| Oak Street Health Physicians Group, PC | |
|
1715 E 95th St Chicago IL 60617-4708 | |
| (773) 768-4437 | |
| (773) 564-3515 |
| Full Name | Oak Street Health Physicians Group, PC |
|---|---|
| Speciality | Clinic/Center |
| Location | 1715 E 95th St, Chicago, Illinois |
| Authorized Official Name and Position | Terrence Morton (CMO) |
| Authorized Official Contact | 7046074835 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Oak Street Health Physicians Group, PC Po Box 746721 Atlanta GA 30374-6721 Ph: (773) 352-1515 | Oak Street Health Physicians Group, PC 1715 E 95th St Chicago IL 60617-4708 Ph: (773) 768-4437 |
| NPI Number | 1083051643 |
|---|---|
| Provider Enumeration Date | 05/22/2013 |
| Last Update Date | 07/23/2025 |
| Certification Date | 07/23/2025 |
| Medicare PECOS PAC ID | 7517109879 |
|---|---|
| Medicare Enrollment ID | O20130815000670 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083051643 | NPI | - | NPPES |
| Provider Name | Janice L Makela |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700833738 PECOS PAC ID: 3779496914 Enrollment ID: I20031113000146 |
| Provider Name | William H Gillard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457369662 PECOS PAC ID: 5092704536 Enrollment ID: I20040510000755 |
| Provider Name | Deborah Sturgis-hinton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467437558 PECOS PAC ID: 3870579279 Enrollment ID: I20040626000176 |
| Provider Name | Yatin M Shah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235108911 PECOS PAC ID: 1658273099 Enrollment ID: I20040629001427 |
| Provider Name | Todd M Mack |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1114039369 PECOS PAC ID: 1658358684 Enrollment ID: I20040707000559 |
| Provider Name | Mary an Maryland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093740953 PECOS PAC ID: 5092787069 Enrollment ID: I20040810000895 |
| Provider Name | Karen V Jellen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790868347 PECOS PAC ID: 8325013014 Enrollment ID: I20040826001115 |
| Provider Name | Elliott Kroger |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427087063 PECOS PAC ID: 5597732396 Enrollment ID: I20040913000264 |
| Provider Name | Lisa Dorsey Bornfreedom |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427298116 PECOS PAC ID: 6002876430 Enrollment ID: I20041012000128 |
| Provider Name | Sharon L Duval |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366634487 PECOS PAC ID: 5799731311 Enrollment ID: I20050328000325 |
| Provider Name | Seit Wong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669415055 PECOS PAC ID: 0840237970 Enrollment ID: I20050411000934 |
| Provider Name | Elizabeth Redell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821004466 PECOS PAC ID: 5193767739 Enrollment ID: I20050524001274 |
| Provider Name | Beatriz L Huertas Rivera |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508841982 PECOS PAC ID: 3678503315 Enrollment ID: I20050812000761 |
| Provider Name | Ashley a Keren |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1811962020 PECOS PAC ID: 6709804404 Enrollment ID: I20051110000305 |
| Provider Name | Andrea N Slasuraitis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942236393 PECOS PAC ID: 5294755807 Enrollment ID: I20051128000799 |
| Provider Name | Albert L Reynolds |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639155534 PECOS PAC ID: 5092737452 Enrollment ID: I20051230000596 |
| Provider Name | Dharmesh Kanubhai Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619039328 PECOS PAC ID: 1456328020 Enrollment ID: I20060331000126 |
| Provider Name | David R Buchanan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396772992 PECOS PAC ID: 9830192830 Enrollment ID: I20060811000295 |
| Provider Name | Carlos J Aguero Medina |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053364349 PECOS PAC ID: 5698784700 Enrollment ID: I20060915000564 |
| Provider Name | Marianne Kwiatkowski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750307963 PECOS PAC ID: 9638179740 Enrollment ID: I20070112000257 |
| Provider Name | Jennifer Lee Binder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295955284 PECOS PAC ID: 1456450394 Enrollment ID: I20070619000204 |
| Provider Name | Robeela Deans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770517963 PECOS PAC ID: 6709985369 Enrollment ID: I20070621000543 |
| Provider Name | Heather J Kohout |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1770536344 PECOS PAC ID: 0941255095 Enrollment ID: I20070714000235 |
| Provider Name | Jabeen Aqueel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689883225 PECOS PAC ID: 4587764873 Enrollment ID: I20070716000605 |
| Provider Name | Deborah L Edberg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194758722 PECOS PAC ID: 8527152628 Enrollment ID: I20070920000270 |
| Provider Name | Robert J Saqueton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952325664 PECOS PAC ID: 3678669744 Enrollment ID: I20071019000638 |
| Provider Name | Joel J E Augustin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952421042 PECOS PAC ID: 9335237387 Enrollment ID: I20071108000751 |
| Provider Name | Lashunda D Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629194089 PECOS PAC ID: 2365532603 Enrollment ID: I20071226000309 |
| Provider Name | Kyra a Payne |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1487864542 PECOS PAC ID: 9133203581 Enrollment ID: I20080225000538 |
| Provider Name | Miriam K Whiteley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972625333 PECOS PAC ID: 8224112453 Enrollment ID: I20080227000344 |
| Provider Name | Ramesh C Aggarwal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649458712 PECOS PAC ID: 9335214709 Enrollment ID: I20080819000829 |
| Provider Name | Natalya Vladimirskiy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326246356 PECOS PAC ID: 7315012317 Enrollment ID: I20080826000114 |
| Provider Name | Humaira Khan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811174105 PECOS PAC ID: 0941368120 Enrollment ID: I20081016000070 |
| Provider Name | Edwin Earl Hollins |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982721643 PECOS PAC ID: 3971650185 Enrollment ID: I20090403000478 |
| Provider Name | William Sandoval |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912080912 PECOS PAC ID: 6406908334 Enrollment ID: I20090723000334 |
| Provider Name | Rajesh Kumar Sharma |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407881964 PECOS PAC ID: 1951443860 Enrollment ID: I20100114000774 |
| Provider Name | Lea Q Lisowski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669687315 PECOS PAC ID: 6800938762 Enrollment ID: I20100115000417 |
| Provider Name | Elizabeth Nodine |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346449527 PECOS PAC ID: 6507991759 Enrollment ID: I20100312001026 |
| Provider Name | Lucio J Martinez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154397354 PECOS PAC ID: 0840326815 Enrollment ID: I20100329000979 |
