DR. GABRIEL CARDENAS JR. (NPI# 1043521719) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043521719 |
| Entity Type | Individual |
| Full Name | DR. GABRIEL CARDENAS JR. |
| Credential | D.P.M. |
| Practice Address |
6810 State Route 162 Suite 20 Maryville IL 62062-8587 |
| Mailing Address |
521 Meadow Glen Ct House Springs MO 63051-4320 |
| Practice Telephone | 6182882835 |
| Practice Fax Number | 6182886162 |
| Mailing Telephone | 6185141308 |
| Enumeration Date | 2010-06-28 |
| Last Update Date | 2016-11-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
016.005608 | IL | Podiatric Medicine & Surgery Service Providers |
| N | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
2010021578 | MO | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | MEDICARE GROUP PTAN | F100153987 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831570126 | Gabriel Adrian Cardenas | Marriage & Family Therapist | 3025 Beyer Blvd Ste E-101, San Diego, CA 92154-3432 | 2015-06-12 |
| Street Address |
6810 STATE ROUTE 162 SUITE 20 |
| City | MARYVILLE |
| State | IL |
| Zip Code | 62062-8587 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922009943 | Mark Stephen Fedder | Internal Medicine | 6810 State Route 162, Suite 211, Maryville, IL 62062-8501 | 2005-08-02 |
| 1003295213 | Msa Alliance, LLC Dba-southern Illinois Vascular and Vein Surgery | Surgery | 6810 State Route 162, Suite 100, Maryville, IL 62062 | 2015-05-20 |
| 1467867234 | Premier Foot and Ankle of Illinois, PC | Podiatrist | 6810 State Route 162, Suite 20, Maryville, IL 62062-8587 | 2014-06-30 |
| 1780818831 | Patricia Renee Verdu | Registered Nurse | 6810 State Route 162, Maryville, IL 62062-8501 | 2009-05-04 |
| 1518143254 | James J. Dalla Riva, Md, PC | Specialist | 6810 State Route 162, Suite 301, Maryville, IL 62062-8501 | 2008-01-11 |
| 1184806101 | Mark Fedder, Md, PC | Internal Medicine | 6810 State Route 162, Suite 211, Maryville, IL 62062-8501 | 2007-11-30 |
| 1518178730 | Melissa Ann Kershaw | Internal Medicine | 6810 State Route 162, Ste 102, Maryville, IL 62062-8501 | 2007-05-28 |
| 1710009840 | James W. Lane | Psychologist | 6810 State Route 162, Suite 215, Maryville, IL 62062-8501 | 2007-04-06 |
| 1245373489 | Fairview Heights Medical Group Sc | Internal Medicine | 6810 State Route 162, Suite 203, Maryville, IL 62062-8501 | 2007-02-15 |
| 1659423085 | Ursula Louise Thatch | Obstetrics & Gynecology | 6810 State Route 162, Ste 100, Maryville, IL 62062-8501 | 2007-01-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104325091 | Jennifer M Oyler | Physician Assistant | 6812 State Route 162 Suite 120, Maryville, IL 62062 | 2018-02-06 |
| 1710495965 | Sarah Elizabeth Barto | Family Medicine | 2133 Vadalabene Drive, Suite Sb, Maryville, IL 62062 | 2018-01-22 |
| 1104348085 | Lindsey Nicole Langendorf | Chiropractor | 62 Executive Plaza Ct, Maryville, IL 62062 | 2017-07-12 |
| 1043750540 | Gina Saal | Nurse Anesthetist, Certified Registered | 6800 Rt 162, Maryville, IL 62062 | 2017-03-02 |
| 1548657737 | Karen Michelle Bertels | Emergency Medicine | 6800 Il - 162, Maryville, IL 62062 | 2015-04-25 |
| 1811258148 | Debra Ann Hoelscher | Internal Medicine | 2102 Vadalabene, Maryville, IL 62062 | 2012-06-04 |
| 1538438445 | Casey Elizabeth Wiesemeyer | Speech-Language Pathologist | 2201 Copper Creek Rd, Maryville, IL 62062 | 2011-12-21 |
| 1407144819 | Norah Claire Farley Baker | Family Medicine | 10 Professional Park Dr., Maryville, IL 62062 | 2011-07-19 |
| 1891092474 | Kimberly M Schneider | Physician Assistant | 20b Professional Park Drive, Maryville, IL 62062 | 2011-02-17 |
| 1669782397 | Purandhri Patel | Physical Therapist | 6820 State Route 162, Maryville, IL 62062 | 2010-10-15 |
| Find all providers in zip 62062 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417944653 | Louis Aquino | Podiatrist | 122 E Zupan St, Maryville, IL 62062-2010 | 2005-10-03 |
| 1467867234 | Premier Foot and Ankle of Illinois, PC | Podiatrist | 6810 State Route 162, Suite 20, Maryville, IL 62062-8587 | 2014-06-30 |
| 1194940650 | R Brent Harbin Dpm Pllc | Podiatrist | 616 W Lamar Alexander Pkwy, Maryville, TN 37801-3904 | 2007-04-17 |
| 1912930793 | Foot Health Center Inc P C | Podiatrist | 122 E Zupan St, Maryville, IL 62062-2010 | 2006-07-08 |
| 1154352599 | Reginald Brent Harbin | Podiatrist | 417 E Lamar Alexander Pkwy, Maryville, TN 37804-5816 | 2006-07-05 |
| 1942280789 | David W Kinscherff | Podiatrist | 122 E Zupan St, Maryville, IL 62062-2010 | 2006-01-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154930485 | Mid America Foot & Ankle Specialist Illinois LLC | Podiatrist | 2003 Montgomery Rd Ste 108109, Aurora, IL 60504-9078 | 2020-07-22 |
| 1265040026 | Northern Illinois Foot & Ankle Specialists, Ltd | Podiatrist | 4121 Fairview Ave Ste 102, Downers Grove, IL 60515-2266 | 2020-07-17 |
| 1316563612 | Jacob Tilsley | Podiatrist | 610 S Maple Ave Ste 2250, Oak Park, IL 60304-1093 | 2020-06-22 |
| 1033738547 | C James Anderson Dpm LLC | Podiatrist | 1000 Eleven S Ste 3a, Columbia, IL 62236-1077 | 2020-04-14 |
| 1386263895 | C James Anderson Dpm LLC | Podiatrist | 717 Insight Ave Ste 100, O Fallon, IL 62269-2193 | 2020-04-14 |
| 1821631367 | Dr Christine Heck PC | Podiatrist | 111 N Wabash Ave Ste 1914, Chicago, IL 60602-2968 | 2019-10-28 |
| 1013562578 | Bishoy Atef Botros | Podiatrist | 820 S Damen Ave Fl 7, Chicago, IL 60612-3728 | 2019-08-01 |
| 1538623947 | Steven B Overpeck Dpm PC | Podiatrist | 25520 S Pheasant Ln Unit K, Channahon, IL 60410-8808 | 2019-01-30 |
| 1366916355 | Center for Foot and Ankle Surgery Ltd | Podiatrist | 654 W Veterans Pkwy Ste D, Yorkville, IL 60560-2510 | 2019-01-14 |
| 1497224950 | Northern Illinois Foot & Ankle Specialists, Ltd | Podiatrist | 1288 S Us Highway 12, Fox Lake, IL 60020-1950 | 2018-11-14 |
| Find all providers with the same taxonomy | ||||
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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.