DR. JAMAL R ROSS (NPI# 1205156429) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205156429 |
| Entity Type | Individual |
| Full Name | DR. JAMAL R ROSS |
| Credential | M.D. |
| Practice Address |
1715 E 95th St Chicago IL 60617-4708 |
| Mailing Address |
30 W Monroe St Ste 1200 Chicago IL 60603-2420 |
| Practice Telephone | 7737684437 |
| Practice Fax Number | 7735643515 |
| Mailing Telephone | 3127339730 |
| Mailing Fax Number | 7738668014 |
| Enumeration Date | 2010-06-10 |
| Last Update Date | 2020-04-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 036131109 | IL | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | 036131109 | IL | Allopathic & Osteopathic Physicians |
| N | 208M00000X | Hospitalist | 036131109 | IL | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 700 E Ogden Ave, Suite 202, Westmont, IL 605595569 | 6305283215 |
| Street Address |
1715 E 95TH ST |
| City | CHICAGO |
| State | IL |
| Zip Code | 60617-4708 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003082488 | Kevin Paul Malone | Podiatrist | 1715 E 95th St, Chicago, IL 60617-4708 | 2008-05-05 |
| 1215537790 | Emily Leos | Nurse Practitioner | 1715 E 95th St, Chicago, IL 60617-4708 | 2020-10-26 |
| 1063071819 | Abiodun Josephine Atomori | Nurse Practitioner | 1715 E 95th St, Chicago, IL 60617-4708 | 2019-06-06 |
| 1841777687 | Kathryn Allen | Physician Assistant | 1715 E 95th St, Chicago, IL 60617-4708 | 2018-07-24 |
| 1205340080 | Erica Minnion-klyce | Nurse Practitioner | 1715 E 95th St, Chicago, IL 60617-4708 | 2017-12-01 |
| 1790297562 | Kristina Byrd | Social Worker | 1715 E 95th St, Chicago, IL 60617-4708 | 2017-11-01 |
| 1114463049 | Dymond Long | Nurse Practitioner | 1715 E 95th St, Chicago, IL 60617 | 2017-01-17 |
| 1063897155 | Nnebuife Nkem Johnson | Nurse Practitioner | 1715 E 95th St, Chicago, IL 60617-4708 | 2015-07-30 |
| 1770977662 | Kevin Stephens Jr. | Family Medicine | 1715 E 95th St, Chicago, IL 60617-4708 | 2015-03-27 |
| 1588076699 | D2 Dental At Oak Street, P.C. | Dentist | 1715 E 95th St, Chicago, IL 60617-4708 | 2014-05-22 |
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| 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 |
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| 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.