GRAND VEIN SPECIALISTS LLC (NPI# 1255603247) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255603247 |
| Entity Type | Organization |
| Organization Name | GRAND VEIN SPECIALISTS LLC |
| Practice Address |
1508 Grand Ave Waukegan IL 60085-3653 |
| Practice Telephone | 8476724695 |
| Practice Fax Number | 8476724799 |
| Mailing Telephone | 8476724695 |
| Mailing Fax Number | 8476724799 |
| Enumeration Date | 2012-02-06 |
| Last Update Date | 2012-02-06 |
| Authorized Official Name | DR. JAVIER FLORES (PRESIDENT) |
| Authorized Official Telephone | 7735807578 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 202K00000X | Phlebology | 036-116087 | IL | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | 036-116087 | IL | Allopathic & Osteopathic Physicians |
| Street Address |
1508 GRAND AVE |
| City | WAUKEGAN |
| State | IL |
| Zip Code | 60085-3653 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164445854 | Javier Flores | Family Medicine | 1508 Grand Ave, Waukegan, IL 60085-3653 | 2006-07-25 |
| 1609147420 | Alameda Foot Centers | Podiatrist | 1508 Grand Ave, Waukegan, IL 60085-3653 | 2012-01-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285285189 | Allison Rose Matuszewski | Speech-Language Pathologist | Robbie M. Lightfoot, 1721 N Mcaree Rd, Waukegan, IL 60085 | 2019-09-23 |
| 1164985602 | Kristin Kaprak | Speech-Language Pathologist | Thomas Jefferson Middle School, 600 S. Lewis, Waukegan, IL 60085 | 2019-04-11 |
| 1861972317 | Mitchum Smith | Student in an Organized Health Care Education/Training Program | 2025 Washington Street, Waukegan, IL 60085 | 2018-08-15 |
| 1447702998 | Rachel Martinez | Registered Nurse | 3002 Grand Ave., Waukegan, IL 60085 | 2016-11-01 |
| 1831649250 | Kenneth Caples | Specialist/Technologist | 211 S County St, Waukegan, IL 60085 | 2016-10-10 |
| 1033666490 | Catholic Charities of The Archdiocese of Chicago | Community/Behavioral Health | 671 S. Lewis Ave., Waukegan, IL 60085 | 2016-09-02 |
| 1285007757 | Michael Moore | Counselor | 1113 Greenwood Ave, Waukegan, IL 60085 | 2015-11-05 |
| 1740656503 | Emperatriz Guerra | Counselor | 329 N. Genesee Street, Waukegan, IL 60085 | 2015-08-17 |
| 1992189880 | County of Lake | Clinic/Center | 540 S. Mcalister Ave., Waukegan, IL 60085 | 2015-07-10 |
| 1922406354 | Ebele Okonkwor | Nurse Anesthetist, Certified Registered | 1324 N. Sheridan, Waukegan, IL 60085 | 2014-12-17 |
| Find all providers in zip 60085 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720287378 | Alpesh M. Patel | Family Medicine | 1075n Green Bay Rd, Waukegan, IL 60085-2244 | 2007-07-13 |
| 1609969138 | Benjamin Calayag | Family Medicine | 2400 Belvidere Rd., Waukegan, IL 60085 | 2006-10-02 |
| 1093723413 | Daisy Andaleon | Family Medicine | 1616 Grand Ave Ste B, Waukegan, IL 60085-3676 | 2006-08-03 |
| 1134136336 | Jane R Malalis | Family Medicine | 1401 Dugdale Circle, Ann Kicey Center, Waukegan, IL 60085 | 2006-08-01 |
| 1164445854 | Javier Flores | Family Medicine | 1508 Grand Ave, Waukegan, IL 60085-3653 | 2006-07-25 |
| 1003893017 | Family Health Services S.c. | Family Medicine | 935 Glen Flora Ave, Ste 201, Waukegan, IL 60085 | 2005-12-30 |
| 1437145141 | Richard Loran Keller | Family Medicine | 1738 Washington St, Waukegan, IL 60085-5137 | 2005-09-27 |
| 1659371276 | Sara Eileen Tranchina | Family Medicine | 2323 Grand Ave, Waukegan, IL 60085-3312 | 2005-07-26 |
| 1053860080 | App of Illinois Ed Pllc | Family Medicine | 1324 N Sheridan Rd, Waukegan, IL 60085-2161 | 2016-10-03 |
| 1215270111 | Lupita Catrina Gallardo | Family Medicine | 2323 Grand Ave, Waukegan, IL 60085-3312 | 2013-03-29 |
| Find all providers in WAUKEGAN | ||||
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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.