TYLER WISHAU (NPI# 1144649856) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1144649856 |
Entity Type | Individual |
Full Name | TYLER WISHAU |
Practice Address |
2 Good Samaritan Way Ste 420 Mount Vernon IL 62864-2478 |
Mailing Address |
Po Box 955860 Saint Louis MO 63195-2588 |
Practice Telephone | 6188993900 |
Mailing Telephone | 6364985944 |
Enumeration Date | 2014-04-09 |
Last Update Date | 2020-10-22 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 213E00000X | Podiatrist | 016005806 | IL | Podiatric Medicine & Surgery Service Providers |
Address | Telephone Number | Fax Number |
---|---|---|
12303 Depaul Dr., Bridgeton, MO 630442588 | 3143446000 |
Street Address |
2 GOOD SAMARITAN WAY STE 420 |
City | MOUNT VERNON |
State | IL |
Zip Code | 62864-2478 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1841268521 | Gregory Szych | Internal Medicine | 2 Good Samaritan Way Ste 420, Mount Vernon, IL 62864-2478 | 2006-03-09 |
1295192805 | Tamara Copeland | Nurse Practitioner | 2 Good Samaritan Way Ste 420, Mount Vernon, IL 62864-2478 | 2016-01-27 |
1215311683 | Chandra Kanth Chaturvedula | Internal Medicine | 2 Good Samaritan Way Ste 420, Mount Vernon, IL 62864-2478 | 2015-07-16 |
1194022541 | Faizan Ali Khan | Internal Medicine | 2 Good Samaritan Way Ste 420, Mount Vernon, IL 62864-2478 | 2011-02-22 |
1689810855 | Marc Louis Sabatino | Physical Medicine & Rehabilitation | 2 Good Samaritan Way Ste 420, Mount Vernon, IL 62864-2478 | 2008-12-18 |
1396919544 | Naga Srinivas Sirikonda | Internal Medicine | 2 Good Samaritan Way Ste 420, Mount Vernon, IL 62864-2478 | 2008-04-18 |
1437210341 | Richard Chernecky | Internal Medicine | 2 Good Samaritan Way Ste 420, Mount Vernon, IL 62864-2478 | 2006-12-13 |
1649280793 | Louis Clarence Remynse IIi | Urology | 2 Good Samaritan Way Ste 420, Mount Vernon, IL 62864-2478 | 2006-08-09 |
1841239316 | Michelle Burwell | Physician Assistant | 2 Good Samaritan Way Ste 420, Mount Vernon, IL 62864-2478 | 2006-06-06 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619438892 | Melissa Pryer | Dietitian, Registered | 2020 Broadway, Suite 1, Mt. Vernon, IL 62864 | 2019-03-28 |
1487145454 | Chiropractic Wellness Center of Mt Vernon, LLC. | Chiropractor | 1009 S 42nd St Ste 5, Mount Vernon, IL 62864 | 2018-05-24 |
1851889208 | Kimberly Tate | Counselor | 4110 North Water Place, Mt. Vernon, IL 62864 | 2018-05-01 |
1871907790 | University Hematology Oncology Inc | Specialist | #11 Cusumano Professional Plaza, Mount Vernon, IL 62864 | 2014-06-18 |
1457771677 | Dynamic Counseling and Consultation Services | Social Worker | 3600 S Water Tower Pl, Mt Vernon, IL 62864 | 2014-04-27 |
1619239431 | Judith C Morgan | Counselor | 16338 N Illinois Hwy 37, Mount Vernon, IL 62864 | 2012-06-08 |
1073888624 | James Brian Verges | Counselor | 16338 N. Illinois Hwy 37, Mount Vernon, IL 62864 | 2012-03-15 |
1720352271 | Lucinda M. Holdren | Counselor | 16338 North Illinois Highway 37, Mount Vernon, IL 62864 | 2012-03-01 |
1780978627 | Jamie M Orange | Physical Therapy Assistant | 19958 Fairfield Rd, Mt. Vernon, IL 62864 | 2011-06-08 |
1780978791 | Wendy Marie Claytor | Speech-Language Pathologist | 600 E Il Hwy 15, Mount Vernon, IL 62864 | 2011-06-07 |
Find all providers in zip 62864 |
Taxonomy Code | 213E00000X |
Grouping | Podiatric Medicine & Surgery Service Providers |
Classification | Podiatrist |
A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1598996043 | Dorinda Amun King-adekunle | Podiatrist | 9 Harrison Street, Mount Vernon, NY 10550-3611 | 2009-07-31 |
1588725709 | Anthony Dimarino | Podiatrist | 319 N 7th Ave, Mount Vernon, NY 10550-1792 | 2006-12-12 |
1649293846 | Michael Fracassa | Podiatrist | 812 Coshocton, Mount Vernon, OH 43050 | 2006-07-26 |
1407827454 | Randolph Verity Anderson | Podiatrist | 120 S 15th St, Suite 2, Mount Vernon, WA 98274-4500 | 2006-01-29 |
1427049535 | Jonathan M Knee | Podiatrist | 514 Gramatan Ave, P4, Mount Vernon, NY 10552-3054 | 2005-10-31 |
1659369155 | Robert A Atwell | Podiatrist | 809 Coshocton Ave, Suite A, Mount Vernon, OH 43050-1900 | 2005-10-10 |
1437698842 | S Thomas Sehy Dpm LLC | Podiatrist | 209 Crossroads Pl, Suite 130, Mount Vernon, IL 62864-6545 | 2017-02-17 |
1104205103 | Dae Yong Lee | Podiatrist | 12 N 7th Ave, Mount Vernon, NY 10550-2026 | 2015-05-22 |
1568777175 | Nathan Allen Ullom | Podiatrist | 1400 E Kincaid St, Mount Vernon, WA 98274-4127 | 2010-08-09 |
1275720922 | Jay Mermelstein | Podiatrist | 105 Stevens Ave, Suite 301, Mount Vernon, NY 10550-2686 | 2007-09-26 |
Find all providers in MOUNT VERNON |
City | MOUNT VERNON |
Zip Code | 62864 |
Please comment or provide details below to improve the information on TYLER WISHAU.
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.