| Provider Name | Paramjit Sikand |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902875628 PECOS PAC ID: 2860529104 Enrollment ID: I20100419000680 |
| Provider Name | Augusto Guevara |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962557686 PECOS PAC ID: 5890827620 Enrollment ID: I20100714000827 |
| Provider Name | Diane Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992953152 PECOS PAC ID: 1254465875 Enrollment ID: I20100818000935 |
| Provider Name | Julie R Blankemeier |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801101555 PECOS PAC ID: 4082730197 Enrollment ID: I20100927000705 |
| Provider Name | Kevin P Malone |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1003082488 PECOS PAC ID: 7214002310 Enrollment ID: I20101007000277 |
| Provider Name | Cynthia Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265749972 PECOS PAC ID: 5092908590 Enrollment ID: I20101015001119 |
| Provider Name | Muhammad Ahmed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487848453 PECOS PAC ID: 7810181310 Enrollment ID: I20101028000933 |
| Provider Name | Ruchi R Balaney |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1831408889 PECOS PAC ID: 8729274592 Enrollment ID: I20101119000525 |
| Provider Name | Rusalina Muntean Mincu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295782431 PECOS PAC ID: 4486603610 Enrollment ID: I20110117000153 |
| Provider Name | Sameer S Jain |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699987230 PECOS PAC ID: 0244383404 Enrollment ID: I20110211000889 |
| Provider Name | Maria Elena Santiago |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831325497 PECOS PAC ID: 6901086537 Enrollment ID: I20110214000621 |
| Provider Name | Susan C Winterbauer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073816013 PECOS PAC ID: 9638350101 Enrollment ID: I20110217000245 |
| Provider Name | Sherie D Marshall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306176862 PECOS PAC ID: 9931380110 Enrollment ID: I20110221001021 |
| Provider Name | Sergio Rodriguez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588705230 PECOS PAC ID: 4880875566 Enrollment ID: I20110301000558 |
| Provider Name | Alfred J Martin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386764090 PECOS PAC ID: 2961684162 Enrollment ID: I20110309000616 |
| Provider Name | Angelina D Ledonne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407977838 PECOS PAC ID: 6305024365 Enrollment ID: I20110623000024 |
| Provider Name | Christabelle Andrea Cabanilla |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447412366 PECOS PAC ID: 7214108471 Enrollment ID: I20110919000795 |
| Provider Name | Priscilla Rivera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205116282 PECOS PAC ID: 8527230325 Enrollment ID: I20111019000782 |
| Provider Name | Sandra Pinilla |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013172139 PECOS PAC ID: 5193990018 Enrollment ID: I20111205000498 |
| Provider Name | Mark S Stolspart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437428786 PECOS PAC ID: 2961669429 Enrollment ID: I20120210000565 |
| Provider Name | Irma Teresa Esposito |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184863672 PECOS PAC ID: 0840453593 Enrollment ID: I20120517000088 |
| Provider Name | Daniel Novella |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366670846 PECOS PAC ID: 0547426447 Enrollment ID: I20120720000535 |
| Provider Name | Bonnie Tse |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316180102 PECOS PAC ID: 4587811823 Enrollment ID: I20120822000033 |
| Provider Name | Joanna L Kmiecik |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508173329 PECOS PAC ID: 0648427401 Enrollment ID: I20120829000714 |
| Provider Name | May Han Soong |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932336872 PECOS PAC ID: 2466600093 Enrollment ID: I20120924000357 |
| Provider Name | Kelley O Holloway Marshall |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1942593231 PECOS PAC ID: 6608026166 Enrollment ID: I20121019000037 |
| Provider Name | Dagoberto Camacho |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629201512 PECOS PAC ID: 9234382730 Enrollment ID: I20130112000073 |
| Provider Name | Brian a Filippini |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1902156045 PECOS PAC ID: 2365696275 Enrollment ID: I20130130000378 |
| Provider Name | Jean E Reidy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811248750 PECOS PAC ID: 0143475384 Enrollment ID: I20130219000527 |
| Provider Name | Elba M Villavicencio |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720318074 PECOS PAC ID: 0749425882 Enrollment ID: I20130320000755 |
| Provider Name | Emily Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437403755 PECOS PAC ID: 9032354949 Enrollment ID: I20130326000056 |
| Provider Name | Andrea Khosropour |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689802340 PECOS PAC ID: 3072758770 Enrollment ID: I20130401000103 |
| Provider Name | Niraj Y Shah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215248067 PECOS PAC ID: 6103068036 Enrollment ID: I20130806000401 |
| Provider Name | Griffin Myers |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1871817643 PECOS PAC ID: 7719145127 Enrollment ID: I20130815000938 |
| Provider Name | Katherine M Suberlak |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811125412 PECOS PAC ID: 2365678737 Enrollment ID: I20131114000409 |
| Provider Name | Joan C Temmerman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710984158 PECOS PAC ID: 2365423803 Enrollment ID: I20131204001335 |
| Provider Name | Jill N Degen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811292717 PECOS PAC ID: 2264660521 Enrollment ID: I20140113000171 |
| Provider Name | Gretel Ruiz Jorge |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1427289859 PECOS PAC ID: 4789813254 Enrollment ID: I20140203000366 |
| Provider Name | Rebecca Murray |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134557473 PECOS PAC ID: 2365675451 Enrollment ID: I20140424001814 |
| Provider Name | Binita Chandran |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487941944 PECOS PAC ID: 9234352329 Enrollment ID: I20140516002029 |
| Provider Name | Toi Juana R Murray |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275764730 PECOS PAC ID: 2062636798 Enrollment ID: I20140618002195 |
| Provider Name | Jamal Ross |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205156429 PECOS PAC ID: 9739304791 Enrollment ID: I20140707001101 |
| Provider Name | Francina M Peralta Machado |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508181108 PECOS PAC ID: 0446476899 Enrollment ID: I20140722000473 |
| Provider Name | Barbara J Hardt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811307614 PECOS PAC ID: 0941426621 Enrollment ID: I20140801001902 |
| Provider Name | Brian Luc |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376833657 PECOS PAC ID: 9234352014 Enrollment ID: I20140811001577 |
| Provider Name | Masha M Chizhik |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1841614666 PECOS PAC ID: 8325265135 Enrollment ID: I20140818002139 |
