MR. GERALD M. BEDORE (NPI# 1003075706) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003075706 |
| Entity Type | Individual |
| Full Name | MR. GERALD M. BEDORE |
| Credential | APN/CNP |
| Practice Address |
835 S Wolcott Ave Rm E-144 Chicago IL 60612-3748 |
| Practice Telephone | 3129967420 |
| Practice Fax Number | 3124138485 |
| Mailing Telephone | 3129967420 |
| Mailing Fax Number | 3124138485 |
| Enumeration Date | 2008-06-06 |
| Last Update Date | 2008-06-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
209.004416 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
209.004416 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
835 S WOLCOTT AVE RM E-144 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60612-3748 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144839739 | Sandhya Shri Kannayiram | Internal Medicine | 1901w Harrison Street, Chicago, IL 60612 | 2020-07-29 |
| 1568080174 | Nastaran Ordoyo Haghani Rad | Student in an Organized Health Care Education/Training Program | 1950 W. Polk Street, Room 6203, Chicago, IL 60612 | 2020-07-09 |
| 1669090403 | Marianne Gagnon-konamna | Student in an Organized Health Care Education/Training Program | 1950 West Polk Street, Chicago, IL 60612 | 2020-07-08 |
| 1922625672 | Tanya Montgomery Nee Brown | Pediatrics | 1950 West Polk Street, Neonatal and Perinatal Department, Chicago, IL 60612 | 2020-06-29 |
| 1124643028 | Ashley Swan | Dentist | 801 S. Paulina St, Uic College of Dentistry - Endodontics Clinic, Chicago, IL 60612 | 2020-06-16 |
| 1831711381 | Baillie Anne Bronner | Obstetrics & Gynecology | 1653 W Congress Pkwy Chicago, Il 60612, Chicago, IL 60612 | 2020-05-07 |
| 1154942449 | Keisha Davell Cole | Case Manager/Care Coordinator | 612 S Western Ave Unit 1, Chicago, IL 60612 | 2020-04-28 |
| 1275153777 | Isac Lim | Student in an Organized Health Care Education/Training Program | 1234 S. Wells, Chicago, IL 60612 | 2020-04-24 |
| 1578183414 | Zachary Belden | Student in an Organized Health Care Education/Training Program | Uic Psychiatry Residency 912 S. Wood St., Rm 130b Npi-s (mc 913), Chicago, IL 60612 | 2020-04-21 |
| 1548880560 | Christina Nunez | Student in an Organized Health Care Education/Training Program | 801 S. Paulina Street, M/c 850, Chicago, IL 60612 | 2020-04-20 |
| Find all providers in zip 60612 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932724200 | Tatyana Menaker | Nurse Practitioner | 2958 West Devon Ave, Chicago, IL 60659 | 2020-06-12 |
| 1366926347 | Kimberly Snell Blanchard | Nurse Practitioner | 600 S Paulina St Ste 130, Chicago, IL 60612-3806 | 2018-09-17 |
| 1942796123 | Elizabeth R Reyna | Nurse Practitioner | 5841 S Maryland Ave # Mc7120, Chicago, IL 60637-1443 | 2018-07-10 |
| 1518475615 | Kyla Lynn Musser | Nurse Practitioner | 2525 S Michigan Ave Ste 12, Chicago, IL 60616-2315 | 2018-01-11 |
| 1942717418 | Madiha Khan | Nurse Practitioner | 3000 N Halsted St Ste 623, Chicago, IL 60657 | 2018-01-05 |
| 1952828980 | Paulina Petrishka | Nurse Practitioner | 1115 N Crosby St # C, Chicago, IL 60610-2405 | 2017-08-30 |
| 1831639384 | Ivory Rhymes | Nurse Practitioner | 8750 W Bryn Mawr Ave, Chicago, IL 60631-3655 | 2017-03-02 |
| 1265971204 | Venus Liezl Basnillo- San Diego | Nurse Practitioner | 1628 N Bell Ave, Apt 1, Chicago, IL 60647-5289 | 2017-02-22 |
| 1093253718 | Daniel Robert Mead | Nurse Practitioner | 1540 W Chicago Ave, Chicago, IL 60642-5236 | 2017-02-01 |
| 1992249585 | Karen Panganiban | Nurse Practitioner | 4605 N Elston Ave, 3a, Chicago, IL 60630-4373 | 2016-12-15 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.