MATTHEW ALEXIS IVANOVICH (NPI# 1174516314) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174516314 |
| Entity Type | Individual |
| Full Name | MATTHEW ALEXIS IVANOVICH |
| Credential | M.D. |
| Practice Address |
1710 N Randall Rd Suite 260 Elgin IL 60123-9400 |
| Practice Telephone | 8479317900 |
| Practice Fax Number | 8479311562 |
| Mailing Telephone | 8479317900 |
| Mailing Fax Number | 8479311562 |
| Enumeration Date | 2005-08-23 |
| Last Update Date | 2012-09-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
036072285 | IL | Allopathic & Osteopathic Physicians |
| Y | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
036072285 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036072285 | 05 |
| Street Address |
1710 N RANDALL RD SUITE 260 |
| City | ELGIN |
| State | IL |
| Zip Code | 60123-9400 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851398218 | Gulzar Fidai | Internal Medicine | 1710 N Randall Rd, 380, Elgin, IL 60123-4902 | 2005-06-30 |
| 1992285613 | Chul Jong David Kim | Physical Therapist | 1710 N Randall Rd, Elgin, IL 60123-9400 | 2018-08-21 |
| 1992234306 | Lorin Gene Brody | Nurse Practitioner | 1710 N Randall Rd, 160, Elgin, IL 60123 | 2017-06-08 |
| 1275075061 | Specialists In Gastroenterology | Nurse Practitioner | 1710 N Randall Rd, Suite 280, Elgin, IL 60123-9400 | 2016-11-09 |
| 1821549064 | Amanda Robinson | Physician Assistant | 1710 N Randall Rd, 160, Elgin, IL 60123-9400 | 2016-10-24 |
| 1710330154 | Jordan Altieri | Physical Therapy Assistant | 1710 N Randall Rd, Elgin, IL 60123-9400 | 2016-07-21 |
| 1902263486 | Lisa Gallagher | Counselor | 1710 N Randall Rd, Elgin, IL 60123-9400 | 2016-01-28 |
| 1669888558 | Jennifer Chang | Physician Assistant | 1710 N Randall Rd, Suite #160, Elgin, IL 60123-9400 | 2014-07-11 |
| 1619305034 | Alicia Joanna Van Slee | Physician Assistant | 1710 N Randall Rd, Suite 160, Elgin, IL 60123-9400 | 2013-10-22 |
| 1760829667 | Kazmer Foot and Ankle Centers, Ltd | Podiatrist | 1710 N Randall Rd, Suite 140, Elgin, IL 60123-9400 | 2013-05-31 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629625736 | Edna Lopez | Social Worker | 1140 N. Mclean Blvd #1, Elgin, IL 60123 | 2019-08-22 |
| 1003472259 | Katelyn Lee O'connell | Counselor | 695 S. Sate Street, Elgin, IL 60123 | 2019-05-14 |
| 1598235152 | Katie Elizabeth Dwyer | Counselor | 695 S. State Street, Elgin, IL 60123 | 2018-11-27 |
| 1174002778 | James M Accetta | Counselor | 52 Surry Drive, Elgin, IL 60123 | 2018-08-14 |
| 1770086175 | Griswold Home Care | Adult Companion | 707 A Davis Road, Suite 203, Elgin, IL 60123 | 2018-03-12 |
| 1003315706 | Danielle Bryant | Nurse Practitioner | 745 Fletcher Dr Ste 101, Elgin, IL 60123 | 2018-02-08 |
| 1912421470 | Deborah Foshager | Counselor | 680 Shenandoah Trail, Elgin, IL 60123 | 2017-07-26 |
| 1760903470 | Miguel Camargo | Specialist/Technologist | 12 N Aldine St, Elgin, IL 60123 | 2017-07-03 |
| 1134658594 | David Sommer | Counselor | 1460 Umbdenstock Rd, Elgin, IL 60123 | 2017-06-08 |
| 1649719618 | Faheem Unisa Syed | Clinical Nurse Specialist | 1990 Larkin Ave., Elgin, IL 60123 | 2017-02-23 |
| Find all providers in zip 60123 | ||||
| Taxonomy Code | 207RP1001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Pulmonary Disease |
| An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. |
| 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 |
|---|---|---|---|---|
| 1033593454 | Kershaw Clinics LLC | Internal Medicine | 40 Pinnacle Pkwy, Suite 208, Elgin, SC 29045-8390 | 2015-07-15 |
| 1982972303 | Daksha N.mehta M.d.s.c. | Internal Medicine | 901 Center St, Elgin, IL 60120-2104 | 2011-12-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720636202 | Pulmonary Associates Ltd | Internal Medicine | 71 W 156th St Ste 203, Harvey, IL 60426-4262 | 2019-08-28 |
| 1336516467 | Hesham A. Hassaballa, Md, Ltd | Internal Medicine | 109 Symonds Dr Unit 684, Hinsdale, IL 60522-7304 | 2015-08-24 |
| 1497141394 | Pulmonary and Critical Care Solutions, LLC | Internal Medicine | 6116 N 2200 East Rd, Downs, IL 61736-9459 | 2015-04-08 |
| 1558771220 | Christopher Charles Sutton | Internal Medicine | 3 Saint Elizabeth Blvd, O Fallon, IL 62269-1281 | 2014-05-05 |
| 1861835985 | Christie Ann Brillante | Internal Medicine | 1801 W. Taylor, Suite 3c, Chicago, IL 60612-4795 | 2013-04-08 |
| 1992050850 | Thomas Christopher Draghi | Internal Medicine | 155 Linden Ave, Oak Park, IL 60302-2610 | 2012-07-17 |
| 1144586041 | Robert T Zeck | Internal Medicine | 13141 Lake Mary Dr, Plainfield, IL 60585-2650 | 2012-04-04 |
| 1508160359 | Aziz Rahman Md Facp PC | Internal Medicine | 1050 Martin Luther King Dr, Ste 109, Centralia, IL 62801 | 2011-01-07 |
| 1811211774 | Vitalcare Medical Sc | Internal Medicine | 1146 S Waukegan Rd, Waukegan, IL 60085-6731 | 2010-03-22 |
| 1508095605 | Farhan Zaidi | Internal Medicine | 444 N Northwest Hwy Ste 206, Park Ridge, IL 60068 | 2009-07-09 |
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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.