| Provider Name | Prerak Shah |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902032014 PECOS PAC ID: 2961648373 Enrollment ID: I20141015000607 |
| Provider Name | Nicole Owens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811305758 PECOS PAC ID: 9739301953 Enrollment ID: I20141103002302 |
| Provider Name | Mayra Gonzalez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548550262 PECOS PAC ID: 4284856378 Enrollment ID: I20141105000014 |
| Provider Name | Jacqueline E Arroyo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851791719 PECOS PAC ID: 4082836143 Enrollment ID: I20141105002503 |
| Provider Name | Saima D Najam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386930675 PECOS PAC ID: 0244552271 Enrollment ID: I20141203000077 |
| Provider Name | Diana Guillaume |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396037685 PECOS PAC ID: 0042532806 Enrollment ID: I20141204002482 |
| Provider Name | Marta H Sciubisz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922394808 PECOS PAC ID: 9739402637 Enrollment ID: I20141230000401 |
| Provider Name | Carolyn a Read |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942605886 PECOS PAC ID: 4789908815 Enrollment ID: I20150121000855 |
| Provider Name | Tina Valdez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780905349 PECOS PAC ID: 6507096443 Enrollment ID: I20150218000749 |
| Provider Name | Vanessa E Ortiz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205234879 PECOS PAC ID: 2264758739 Enrollment ID: I20150226001810 |
| Provider Name | Danbee K Kwon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932536703 PECOS PAC ID: 6305069287 Enrollment ID: I20150504002020 |
| Provider Name | Rebecca Ann Levine |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841553294 PECOS PAC ID: 8820309941 Enrollment ID: I20150616002190 |
| Provider Name | Charlotte Allen O'brien |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902123938 PECOS PAC ID: 6002945961 Enrollment ID: I20150630000383 |
| Provider Name | Michelle Lee Morrison |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508120783 PECOS PAC ID: 5496067910 Enrollment ID: I20150710002328 |
| Provider Name | Eric Tuason Aguinaldo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720374002 PECOS PAC ID: 0345553293 Enrollment ID: I20150721001475 |
| Provider Name | Daniela a Cvetkova |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1548534977 PECOS PAC ID: 4183939606 Enrollment ID: I20150812009173 |
| Provider Name | Ashley Chou |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033409297 PECOS PAC ID: 9234376054 Enrollment ID: I20150831002841 |
| Provider Name | Mira Desai |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538559190 PECOS PAC ID: 6800104787 Enrollment ID: I20150925000574 |
| Provider Name | Ashton N Forsythe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942677984 PECOS PAC ID: 8921316365 Enrollment ID: I20151005000359 |
| Provider Name | Abiah Grant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720488760 PECOS PAC ID: 5395068043 Enrollment ID: I20151201000414 |
| Provider Name | Dawn M Tornow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336512532 PECOS PAC ID: 4486955481 Enrollment ID: I20151216001947 |
| Provider Name | Ausra Simmert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386009686 PECOS PAC ID: 1658673215 Enrollment ID: I20160113002463 |
| Provider Name | Sandra Montes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962630566 PECOS PAC ID: 4385947522 Enrollment ID: I20160122000632 |
| Provider Name | Jamilah F Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154796605 PECOS PAC ID: 7113223769 Enrollment ID: I20160309000240 |
| Provider Name | Vanessa R Sohn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891135059 PECOS PAC ID: 1153610274 Enrollment ID: I20160512002114 |
| Provider Name | Laurie C Peercy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003365842 PECOS PAC ID: 3577851930 Enrollment ID: I20161018001267 |
| Provider Name | Lesbia Rodriguez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861735508 PECOS PAC ID: 8325340250 Enrollment ID: I20161019002276 |
| Provider Name | Leshaun Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043679681 PECOS PAC ID: 0941580823 Enrollment ID: I20161212000651 |
| Provider Name | Jorel O Martinez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336553684 PECOS PAC ID: 7618271131 Enrollment ID: I20170105000543 |
| Provider Name | Luis L Rivera |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619396371 PECOS PAC ID: 6901187996 Enrollment ID: I20170105002316 |
| Provider Name | Gioconda Arias |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558806539 PECOS PAC ID: 8224310404 Enrollment ID: I20170124000536 |
| Provider Name | Shamecka N Edwards |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497098289 PECOS PAC ID: 6002118007 Enrollment ID: I20170131000345 |
| Provider Name | Cindy Suthar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750815981 PECOS PAC ID: 6204113194 Enrollment ID: I20170502001360 |
| Provider Name | Olayinka T Durojaiye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811439300 PECOS PAC ID: 6608153523 Enrollment ID: I20170502002706 |
| Provider Name | Cindy Valencia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992259410 PECOS PAC ID: 1153585849 Enrollment ID: I20170505000200 |
| Provider Name | Marisa Reyes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568997369 PECOS PAC ID: 4486927670 Enrollment ID: I20170911001293 |
| Provider Name | Avani Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487170213 PECOS PAC ID: 0547534562 Enrollment ID: I20170914001590 |
| Provider Name | Jennifer Danielle Mainor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467979260 PECOS PAC ID: 5991079899 Enrollment ID: I20170915001121 |
| Provider Name | Elizabeth Boone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235517954 PECOS PAC ID: 1355617515 Enrollment ID: I20171017000580 |
| Provider Name | Jessika Epperson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487171328 PECOS PAC ID: 0345516225 Enrollment ID: I20171019003222 |
| Provider Name | Gabriela Amaro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255859534 PECOS PAC ID: 9931475548 Enrollment ID: I20171026002242 |
| Provider Name | Dinora Flores |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073024501 PECOS PAC ID: 4183981285 Enrollment ID: I20171128001339 |
| Provider Name | Emily K Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811415342 PECOS PAC ID: 1850658832 Enrollment ID: I20171129001899 |
| Provider Name | Dana Sebek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992214373 PECOS PAC ID: 7810254836 Enrollment ID: I20171129003588 |
| Provider Name | Erica Minnion-klyce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205340080 PECOS PAC ID: 3072872522 Enrollment ID: I20180109002120 |
| Provider Name | Dymond Denee Long |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114463049 PECOS PAC ID: 3173807625 Enrollment ID: I20180112000180 |
