DR. JUSTIN T MAO (NPI# 1427052273) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427052273 |
| Entity Type | Individual |
| Full Name | DR. JUSTIN T MAO |
| Credential | MD |
| Practice Address |
1340 Charles St Ste 300 Rockford IL 61104-2200 |
| Mailing Address |
Po Box 1567 Rockford IL 61110-0067 |
| Practice Telephone | 8154905888 |
| Practice Fax Number | 8154905898 |
| Mailing Telephone | 7796967150 |
| Mailing Fax Number | 8154905898 |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2012-04-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 036-124995 | IL | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | 219331 | MA | Allopathic & Osteopathic Physicians |
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
036-124995 | IL | Allopathic & Osteopathic Physicians |
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
225456 | MI | Allopathic & Osteopathic Physicians |
| Y | 207RC0001X |
Internal Medicine Specialization: Clinical Cardiac Electrophysiology |
036-124995 | IL | Allopathic & Osteopathic Physicians |
| Street Address |
1340 CHARLES ST STE 300 |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61104-2200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215496914 | Elizabeth C Zook | Registered Nurse | 1340 Charles St Ste 300, Rockford, IL 61104-2200 | 2019-03-13 |
| 1306380555 | Kimberly M Harris | Nurse Practitioner | 1340 Charles St Ste 300, Rockford, IL 61104-2200 | 2016-12-07 |
| 1639429855 | Danielle Jordal | Nurse Practitioner | 1340 Charles St Ste 300, Rockford, IL 61104-2200 | 2012-09-14 |
| 1801121405 | Christine L. Valentine | Nurse Practitioner | 1340 Charles St Ste 300, Rockford, IL 61104-2200 | 2009-10-15 |
| 1477704252 | Mazen Hadid | Internal Medicine | 1340 Charles St Ste 300, Rockford, IL 61104-2200 | 2008-10-09 |
| 1457516965 | Rehmat Ullah Sheikh | Internal Medicine | 1340 Charles St Ste 300, Rockford, IL 61104-2200 | 2008-07-23 |
| 1508060518 | Rebecca Jo Behling | Nurse Practitioner | 1340 Charles St Ste 300, Rockford, IL 61104 | 2007-06-13 |
| 1639260508 | Paul T Vaitkus | Internal Medicine | 1340 Charles St Ste 300, Rockford, IL 61104-2200 | 2006-09-27 |
| 1174553523 | John Carlton Myers | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1340 Charles St Ste 300, Rockford, IL 61104-2200 | 2006-07-03 |
| 1871574301 | Ian J Goldberg | Internal Medicine | 1340 Charles St Ste 300, Rockford, IL 61104-2200 | 2005-11-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699216564 | Swedishamerican Hospital | Nutritionist | 1415 E. State St., Lower Level A3, Rockford, IL 61104 | 2017-03-13 |
| 1376950485 | Swedishamerican Hospital | Nurse Practitioner | 1340 Charles St Ste 200, Rockford, IL 61104 | 2014-07-21 |
| 1871907774 | Oday Alsarraf | Psychiatry & Neurology | 1401 E State Street, Center for Mental Health, Swedish American Hospital, Rockford, IL 61104 | 2014-06-18 |
| 1962652339 | Children's Home and Aid | Community/Behavioral Health | 424 7th St, Rockford, IL 61104 | 2008-09-23 |
| 1689729535 | Swedishamerican Hospital | Nurse Practitioner | 1340 Charles St Ste 100, Rockford, IL 61104 | 2007-01-23 |
| 1790873016 | David J Schleicher | Obstetrics & Gynecology | 209 9th St Ste 200, Rockford, IL 61104 | 2006-10-11 |
| 1013026624 | Thomas Ryan Moss | Dentist | 1415 E State Street, Rockford, IL 61104 | 2006-08-29 |
| 1366452096 | Arturo Santiago Manas | Obstetrics & Gynecology | 1415 E State St Fl 8, Rockford, IL 61104 | 2006-08-08 |
| 1245263268 | William John Stout | Physician Assistant | 1401 E State Street, Rockford, IL 61104 | 2006-07-10 |
| 1689604969 | Prabha Chand Dosi | Pediatrics | 1401 E. State Street, Rockford, IL 61104 | 2006-07-03 |
| Find all providers in zip 61104 | ||||
| Taxonomy Code | 207RC0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Clinical Cardiac Electrophysiology |
| A field of special interest within the subspecialty of cardiovascular disease, specialty of Internal Medicine, which involves intricate technical procedures to evaluate heart rhythms and determine appropriate treatment for them. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154476802 | Swedishamerican Hospital | Internal Medicine | 1340 Charles St, Suite 300, Rockford, IL 61104 | 2007-01-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508363185 | Deaconess Specialty Physicians, Inc | Internal Medicine | 1340 Il Highway 1 Ste A, Carmi, IL 62821 | 2018-04-10 |
| 1568637833 | Krishnaswami Sriram | Internal Medicine | 611 Hunter Ln, Lake Forest, IL 60045-4905 | 2008-04-28 |
| 1083712467 | Ohio Valley Heartcare Inc | Internal Medicine | 1405 Locust St, Eldorado, IL 62930-1629 | 2006-09-20 |
| 1912917030 | Martin C Burke | Internal Medicine | 1006 S Michigan Ave, Suite 501, Chicago, IL 60605-2254 | 2006-08-09 |
| 1316998578 | West Suburban Cardiologists, Ltd. | Internal Medicine | 3118 N Ashland Ave, Chicago, IL 60657-3014 | 2006-05-13 |
| 1952359242 | Samer Dibs | Internal Medicine | 2222 W Division St Ste 340, Chicago, IL 60622-2995 | 2006-05-05 |
| 1164483145 | Mehran Jabbarzadeh | Internal Medicine | 900 Technology Way Ste 220, Libertyville, IL 60048-5364 | 2006-03-30 |
| 1497754634 | Rebecca Sue Riepshoff | Internal Medicine | Three Saint Elizabeth Blvd Ste 2800, O Fallon, IL 62269-1282 | 2005-07-19 |
| 1093712481 | Erica D Engelstein | Internal Medicine | 7447 W Talcott Ave Ste 222, Chicago, IL 60631-3713 | 2005-06-30 |
| 1861007239 | Marian Heart Rhythm Consultants Sc | Internal Medicine | 2222 W Division St Ste 205, Chicago, IL 60622-3094 | 2020-09-13 |
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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.