MR. DOMINIK WIEST (NPI# 1215563267) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215563267 |
| Entity Type | Individual |
| Full Name | MR. DOMINIK WIEST |
| Credential | PA-C |
| Practice Address |
9000 Waukegan Rd Ste 200 Morton Grove IL 60053-2127 |
| Mailing Address |
9000 Waukegan Rd Ste 200900 Morton Grove IL 60053-2127 |
| Practice Telephone | 8473753000 |
| Enumeration Date | 2020-03-20 |
| Last Update Date | 2020-08-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | 085007755 | IL | Allopathic & Osteopathic Physicians |
| Street Address |
9000 WAUKEGAN RD STE 200 |
| City | MORTON GROVE |
| State | IL |
| Zip Code | 60053-2127 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285078766 | Sheela Metgud | Internal Medicine | 9000 Waukegan Rd Ste 200, Morton Grove, IL 60053-2127 | 2013-04-26 |
| 1598377202 | Leonard Jack Stewart Iv | Physician Assistant | 9000 Waukegan Rd Ste 200, Morton Grove, IL 60053-2127 | 2020-08-24 |
| 1336760669 | Lindsay Newton | Physician Assistant | 9000 Waukegan Rd Ste 200, Morton Grove, IL 60053-2127 | 2020-04-28 |
| 1033745948 | Aaron Gore | Physician Assistant | 9000 Waukegan Rd Ste 200, Morton Grove, IL 60053-2127 | 2020-03-23 |
| 1083248587 | Elaine Chen | Physician Assistant | 9000 Waukegan Rd Ste 200, Morton Grove, IL 60053-2127 | 2020-02-24 |
| 1881225084 | Jordan Rivett | Physician Assistant | 9000 Waukegan Rd Ste 200, Morton Grove, IL 60053-2127 | 2020-01-28 |
| 1306489943 | Jacob Babinec | Physician Assistant | 9000 Waukegan Rd Ste 200, Morton Grove, IL 60053-2127 | 2019-10-28 |
| 1750923298 | Marissa Masini | Physician Assistant | 9000 Waukegan Rd Ste 200, Morton Grove, IL 60053-2127 | 2019-10-16 |
| 1710456017 | Maragret Wilson | Physician Assistant | 9000 Waukegan Rd Ste 200, Morton Grove, IL 60053-2127 | 2018-11-15 |
| 1255823233 | Madeline Tennant | Physician Assistant | 9000 Waukegan Rd Ste 200, Morton Grove, IL 60053-2127 | 2018-06-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710536206 | 360 Rehabilitation & Physical Therapy LLC | Clinic/Center | 9041 Moody Avenue, Morton Grove, IL 60053 | 2019-09-06 |
| 1205312147 | Ziing Healthcare, Inc | Nursing Care | 6126 Lincoln Ave, Suite 1010, Morton Grove, IL 60053 | 2018-07-13 |
| 1578053674 | Megan Ruffalo | Home Health | 8922 Marion Ave, Morton Grove, IL 60053 | 2018-05-14 |
| 1215441381 | Kristen Marie Kowalski | Occupational Therapist | 8145 River Dr Ste 101, Morton Grove, IL 60053 | 2017-11-27 |
| 1760846190 | Lukasz Jarosinski | Physical Therapy Assistant | 8425 N Waukegan, Morton Grove, IL 60053 | 2016-04-12 |
| 1538547898 | Alysha Gillani | Behavioral Analyst | 9240 Merrill Ave, Morton Grove, IL 60053 | 2015-05-07 |
| 1043578909 | Jordan Jon Wolf | Social Worker | 9224 Cameron Lane, Morton Grove, IL 60053 | 2012-04-30 |
| 1427217454 | Amy Sakoda | Specialist | 9400 N Orile, Morton Grove, IL 60053 | 2008-06-05 |
| 1063679348 | Minsook Do Kroon | Chiropractor | 6021 W Dempster, Morton Grove, IL 60053 | 2008-05-22 |
| 1023282217 | Simona Balan | Dentist | 6223 W Dempster St, Morton Grove, IL 60053 | 2008-04-17 |
| Find all providers in zip 60053 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053577916 | Ibji, LLC | Orthopaedic Surgery | 9000 Waukegan Rd, Suite 200, Morton Grove, IL 60053-2127 | 2008-07-31 |
| 1407019953 | Ritesh R Shah | Orthopaedic Surgery | 9000 Waukegan Rd, Suite 200, Morton Grove, IL 60053-2127 | 2008-07-04 |
| 1689848897 | Jeffrey Goldstein | Orthopaedic Surgery | 9000 Waukegan Rd, Suite 200, Morton Grove, IL 60053-2127 | 2008-04-17 |
| 1083818173 | Ari Youderian | Orthopaedic Surgery | 9000 Waukegan Rd, Suite 200, Morton Grove, IL 60053-2127 | 2007-06-12 |
| 1407938186 | Alan C League | Orthopaedic Surgery | 9000 Waukegan Rd, Suite 200, Morton Grove, IL 60053-2127 | 2006-10-20 |
| 1144269051 | Illinois Bone and Joint Institute | Orthopaedic Surgery | 9000 Waukegan Rd, Suite 200 -, Morton Grove, IL 60053-2111 | 2006-06-06 |
| 1669428538 | Jeffrey Visotsky | Orthopaedic Surgery | 9000 Waukegan Rd, Suite 200, Morton Grove, IL 60053-2111 | 2006-05-25 |
| 1689629859 | Craig Williams | Orthopaedic Surgery | 9000 Waukegan Rd, Suite 200, Morton Grove, IL 60053-2111 | 2006-05-24 |
| 1275588089 | Andrea Kramer | Orthopaedic Surgery | 9000 Waukegan Rd, Suite 200, Morton Grove, IL 60053-2111 | 2006-05-23 |
| 1235183351 | Michael Kornblatt | Orthopaedic Surgery | 9000 Waukegan Rd, Suite 200, Morton Grove, IL 60053-2111 | 2006-05-22 |
| Find all providers in MORTON GROVE | ||||
| City | MORTON GROVE |
| Zip Code | 60053 |
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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.