117884 Enrollment ID: I20190709000911 |
| Provider Name | Janet Cruz |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1447697206 PECOS PAC ID: 4688909427 Enrollment ID: I20190716001497 |
| Provider Name | Bati A Myles |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1548421233 PECOS PAC ID: 5698085926 Enrollment ID: I20190809000660 |
| Provider Name | Jigisha Paresh Thakkar |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1750795696 PECOS PAC ID: 4183938079 Enrollment ID: I20190823002632 |
| Provider Name | Jennifer Thai Andersen |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1336569557 PECOS PAC ID: 5496058000 Enrollment ID: I20190830000607 |
| Provider Name | Claire F Cunningham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366097826 PECOS PAC ID: 9931430469 Enrollment ID: I20191014002214 |
| Provider Name | Christopher Robert-james Schilf |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1740608447 PECOS PAC ID: 2668755802 Enrollment ID: I20191018000896 |
| Provider Name | Charles E Umunna |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1922325661 PECOS PAC ID: 2264738111 Enrollment ID: I20191101002382 |
| Provider Name | Sunhee Jung Moon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265778864 PECOS PAC ID: 5890127567 Enrollment ID: I20191118003264 |
| Provider Name | Sarah Mennella |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659802148 PECOS PAC ID: 6204107956 Enrollment ID: I20191126000082 |
| Provider Name | Priyanka Sultania Dudani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316255847 PECOS PAC ID: 5890922678 Enrollment ID: I20191216000245 |
| Provider Name | Mukarram Amine |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1558899153 PECOS PAC ID: 5890043632 Enrollment ID: I20200312000006 |
| Provider Name | Neeraj Joshi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1902249683 PECOS PAC ID: 9436374394 Enrollment ID: I20200326001144 |
| Provider Name | Hemlatta Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366075319 PECOS PAC ID: 0648601658 Enrollment ID: I20200507000339 |
| Provider Name | Edward Capoccia |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1891177051 PECOS PAC ID: 7618274713 Enrollment ID: I20200629000215 |
| Provider Name | Hiten D Patel |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1093084907 PECOS PAC ID: 8820216583 Enrollment ID: I20200706002444 |
| Provider Name | Elizabeth M Stranges |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912438482 PECOS PAC ID: 3971869918 Enrollment ID: I20200715003599 |
| Provider Name | Alberto Degiovanni |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1376070102 PECOS PAC ID: 2466723523 Enrollment ID: I20200720003367 |
| Provider Name | Lucas Chan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578094710 PECOS PAC ID: 5294006706 Enrollment ID: I20200818002264 |
| Provider Name | Lindsey Korepta |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1194088120 PECOS PAC ID: 2163651654 Enrollment ID: I20200831002178 |
| Provider Name | Layan Alrahmani |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1912294455 PECOS PAC ID: 5294046264 Enrollment ID: I20200917001177 |
| Provider Name | Adriana Russ |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1295208890 PECOS PAC ID: 3577982966 Enrollment ID: I20201005001378 |
| Provider Name | Rebecca Rajasekhar |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1376090878 PECOS PAC ID: 7214357433 Enrollment ID: I20201008003066 |
| 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 | Katherine Cotangco |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1902260904 PECOS PAC ID: 4880988179 Enrollment ID: I20201117002322 |
| Provider Name | Lisa Meraz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790323657 PECOS PAC ID: 3476969916 Enrollment ID: I20210309001488 |
| 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 | Ahmad El-arabi |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1740636398 PECOS PAC ID: 5294021739 Enrollment ID: I20210701001601 |
| 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 | Natalia Alwan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457979643 PECOS PAC ID: 9133521172 Enrollment ID: I20210713001980 |
| Provider Name | Deyger Navarrete |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1023513025 PECOS PAC ID: 1254689672 Enrollment ID: I20210713002532 |
| Provider Name | Adam Hintz |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1427444884 PECOS PAC ID: 3678866712 Enrollment ID: I20210727003935 |
| Provider Name | Cameron Killen |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1811376437 PECOS PAC ID: 6103126073 Enrollment ID: I20210826002537 |
| Provider Name | Denise Asafu-adjei |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1376969436 PECOS PAC ID: 7416293089 Enrollment ID: I20210830001940 |
| Provider Name | Amit K Singh |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1669913836 PECOS PAC ID: 4688924533 Enrollment ID: I20210907000685 |
| Provider Name | Robert L Brochin |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1225423791 PECOS PAC ID: 7810233137 Enrollment ID: I20210910001772 |
| Provider Name | Zohaib Haque |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215422142 PECOS PAC ID: 3173876950 Enrollment ID: I20210913002989 |
| 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 | Alec Johnson |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1295499325 PECOS PAC ID: 6608266184 Enrollment ID: I20211124002158 |
| 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 | Kirsten H Fill |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1235659855 PECOS PAC ID: 3072844224 Enrollment ID: I20211228001593 |
| Provider Name | Ewa Zofia Ehrlich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134895196 PECOS PAC ID: 7416348198 Enrollment ID: I20220107000530 |
| Provider Name | Syed J Khan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407807746 PECOS PAC ID: 8224035480 Enrollment ID: I20220114001441 |
| Provider Name | Joseph Divincenzo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740201425 PECOS PAC ID: 3577475649 Enrollment ID: I20220310001108 |
| Provider Name | Tianyi Swartz |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1912402405 PECOS PAC ID: 8527317270 Enrollment ID: I20220602001397 |
