JEFFREY H PORT (NPI# 1285635987) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285635987 |
| Entity Type | Individual |
| Full Name | JEFFREY H PORT |
| Credential | M.D. |
| Practice Address |
9921 Southwest Hwy Oak Lawn IL 60453-3767 |
| Mailing Address |
1111 W Vernon Park Pl Chicago IL 60607-3424 |
| Practice Telephone | 7084995678 |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2009-01-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 036-060518 | IL | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245320415 | Jeffrey Port | Surgery | 525 E 68th St # M404, New York, NY 10065-4870 | 2006-10-16 |
| Street Address |
9921 SOUTHWEST HWY |
| City | OAK LAWN |
| State | IL |
| Zip Code | 60453-3767 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457359697 | Charles Berkelhammer | Specialist | 9921 Southwest Hwy, Oak Lawn, IL 60453-3767 | 2005-07-12 |
| 1306331830 | Lauren Smith | Registered Nurse | 9921 Southwest Hwy, Oak Lawn, IL 60453-3754 | 2018-06-27 |
| 1407360308 | Amy Liss | Physician Assistant | 9921 Southwest Hwy, Oak Lawn, IL 60453-3754 | 2017-11-30 |
| 1962884460 | Trisha Brown | Nurse Practitioner | 9921 Southwest Hwy, Oak Lawn, IL 60453-3754 | 2015-06-22 |
| 1659799948 | Amsurg Oak Lawn Il Anesthesia LLC | Nurse Anesthetist, Certified Registered | 9921 Southwest Hwy, Oak Lawn, IL 60453-3754 | 2014-04-03 |
| 1679816342 | Oak Lawn Il Endoscopy Asc LLC | Clinic/Center | 9921 Southwest Hwy, Oak Lawn, IL 60453-3767 | 2013-04-01 |
| 1821247495 | Southwest Gastroenterology, S.c. | Internal Medicine | 9921 Southwest Hwy, Oak Lawn, IL 60453-3767 | 2008-09-18 |
| 1982850855 | Midwest Center for Digestive Health, Sc | Internal Medicine | 9921 Southwest Hwy, Oak Lawn, IL 60453-3767 | 2008-08-12 |
| 1528245925 | Lola Kwan | Internal Medicine | 9921 Southwest Hwy, Oak Lawn, IL 60453-3767 | 2008-01-28 |
| 1912057803 | Sarah Jane Ehrhardt | Physician Assistant | 9921 Southwest Hwy, Oak Lawn, IL 60453-3767 | 2007-01-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659995231 | Natalia Zero | Student in an Organized Health Care Education/Training Program | 4440 W 95th St, Rm 131 North, Oak Lawn, IL 60453 | 2020-05-30 |
| 1114554300 | Sylvia Maria Chlebek | Student in an Organized Health Care Education/Training Program | Advocate Christ Medical Center 4440 W. 95th St., Rm 131 North, Oak Lawn, IL 60453 | 2020-03-26 |
| 1972066751 | Amanda Mroczek | Family Medicine | 9555 52nd Avenue, Suite F, Oak Lawn, IL 60453 | 2019-04-09 |
| 1013479955 | Leah Rae Prager | Physician Assistant | 4400 W. 95th St., Attn: Pediatric General Surgery, Oak Lawn, IL 60453 | 2019-04-01 |
| 1659833473 | Chelsea Sumida Gipson | Family Medicine | 9555 South 52nd Avenue, Suite F, Oak Lawn, IL 60453 | 2019-04-01 |
| 1518427418 | Robert Lindgren | Family Medicine | 9555 S. 52nd Ave., Suite F, Oak Lawn, IL 60453 | 2019-03-25 |
| 1154886695 | Stephanie Anne Comer | Social Worker | 10102 South Cicero Avenue, Suite C, Oak Lawn, IL 60453 | 2019-02-08 |
| 1700360070 | Brian L Lee | Counselor | 8938 S Ridgeland Avenue Suite 100, Oak Lawn, IL 60453 | 2018-09-21 |
| 1679085245 | International Dental of Oak Lawn | Clinic/Center | 9539 S Cicero Ave, Oak Lawn, IL 60453 | 2017-11-03 |
| 1124538301 | Kavitha Rajendran | Physician Assistant | 5851 W. 95th Street, Suite 300, Oak Lawn, IL 60453 | 2017-10-02 |
| Find all providers in zip 60453 | ||||
| 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 |
|---|---|---|---|---|
| 1023225331 | Southwest Hematology-oncology Consultant, Sc | Specialist | 6419 West 87th St, Oak Lawn, IL 60453 | 2007-05-17 |
| 1811027808 | Southwest Medical Specialists, Sc | Specialist | 6311 W 95th Street, Oak Lawn, IL 60453-2201 | 2007-03-07 |
| 1902986961 | Vinod Upadhyaya | Specialist | 4400 W 95th St Ste 201, Oak Lawn, IL 60453-2657 | 2006-10-16 |
| 1598845554 | Varsha Upadhyaya | Specialist | 4400 W 95th St Ste 202, Oak Lawn, IL 60453-2657 | 2006-10-16 |
| 1548224306 | Raj R Mittal | Specialist | 6419 W 87th St, Suite 1, Oak Lawn, IL 60453-1072 | 2006-04-17 |
| 1659344778 | Sara Ann Barr | Specialist | 9634 S Pulaski Rd, Oak Lawn, IL 60453-3391 | 2006-02-09 |
| 1194711655 | Retina Vitreous Associates, PC | Specialist | 4930 W 95th St, Oak Lawn, IL 60453-2504 | 2005-09-21 |
| 1457359697 | Charles Berkelhammer | Specialist | 9921 Southwest Hwy, Oak Lawn, IL 60453-3767 | 2005-07-12 |
| 1366445678 | Richard Z Belch | Specialist | 4400 W 95th St, Suite 207, Oak Lawn, IL 60453-2654 | 2005-05-31 |
| 1134531973 | Southside Pain Relief Center Inc | Specialist | 5569 W 95th St, Oak Lawn, IL 60453-2356 | 2014-05-28 |
| Find all providers in OAK LAWN | ||||
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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.