KIMBERLY A DETTLOFF (NPI# 1114044476) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114044476 |
| Entity Type | Individual |
| Full Name | KIMBERLY A DETTLOFF |
| Credential | M.D. |
| Practice Address |
1830 Jarvis Ave Elk Grove Village IL 60007-2440 |
| Mailing Address |
5080 Spectrum Dr Suite 1200w Addison TX 75001-4648 |
| Practice Telephone | 6157784066 |
| Mailing Telephone | 9723648000 |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2010-02-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2083P0500X |
Preventive Medicine Specialization: Preventive Medicine/Occupational Environmental Medicine |
036-086013 | IL | Allopathic & Osteopathic Physicians |
| Street Address |
1830 JARVIS AVE |
| City | ELK GROVE VILLAGE |
| State | IL |
| Zip Code | 60007-2440 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700997319 | Jason Markworth | Physical Therapist | 1830 Jarvis Ave, Elk Grove Village, IL 60007-2440 | 2006-08-31 |
| 1386085686 | Occupational Health Centers of Illinois PC | Clinic/Center | 1830 Jarvis Ave, Elk Grove Village, IL 60007 | 2013-07-15 |
| 1902247232 | Us Medgroup of Illinois PC | Clinic/Center | 1830 Jarvis Ave, Elk Grove Village, IL 60007-2440 | 2013-07-15 |
| 1780025478 | American Current Care of Illinois PC | Clinic/Center | 1830 Jarvis Ave, Elk Grove Village, IL 60007-2440 | 2013-07-10 |
| 1558640755 | Occuspecialists PC | Clinic/Center | 1830 Jarvis Ave, Elk Grove Village, IL 60007-2440 | 2011-08-05 |
| 1598882839 | Fatema T Azhar | Occupational Therapist | 1830 Jarvis Ave, Elk Grove Village, IL 60007-2440 | 2007-03-23 |
| 1629195011 | Eduardo M Israel | Preventive Medicine | 1830 Jarvis Ave, Elk Grove Village, IL 60007-2440 | 2007-03-23 |
| 1912024902 | Daniel A Dudek | Physical Therapist | 1830 Jarvis Ave, Elk Grove Village, IL 60007-2440 | 2007-03-23 |
| 1679690887 | William D Weaver | Preventive Medicine | 1830 Jarvis Ave, Elk Grove Village, IL 60007-2440 | 2007-03-23 |
| 1467579656 | Melanio B Sebayan | Preventive Medicine | 1830 Jarvis Ave, Elk Grove Village, IL 60007-2440 | 2007-03-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518593706 | Anthony Ray Zwaga | Social Worker | 1001 Il-53 N, Elk Grove Village, IL 60007 | 2020-03-19 |
| 1104471333 | Highway Dental Inc | Dentist | 1055 Rohlwing Road, Elk Grove Village, IL 60007 | 2019-08-05 |
| 1699335984 | Orsini Pharmaceutical Services, LLC | Pharmacy | 1107 Nicholas Boulevard, Elk Grove Village, IL 60007 | 2019-06-18 |
| 1700371457 | Kandy Sandhu | Specialist/Technologist, Other | 910 Biesterfield Rd, Suite 105, Elk Grove Village, IL 60007 | 2018-06-26 |
| 1447761085 | Trevor W Avella | Physician Assistant | 800 Biesterfield Rd Ste 101, Elk Grove Village, IL 60007 | 2017-10-23 |
| 1649792573 | Paige Wesa | Speech-Language Pathologist | 936 Victoria Ln, Elk Grove Village, IL 60007 | 2017-07-12 |
| 1093242414 | Assist Illinois Senior Care Services, Inc. | In Home Supportive Care | 1052 Florida Lane, Elk Grove Village, IL 60007 | 2017-05-16 |
| 1598205098 | Azadeh Bassij | Counselor | 1001 Rohwing Rd., Kenneth Young Center, Elk Grove Village, IL 60007 | 2017-03-02 |
| 1700245438 | Roma H Venkatesan | Nurse Practitioner | 800 Biesterfield Road Cancer Institute, Suite 120, Elk Grove Village, IL 60007 | 2016-02-23 |
| 1295114825 | Shelagh Robyn Nikkel | Massage Therapist | 901 Biesterfield Rd. Suite 211, Maria A. Castellese D.c., P.C., Elk Grove Village, IL 60007 | 2015-05-28 |
| Find all providers in zip 60007 | ||||
| Taxonomy Code | 2083P0500X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Preventive Medicine |
| Specialization | Preventive Medicine/Occupational Environmental Medicine |
| A preventive medicine physician who specializes in preventive medicine/occupational-environmental medicine, which is focused on protecting the population from occupational and environmental conditions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Preventive Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609905710 | Robert Kevin Smith | Preventive Medicine | 2424 Landmeier Rd, Elk Grove Village, IL 60007-2625 | 2007-03-05 |
| 1629195011 | Eduardo M Israel | Preventive Medicine | 1830 Jarvis Ave, Elk Grove Village, IL 60007-2440 | 2007-03-23 |
| 1679690887 | William D Weaver | Preventive Medicine | 1830 Jarvis Ave, Elk Grove Village, IL 60007-2440 | 2007-03-23 |
| 1467579656 | Melanio B Sebayan | Preventive Medicine | 1830 Jarvis Ave, Elk Grove Village, IL 60007-2440 | 2007-03-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568860500 | Healthstat On-site Clinic Watlow Richmond Il | Preventive Medicine | 5710 Kenosha St, Richmond, IL 60071-9411 | 2014-12-08 |
| 1164854402 | Healthstat On-site Clinic/parker Hannifin Rockford | Preventive Medicine | 10711 N 2nd St, Machesney Park, IL 61115-1459 | 2013-08-08 |
| 1114299476 | Martin W Harrison | Preventive Medicine | 1318 W Catalpa Ave, Chicago, IL 60640-1317 | 2012-02-02 |
| 1851660583 | Healthstat Inc | Preventive Medicine | 2700 Ellis Rd, Joliet, IL 60433-8459 | 2011-12-27 |
| 1568756831 | William Leslie Rutherford Jr. | Preventive Medicine | 9660 Wolf Rd, Box 42, Geneseo, IL 61254-9039 | 2011-06-04 |
| 1437451374 | Maria Rosa | Preventive Medicine | 2133 W Lexington St, Chicago, IL 60612-3707 | 2010-11-29 |
| 1437464112 | Leena H.a.h Almarzouqi | Preventive Medicine | 114 E Cook Ave, Libertyville, IL 60048-2015 | 2010-08-18 |
| 1598995870 | Shari Beth Glynn | Preventive Medicine | 100 Abbott Park Road, C/o Abbott Laboratories: Ap6d/dept. 058p, Abbott Park, IL 60064-6035 | 2009-07-21 |
| 1578786117 | John K Parker | Preventive Medicine | Veeder Health Center, 20th and Iowa, Granite City, IL 62040 | 2007-04-11 |
| 1063539674 | James Robert Desalvio | Preventive Medicine | 810 W. Anthony Dr., Urbana, IL 61802-7431 | 2007-03-26 |
| Find all providers with the same taxonomy | ||||
| City | ELK GROVE VILLAGE |
| Zip Code | 60007 |
Please comment or provide details below to improve the information on KIMBERLY A DETTLOFF.
| 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.