| Provider Name | Shelane Solt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134634488 PECOS PAC ID: 3274894092 Enrollment ID: I20180219000843 |
| Provider Name | Elizabeth Bolanos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518465632 PECOS PAC ID: 0547521676 Enrollment ID: I20180306000030 |
| Provider Name | Silvia Nunez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598272023 PECOS PAC ID: 4486918208 Enrollment ID: I20180503000001 |
| Provider Name | Patricia Galvez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740788009 PECOS PAC ID: 6901161199 Enrollment ID: I20180517000058 |
| Provider Name | Valerie R. Turlan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487172136 PECOS PAC ID: 9638424955 Enrollment ID: I20180608001769 |
| Provider Name | Laura Trujillo-castellanos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588155956 PECOS PAC ID: 6709131907 Enrollment ID: I20180612000384 |
| Provider Name | John Thomas Matera |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1770970931 PECOS PAC ID: 8325341944 Enrollment ID: I20180613003235 |
| Provider Name | Babatunde Ogundipe |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497911267 PECOS PAC ID: 7315292331 Enrollment ID: I20180628002908 |
| Provider Name | Jennifer Denise Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467946517 PECOS PAC ID: 3476809906 Enrollment ID: I20180712003241 |
| Provider Name | Steven Wei Song |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538540984 PECOS PAC ID: 6800198201 Enrollment ID: I20180802002111 |
| Provider Name | Rachel E Vandyken |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1477040467 PECOS PAC ID: 9638427776 Enrollment ID: I20180806001328 |
| Provider Name | Kathryn Allen |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1841777687 PECOS PAC ID: 7911256425 Enrollment ID: I20180816001516 |
| Provider Name | Berlinda Torres |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477709277 PECOS PAC ID: 0042569204 Enrollment ID: I20180821002270 |
| Provider Name | Brandon C John |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1982016325 PECOS PAC ID: 9436379740 Enrollment ID: I20180822003707 |
| Provider Name | Kevin Stephens |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770977662 PECOS PAC ID: 0840504296 Enrollment ID: I20180827002046 |
| Provider Name | Reem Jamal Mohammad |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1407268378 PECOS PAC ID: 0648579839 Enrollment ID: I20180901000126 |
| Provider Name | Kynyahta L Walters |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255810966 PECOS PAC ID: 7416207626 Enrollment ID: I20180910002456 |
| Provider Name | Rachel Cheeks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053836106 PECOS PAC ID: 0244582088 Enrollment ID: I20181006000004 |
| Provider Name | Holly M Krawza |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033645395 PECOS PAC ID: 6204189764 Enrollment ID: I20181030002780 |
| Provider Name | Claudia Navarrete |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861807562 PECOS PAC ID: 5395099477 Enrollment ID: I20181107002933 |
| Provider Name | Omar a Oliveros |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538542337 PECOS PAC ID: 4385988211 Enrollment ID: I20181204002916 |
| Provider Name | Luis Alfredo Lopez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760895395 PECOS PAC ID: 6103195078 Enrollment ID: I20181214001471 |
| Provider Name | Ali Khan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1710202999 PECOS PAC ID: 7810137718 Enrollment ID: I20181231000284 |
| Provider Name | Monika Cachro |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1699248526 PECOS PAC ID: 2961749759 Enrollment ID: I20190201001055 |
| Provider Name | Naomi Shirleen Chinavong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487118550 PECOS PAC ID: 2365780434 Enrollment ID: I20190214002725 |
| Provider Name | Shivani a Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164831251 PECOS PAC ID: 8527364181 Enrollment ID: I20190215001766 |
| Provider Name | Agnes G Nawrot |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689023889 PECOS PAC ID: 0244579613 Enrollment ID: I20190228003054 |
| Provider Name | Miriam Teresa Rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730645912 PECOS PAC ID: 4284975178 Enrollment ID: I20190402001620 |
| Provider Name | Mira Elizabeth Hager |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1619447745 PECOS PAC ID: 6002157146 Enrollment ID: I20190417003039 |
| Provider Name | Tarryn Ellis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801387089 PECOS PAC ID: 9133461924 Enrollment ID: I20190426000803 |
| Provider Name | Jovana Simovic |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912418484 PECOS PAC ID: 0840532230 Enrollment ID: I20190506000918 |
| Provider Name | Edna M Rios |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982145967 PECOS PAC ID: 7012250996 Enrollment ID: I20190516000591 |
| Provider Name | Zeba S Geloo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730255977 PECOS PAC ID: 8224062286 Enrollment ID: I20190529001120 |
| Provider Name | Abiodun Josephine Atomori |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063071819 PECOS PAC ID: 0547593964 Enrollment ID: I20190617002366 |
| Provider Name | Gianna Martelli |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013574656 PECOS PAC ID: 9638402068 Enrollment ID: I20190617002845 |
| Provider Name | Jeremy Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477902484 PECOS PAC ID: 6507158599 Enrollment ID: I20190618001116 |
| Provider Name | Nancy Carter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417513813 PECOS PAC ID: 9638402027 Enrollment ID: I20190618002094 |
| Provider Name | Deidra Sanford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386106649 PECOS PAC ID: 8921332305 Enrollment ID: I20190619002451 |
| Provider Name | Janey Eden Kottler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316506082 PECOS PAC ID: 2365776465 Enrollment ID: I20190624002054 |
| Provider Name | Dominique Yvette Murry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538675699 PECOS PAC ID: 7012242886 Enrollment ID: I20190716002433 |
| Provider Name | Shuying Chang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376109918 PECOS PAC ID: 4486981214 Enrollment ID: I20190816000019 |
| Provider Name | Tenisha Shawan Mccaskill |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659729663 PECOS PAC ID: 3274820006 Enrollment ID: I20190830000304 |
| Provider Name | Margaret a Clemons Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023661980 PECOS PAC ID: 9335478171 Enrollment ID: I20190904002268 |
| Provider Name | Neerja S Joshi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306292412 PECOS PAC ID: 5698062784 Enrollment ID: I20190917002830 |
| Provider Name | Nakia Monique Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508425083 PECOS PAC ID: 4688905631 Enrollment ID: I20191007001054 |
