15 PARK PLACE LLC (NPI# 1447870274) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447870274 |
| Entity Type | Organization |
| Organization Name | 15 PARK PLACE LLC |
| Practice Address |
15 Park Pl Ste 1 Swansea IL 62226-2918 |
| Practice Telephone | 6185801359 |
| Practice Fax Number | 6182347242 |
| Mailing Telephone | 6185801359 |
| Mailing Fax Number | 6182347242 |
| Enumeration Date | 2020-04-22 |
| Last Update Date | 2020-07-08 |
| Authorized Official Name | CLARA AMPADU (CEO) |
| Authorized Official Telephone | 6185801359 |
| Authorized Official Credential | FNPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 0360832704 | 05 |
| Other Name | Type Code |
|---|---|
| Adult Internal Medicine Office Practice | Doing Business As Name - Organization |
| Street Address |
15 PARK PL STE 1 |
| City | SWANSEA |
| State | IL |
| Zip Code | 62226-2918 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639778160 | Roxanna Lee Gunnels | Nurse Practitioner | 1 Bronze Pointe Plaza Suite 1a, Swansea, IL 62226 | 2020-10-26 |
| 1053969790 | Consistent Medical Transportation | Driver | 2012 N 17th St, Swansea, IL 62226 | 2019-08-27 |
| 1497314371 | Medi-plex Hospice of Illinois, LLC | Registered Nurse | 8 Park Place, Suite #3, Swansea, IL 62226 | 2019-06-13 |
| 1336617364 | Nicole Renee Schmidt | Speech-Language Pathologist | 150 N 27th St., Belleville, IL 62226 | 2018-11-07 |
| 1295258903 | Catherine Espino | Pharmacist | 11 Chambers Blvd, Swansea, IL 62226 | 2017-07-25 |
| 1366806838 | Kiley Faires | Nurse Practitioner | 4600 Memorial Drive Ste 360, Belleville, IL 62226 | 2016-04-11 |
| 1760857585 | Mvp Transportation | Non-emergency Medical Transport (VAN) | 1229 N 17th Street, Number 23, Belleville, IL 62226 | 2015-12-04 |
| 1275952566 | Aisha Danyale Franklin | Internal Medicine | 4261 Woodfield Pl, Belleville, IL 62226 | 2014-04-15 |
| 1396168332 | Jayne E. Ninness | Physical Therapy Assistant | 4500 Memorial Dr., Memorial Hospital, Belleville, IL 62226 | 2014-01-28 |
| 1053758193 | Gateway Foundation, Inc. | Clinic/Center | 1 Bronze Point, Suite 1, Swansea, IL 62226 | 2013-05-30 |
| Find all providers in zip 62226 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| 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 |
|---|---|---|---|---|
| 1306020664 | Mark Andrew Walshauser | Internal Medicine | 13 Wolf Creek Dr Ste 1, Swansea, IL 62226-2367 | 2007-12-21 |
| 1235181231 | Sarah Shreter | Internal Medicine | 1738 Gar Highway, Mount Hope Medical Center, Inc., Swansea, MA 02777-3906 | 2006-05-17 |
| 1730162108 | Khaja G Mohsin | Internal Medicine | 10 Emerald Ter, Swansea, IL 62226-2310 | 2005-11-21 |
| 1013998152 | Deborah K Mcdermott | Internal Medicine | 4 Park Pl, Swansea, IL 62226-2965 | 2005-11-07 |
| 1972031706 | Cep America - Illinois Snf, LLP | Internal Medicine | 100 Rosewood Village Dr, Swansea, IL 62226-2301 | 2017-05-24 |
| 1912347790 | John Thomas English | Internal Medicine | 4 Park Pl, Swansea, IL 62226-2965 | 2013-06-26 |
| 1184679466 | Master Medical Care LLC | Internal Medicine | 10 Emerald Ter, Swansea, IL 62226-2310 | 2006-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962002832 | Coleman Clinic, Inc. | Internal Medicine | 1893 Daimler Rd Ste A, Rockford, IL 61112-1081 | 2020-10-29 |
| 1922606193 | Thatiana Carolina Schulze Goni | Internal Medicine | 5924 N Lincoln Ave Apt 205, Chicago, IL 60659-3736 | 2020-10-11 |
| 1447866579 | Jashan Gill | Internal Medicine | 3707 Doty Rd Ste Eandf, Woodstock, IL 60098-7530 | 2020-09-23 |
| 1649884636 | Maria Detolve Donoghue | Internal Medicine | 905 Eldorado St, Winnetka, IL 60093-1951 | 2020-09-07 |
| 1750995742 | Eva Bartaula | Internal Medicine | 1500 S Fairfield Ave # 3, Chicago, IL 60608-1782 | 2020-09-07 |
| 1750994513 | Ranjit Babu Jasaraj | Internal Medicine | 1500 S Fairfield Ave # F-914, Chicago, IL 60608-1782 | 2020-08-30 |
| 1871106005 | Vijay Ketan Reddy | Internal Medicine | 1500 S Fairfield Ave Dept Roomf914, Chicago, IL 60608-1782 | 2020-08-27 |
| 1144839739 | Sandhya Shri Kannayiram | Internal Medicine | 1901w Harrison Street, Chicago, IL 60612 | 2020-07-29 |
| 1417566084 | Avani Sushilkumar Mohta | Internal Medicine | Carle Foundation Hospital, 611 W. Park Street, Urbana, IL 61801 | 2020-07-29 |
| 1659989937 | Consultant Physicians | Internal Medicine | 580 Bankview Dr, Frankfort, IL 60423-1382 | 2020-07-22 |
| Find all providers with the same taxonomy | ||||
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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.