DR. JEFFREY M MJAANES (NPI# 1083641427) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083641427 |
| Entity Type | Individual |
| Full Name | DR. JEFFREY M MJAANES |
| Credential | MD |
| Practice Address |
1611 W Harrison St Ste 400 Chicago IL 60612-3841 |
| Mailing Address |
1 Westbrook Corporate Ctr #240 Westchester IL 60154-5701 |
| Practice Telephone | 3122434244 |
| Practice Fax Number | 3129421517 |
| Mailing Telephone | 7082362673 |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2012-09-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080S0010X |
Pediatrics Specialization: Sports Medicine |
036107254 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | MEDICARE PTAN NUMBER LOCALITY #16 | 207067 | 01 |
| AETNA PROVIDER NUMBER | 7081518 | 01 | |
| IL | BCBS PROVIDER NUMBER | 1633878 | 01 |
| IL | MEDICARE PTAN NUMBER LOCALITY #15 | 207073 | 01 |
| IL | 036107254 2 | 05 |
| Street Address |
1611 W HARRISON ST STE 400 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60612-3841 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235138546 | Thomas J Nielsen | Otolaryngology | 1611 W Harrison St, Suite 550, Chicago, IL 60612-4861 | 2005-07-19 |
| 1699376996 | Lauren Kennerly | Registered Nurse | 1611 W Harrison St, Chicago, IL 60612-4861 | 2020-11-03 |
| 1225677404 | Mary Kathleen Walsh | Orthopaedic Surgery | 1611 W Harrison St, Chicago, IL 60612-4861 | 2020-01-05 |
| 1407417900 | Megan Merritt | Specialist/Technologist | 1611 W Harrison St, Chicago, IL 60612-4861 | 2019-06-25 |
| 1881253292 | Ellen Rohan | Physician Assistant | 1611 W Harrison St, Chicago, IL 60612-4861 | 2019-06-10 |
| 1588136154 | Elle Steele | Physician Assistant | 1611 W Harrison St, Chicago, IL 60612-4861 | 2018-12-20 |
| 1720591704 | Tricia Jacobs | Speech-Language Pathologist | 1611 W Harrison St, Chicago, IL 60612-4861 | 2017-11-13 |
| 1811415227 | Emily Marie Krogel | Nurse Practitioner | 1611 W Harrison St, Chicago, IL 60612-4861 | 2017-09-06 |
| 1104376912 | Paige Maher | Physician Assistant | 1611 W Harrison St, Ste 300, Chicago, IL 60612-4861 | 2016-10-05 |
| 1902350929 | Leah Kathleen Sparker | Specialist/Technologist | 1611 W Harrison St, Orthopedic Building Suite 530, Chicago, IL 60612-4861 | 2016-08-08 |
| Find all providers in the same location | ||||
| 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 | 2080S0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Sports Medicine |
| A pediatrician who is responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the healthcare of the individual engaged in physical exercise (sports) whether as an individual or in team participation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174673107 | Holly J Benjamin | Pediatrics | 180 Harvester Dr Ste 110, Burr Ridge, IL 60527-6686 | 2007-01-11 |
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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.