| Provider Name | Vonnise R Hussey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902379621 PECOS PAC ID: 5698007805 Enrollment ID: I20191021002221 |
| Provider Name | Jovan L Butler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235783267 PECOS PAC ID: 3870926157 Enrollment ID: I20191126002403 |
| Provider Name | Claudelia Cano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295380152 PECOS PAC ID: 5395170971 Enrollment ID: I20200109001431 |
| Provider Name | Erica Navarro |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568001337 PECOS PAC ID: 7618302142 Enrollment ID: I20200110001188 |
| Provider Name | Amanda E Wright |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033505045 PECOS PAC ID: 5092087643 Enrollment ID: I20200113001088 |
| Provider Name | Anna Burcenski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821636879 PECOS PAC ID: 8022446269 Enrollment ID: I20200321000058 |
| Provider Name | Antonio Wheeler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356980486 PECOS PAC ID: 7416386636 Enrollment ID: I20200408003966 |
| Provider Name | Doris Fandohan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679038186 PECOS PAC ID: 1557603974 Enrollment ID: I20200501000028 |
| Provider Name | Alissa Haight |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508342874 PECOS PAC ID: 5496185662 Enrollment ID: I20200501000313 |
| Provider Name | Patricia Jazmin Martinez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427687524 PECOS PAC ID: 7810328689 Enrollment ID: I20200511002491 |
| Provider Name | Hilda Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669841508 PECOS PAC ID: 0042528192 Enrollment ID: I20200722003994 |
| Provider Name | Sommer Mckinney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578189577 PECOS PAC ID: 8921423393 Enrollment ID: I20200731002083 |
| Provider Name | Michael Duarte |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306379268 PECOS PAC ID: 1456785039 Enrollment ID: I20200819000767 |
| Provider Name | James Hodges |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1659620029 PECOS PAC ID: 5395965636 Enrollment ID: I20200819001523 |
| Provider Name | Hebah Arroyo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265951792 PECOS PAC ID: 1557787637 Enrollment ID: I20200819003760 |
| Provider Name | Palak Shah |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598292799 PECOS PAC ID: 5395161210 Enrollment ID: I20200821001550 |
| Provider Name | Patrick J Hines |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023549821 PECOS PAC ID: 0547530396 Enrollment ID: I20200828002667 |
| Provider Name | Unnati Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952838179 PECOS PAC ID: 9436577178 Enrollment ID: I20200914000681 |
| Provider Name | Margaux N Metellus |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427589134 PECOS PAC ID: 7214208982 Enrollment ID: I20200917001075 |
| Provider Name | Ana Paula Carvalho DO Amaral |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912430208 PECOS PAC ID: 6204107592 Enrollment ID: I20201012002458 |
| Provider Name | Christopher Than |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477947844 PECOS PAC ID: 1850637323 Enrollment ID: I20201027000342 |
| Provider Name | Mutengwana Kasapu-mwaba |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619480696 PECOS PAC ID: 7618214503 Enrollment ID: I20201029000226 |
| Provider Name | Justin Hunt |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326138074 PECOS PAC ID: 6901842228 Enrollment ID: I20210128000438 |
| Provider Name | Joyce Fricks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174900450 PECOS PAC ID: 1951716331 Enrollment ID: I20210217000664 |
| Provider Name | Emily Leos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215537790 PECOS PAC ID: 2466867858 Enrollment ID: I20210217000842 |
| Provider Name | Monica Figueroa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417556812 PECOS PAC ID: 7810302106 Enrollment ID: I20210218002284 |
| Provider Name | Rochelle a Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104416163 PECOS PAC ID: 6305252990 Enrollment ID: I20210305000817 |
| Provider Name | April Gallik |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134720436 PECOS PAC ID: 7315354446 Enrollment ID: I20210407002002 |
| Provider Name | Rachel Leah Sabb |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629321096 PECOS PAC ID: 0547412371 Enrollment ID: I20210415000079 |
| Provider Name | Demetrius Marcoulides |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952887093 PECOS PAC ID: 5991139065 Enrollment ID: I20210419002153 |
| Provider Name | Ashley Elise Cohen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689269698 PECOS PAC ID: 5597173815 Enrollment ID: I20210426001116 |
| Provider Name | Agnieszka Glowik |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942820014 PECOS PAC ID: 7416365770 Enrollment ID: I20210427000024 |
| Provider Name | Alma Carlin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972170363 PECOS PAC ID: 4981004926 Enrollment ID: I20210614002105 |
| Provider Name | Veronica Newburn |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1013376201 PECOS PAC ID: 7719261767 Enrollment ID: I20210707001463 |
| Provider Name | Michelle Woo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942690243 PECOS PAC ID: 2466778063 Enrollment ID: I20210709002021 |
| Provider Name | Joanna N Godlewska |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922561794 PECOS PAC ID: 6507268422 Enrollment ID: I20210714001320 |
| Provider Name | Laura Hernandez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851965222 PECOS PAC ID: 0244633964 Enrollment ID: I20210719002549 |
| Provider Name | Marie Jena Rud |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235622432 PECOS PAC ID: 4880939263 Enrollment ID: I20210723000148 |
| Provider Name | Kelly Quaine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609499060 PECOS PAC ID: 5193128098 Enrollment ID: I20210729003584 |
| Provider Name | Megan Whitley Hatcher |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649701954 PECOS PAC ID: 5799055661 Enrollment ID: I20210806002478 |
| Provider Name | Heriberto Rodriguez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811480908 PECOS PAC ID: 6800291386 Enrollment ID: I20210820002520 |
| Provider Name | Marco Palomo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174029284 PECOS PAC ID: 8325443310 Enrollment ID: I20210830002244 |
| Provider Name | Jordan R Keller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386318947 PECOS PAC ID: 7911305099 Enrollment ID: I20211004001450 |
| Provider Name | Forrest Yeakley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841787611 PECOS PAC ID: 7911305842 Enrollment ID: I20211007001509 |
| Provider Name | Adib Rushdan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932692746 PECOS PAC ID: 8527309301 Enrollment ID: I20211007001727 |
| Provider Name | Bagum Karimullah Gulshad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154963544 PECOS PAC ID: 9931533270 Enrollment ID: I20211011001954 |
