JENCARE NEIGHBORHOOD MEDICAL CENTER SOUTH CHICAGO, LLC (NPI# 1164768354) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1164768354 |
Entity Type | Organization |
Organization Name | JENCARE NEIGHBORHOOD MEDICAL CENTER SOUTH CHICAGO, LLC |
Practice Address |
2231 E 95th St Chicago IL 60617-4804 |
Mailing Address |
1000 Park Centre Blvd Suite 136 Miami FL 33169-5373 |
Practice Telephone | 3056286117 |
Practice Fax Number | 3122769660 |
Mailing Telephone | 3056286117 |
Mailing Fax Number | 3056500674 |
Enumeration Date | 2012-12-17 |
Last Update Date | 2012-12-17 |
Authorized Official Name | DR. GORDON CHEN (OWNER) |
Authorized Official Telephone | 3056286117 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 332900000X | Non-Pharmacy Dispensing Site | 036.131322 | IL | Suppliers |
Y | 174400000X | Specialist | 036.131322 | IL | Other Service Providers |
Street Address |
2231 E 95TH ST |
City | CHICAGO |
State | IL |
Zip Code | 60617-4804 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275735706 | Geraldine Luna | Internal Medicine | 2231 E 95th St, Chicago, IL 60617-4804 | 2007-06-05 |
1447784517 | Masood Khan | Family Medicine | 2231 E 95th St, Chicago, IL 60617-4804 | 2017-04-16 |
1851823462 | Angela Maria Cano-garcia | Family Medicine | 2231 E 95th St, Chicago, IL 60617-4804 | 2017-04-02 |
1659729663 | Tenisha Shawan Mccaskill | Internal Medicine | 2231 E 95th St, Chicago, IL 60617-4804 | 2016-05-31 |
1710365085 | Lidia Jennifer Ortiz | Nurse Practitioner | 2231 E 95th St, Chicago, IL 60617 | 2015-05-07 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1871102921 | Manuel Lule | Physical Therapy Assistant | 9535 S Jeffery Boulevard, Chicago, IL 60617 | 2020-07-24 |
1083253546 | Vanaja Thotten | Internal Medicine | 8012 S.crandon Ave, Chicago, IL 60617 | 2020-01-02 |
1427527365 | Stony Island Dental PC | Dentist | 1600 E 93rd Street, Chicago, IL 60617 | 2018-11-21 |
1871060301 | Tamika Nicole Whitehead | Social Worker | 2822 East 83rd Street, Chicago, IL 60617 | 2018-11-02 |
1528543774 | Felicia Nwankwo | Nurse Practitioner | 2822 E 83rd Street Bradond Famiy Health Cener, Chicago, IL 60617 | 2018-10-03 |
1972099307 | David Phan | Optometrist | 1753 E 95th St Ste B-100, Chicago, IL 60617 | 2018-07-09 |
1831607340 | Pamela Evette Ewing | Counselor | 9145 S. Merrill Ave, Chicago, IL 60617 | 2018-01-18 |
1366976631 | Ali Mostafa Serhal | Radiology | 240 E. Huron St, Suite 1-203, Chicago, IL 60617 | 2017-04-13 |
1447784921 | 1915-25 95th St., LLC | Clinic/Center | 1915 E 95th St, Chicago, IL 60617 | 2017-04-12 |
1881140408 | Yeferson Laverde | Social Worker | 3062 East 31st, Chicago, IL 60617 | 2016-09-01 |
Find all providers in zip 60617 |
Taxonomy Code | 174400000X |
Grouping | Other Service Providers |
Classification | Specialist |
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346899630 | Jeremy Gantz Morse | Specialist | 815 W Buena Ave, Chicago, IL 60613-1694 | 2019-09-09 |
1619539632 | Benjamin Mendoza | Specialist | 6303 W 63rd St Unit 3c, Chicago, IL 60638-7015 | 2019-06-29 |
1811471808 | Judith M Penn | Specialist | 8312 S Kedzie Ave, Chicago, IL 60652-3309 | 2018-09-17 |
1841774825 | Matthew E Huggins | Specialist | 4553 W 56th St Apt 204c, Chicago, IL 60629-5389 | 2018-09-17 |
1750860177 | Muhammad Asim Khan | Specialist | 60 E Delaware Pl, Chicago, Il 60611, 14th Floor Urology- Andrology Clinic, Chicago, IL 60611 | 2018-08-07 |
1922502657 | Shauntay Robertson | Specialist | 7342 S Richmond St, Chicago, IL 60629-3015 | 2018-03-19 |
1114448644 | Ageless Men's Health Holdings Inc | Specialist | 1729 N Clybourn Ave, Chicago, IL 60614-6503 | 2017-07-06 |
1447798871 | Andria Miller | Specialist | 840 N Western Ave, Chicago, IL 60622-4638 | 2017-02-06 |
1710425129 | Rtb Sc | Specialist | 5015 N. Paulina #225, Chicago, IL 60640 | 2017-02-06 |
1881137354 | Joy Deliverance Williamson | Specialist | 3863 W Flournoy St, Apt. 1w, Chicago, IL 60624-3617 | 2016-11-30 |
Find all providers in CHICAGO |
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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.