BIANCA ALEXANDRIA DOHERTY (NPI# 1053836783) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053836783 |
| Entity Type | Individual |
| Full Name | BIANCA ALEXANDRIA DOHERTY |
| Credential | PA-C |
| Practice Address |
2073 N Clybourn Ave Chicago IL 60614-4003 |
| Mailing Address |
3909 N Western Ave Chicago IL 60618-3741 |
| Practice Telephone | 7736654016 |
| Practice Fax Number | 7733606200 |
| Mailing Telephone | 7737399200 |
| Enumeration Date | 2017-08-03 |
| Last Update Date | 2017-11-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 085.006228 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336699271 | Bianca Maria Doherty | Student in an Organized Health Care Education/Training Program | 4650 Sunset Blvd Ms, Children's Hospital of Los Angeles, Los Angeles, CA 90027 | 2016-10-04 |
| Street Address |
2073 N CLYBOURN AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60614-4003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295729887 | Jennifer B Hartman | Nurse Practitioner | 2073 N Clybourn Ave, Chicago, IL 60614-4003 | 2005-09-09 |
| 1538457759 | Kinzie G. Sharp | Physician Assistant | 2073 N Clybourn Ave, Chicago, IL 60614-4003 | 2011-07-21 |
| 1487630364 | John G Latall | Allergy & Immunology | 2073 N Clybourn Ave, Chicago, IL 60614-4003 | 2005-12-21 |
| 1518951185 | Howard Monroe Rice | Pediatrics | 2073 N Clybourn Ave, Chicago, IL 60614-4003 | 2005-09-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487266516 | Taylor Connington | Pharmacist | 843 W Armitage Ave, Chicago, IL 60614 | 2020-08-19 |
| 1356975692 | Amarilis Diaz | Social Worker | Terry Hefter Associates, LLC, 1731 N. Marcey Suite 535, Chicago, IL 60614 | 2020-02-25 |
| 1457902975 | Michele Waggoner | Physical Therapist | 2515 N. Clark St, Chicago, IL 60614 | 2019-09-25 |
| 1669031936 | Justin Pomeroy | Acupuncturist | 1350 W. Schubert Ave., Chicago, IL 60614 | 2019-06-11 |
| 1801451547 | Amanda Harris | Counselor | 2451 N Lincoln Ave # 206, Chicago, IL 60614 | 2019-05-08 |
| 1780164574 | Danielle Trokey | Psychiatry & Neurology | 2515 N Clark St Ste 801, Chicago, IL 60614 | 2018-08-21 |
| 1841707353 | Madison Counseling Solutions LLC | Social Worker | 2502 N. Clark St., Chicago, IL 60614 | 2018-01-05 |
| 1386154011 | Allison Cooper Boyan | Occupational Therapist | 1640 N. Wells St., Unit 103, Chicago, IL 60614 | 2017-10-09 |
| 1245759653 | Eileen Davidson Siegel | Physician Assistant | 2073 N. Clybourn Ave., Chicago, IL 60614 | 2017-09-18 |
| 1447779814 | Elizabeth Hobart | Psychologist | 1800 W. Diversey Pkwy, Unit H, Chicago, IL 60614 | 2017-09-16 |
| Find all providers in zip 60614 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508470709 | Bryan Ying Wong | Physician Assistant | 3420 S Morgan St Apt 2e, Chicago, IL 60608-6904 | 2020-09-04 |
| 1245858117 | Emily Victoria Headley | Physician Assistant | 1431 N Western Ave Ste 134, Chicago, IL 60622-1797 | 2020-07-08 |
| 1548884547 | Crystal Afua Amoah | Physician Assistant | 1665 N Orchard St Apt 104, Chicago, IL 60614-5385 | 2020-06-04 |
| 1841814274 | Zubair Aslam Khan | Physician Assistant | 3037 W Wilson Ave Apt 2w, Chicago, IL 60625-4345 | 2020-06-01 |
| 1659991818 | Taylor Nicole Anderson | Physician Assistant | 25 W Randolph St Apt 603, Chicago, IL 60601-3514 | 2020-04-17 |
| 1720616444 | Melanie Doretti | Physician Assistant | 3052 N Seminary Ave Apt 2r, Chicago, IL 60657-6788 | 2020-03-29 |
| 1154958544 | Joerissa Gearlds | Physician Assistant | 5645 W Addison St Rm 353, Chicago, IL 60634-4403 | 2020-03-25 |
| 1932736816 | Taylor Evan Fisher | Physician Assistant | 3033 N Sheridan Rd Apt 301, Chicago, IL 60657-5578 | 2020-03-23 |
| 1285260844 | Krista A Saum | Physician Assistant | 661 W Sheridan Rd Apt 601, Chicago, IL 60613-3311 | 2020-03-16 |
| 1386278430 | Adara Simonelli | Physician Assistant | 6317 S Lorel Avenue, Chicago, IL 60638 | 2020-02-27 |
| 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.