NICHOLAS G STISO (NPI# 1114928835) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114928835 |
| Entity Type | Individual |
| Full Name | NICHOLAS G STISO |
| Credential | MD |
| Practice Address |
47 W Polk St Suite G Chicago IL 60605-2000 |
| Mailing Address |
Po Box 1152 La Grange Park IL 60526-9252 |
| Practice Telephone | 3129223409 |
| Practice Fax Number | 3125831712 |
| Mailing Telephone | 7083521202 |
| Mailing Fax Number | 7083527311 |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2016-03-10 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 4301049152 | MI | Allopathic & Osteopathic Physicians |
| Y | 207R00000X | Internal Medicine | 036-072335 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | RAILROAD MEDICARE | 110084980 | 01 |
| IL | 36072335 | 05 | |
| IL | MEDICARE PTAN | 950150135 | 01 |
| IL | BLUE CROSS BLUE SHIELD | 31604458 | 01 |
| Street Address |
47 W POLK ST SUITE G |
| City | CHICAGO |
| State | IL |
| Zip Code | 60605-2000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497288096 | Volunteers of America of Illinois | Community/Behavioral Health | 47 W Polk St, Suite 250, Chicago, IL 60605-2000 | 2017-04-10 |
| 1326591702 | Travis Latham | Driver | 47 W Polk St, Chicago, IL 60605-2000 | 2016-08-02 |
| 1326319823 | Rachelle Ann Meade | Dietitian, Registered | 47 W Polk St, Ste G-1, Chicago, IL 60605-2000 | 2012-01-16 |
| 1639333826 | Heather Therese Fritz | Family Medicine | 47 W Polk St, G1, Chicago, IL 60605-2000 | 2008-07-16 |
| 1013184233 | Anthony David Capps | Family Medicine | 47 W Polk St, Ste 301, Chicago, IL 60605-2171 | 2008-05-15 |
| 1386812402 | Allgeier Chiropractic Ltd | Clinic/Center | 47 W Polk St, Suite G-1, Chicago, IL 60605-2000 | 2008-02-11 |
| 1053467258 | Steven Alan Meyers | Psychologist | 47 W Polk St, Suite 305, Chicago, IL 60605-2000 | 2007-01-28 |
| 1558420802 | Illinois Bone and Joint Institute,llc | Orthopaedic Surgery | 47 W Polk St, Ste G1, Chicago, IL 60605-2000 | 2006-12-06 |
| 1275629412 | Victoria L Hernandez | Pediatrics | 47 W Polk St, Suite G1, Chicago, IL 60605-2000 | 2006-10-05 |
| 1346358629 | Michael A. Allgeier Jr. | Chiropractor | 47 W Polk St, Suite G-1, Chicago, IL 60605-2000 | 2006-08-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568074219 | Kheri Dunkins | Counselor | 1136 S Delano Ct, Suite B201, Chicago, IL 60605 | 2020-08-22 |
| 1134739196 | Erin Odonnell | Physical Therapist | 1255 Soputh State Street, Unit 6, Chicago, IL 60605 | 2020-08-05 |
| 1225658032 | Rita Haber | Speech-Language Pathologist | 1255 S Michigan Avenue, 207, Chicago, IL 60605 | 2020-04-21 |
| 1285288753 | My Travel Guy, Inc. | Transportation Broker | 1300 S. Wabash Ave. Suite # 205, Chicago, IL 60605 | 2019-08-01 |
| 1699230417 | Iesha Marsh | Home Health Aide | 820 S Park Terrance, Apt813, Chicago, IL 60605 | 2019-02-06 |
| 1538633482 | Sara Miller | Counselor | 401 S. Lasalle St. Suite 800h, Chicago, IL 60605 | 2019-01-14 |
| 1992203798 | Lorna Johnson | Nurse Practitioner | 1740 W Taylor St., 764e Uih, Mc 509, Chicago, IL 60605 | 2018-01-26 |
| 1790226207 | Undine and Associates | Social Worker | 410 S. Michigan Ave, Ste 943, Chicago, IL 60605 | 2017-03-16 |
| 1659811529 | Paul Parpart | Occupational Therapist | 1235 S Prairie, Chicago, IL 60605 | 2017-02-27 |
| 1144679879 | Osco Drug | Ambulance | 1529 S State St 6e, Chicago, IL 60605 | 2016-06-03 |
| Find all providers in zip 60605 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922606193 | Thatiana Carolina Schulze Goni | Internal Medicine | 5924 N Lincoln Ave Apt 205, Chicago, IL 60659-3736 | 2020-10-11 |
| 1750995742 | Eva Bartaula | Internal Medicine | 1500 S Fairfield Ave # 3, Chicago, IL 60608-1782 | 2020-09-07 |
| 1750994513 | Ranjit Babu Jasaraj | Internal Medicine | 1500 S Fairfield Ave # F-914, Chicago, IL 60608-1782 | 2020-08-30 |
| 1871106005 | Vijay Ketan Reddy | Internal Medicine | 1500 S Fairfield Ave Dept Roomf914, Chicago, IL 60608-1782 | 2020-08-27 |
| 1144839739 | Sandhya Shri Kannayiram | Internal Medicine | 1901w Harrison Street, Chicago, IL 60612 | 2020-07-29 |
| 1871119172 | Irina Komissarova | Internal Medicine | 916 S Oakley Blvd, Chicago, IL 60612-4230 | 2020-06-22 |
| 1336760719 | Arslan Zahid | Internal Medicine | 5847 S Maryland Ave, Chicago, IL 60637-1463 | 2020-04-27 |
| 1104447572 | Nirmal Desai | Internal Medicine | 5841 S Maryland Ave., M/c 7082, Chicago, IL 60637-1443 | 2020-04-27 |
| 1467072447 | Justin Edmond Sipiora | Internal Medicine | 5841 S. Maryland Ave Mc 7082, Chicago, IL 60637-1443 | 2020-04-20 |
| 1003449612 | Eoht LLC | Internal Medicine | 1718 W North Shore Ave Apt 11, Chicago, IL 60626-4030 | 2020-02-21 |
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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.