| Provider Name | Sarah Torregiani |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1891774980 PECOS PAC ID: 0840231452 Enrollment ID: I20211013003717 |
| Provider Name | Gabrielle T Garzony |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952926495 PECOS PAC ID: 5496174039 Enrollment ID: I20211027002098 |
| Provider Name | Vanessa K Bajaj |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316546641 PECOS PAC ID: 2769870492 Enrollment ID: I20211028001612 |
| Provider Name | Anwar Jebran |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205356821 PECOS PAC ID: 6608148226 Enrollment ID: I20211104002776 |
| Provider Name | Timanika Dansby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083016547 PECOS PAC ID: 5698061299 Enrollment ID: I20211106000212 |
| Provider Name | Amanda Keenan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457014086 PECOS PAC ID: 9133519655 Enrollment ID: I20211124000033 |
| Provider Name | Irene V Drabysheuskaya |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073284907 PECOS PAC ID: 8325439631 Enrollment ID: I20211221002196 |
| Provider Name | Mariana Racovita |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1881066272 PECOS PAC ID: 2062716160 Enrollment ID: I20211227000522 |
| Provider Name | Melissa Leniece Oliver |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073270989 PECOS PAC ID: 4587055694 Enrollment ID: I20211228002154 |
| Provider Name | Christiana Shoushtari |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265938906 PECOS PAC ID: 6305238189 Enrollment ID: I20220128001225 |
| Provider Name | Tanvi Kadakia |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1891289765 PECOS PAC ID: 3476809559 Enrollment ID: I20220209002134 |
| Provider Name | Elizabeth a Kislov |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508524174 PECOS PAC ID: 6901291780 Enrollment ID: I20220314000596 |
| Provider Name | Jodi M Roque |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346478526 PECOS PAC ID: 8022265768 Enrollment ID: I20220315001300 |
| Provider Name | Sully Vega |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699434266 PECOS PAC ID: 2264827716 Enrollment ID: I20220318001027 |
| Provider Name | Laura S Tse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467951483 PECOS PAC ID: 5193087708 Enrollment ID: I20220329000715 |
| Provider Name | Ashley Harrison Ragle |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851880744 PECOS PAC ID: 1759777485 Enrollment ID: I20220406001632 |
| Provider Name | Heather Duncan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952858813 PECOS PAC ID: 4082997739 Enrollment ID: I20220408001156 |
| Provider Name | Ana K Gilman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093331837 PECOS PAC ID: 3173919503 Enrollment ID: I20220411002012 |
| Provider Name | Sheila Barrenechea Glashower |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104420751 PECOS PAC ID: 4880007962 Enrollment ID: I20220412001146 |
| Provider Name | Rene Roberts |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073894283 PECOS PAC ID: 1557688603 Enrollment ID: I20220426001135 |
| Provider Name | Dorothy Jakubowski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588299705 PECOS PAC ID: 9739576547 Enrollment ID: I20220426001977 |
| Provider Name | Olufunke Grace Ajifolokun |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922600873 PECOS PAC ID: 7315334893 Enrollment ID: I20220502001538 |
| Provider Name | Carol Sacco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609265149 PECOS PAC ID: 2668797762 Enrollment ID: I20220506001948 |
| Provider Name | Alexandra Beris |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174520050 PECOS PAC ID: 2567455801 Enrollment ID: I20220511000405 |
| Provider Name | Carolina Diaz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558005389 PECOS PAC ID: 7618355405 Enrollment ID: I20220607002454 |
| Provider Name | Royal Dawson Mckenna |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043730344 PECOS PAC ID: 5092088492 Enrollment ID: I20220627003056 |
| Provider Name | Michele Mitchell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174505325 PECOS PAC ID: 9234215401 Enrollment ID: I20220730000421 |
| Provider Name | Michael Y Chen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861954695 PECOS PAC ID: 3577899798 Enrollment ID: I20220804002547 |
| Provider Name | Cynthia Cazares |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154067858 PECOS PAC ID: 5294117347 Enrollment ID: I20220805000692 |
| Provider Name | Jessie Wayne Castro |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144614454 PECOS PAC ID: 0143603274 Enrollment ID: I20220822003275 |
| Provider Name | Laura Kaufman Minardi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710337977 PECOS PAC ID: 2769776277 Enrollment ID: I20220823001767 |
| Provider Name | Sean Llewellyn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215499975 PECOS PAC ID: 7214279280 Enrollment ID: I20220830002007 |
| Provider Name | Frances Rivera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326711359 PECOS PAC ID: 2961886585 Enrollment ID: I20220831002143 |
| Provider Name | Deval Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649910514 PECOS PAC ID: 9032594015 Enrollment ID: I20220912001039 |
| Provider Name | Richie Torres |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639801533 PECOS PAC ID: 7012392020 Enrollment ID: I20220912001957 |
| Provider Name | June Swain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912543257 PECOS PAC ID: 7911317334 Enrollment ID: I20221004003155 |
| Provider Name | Lisa Ryan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710207444 PECOS PAC ID: 0244464725 Enrollment ID: I20221005002253 |
| Provider Name | Miglena Garkova |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447978887 PECOS PAC ID: 4082090329 Enrollment ID: I20221010002814 |
| Provider Name | Rachel Hildebrand |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528531258 PECOS PAC ID: 7416299748 Enrollment ID: I20221018003087 |
| Provider Name | Marjorie Remy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164151171 PECOS PAC ID: 8325415995 Enrollment ID: I20221110002870 |
| Provider Name | Melissa a Clark |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982054862 PECOS PAC ID: 6800264110 Enrollment ID: I20221117001414 |
| Provider Name | Ivonne Pino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356802730 PECOS PAC ID: 7911376801 Enrollment ID: I20221215002967 |
| Provider Name | Christina Guerrero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992395594 PECOS PAC ID: 1759752488 Enrollment ID: I20230117001801 |
| Provider Name | Tenilya S Mumphus |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255086641 PECOS PAC ID: 0244602365 Enrollment ID: I20230217000892 |
| Provider Name | Lindsay Chrzanowski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003566258 PECOS PAC ID: 0143603209 Enrollment ID: I20230331001827 |
| Provider Name | Jessica C Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770289639 PECOS PAC ID: 2668846205 Enrollment ID: I20230404000775 |
