CARLOS BALDOCEDA (NPI# 1225048127) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225048127 |
| Entity Type | Individual |
| Full Name | CARLOS BALDOCEDA |
| Credential | M.D. |
| Practice Address |
3407 W Fullerton Ave Chicago IL 60647-2497 |
| Practice Telephone | 7738629681 |
| Mailing Telephone | 7738629681 |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VG0400X |
Obstetrics & Gynecology Specialization: Gynecology |
036-054338 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 073703710040 | 05 |
| Street Address |
3407 W FULLERTON AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60647-2497 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356860928 | Diverse Investments Inc. | Durable Medical Equipment & Medical Supplies | 3407 W Fullerton Ave, Chicago, IL 60647-2497 | 2017-09-14 |
| 1649696147 | Premiercare Anesthesia & Pain P.C. | Anesthesiology | 3407 W Fullerton Ave, Chicago, IL 60647-2497 | 2014-03-09 |
| 1932450285 | Daniel Maksimovich | Anesthesiology | 3407 W Fullerton Ave, Chicago, IL 60647-2497 | 2012-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164035879 | Scott Spine and Health LLC | Chiropractor | 2560 W. Armitage Ave, Unit C2, Chicago, IL 60647 | 2020-08-24 |
| 1003424458 | Emily Gleesing | Physical Therapist | 1923 N Western Ave, Chicago, IL 60647 | 2020-07-21 |
| 1699301358 | Marcella Guzman P.C. | Dentist | 3236 W. Fullerton Ave., Chicago, IL 60647 | 2020-03-13 |
| 1740772342 | Envision Unlimited | Case Management | 2646 N Washtenaw Ave # 3n, Chicago, IL 60647 | 2018-05-31 |
| 1992297535 | Envision Unlimited | Case Management | 2646 N Washtenaw Ave # 2n, Chicago, IL 60647 | 2018-05-30 |
| 1942704580 | Team Rehabilitation Il15, LLC | Physical Therapist | 1923 N Western Avenue, Chicago, IL 60647 | 2018-03-20 |
| 1023517331 | Chicago Medical Healthcare Group, S.c. | Family Medicine | 3648 W Armitage Avenue, Chicago, IL 60647 | 2018-02-02 |
| 1023537693 | Erin Frommeyer | Physician Assistant | 2228 W Dickens Avenue, Chicago, IL 60647 | 2017-09-15 |
| 1457872475 | Stefanie Paola Maurtua | Behavioral Analyst | 2448 West Bloomingdale Ave., Apt 2e, Chicago, IL 60647 | 2017-06-29 |
| 1700322922 | Lumen Optical Illinois 4, LLC | Optometrist | 2420 N Elston, Bucktown, IL 60647 | 2017-01-11 |
| Find all providers in zip 60647 | ||||
| Taxonomy Code | 207VG0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Gynecology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396142857 | Illinois Institute of Gynecology and Advanced Pelvic Surgery, Sc | Obstetrics & Gynecology | 1351 W Belmont Ave, Chicago, IL 60657-7195 | 2014-11-28 |
| 1477715142 | Michel Medical Assoc., S.c. | Obstetrics & Gynecology | 2600 S Michigan Ave Ste 314, Chicago, IL 60616-2860 | 2008-06-25 |
| 1477727550 | All Women's Medical Center | Obstetrics & Gynecology | 3140 W Irving Prk. Rd, Chicago, IL 60618 | 2008-04-18 |
| 1477731784 | Marianna Vardaka Md Inc | Obstetrics & Gynecology | 1087 Solutions Ctr, Chicago, IL 60677-1000 | 2008-02-08 |
| 1578747648 | Progressivecare for Women | Obstetrics & Gynecology | 676 N Saint Clair, 1800, Chicago, IL 60611 | 2007-12-24 |
| 1720273311 | Dorothy Jean Lucas | Obstetrics & Gynecology | 8346 S Rhodes Ave, 65 East 75th Street, Chicago, IL 60619-5705 | 2007-09-07 |
| 1497971931 | Helen Elizabeth Cejtin | Obstetrics & Gynecology | 1935 W Farwell Ave, Chicago, IL 60626-3102 | 2007-04-17 |
| 1427132950 | Edward S Lichtenberg | Obstetrics & Gynecology | 5086 N Elston Ave, Chicago, IL 60630-2427 | 2006-10-24 |
| 1699874560 | Anita Blanchard | Obstetrics & Gynecology | 5841south Maryland Avenue, Mc 2050, Chicago, IL 60637 | 2006-09-21 |
| 1356443147 | Melissa Lynn Gilliam | Obstetrics & Gynecology | 5841 S Maryland Ave # 2050, Chicago, IL 60637-1447 | 2006-09-02 |
| 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.