| Provider Name | Bahareh N Alavi-dunn |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1447783501 PECOS PAC ID: 8022352095 Enrollment ID: I20220617001315 |
| Provider Name | Jeffrey Lee Ellis |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1538698543 PECOS PAC ID: 5395124200 Enrollment ID: I20220623002551 |
| Provider Name | Tonia Gooden |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1962065623 PECOS PAC ID: 4789915042 Enrollment ID: I20220715000211 |
| Provider Name | Mary Fahrmeier |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245252303 PECOS PAC ID: 4880657527 Enrollment ID: I20220720000119 |
| Provider Name | Shaheen Jadidi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588124077 PECOS PAC ID: 9335473016 Enrollment ID: I20220728002636 |
| Provider Name | Christopher Gozali |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598225773 PECOS PAC ID: 6103208699 Enrollment ID: I20220730000133 |
| Provider Name | Lane Lagattuta |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174015168 PECOS PAC ID: 8729334131 Enrollment ID: I20220804002760 |
| Provider Name | Maria Khalil |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770143893 PECOS PAC ID: 1658753868 Enrollment ID: I20220804002777 |
| Provider Name | Kirsten Aimee Sorum |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1477818912 PECOS PAC ID: 7911393244 Enrollment ID: I20220805002240 |
| Provider Name | Matthew Hall |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1306293915 PECOS PAC ID: 8426346792 Enrollment ID: I20220808001929 |
| Provider Name | Musaddiq Tariq |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326465436 PECOS PAC ID: 7012338924 Enrollment ID: I20220812002664 |
| Provider Name | Elizabeth Anne Paganessi |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1548754518 PECOS PAC ID: 5597140475 Enrollment ID: I20220913001618 |
| Provider Name | Syed Ghazanfar Hasan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053809442 PECOS PAC ID: 4981070919 Enrollment ID: I20221017002360 |
| Provider Name | Kayla Janine Dmytruk |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1467974402 PECOS PAC ID: 8921371618 Enrollment ID: I20221025000621 |
| Provider Name | David M Hanrahan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033347125 PECOS PAC ID: 2163835398 Enrollment ID: I20221028000330 |
| Provider Name | Karen J Severson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689787426 PECOS PAC ID: 0840364030 Enrollment ID: I20221028000829 |
| 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 | Elizabeth Ann Murphy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669108460 PECOS PAC ID: 4486023652 Enrollment ID: I20221209001318 |
| 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 | Lauren Prest |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881012235 PECOS PAC ID: 3971804147 Enrollment ID: I20221220000225 |
| Provider Name | Elizabeth Hughes |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1891251203 PECOS PAC ID: 2062752454 Enrollment ID: I20230123001835 |
| Provider Name | Megan Lobner |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1003537002 PECOS PAC ID: 0446621676 Enrollment ID: I20230125001745 |
| Provider Name | Manpreet Singh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659089274 PECOS PAC ID: 8224400981 Enrollment ID: I20230207002270 |
| Provider Name | Daisy Marty Placencia |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1205495728 PECOS PAC ID: 4082093687 Enrollment ID: I20230207003080 |
| 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 | Okechukwu Obi |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1083134704 PECOS PAC ID: 7012282742 Enrollment ID: I20230622002111 |
| Provider Name | Aaron M Gish |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1063971844 PECOS PAC ID: 2264897107 Enrollment ID: I20230623002846 |
| Provider Name | Nora Ekeanya |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154749844 PECOS PAC ID: 8628370467 Enrollment ID: I20230627001574 |
| Provider Name | Molly Leavitt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497375349 PECOS PAC ID: 8224452776 Enrollment ID: I20230704000062 |
| Provider Name | Adeel A Yaseen |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1841759735 PECOS PAC ID: 0941543599 Enrollment ID: I20230714001551 |
| Provider Name | Briana Nicole O'donnell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649807793 PECOS PAC ID: 7810357936 Enrollment ID: I20230720001039 |
| Provider Name | Matthew Lo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154958627 PECOS PAC ID: 5698185338 Enrollment ID: I20230726002557 |
| 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 | Sallu Jabati |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1184185498 PECOS PAC ID: 0547621682 Enrollment ID: I20230808001296 |
| Provider Name | Sarah Finucane |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1235633629 PECOS PAC ID: 5799034385 Enrollment ID: I20230808003959 |
| Provider Name | Elaine Cheng |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1992122915 PECOS PAC ID: 7113229816 Enrollment ID: I20230809002349 |
| 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 | Laura Rios-coste |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1801679626 PECOS PAC ID: 5395191134 Enrollment ID: I20231030003734 |
| Provider Name | Namisha Kaur Dhillon |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1205369691 PECOS PAC ID: 5193171973 Enrollment ID: I20231031001181 |
| Provider Name | Stephanie Rodriguez |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1508337932 PECOS PAC ID: 5294196382 Enrollment ID: I20231113001287 |
| Provider Name | Julie Graf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114508272 PECOS PAC ID: 4981005568 Enrollment ID: I20231206000675 |
| Provider Name | Nuong Truong |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1578052890 PECOS PAC ID: 5799030276 Enrollment ID: I20240109001595 |
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 | |
Gottlieb Community Health Services Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3249 Oak Park Ave, Berwyn, IL 60402 Phone: 708-783-3125 | |
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 |