DR. PETER MISUREC (NPI# 1114087962) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114087962 |
| Entity Type | Individual |
| Full Name | DR. PETER MISUREC |
| Credential | M.D. |
| Practice Address |
3340 Oak Park Ave Suite 305 Berwyn IL 60402-3420 |
| Practice Telephone | 7084846019 |
| Practice Fax Number | 7084840251 |
| Mailing Telephone | 7084846019 |
| Mailing Fax Number | 7084840251 |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2016-10-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 036-061571 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036061571 | 05 |
| Street Address |
3340 OAK PARK AVE SUITE 305 |
| City | BERWYN |
| State | IL |
| Zip Code | 60402-3420 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508862368 | Allen Jerome Rosenbaum | Internal Medicine | 3340 Oak Park Ave, Ste 304, Berwyn, IL 60402-3483 | 2005-06-24 |
| 1215251269 | Comprehensive Pain Solutions | Clinic/Center | 3340 Oak Park Ave, 314, Berwyn, IL 60402-3420 | 2010-03-19 |
| 1366626996 | Suburban Urology Associates,ltd | Specialist | 3340 Oak Park Ave, Suite 305, Berwyn, IL 60402-3420 | 2007-12-18 |
| 1821204082 | Suburban Otolaryngology,s.c. | Specialist | 3340 Oak Park Ave, Berwyn, IL 60402-3420 | 2007-05-15 |
| 1821187923 | Larry L Bailey | Otolaryngology | 3340 Oak Park Ave, Berwyn, IL 60402-3420 | 2006-10-12 |
| 1588753693 | Daniel M Kurtzman | Otolaryngology | 3340 Oak Park Ave, Berwyn, IL 60402-3420 | 2006-10-12 |
| 1316044233 | Damayanti S Hathiwala | Pediatrics | 3340 Oak Park Ave, Suite 201, Berwyn, IL 60402-3420 | 2006-09-20 |
| 1821196643 | Anthony Joseph Guido | Dentist | 3340 Oak Park Ave, Suite 308, Berwyn, IL 60402-3420 | 2006-09-20 |
| 1376563742 | Jennifer Renee Glover | Surgery | 3340 Oak Park Ave, 309, Berwyn, IL 60402-3420 | 2006-07-20 |
| 1992731491 | Neurologic Care Associates, P.C. | Psychiatry & Neurology | 3340 Oak Park Ave, Suite 200, Berwyn, IL 60402-3420 | 2006-06-25 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619586518 | Lisa K Anderson-shaw | Clinical Ethicist | Macneal Trinity Medical Cetner, 3249 Oak Park Avenue, Berwyn, IL 60402 | 2020-07-27 |
| 1922622380 | Ayesha Ikram | Internal Medicine | Macneal Hospital 3249 S. Oak Park Ave, Brewyn, IL 60402 | 2020-06-02 |
| 1598329146 | Eleanor Teoh | Student in an Organized Health Care Education/Training Program | Family Medicine, Macneal Family Medicine Center, 3231 Eucild Ave, 5th Floor, Berwyn, IL 60402 | 2019-04-30 |
| 1376013920 | Virginia Mireles | Behavior Technician | 2317 S. Home, Berwyn, IL 60402 | 2018-11-27 |
| 1245709047 | Saraswati Koirala | Dentist | 1227 S Harlem Ave Apt414, Berwyn, IL 60402 | 2018-11-21 |
| 1295204220 | Dental Town Ltd | Dentist | 7106 W Cermak Rd, Berwyn, IL 60402 | 2018-11-20 |
| 1396231684 | Toya M Gildart | Counselor | Pillars, 6415 Stanley Avenue, Berwyn, IL 60402 | 2018-07-10 |
| 1437655685 | Ana Luisa Desantiago | Social Worker | 3245 Grove Ave Ste 201, Berwyn, IL 60402 | 2018-04-04 |
| 1821520198 | Chetan Velagapudi | Student in an Organized Health Care Education/Training Program | 3231 S Euclid Avenue, Suite 203, Berwyn, IL 60402 | 2017-03-28 |
| 1174976567 | Sydney Talavera | Counselor | 6415 Stanley Ave., Berwyn, IL 60402 | 2016-07-20 |
| Find all providers in zip 60402 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699708552 | Joseph Kucera | Urology | 3231 Euclid Ave Ste 403, Berwyn, IL 60402-3472 | 2006-07-07 |
| 1467689281 | Samer Totonchi | Urology | 3231 Euclid Ave, Suite 403, Berwyn, IL 60402-3471 | 2009-06-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699236612 | Behdod Katebian | Urology | 5841 S Maryland Ave Rm J-653, Chicago, IL 60637-1443 | 2019-03-31 |
| 1912436015 | Robert Ara Petrossian | Urology | 301 N 8th St # 4b143c, Springfield, IL 62701-1041 | 2017-06-12 |
| 1134657026 | Soojin Kim | Urology | 225 E. Chicago Avenue, Box 24, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL 60611 | 2017-05-23 |
| 1619337912 | George Robert Buckun | Urology | 930 Rogers St., #301, Downers Grove, IL 60515 | 2016-02-29 |
| 1275991606 | Nicole Alyssa Hamilton | Urology | 22285 N Pepper Rd Ste 201, Lake Barrington, IL 60010-2540 | 2016-01-30 |
| 1790164002 | Shay Golan | Urology | 5841 S Maryland Ave Mc6038, Chicago, IL 60637-1447 | 2015-05-20 |
| 1528453594 | Christopher Stockdale | Urology | 300 W Hill St Apt 707, Chicago, IL 60610-7537 | 2015-04-06 |
| 1639568447 | Jeremy Lai | Urology | 420 E Superior St Ste 9-900, Chicago, IL 60611-4494 | 2015-01-16 |
| 1386053759 | Ramiro Felix Prudencio | Urology | 1200 Broadmeadow Rd, Winnetka, IL 60093-3707 | 2014-08-10 |
| 1174933048 | Kyle John Ericson | Urology | 924 E 57th St, Suite 104, Chicago, IL 60637-1455 | 2014-05-01 |
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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.