| Provider Name | Rebecca Gloria Shah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164129458 PECOS PAC ID: 6507221512 Enrollment ID: I20230426002741 |
| Provider Name | Tina Morrison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730703695 PECOS PAC ID: 8123448669 Enrollment ID: I20230508001940 |
| Provider Name | Clementina Verdin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760178909 PECOS PAC ID: 6709241169 Enrollment ID: I20230508002825 |
| Provider Name | Emma Wessels |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1003517210 PECOS PAC ID: 7517324734 Enrollment ID: I20230602002542 |
| Provider Name | Paige Scholer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154827806 PECOS PAC ID: 2860805413 Enrollment ID: I20230621002952 |
| Provider Name | Zue Head |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275034753 PECOS PAC ID: 2062773344 Enrollment ID: I20230726000486 |
| Provider Name | Candace Stone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467100149 PECOS PAC ID: 7517348899 Enrollment ID: I20230727001065 |
| Provider Name | Rasmeet Kaur Miller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912529199 PECOS PAC ID: 6204297484 Enrollment ID: I20230803003668 |
| Provider Name | Beverly Onyekwuluje |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235594375 PECOS PAC ID: 2668834904 Enrollment ID: I20230817002636 |
| Provider Name | Melissa Carolyn Chiang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609339159 PECOS PAC ID: 3577896968 Enrollment ID: I20230818000140 |
| Provider Name | Kazandra Diaz |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1881347748 PECOS PAC ID: 0840652145 Enrollment ID: I20230818000690 |
| Provider Name | Oludara Olutomi Talabi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023646494 PECOS PAC ID: 0446613517 Enrollment ID: I20230823001909 |
| Provider Name | Sheby Elsa Jacob |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407535826 PECOS PAC ID: 3971966714 Enrollment ID: I20230828001883 |
| Provider Name | Beata Barbara Binski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285318048 PECOS PAC ID: 7012370786 Enrollment ID: I20230829000042 |
| Provider Name | Hee Chong Jennifer Zimmerman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609405653 PECOS PAC ID: 3678984036 Enrollment ID: I20230830001624 |
| Provider Name | Anita Vasudevan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215556097 PECOS PAC ID: 4981028396 Enrollment ID: I20230908001606 |
| Provider Name | Keirsten Michelle Reilly |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750903654 PECOS PAC ID: 7315361706 Enrollment ID: I20230914002044 |
| Provider Name | Justyna E Pomiotlo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629475546 PECOS PAC ID: 5698094621 Enrollment ID: I20230914003565 |
| Provider Name | Chiquita Arnet Hudson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609559194 PECOS PAC ID: 6901250075 Enrollment ID: I20230922001441 |
| Provider Name | Janee S Ware |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952692816 PECOS PAC ID: 4981921038 Enrollment ID: I20231005001943 |
| Provider Name | Shweta Agarwal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982382511 PECOS PAC ID: 7810342102 Enrollment ID: I20231005002485 |
| Provider Name | Jasmine Marie Gaona |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1255020624 PECOS PAC ID: 9931554144 Enrollment ID: I20231009000434 |
| Provider Name | Rebecca Ilene Stern |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467913855 PECOS PAC ID: 9133456742 Enrollment ID: I20231023000682 |
| Provider Name | Shira Lerner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609226869 PECOS PAC ID: 5294029708 Enrollment ID: I20231027002580 |
| Provider Name | Pooja Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518481845 PECOS PAC ID: 1557603388 Enrollment ID: I20231030001277 |
| Provider Name | Nayely Cortes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548947526 PECOS PAC ID: 4587010178 Enrollment ID: I20231102002907 |
| Provider Name | Timothy David Prajka |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003445248 PECOS PAC ID: 6709235773 Enrollment ID: I20231215002238 |
| Provider Name | Cler Vicentina Aquillas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518587302 PECOS PAC ID: 1658763701 Enrollment ID: I20231228000613 |
| Provider Name | Amarilis Diaz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356975692 PECOS PAC ID: 9931552494 Enrollment ID: I20240131003023 |
| Provider Name | Francisco Lopez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609140060 PECOS PAC ID: 5799120457 Enrollment ID: I20240304003110 |
| Provider Name | Jessica Jurado |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821853805 PECOS PAC ID: 8729424965 Enrollment ID: I20240311003202 |
| Provider Name | Barbara Tapps |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316158900 PECOS PAC ID: 3274694419 Enrollment ID: I20240312002821 |
| Provider Name | Shazia Shivji |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639681018 PECOS PAC ID: 0648690784 Enrollment ID: I20240328002148 |
| Provider Name | Yuly X Rebollar |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740048354 PECOS PAC ID: 1658719489 Enrollment ID: I20240329000678 |
| Provider Name | Patricia Gomez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093428955 PECOS PAC ID: 4284073396 Enrollment ID: I20240422001491 |
| Provider Name | Cassandra Pax |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1487373809 PECOS PAC ID: 7719326727 Enrollment ID: I20240423002186 |
| Provider Name | Wendee Anderson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245847722 PECOS PAC ID: 3375941446 Enrollment ID: I20240429002331 |
| Provider Name | Kelley Nicole Larson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023764263 PECOS PAC ID: 3971045162 Enrollment ID: I20240603003354 |
| Provider Name | Ellen R Walukas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508581851 PECOS PAC ID: 4284004946 Enrollment ID: I20240610003480 |
| Provider Name | Jorge Diego Yahuaca |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033664149 PECOS PAC ID: 7012450208 Enrollment ID: I20240617000558 |
| Provider Name | Adnan Abdur Razzaque |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497320626 PECOS PAC ID: 9133663255 Enrollment ID: I20240701001332 |
| Provider Name | Daphne Janice Martin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801637020 PECOS PAC ID: 0345784005 Enrollment ID: I20240705000753 |
| Provider Name | Allison Frances Rustin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952908212 PECOS PAC ID: 2062958226 Enrollment ID: I20240724000465 |
| Provider Name | Maribel Caguana |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386488633 PECOS PAC ID: 1355880279 Enrollment ID: I20240823000322 |
| Provider Name | Jaskirat Bhatia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003496597 PECOS PAC ID: 0941745293 Enrollment ID: I20240826000039 |
