MRS. HALEY RANAE GOULSON (NPI# 1417283938) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417283938 |
| Entity Type | Individual |
| Full Name | MRS. HALEY RANAE GOULSON |
| Credential | PA-C |
| Practice Address |
17495 South Lagrange Road Tinley Park IL 60487 |
| Practice Telephone | 7082267000 |
| Practice Fax Number | 7082267192 |
| Mailing Telephone | 7082267000 |
| Mailing Fax Number | 7082267192 |
| Enumeration Date | 2009-10-19 |
| Last Update Date | 2017-02-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 085.003590 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
17495 SOUTH LAGRANGE ROAD |
| City | TINLEY PARK |
| State | IL |
| Zip Code | 60487 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346850492 | Essential Counseling Group LLC | Social Worker | 17550 W Quail Trail, Tinley Park, IL 60487 | 2020-08-04 |
| 1457972705 | Michelle E Estand | Speech-Language Pathologist | 8200 185th, Tinley Park, Il 60487, Suite A/b, Suite A/b, Suite A/b, Tinley Park, IL 60487 | 2020-04-28 |
| 1659839108 | Jasmine Mccloskey | Behavioral Analyst | Cards, 8505 183rd Suite D, IL 60487 | 2019-03-04 |
| 1669951158 | Christine Marie Cavanaugh | Developmental Therapist | 8384 Dunmore Dr, Tinley Park, IL 60487 | 2018-08-07 |
| 1851810998 | Jeffrey Beck | Counselor | 16243 Haven Ave., Orland Hills, IL 60487 | 2017-09-09 |
| 1730634700 | Liyun Huang | Internal Medicine | 17495 South La Grange Rd, Tinley Park, IL 60487 | 2016-08-19 |
| 1780016162 | Kristin Ann Strausbaugh | Nurse Practitioner | 7300 191st Street, Tinley Park, IL 60487 | 2013-08-07 |
| 1679855597 | Florence Delavega | Pharmacist | 9151 Mansfield Dr, Tinley Park, IL 60487 | 2011-09-16 |
| 1912285685 | Michelle Vansetten | Behavioral Analyst | 8200 W. 185th Street, Suite A/b, Tinley Park, IL 60487 | 2011-07-29 |
| 1033358254 | Visionworks, Inc | Eyewear Supplier (Equipment, not the service) | 7208 W. 191st Street, Tinley Park, IL 60487 | 2009-02-11 |
| Find all providers in zip 60487 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144888686 | Alexa Rae Eggert | Physician Assistant | 8837 Woodbine Ct, Tinley Park, IL 60487-8640 | 2019-05-30 |
| 1952943649 | Alexander Porucznik | Physician Assistant | 6850 Centennial Dr, Tinley Park, IL 60477-1653 | 2019-10-14 |
| 1396229043 | Sarah Traverso | Physician Assistant | 17495 La Grange Rd, Tinley Park, IL 60487-7581 | 2018-09-19 |
| 1386186971 | Nicole Jenette Golak | Physician Assistant | 17495 La Grange Rd, Tinley Park, IL 60487-7581 | 2016-11-14 |
| 1851744833 | Elzbieta Kolodziej | Physician Assistant | 17495 La Grange Rd, Tinley Park, IL 60487-7581 | 2016-07-14 |
| 1255706248 | Sara Nannette Chabra | Physician Assistant | 17495 La Grange Rd, Tinley Park, IL 60487-7581 | 2015-12-02 |
| 1588052385 | Kristin M Derungs | Physician Assistant | 17495 La Grange Rd, Tinley Park, IL 60487-7581 | 2014-12-31 |
| 1104222389 | Michelle Galan | Physician Assistant | 17495 La Grange Rd, Tinley Park, IL 60487-7581 | 2014-11-14 |
| 1174842926 | Ishani Patel | Physician Assistant | 17495 La Grange Rd, Tinley Park, IL 60487-7581 | 2010-05-19 |
| 1972757557 | Meagan M Turner | Physician Assistant | 17495 La Grange Rd, Tinley Park, IL 60487-7581 | 2008-11-10 |
| Find all providers in TINLEY PARK | ||||
| City | TINLEY PARK |
| Zip Code | 60487 |
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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.