ELENA PETRUSEVSKA (NPI# 1013253384) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1013253384 |
Entity Type | Individual |
Full Name | ELENA PETRUSEVSKA |
Credential | PA-C |
Practice Address |
840 W Irving Park Rd Ste 301 Chicago IL 60613-3011 |
Mailing Address |
Po Box 3276 Evansville IN 47731-3276 |
Practice Telephone | 7739753269 |
Practice Fax Number | 7739753270 |
Mailing Telephone | 8124730181 |
Mailing Fax Number | 8124735822 |
Enumeration Date | 2012-12-14 |
Last Update Date | 2015-09-17 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AM0700X |
Physician Assistant Specialization: Medical |
085-004506 | IL | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IL | STATE OF IL LICENSE | 085-004506 | 01 |
Street Address |
840 W IRVING PARK RD STE 301 |
City | CHICAGO |
State | IL |
Zip Code | 60613-3011 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346298932 | Chicago Prosthetics, Inc | Durable Medical Equipment & Medical Supplies | 840 W Irving Park Rd, Suite 207, Chicago, IL 60613-3011 | 2006-05-05 |
1598282329 | Damian Janusz Skalak | Physical Therapist | 840 W Irving Park Rd, Chicago, IL 60613-3011 | 2017-08-23 |
1215395652 | Joelle Jackson | Nurse Practitioner | 840 W Irving Park Rd, Suite 301, Chicago, IL 60613-3011 | 2016-01-30 |
1356707111 | Lubov Bakman | Clinical Nurse Specialist | 840 W Irving Park Rd, 301, Chicago, IL 60613-3011 | 2016-01-10 |
1588030373 | Grezelro Gonzales | Nurse Practitioner | 840 W Irving Park Rd, 301, Chicago, IL 60613-3011 | 2015-08-15 |
1124412168 | Katie Rahoi | Registered Nurse | 840 W Irving Park Rd, Ste 301, Chicago, IL 60613-3011 | 2015-03-27 |
1083005268 | Zivile Calderon | Nurse Practitioner | 840 W Irving Park Rd, Ste 301, Chicago, IL 60613-3011 | 2015-02-10 |
1720478829 | Christian De Guia | Nurse Practitioner | 840 W Irving Park Rd, Ste 301, Chicago, IL 60613-3011 | 2015-01-27 |
1871983288 | Erin Lark | Nurse Practitioner | 840 W Irving Park Rd, Suite 301, Chicago, IL 60613-3011 | 2015-01-23 |
1295159846 | Michele Bey | Nurse Practitioner | 840 W Irving Park Rd, Ste 301, Chicago, IL 60613-3011 | 2014-02-18 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1588261978 | Thorek Radiology Group Nfp | Radiology | 850 West Irving Park Road, Chicago, IL 60613 | 2020-10-08 |
1760034128 | Maryellen Karas Lajeunesse | Social Worker | 3930 N. Pine Grove Ave, #2403, Chicago, IL 60613 | 2019-07-15 |
1801366430 | Stephanie A Dykema | Psychologist | 4043 N Ravenswood Ave Suite 302, Chicago, IL 60613 | 2018-11-27 |
1487154191 | Alan Tsang | Counselor | 655 W Irving Park Rd Ste 203, Chicago, IL 60613 | 2018-02-19 |
1972015782 | Integrated Ortho, LLC. | Durable Medical Equipment & Medical Supplies | 3717 N. Ravenswood Ave, Suite 219w, Chicago, IL 60613 | 2017-11-02 |
1073048005 | Claire Jolly | Social Worker | 3701 N Ravenswood Ave Ste 301, Chicago, IL 60613 | 2017-04-27 |
1730626011 | Marc Fagan | Psychologist | 4101 N Ravenswood Ave., Chicago, IL 60613 | 2017-01-25 |
1205385671 | Sara Turner | Psychologist | 3855 N Greenview Ave # 2a, Chicago, IL 60613 | 2016-09-27 |
1962955997 | Michelle Montero | Psychologist | 925 W Dakin St Apt 405, Chicago, IL 60613 | 2016-07-26 |
1063883494 | Athletico, Ltd | Physical Therapist | 3922 North Sheridan Rd, Chicago, IL 60613 | 2015-10-12 |
Find all providers in zip 60613 |
Taxonomy Code | 363AM0700X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Medical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518591759 | Julie Jenkot | Physician Assistant | 333 N Michigan Ave Fl 14, Chicago, IL 60601-3901 | 2020-02-26 |
1457997561 | Jasleen Mohini Singh | Physician Assistant | 1645a W School Street, Suite A, Clinic Entrance, Chicago, IL 60657 | 2019-11-24 |
1598238883 | Andrea Budzon | Physician Assistant | 2940 N Kimball Ave Apt 2, Chicago, IL 60618-6846 | 2019-01-09 |
1760995161 | Leena Abed Hamdan | Physician Assistant | 251 E Huron St Fl 1, Chicago, IL 60611-2908 | 2017-11-08 |
1134580079 | Joseph Smith II | Physician Assistant | 654 E 84th St, Chicago, IL 60619-5802 | 2016-03-18 |
1679950232 | Alexis Davidman | Physician Assistant | 20 S Clark St Ste, Chicago, IL 60603-1802 | 2015-05-04 |
1669861589 | Stewart David Harsant | Physician Assistant | 1702 N Milwaukee Ave, Chicago, IL 60647-5424 | 2015-01-15 |
1063817013 | Jenna Lynn Sniegowski | Physician Assistant | 675 N Saint Clair St Fl 21, Chicago, IL 60611-5975 | 2014-11-01 |
1851700066 | Lauren Lew | Physician Assistant | 555 West Madison St. Apt 4903, Chicago, IL 60661 | 2014-08-13 |
1306270137 | Brianne Patricia Randall | Physician Assistant | California Blvd. At 15th St., Chicago, IL 60608 | 2013-08-28 |
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.