| Provider Name | Leena Malik |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285263814 PECOS PAC ID: 8921547746 Enrollment ID: I20240826000203 |
| Provider Name | Emma Flores |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104686922 PECOS PAC ID: 1759820509 Enrollment ID: I20240826001343 |
| Provider Name | Megan Romine |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922236181 PECOS PAC ID: 5294983011 Enrollment ID: I20240827000704 |
| Provider Name | Maritza Munoz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487315511 PECOS PAC ID: 7618323106 Enrollment ID: I20240830003121 |
| Provider Name | Manas Rane |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770016040 PECOS PAC ID: 9638449309 Enrollment ID: I20240920002365 |
| Provider Name | Evgeni Mirkin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861060881 PECOS PAC ID: 2466855101 Enrollment ID: I20240930000988 |
| Provider Name | Sandra Anim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821422320 PECOS PAC ID: 3577880111 Enrollment ID: I20241014003470 |
| Provider Name | Camisha Martin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083357685 PECOS PAC ID: 5395278808 Enrollment ID: I20241023000079 |
| Provider Name | Dhara Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386462794 PECOS PAC ID: 1153857909 Enrollment ID: I20241204001510 |
| Provider Name | Julia Warden |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316504350 PECOS PAC ID: 6901136464 Enrollment ID: I20241210003970 |
| Provider Name | Shannon Krop |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104393347 PECOS PAC ID: 4082956172 Enrollment ID: I20241226001090 |
| Provider Name | Andrew Wade Belton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699517466 PECOS PAC ID: 8729518931 Enrollment ID: I20250203002990 |
| Provider Name | David Arthur Sterling |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922685056 PECOS PAC ID: 2567862220 Enrollment ID: I20250206000111 |
| Provider Name | Marques Cosby |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619625795 PECOS PAC ID: 5890225460 Enrollment ID: I20250212000333 |
| Provider Name | Kara Pedersen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215781265 PECOS PAC ID: 1456871326 Enrollment ID: I20250221001731 |
| Provider Name | Magdalena Milonean |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457166902 PECOS PAC ID: 2769902543 Enrollment ID: I20250224002363 |
| Provider Name | Kenisha Francisco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033581350 PECOS PAC ID: 4183934227 Enrollment ID: I20250228001290 |
| Provider Name | Angela Nicole Hunter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114722519 PECOS PAC ID: 6103348578 Enrollment ID: I20250314003407 |
| Provider Name | Marie Rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982990149 PECOS PAC ID: 2163727603 Enrollment ID: I20250320003109 |
| Provider Name | Yesenia Reyes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518762590 PECOS PAC ID: 7618491259 Enrollment ID: I20250404001973 |
| Provider Name | Alexander Cruz Lopez |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1205421518 PECOS PAC ID: 5890219786 Enrollment ID: I20250414000233 |
| Provider Name | Yesenia Uriostegui Nunez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952767113 PECOS PAC ID: 3971017161 Enrollment ID: I20250709003203 |
| Provider Name | Wilson J Fong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558534008 PECOS PAC ID: 3072881648 Enrollment ID: I20250805000858 |
| Provider Name | Vivian Estrada |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1801787395 PECOS PAC ID: 3274033048 Enrollment ID: I20250826000870 |
| Provider Name | Janet Rodriguez |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1609094176 PECOS PAC ID: 6800390220 Enrollment ID: I20250918002975 |
| Provider Name | Veronica Aguilar |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558249144 PECOS PAC ID: 0143727057 Enrollment ID: I20251008000088 |
| Provider Name | Bridget Slevin Adamjee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023909892 PECOS PAC ID: 8123525813 Enrollment ID: I20251008002796 |
| Provider Name | Sunita Kolareth |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639759293 PECOS PAC ID: 5092243857 Enrollment ID: I20251009002896 |
| Provider Name | Yucheng Liu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609516723 PECOS PAC ID: 7315328689 Enrollment ID: I20251010001751 |
| Provider Name | Jamilec Sanchez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508648643 PECOS PAC ID: 0244728582 Enrollment ID: I20251020002136 |
| Provider Name | Arturo Hernandez |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1447045885 PECOS PAC ID: 8022508951 Enrollment ID: I20251107003150 |
| Provider Name | Abriana Monae Pettigrew |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356227656 PECOS PAC ID: 4587155734 Enrollment ID: I20251114003081 |
| Provider Name | Jorge Martinez Noa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295106193 PECOS PAC ID: 2860783016 Enrollment ID: I20251203002929 |
| Provider Name | Gabriela Adriana Rueda |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184356396 PECOS PAC ID: 0446633010 Enrollment ID: I20251217001485 |
| Provider Name | Michael Embrey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104569169 PECOS PAC ID: 1254797657 Enrollment ID: I20251218000024 |
| Provider Name | Caitlin Rebecca Bodner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265292908 PECOS PAC ID: 8921446808 Enrollment ID: I20260206001615 |
| Provider Name | Karina Meza |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1730790171 PECOS PAC ID: 3476034232 Enrollment ID: I20260220000299 |
| Provider Name | Elvira Micaela Ruiz Garate |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184494213 PECOS PAC ID: 1456798230 Enrollment ID: I20260317004500 |
| Provider Name | Shafaq Taj |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811638109 PECOS PAC ID: 8325516628 Enrollment ID: I20260505003634 |
| Provider Name | Haleema Tasneem Latifi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942380340 PECOS PAC ID: 1658565536 Enrollment ID: I20260611000413 |
Pilsen Pediatrics Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1952 W Cermak Rd, Chicago, IL 60608 Phone: 773-254-6611 Fax: 773-254-8590 |
A Kavaliunas MD SC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5540 S Pulaski Rd, Chicago, IL 60629 Phone: 773-585-2802 |
Doc Cam Medical Center SC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2315 E 93rd St Ste 337, Chicago, IL 60617 Phone: 773-731-2700 Fax: 773-373-1868 |
Excellent Eye Care Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5352 N Milwaukee Ave, Chicago, IL 60630 Phone: 773-777-7444 Fax: 773-775-4030 |
Pediatric General Care & Research Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4527 N Pulaski Rd, Chicago, IL 60630 Phone: 773-267-7060 Fax: 773-267-4752 |
Urban Family Health Center Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10830 S Halsted St, Chicago, IL 60628 Phone: 773-264-1400 Fax: 773-264-1401 |