DR. JEFFREY DONALD LARSON (NPI# 1144516097) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144516097 |
| Entity Type | Individual |
| Full Name | DR. JEFFREY DONALD LARSON |
| Credential | M.D. |
| Practice Address |
14 Lake St Oak Park IL 60302-2606 |
| Practice Telephone | 7083830113 |
| Practice Fax Number | 7083839911 |
| Mailing Telephone | 7083830113 |
| Mailing Fax Number | 7083839911 |
| Enumeration Date | 2011-06-20 |
| Last Update Date | 2011-06-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 125060226 | IL | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699824177 | Jeffrey R. Larson | Preventive Medicine | 9250 N 32nd Pl, Phoenix, AZ 85028-4917 | 2007-01-10 |
| 1649353947 | Jeffrey J Larson | Neurological Surgery | 3320 N Grand Mill Ln, Coeur D Alene, ID 83814-5689 | 2006-10-23 |
| 1164435855 | Jeffrey D Larson | Dentist | 1211 S Kimball Ave, Caldwell, ID 83605-4626 | 2006-08-14 |
| 1023575263 | Jeffrey Donald Larson | Counselor | 401 Harding St Ne Ste 100, Minneapolis, MN 55413-2801 | 2019-02-25 |
| 1790269645 | Jeffrey Larson | Student in an Organized Health Care Education/Training Program | 240 E Huron St, Chicago, IL 60611-2909 | 2018-09-17 |
| 1255864823 | Jeffrey Larson | Student in an Organized Health Care Education/Training Program | 701 Park Ave, Minneapolis, MN 55415-1623 | 2017-04-10 |
| 1578868527 | Jeffrey David Larson | Social Worker | 1776 S Main St, Salt Lake City, UT 84115-1951 | 2011-01-24 |
| 1154657245 | Jeffrey Gerard Larson | Social Worker | 451 Dunham Rd, Suite 400, Saint Charles, IL 60174-1431 | 2009-10-23 |
| 1013166990 | Jeffrey A Larson | Urology | 2000 E Greenville St, Anderson, SC 29621-1580 | 2008-09-16 |
| 1326179177 | Jeffrey J Larson | Counselor | 18623 Vashon Hwy Sw, Vashon, WA 98070-5211 | 2007-03-07 |
| Street Address |
14 LAKE ST |
| City | OAK PARK |
| State | IL |
| Zip Code | 60302-2606 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548254972 | Ralph G. Ryan | Internal Medicine | 14 Lake St, Oak Park, IL 60302-2606 | 2005-08-31 |
| 1962026005 | Kathryn Elizabeth Ryan Nutting | Student in an Organized Health Care Education/Training Program | 14 Lake St, Oak Park, IL 60302-2606 | 2020-06-04 |
| 1972127165 | Jacqueline Marcella Greene-roper | Student in an Organized Health Care Education/Training Program | 14 Lake St, Oak Park, IL 60302-2606 | 2020-06-03 |
| 1881215960 | Jennifer Nudo | Social Worker | 14 Lake St, Oak Park, IL 60302-2606 | 2020-04-30 |
| 1891356721 | Maryam A Syed | Registered Nurse | 14 Lake St, Oak Park, IL 60302-2606 | 2019-06-21 |
| 1962060723 | Elizabeth Jeanne Burgess | Student in an Organized Health Care Education/Training Program | 14 Lake St, Oak Park, IL 60302-2606 | 2019-06-05 |
| 1689158271 | Pcc Community Wellness Center | Case Management | 14 Lake St, Oak Park, IL 60302-2606 | 2018-09-19 |
| 1760973515 | Leslie Smebak | Student in an Organized Health Care Education/Training Program | 14 Lake St, Oak Park, IL 60302-2606 | 2018-05-28 |
| 1811488679 | Morgan Colleen Beatty | Student in an Organized Health Care Education/Training Program | 14 Lake St, Oak Park, IL 60302-2606 | 2018-05-28 |
| 1104344431 | Kimberly Zoellick | Nurse Practitioner | 14 Lake St, Oak Park, IL 60302-2606 | 2017-09-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306473244 | Tasha Kimberly Young | Counselor | 1216 N Austin Bvld, Oak Park, IL 60302 | 2020-03-23 |
| 1306492186 | Camiesa Rashida Rogers | Pharmacy Technician | 626 N Austin #7, Oak Park, IL 60302 | 2019-08-16 |
| 1326603887 | Right Choice Therapy LLC | Social Worker | 428 S. Scoville Avenue, Rear 1b, Oak Park, IL 60302 | 2019-05-09 |
| 1407328941 | Arundathi Bannur Suresh | Occupational Therapist | 3 Erie Court, West Suburban Medical Center, Oak Park, IL 60302 | 2018-12-21 |
| 1427537455 | Shannon Vogel | Occupational Therapist | 405 Home Ave Apt 207, Oak Park, IL 60302 | 2018-08-10 |
| 1568958726 | Loretto Hospital | Clinic/Center | 1000 Madison St, Oak Park, IL 60302 | 2018-07-10 |
| 1649783143 | Mary Joyce Arenas Lagatao | Nurse Practitioner | 101 Madison St, 3rd Floor, Oak Park, IL 60302 | 2017-11-07 |
| 1427578251 | Amanda Lam | Behavior Technician | 721 South Blvd., Suite 210, Oak Park, IL 60302 | 2017-06-22 |
| 1649790577 | Samantha Lotti | Acupuncturist | 1119 Pleasant St, Oak Park, IL 60302 | 2017-06-21 |
| 1770010480 | Robert Smith IIi | Behavior Technician | 412a S. Taylor Ave, Oak Park, IL 60302 | 2017-05-12 |
| Find all providers in zip 60302 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912559303 | I2 Medicine LLC | Family Medicine | 1100 Lake St Ste 125, Oak Park, IL 60301-6702 | 2019-07-15 |
| 1629507975 | Steven Dewilde | Family Medicine | 25900 Greenfield Rd Ste 413, Oak Park, MI 48237-1286 | 2017-06-09 |
| 1073045266 | Kathryn Vanbuskirk | Family Medicine | 1010 Lake St Ste 301, Oak Park, IL 60301-1133 | 2017-03-28 |
| 1770933194 | Christina L Kimbrough Pllc | Family Medicine | 23300 Greenfield Rd Ste 222, Oak Park, MI 48237-8411 | 2016-06-16 |
| 1699116186 | Amrit Kaur Rao | Family Medicine | 3 Erie Ct Ste 1300, Oak Park, IL 60302-2519 | 2013-07-11 |
| 1427495241 | Alison Linn Sage | Family Medicine | 932 Lake St Ste 300, Oak Park, IL 60301-1204 | 2013-06-03 |
| 1982968806 | Monica Singhvi | Family Medicine | 610 S Maple Ave Ste 4600, Oak Park, IL 60304 | 2012-06-25 |
| 1316236987 | Kristin M Baier | Family Medicine | 932 Lake St, Oak Park, IL 60301 | 2011-04-04 |
| 1972815033 | Muneeb Qadri | Family Medicine | 601 South Blvd Apt F, Oak Park, IL 60302-2942 | 2010-07-06 |
| 1164661393 | Tatiana Claudia Doyle | Family Medicine | 501 N. Linden Ave, Oak Park, IL 60302 | 2009-02-11 |
| Find all providers in OAK PARK | ||||
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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.