DR. LORIN DIXON WHITTAKER JR. (NPI# 1457480063) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457480063 |
| Entity Type | Individual |
| Full Name | DR. LORIN DIXON WHITTAKER JR. |
| Credential | M.D. |
| Practice Address |
624 Ne Glen Oak Ave 2686 Peoria IL 61603-3135 |
| Practice Telephone | 3096556939 |
| Practice Fax Number | 3096553630 |
| Mailing Telephone | 3096556939 |
| Mailing Fax Number | 3096553630 |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | IL | Allopathic & Osteopathic Physicians |
| Street Address |
624 NE GLEN OAK AVE 2686 |
| City | PEORIA |
| State | IL |
| Zip Code | 61603-3135 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881129302 | Jameil Abou-hanna | Student in an Organized Health Care Education/Training Program | 624 Ne Glen Oak Ave, Peoria, IL 61603-3135 | 2017-04-21 |
| 1548611924 | Jonathan Nitz | Surgery | 624 Ne Glen Oak Ave, Room 2670, Peoria, IL 61603-3135 | 2016-06-27 |
| 1700237187 | Harley Moit | Surgery | 624 Ne Glen Oak Ave, Peoria, IL 61603-3135 | 2016-06-27 |
| 1699117358 | Gregory Mcgovern | Surgery | 624 Ne Glen Oak Ave, North Building, 2nd Floor, Suite 2670, Peoria, IL 61603-3135 | 2013-07-23 |
| 1821275074 | Eric Michael Cox | Surgery | 624 Ne Glen Oak Ave, Peoria, IL 61603-3135 | 2008-01-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598362980 | Courtney Klein | Nurse Practitioner | 1306 N. Berkley Ave, Peoria, IL 61603 | 2020-10-08 |
| 1114588217 | Kong Xing Wang | Dentist | 320 East Armstrong Ave, Peoria, IL 61603 | 2019-06-28 |
| 1073015319 | Sara Kristine Rosenbery | Nurse Practitioner | 515 Ne Glen Oak Ave Ste 202, Peoria, IL 61603 | 2018-03-02 |
| 1861860058 | Jennifer Michelle Kelsey | Clinical Nurse Specialist | 420 Ne Glen Oak Avenue, Suite 401, Peoria, IL 61603 | 2015-09-04 |
| 1467859793 | Bonnie Lansing | Counselor | 617 N Gendale Avenue, Behavioral Health Adult Program, Peoria, IL 61603 | 2014-12-02 |
| 1639597172 | Jael K. Mahasi | Counselor | 1800 Ne Perry Avenue, Peoria, IL 61603 | 2014-04-02 |
| 1992054829 | Justin S Ferragut | Radiology | 530 Northeast Glen Oak Avenue, Peoria, IL 61603 | 2012-09-06 |
| 1780952994 | Syed Muhammad Tayyab | Internal Medicine | 828 Ne Glen Oak Ave Apt No208a, Peoria, IL 61603 | 2011-12-02 |
| 1528389079 | St. Francis Medical Center | General Acute Care Hospital | 530 N E Glen Oak Ave, Peoria, IL 61603 | 2010-06-18 |
| 1780810648 | Children's Home Association of Illinois | Voluntary or Charitable | 400 E. Frye, Peoria, IL 61603 | 2009-06-05 |
| Find all providers in zip 61603 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235760406 | Star Surgery Center, LLC | Surgery | 14155 N 83rd Ave Ste 140, Peoria, AZ 85381-5652 | 2020-01-28 |
| 1093008237 | Jordan J Glenn | Surgery | 6750 W Thunderbird Rd Ste B-108, Peoria, AZ 85381-5026 | 2011-05-20 |
| 1023207131 | Comprehensive Breast Center of Arizona Plc | Surgery | 9179 W Thunderbird Rd # 103, Peoria, AZ 85381-4875 | 2007-10-15 |
| 1659589653 | Matthew Lawrence Lynch | Surgery | 26900 N Lake Pleasant Pkwy, Peoria, AZ 85383-1558 | 2007-05-21 |
| 1639132087 | Brian Edward Prebil | Surgery | 14155 N. 83rd Ave., Ste. A-105, Peoria, AZ 85381 | 2006-04-07 |
| 1073584470 | Eric L Thomas | Surgery | 14155 N 83rd Ave Ste A105, Peoria, AZ 85381-5640 | 2006-02-01 |
| 1801874565 | Maqbool B Ali | Surgery | 4930 N Executive Dr, Peoria, IL 61614-4894 | 2006-01-04 |
| 1518956465 | Leann Cari Allgood | Surgery | 9159 W Thunderbird Rd, Peoria, AZ 85381-4910 | 2005-10-13 |
| 1225037310 | John J Brothwell | Surgery | 9856 W Villa Lindo Dr, Peoria, AZ 85383-1339 | 2005-07-20 |
| 1962401117 | Allen A Agapay | Surgery | 6750 W Thunderbird Rd, Ste B108, Peoria, AZ 85381-5026 | 2005-07-19 |
| Find all providers in PEORIA | ||||
Please comment or provide details below to improve the information on DR. LORIN DIXON WHITTAKER JR..
| 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.