MATTHEW RUSSELL (NPI# 1245868090) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245868090 |
| Entity Type | Individual |
| Full Name | MATTHEW RUSSELL |
| Credential | DO |
| Practice Address |
2160 S 1st Ave Maywood IL 60153-3328 |
| Practice Telephone | 7083279124 |
| Enumeration Date | 2020-03-28 |
| Last Update Date | 2020-06-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 125.076382 | IL | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386244648 | Matthew B Russell | Marriage & Family Therapist | 4125 Temescal St Ste G, Fair Oaks, CA 95628-7558 | 2020-10-27 |
| 1821468604 | Matthew Russell | Psychologist | 520 S Grand Ave Ste 671, Los Angeles, CA 90071-2655 | 2015-10-06 |
| 1821260084 | Matthew Scott Russell | Otolaryngology | 2233 Post St. 3rd Floor; Box 1225, University of California, San Francisco; Department Of, San Francisco, CA 94115 | 2008-03-28 |
| 1699723627 | Matthew L. Russell | Internal Medicine | 1200 Centre Street, Department of Medicine, Roslindale, MA 02131 | 2006-05-04 |
| 1740881143 | Matthew Russell | Counselor | 151 Industrial Dr, Birmingham, AL 35211-4445 | 2020-11-03 |
| 1194352765 | Matthew David Russell | Student in an Organized Health Care Education/Training Program | 75 Francis St # Streetl1, Boston, MA 02115-6110 | 2020-03-24 |
| 1851931059 | Matthew Thomas Russell | Pharmacist | 3410 Northpark Dr, Kingwood, TX 77345-6108 | 2020-01-15 |
| 1487203485 | Matthew E.b. Russell | Psychologist | 1504 Ben Taub Loop, Houton, TX 77030 | 2019-09-11 |
| 1477045326 | Matthew David Russell | Behavioral Analyst | 151 S 4th St Ste 401, Grand Forks, ND 58201-4715 | 2018-06-05 |
| 1366951394 | Matthew Cassady Russell | Physician Assistant | 3 E 101st St, New York, NY 10029-6528 | 2017-09-21 |
| Street Address |
2160 S 1ST AVE |
| City | MAYWOOD |
| State | IL |
| Zip Code | 60153-3328 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174525489 | Michael Jm Raffin | Audiologist | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2005-06-01 |
| 1366049900 | Kenneth Bernard Jordan | Psychiatry & Neurology | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2020-10-06 |
| 1124634712 | Abhilasha Nitin Borkar | Pathology | 2160 S 1st Ave, Maywood, IL 60153 | 2020-09-18 |
| 1306450325 | Linda Ippolito | Nurse Practitioner | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2020-09-08 |
| 1194339135 | Meghan Henry | Nurse Practitioner | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2020-09-08 |
| 1194339911 | Victoria Leah Drozd | Student in an Organized Health Care Education/Training Program | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2020-08-31 |
| 1396357588 | Madison Schaefer | Nurse Practitioner | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2020-08-19 |
| 1134731375 | Otanthia S Williams-brady | Nurse Practitioner | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2020-08-19 |
| 1205454287 | Janet Nickels | Audiologist | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2020-07-07 |
| 1417574054 | Kathryn Clemans | Nurse Anesthetist, Certified Registered | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2020-06-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053933077 | Judie Noemie Hoilat | Internal Medicine | 2160 S 1st Avenue, Maywood, IL 60153 | 2020-05-13 |
| 1457972457 | Yuchen Zheng | Student in an Organized Health Care Education/Training Program | Department of Neurology, Loyola University Medical Cent, 2160 S. First Ave, Maywood, IL 60153 | 2020-04-30 |
| 1437779519 | Amna Amad Siddiqui | Student in an Organized Health Care Education/Training Program | 2160 S. First Avenue, Loyola University Medical Center, Maywood, IL 60153 | 2020-04-20 |
| 1982232211 | Brian Kurtz | Student in an Organized Health Care Education/Training Program | 2160 S First Ave, Bulding 105-suite 2840a, Maywood, IL 60153 | 2020-03-31 |
| 1902434947 | Saadiya Jabbar | Psychiatry & Neurology | Loyola University Medical Center, Building 105, Suite 1940, Maywood, IL 60153 | 2020-03-27 |
| 1558919472 | Linda Sue Moton | Technician | 10 South 15 Apt. 1, Maywood, IL 60153 | 2019-09-04 |
| 1760047518 | Braden Robert Dasovic | Student in an Organized Health Care Education/Training Program | 2160 S. First Avenue Building 105/room 2700, Department, Loyola Medical Center, Maywood, IL 60153 | 2019-05-07 |
| 1134680713 | Madeline Shaoyun Tiee | Orthopaedic Surgery | Loyola University Medical Center, 2160 S 1st Ave, Maywood, IL 60153 | 2019-03-27 |
| 1538629746 | Michael Murphy | Orthopaedic Surgery | 2160 S 1st Ave., Maguire Center, Dept of Ortho Surg, Maywood, IL 60153 | 2019-03-22 |
| 1053871681 | Michael V Padua | Psychiatry & Neurology | 2160 S 1st Ave Bldg, Maywood, IL 60153 | 2019-03-20 |
| Find all providers in zip 60153 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124372347 | Priya Bhakhri Tandon | Pediatrics | 4943 Slauson Ave, Maywood, CA 90270-3020 | 2012-11-09 |
| 1164504965 | Illur Sathy | Pediatrics | 318 Madison St, Maywood, IL 60153-2151 | 2006-10-20 |
| 1861587073 | Tao Trung Nguyen M.d., Inc | Pediatrics | 6043 Atlantic Blvd., Maywood, CA 90270-3118 | 2006-10-04 |
| 1689693749 | Tao T Nguyen | Pediatrics | 6043 Atlantic Blvd, Maywood, CA 90270-3118 | 2006-07-19 |
| 1043849482 | Katelyn Margaret Campbell | Pediatrics | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2020-04-07 |
| 1790314896 | Margaret Lynn Caldwell | Pediatrics | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2020-04-02 |
| 1447888490 | Crystal Nguyen | Pediatrics | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2020-03-27 |
| 1265090237 | Elizabeth Dorora Krupa | Pediatrics | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2019-06-04 |
| 1164085494 | Michael White | Pediatrics | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2019-04-22 |
| 1528520442 | Jenna Berndt | Pediatrics | Loyola University Medical Center, 2160 S. First Ave. Maguire 3rd Floor, Maywood, IL 60153 | 2019-04-01 |
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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.