GAJDA SPORTS MEDICAL CENTER LTD (NPI# 1114063989) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1114063989 |
Entity Type | Organization |
Organization Name | GAJDA SPORTS MEDICAL CENTER LTD |
Practice Address |
400 Lake Cook Road Suite 200c Deerfield IL 60015 |
Mailing Address |
521 Malden Ave La Grange Park IL 60526-5514 |
Practice Telephone | 7083522392 |
Practice Fax Number | 7083522738 |
Mailing Telephone | 7083522392 |
Mailing Fax Number | 7083522738 |
Enumeration Date | 2007-01-29 |
Last Update Date | 2013-01-22 |
Authorized Official Name | KAREN DALE GAJDA (OWNER DOCTOR) |
Authorized Official Telephone | 7083522392 |
Authorized Official Credential | DO |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine & OMM | 036066049 | IL | Allopathic & Osteopathic Physicians |
Street Address |
400 LAKE COOK ROAD SUITE 200C |
City | DEERFIELD |
State | IL |
Zip Code | 60015 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1467073569 | Steven A Ditgen | Physical Therapist | 43 N. Waukegan Road, Deerfield, IL 60015 | 2020-04-29 |
1760017255 | Amanda Barkley | Pharmacist | 200 Wilmont Rd, Deerfield, IL 60015 | 2020-03-05 |
1467001487 | Nora Fahmi | Pharmacist | Walgreen Co., 200 Wilmot Road, Deerfield, IL 60015 | 2019-09-11 |
1477105187 | Anthony Greis | Obstetrics & Gynecology | 540 Lake Cook Road, Suite 300, Deerfield, IL 60015 | 2019-07-12 |
1528628484 | Cynthia Lynne Mckinzie | Psychologist | The Neuroscience Center, 440 Lake Cook Road, Deerfield, IL 60015 | 2019-06-13 |
1073084497 | Mary Jeane Jeane Velez | Nurse Practitioner | Brentwood Rehabilitation Center, 3705 Deerfield Rd., Deerfield, IL 60015 | 2018-12-11 |
1891264644 | Smile On of North Shore, PC | Dentist | 707 Lake Cook Rd., Suite 121, Deerfield, IL 60015 | 2018-11-21 |
1497236376 | Linda Li | Counselor | 15 Parkway North Blvd, Deerfield, IL 60015 | 2018-08-28 |
1174009831 | Rachael Michelle Lynn | Physician Assistant | 1302 Hazel Ave, Deerfield, IL 60015 | 2018-07-16 |
1730675182 | Alexandra Lee Joseph | Social Worker | 420 Lake Cook Road, Suite 113, Deerfield, IL 60015 | 2018-07-09 |
Find all providers in zip 60015 |
Taxonomy Code | 204D00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Neuromusculoskeletal Medicine & OMM |
The Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine physician directs special attention to the neuromusculoskeletal system and its interaction with other body systems. Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine encompasses increased knowledge and understanding of osteopathic principles and practice and heightened technical skills of osteopathic manipulative medicine, and integrates each of these into the management of pediatric, adolescent, adult, and geriatric patients. |
Notes: Source: American Osteopathic Association, 2017 [7/1/2017: added definition] - Additional Resources: American Osteopathic Board of Neuromusculoskeletal Medicine, 2017, http://www.osteopathic.org/certification |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780731067 | Allan J Olthoff | Neuromusculoskeletal Medicine & OMM | 400 Lake Cook Rd, 200c, Deerfield, IL 60015-5607 | 2007-01-05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1639436330 | Christopher Sugihara Ngo | Neuromusculoskeletal Medicine & OMM | 2135 Dorothy Dr Ste 6, Belleville, IL 62223-7751 | 2012-04-19 |
1770749434 | Cheryl B Schwartz | Neuromusculoskeletal Medicine & OMM | 240 Saunders Road, Riverwoods, IL 60015-3835 | 2008-08-01 |
1750453858 | Carol Calhoun Williams | Neuromusculoskeletal Medicine & OMM | 124 E 8th St, Gibson City, IL 60936-1455 | 2006-11-14 |
1336225317 | Advantage Medical Group S.c. | Neuromusculoskeletal Medicine & OMM | 12770 S Harlem Ave, Palos Heights, IL 60463-2145 | 2006-10-31 |
1851485346 | Bernadette Goheen Kohn | Neuromusculoskeletal Medicine & OMM | 5404 W. Elm Street, Suite Q, Mchenry, IL 60050-4052 | 2006-10-02 |
1558462531 | Kurt P Heinking | Neuromusculoskeletal Medicine & OMM | 26520 Network Pl, Chicago, IL 60673-1265 | 2006-09-25 |
1669429908 | Lee Peter Bee | Neuromusculoskeletal Medicine & OMM | 107 W Franklin St, Sesser, IL 62884-1456 | 2006-05-30 |
1245293794 | James Randall Sigler | Neuromusculoskeletal Medicine & OMM | 909 W 3rd St, Mount Carmel, IL 62863-1718 | 2006-04-07 |
1841250339 | Edward A Trudeau | Neuromusculoskeletal Medicine & OMM | 319 E Madison St Ste 2a, Springfield, IL 62701-1035 | 2006-03-27 |
1356315246 | Mark Jennings | Neuromusculoskeletal Medicine & OMM | Pediatric Neurology, 515 Ne Glen Oak #308, Peoria, IL 61603 | 2006-02-15 |
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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.