21ST CENTURY UROLOGY, S.C. (NPI# 1225043896) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225043896 |
| Entity Type | Organization |
| Organization Name | 21ST CENTURY UROLOGY, S.C. |
| Practice Address |
14315 108th Ave Suite 230 Orland Park IL 60467-5700 |
| Practice Telephone | 7083647000 |
| Practice Fax Number | 7083648000 |
| Mailing Telephone | 7083647000 |
| Mailing Fax Number | 7083648000 |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2008-05-01 |
| Authorized Official Name | DR. ROBERT A. BONZANI (PRESIDENT) |
| Authorized Official Telephone | 7083647000 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | AETNA PROVIDER NUMBER | 5642652 | 01 |
| IL | 036097795 | 05 |
| Street Address |
14315 108TH AVE SUITE 230 |
| City | ORLAND PARK |
| State | IL |
| Zip Code | 60467-5700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750376869 | Evaldas Radzevicius | Psychologist | 14315 108th Ave, Ste 215, Orland Park, IL 60467-5701 | 2005-09-14 |
| 1538773627 | Rci (wrs), LLC. | Clinic/Center | 14315 108th Ave, Orland Park, IL 60467-5700 | 2020-09-04 |
| 1184265514 | Physiotherapy Associates, Inc. | Physical Therapist | 14315 108th Ave, Orland Park, IL 60467-5700 | 2019-10-07 |
| 1053798751 | Molecular Imaging Chicago LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 14315 108th Ave, Suite 122, Orland Park, IL 60467-1006 | 2015-05-01 |
| 1114327459 | John F Olivieri Md Sc | Family Medicine | 14315 108th Ave, Suite 230, Orland Park, IL 60467-5700 | 2014-08-22 |
| 1376959312 | National Imaging LLC | Clinic/Center | 14315 108th Ave, Suite 122, Orland Park, IL 60467-5700 | 2014-07-10 |
| 1871906842 | Jennifer Waterman | Social Worker | 14315 108th Ave, Suite 215, Orland Park, IL 60467-5700 | 2014-06-08 |
| 1346661139 | Institute of Neurobehavior Services Sc | Counselor | 14315 108th Ave, Suite 215, Orland Park, IL 60467-5700 | 2013-12-20 |
| 1134560881 | R H Fife and Associates - Bright Futures - R Hall Psyd | Psychologist | 14315 108th Ave, Suite 220a, Orland Park, IL 60467-5700 | 2013-07-10 |
| 1205173051 | Southwest Vision Therapy, P.C. | Clinic/Center | 14315 108th Ave, Suite 110, Orland Park, IL 60467-5700 | 2013-01-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700435666 | Abigail Flaherty | Specialist/Technologist | 17430 Brookwood Ct, Orland Park, IL 60467 | 2019-09-04 |
| 1114483567 | Allison Winkelman I | Behavioral Analyst | 8505 West 183rd Street, Ste D, Tinley Park, ID 60467 | 2019-02-11 |
| 1043794332 | Stella Lewally | Nurse Practitioner | 11528 183rd St, Orland Park, IL 60467 | 2018-09-21 |
| 1992202535 | Du Page Medical Group Ltd | Durable Medical Equipment & Medical Supplies | 16660 South 107th Avenue, Orland Park, IL 60467 | 2018-04-10 |
| 1467955781 | Dr Matthew E Schmidt & Associates Ophthalmologists S.c. | Eyewear Supplier (Equipment, not the service) | 10732 W 165th St, Orland Park, IL 60467 | 2018-03-13 |
| 1053835694 | Mbr In-home Care, LLC | In Home Supportive Care | 16616 S 107th Court, Orland Park, IL 60467 | 2017-07-26 |
| 1568984029 | Meaghan Hansen Hansen | Nurse Practitioner | Laser Spine Center of Chicago, 16604 S. 107th Ct., Orland Park, IL 60467 | 2017-07-16 |
| 1790212587 | Maria Degrazia Cohen | Developmental Therapist | 9800 Liberty Circle, 3w, Orland Park, IL 60467 | 2017-05-11 |
| 1902354319 | Debra Kramer | Nurse Practitioner | 14315 South 108th Ave., Suite 215, Orland Park, IL 60467 | 2016-09-14 |
| 1689071524 | Morgan Johnson | Specialist/Technologist | 11141 Saratoga Drive, Orland Park, IL 60467 | 2014-11-20 |
| Find all providers in zip 60467 | ||||
| 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 |
|---|---|---|---|---|
| 1770992257 | Duangchai Chiranand | Specialist | 11301 Brook Crossing Dr, Orland Park, IL 60467-4474 | 2014-08-08 |
| 1679877302 | Laura Ann Wagner | Specialist | 8129 Wheeler Dr, Orland Park, IL 60462-4928 | 2011-01-10 |
| 1730411232 | Disha M Patel | Specialist | 9870 Cordoba Ct, Orland Park, IL 60462-3658 | 2010-02-08 |
| 1750525168 | Lisa Cisek | Specialist | 17320 Elk Dr, Orland Park, IL 60467-7810 | 2009-04-29 |
| 1578748067 | Childrens Wellness Center LLC | Specialist | 16505 106th Ct, Orland Park, IL 60467-4545 | 2008-01-03 |
| 1396945184 | Barbara S Terpstra | Specialist | 10755-59 West 143rd Street, Orland Park, IL 60462-5701 | 2007-07-20 |
| 1235292483 | Christine Aruguete | Specialist | 15520 112th Ct, Orland Park, IL 60467-4401 | 2006-12-19 |
| 1669569570 | Patricia Ann Mcquinn | Specialist | 7530 Hemlock Dr, Orland Park, IL 60462-4251 | 2006-10-10 |
| 1588763502 | Maternal Fetal Medicine Consultants of Il, PC | Specialist | 16533 106th Ct, Orland Park, IL 60467-4545 | 2006-09-22 |
| 1033128038 | Gail E Ritchie | Specialist | 15631 S 88th Ave, Orland Park, IL 60462-7762 | 2006-08-07 |
| Find all providers in ORLAND PARK | ||||
| City | ORLAND PARK |
| Zip Code | 60467 |
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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.