MR. ROBERT ANTHONY WISDOM (NPI# 1487767117) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1487767117 |
Entity Type | Individual |
Full Name | MR. ROBERT ANTHONY WISDOM |
Credential | CRNP |
Practice Address |
4444 S Prairie Ave Chicago IL 60653-3208 |
Practice Telephone | 9173626997 |
Mailing Telephone | 9173626997 |
Enumeration Date | 2006-08-16 |
Last Update Date | 2016-04-08 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 363LN0000X |
Nurse Practitioner Specialization: Neonatal |
942926-6 | FL | Physician Assistants & Advanced Practice Nursing Providers |
Y | 363LN0000X |
Nurse Practitioner Specialization: Neonatal |
209014169 | IL | Physician Assistants & Advanced Practice Nursing Providers |
N | 363LN0000X |
Nurse Practitioner Specialization: Neonatal |
350263 | NY | Physician Assistants & Advanced Practice Nursing Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1063456721 | Robert Wisdom | Counselor | 1558 Hayes Dr, Manhattan, KS 66502-5068 | 2006-06-15 |
Street Address |
4444 S PRAIRIE AVE |
City | CHICAGO |
State | IL |
Zip Code | 60653-3208 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1881215804 | Pamela Ann Brazelton-sykes | Counselor | Pioneer Gardens Supportive Living, 3800 S King Dr, Chicago, IL 60653 | 2020-04-30 |
1962915439 | Pickup Transport Lllp | Non-emergency Medical Transport (VAN) | 4418 S. Oakenwald Ave, Chicago, IL 60653 | 2017-11-07 |
1245758309 | Qi Wellness LLC | Case Management | 525 E 46th Place, Chicago, IL 60653 | 2017-09-08 |
1598202897 | Fadesire O Ajuwon | Registered Nurse | 4218 S King Dr, 1n, Chicago, IL 60653 | 2017-01-24 |
1013464619 | Roundys Supermarkets Inc | Pharmacy | 3857 S Dr Martin Luther King Jr Dr, Chicago, IL 60653 | 2016-09-01 |
1417384793 | Griffin Orthodontics PC | Dentist | 1040 E 47th Street, Chicago, IL 60653 | 2013-10-02 |
1114350659 | Carita Dale Johnson | Pharmacist | 3753 S. Cottage Grove Ave, 104, Chicago, IL 60653 | 2013-08-20 |
1245677848 | Mercy Diagnostic and Treatment Center | Clinic/Center | 3755 S Cottage Grove, Chicago, IL 60653 | 2013-05-23 |
1952745937 | Mercy Community Pharmacy At Oakwood Shores | Pharmacy | 3753 S. Cottage Grove, Chicago, IL 60653 | 2013-04-22 |
1386952315 | Jami S Little | Developmental Therapist | 617 East 41st, Chicago, IL 60653 | 2010-09-24 |
Find all providers in zip 60653 |
Taxonomy Code | 363LN0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Neonatal |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1447697032 | Jessica Sue Krause | Nurse Practitioner | 1750 W Harrison St Fl 6, Chicago, IL 60612-3825 | 2013-05-23 |
1982975694 | Tiffany Amber Deriggi | Nurse Practitioner | 3831 N Sacramento Ave, Apt 1, Chicago, IL 60618-3530 | 2012-01-26 |
1154590214 | Patricia Mary Lumb | Nurse Practitioner | 2600 Children's Plaza, Chicago, IL 60614 | 2008-02-22 |
1841468139 | Mimi Noelle Hussussian | Nurse Practitioner | Children's Memorial Hospital, 2300children's Plaza, Box #253, Chicago, IL 60614 | 2008-02-20 |
1225250723 | Carolyn Patricia Seng | Nurse Practitioner | 5721 S. Maryland Ave, Chicago, IL 60637 | 2007-05-03 |
1538771340 | Jennifer Aileen Burkett | Nurse Practitioner | 225 E Chicago Ave, Chicago, IL 60611-2991 | 2020-08-21 |
1730728320 | Beckie Anne Tweedle | Nurse Practitioner | 225 E Chicago Ave, Chicago, IL 60611-2991 | 2019-12-30 |
1508404559 | Angel Lampkin-kwabena | Nurse Practitioner | 225 E Chicago Ave, Chicago, IL 60611-2991 | 2019-12-19 |
1083261291 | Kathleen Raftery | Nurse Practitioner | 1653 W Congress Pkwy, Chicago, IL 60612-3833 | 2019-08-22 |
1568017101 | Trena Lynn Horn | Nurse Practitioner | 225 E Chicago Ave, Chicago, IL 60611-2991 | 2019-08-08 |
Find all providers in CHICAGO |
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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.