DR. THEODORE D. FIFER (NPI# 1508034596) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508034596 |
| Entity Type | Individual |
| Full Name | DR. THEODORE D. FIFER |
| Credential | M.D. FACS |
| Practice Address |
14900 N Court 9 Effingham IL 62401-7640 |
| Practice Telephone | 2179946162 |
| Practice Fax Number | 2173427094 |
| Mailing Telephone | 2179946162 |
| Mailing Fax Number | 2173427094 |
| Enumeration Date | 2008-02-13 |
| Last Update Date | 2012-12-12 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2082S0105X |
Plastic Surgery Specialization: Surgery of the Hand |
036084136 | IL | Allopathic & Osteopathic Physicians |
| Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
036084136 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE CROSS | 025-00076 | 01 |
| IL | 036-084136 | 05 |
| Street Address |
14900 N COURT 9 |
| City | EFFINGHAM |
| State | IL |
| Zip Code | 62401-7640 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568021269 | Rhodes To Health, LLC | Chiropractor | 200 E. Fayette Ave, Effingham, IL 62401 | 2019-06-07 |
| 1467951699 | Sarah Bush Lincoln Health Center | Durable Medical Equipment & Medical Supplies | 903 N Maple St, Effingham, IL 62401 | 2018-02-02 |
| 1033632187 | Diel Counseling Inc. | Counselor | 444 S. Willow #7, Effingham, IL 62401 | 2017-07-20 |
| 1770930968 | Community Support Systems | Intermediate Care Facility, Mentally Retarded | 2311 Veterans Drive, Effingham, IL 62401 | 2016-05-18 |
| 1194107102 | Radhika Annam | Internal Medicine | 500 N. Maple St., Joslin Diabetes Center Affiliate At Hshs Medical Group, Effingham, IL 62401 | 2015-06-25 |
| 1912334558 | Ruben Boyajian, Md | Surgery | 904 Medical Park Drive, Suite 2, Effingham, IL 62401 | 2013-09-27 |
| 1427483502 | Daniel E Czajkowski | Physical Therapist | 2611 S Banker St, Effingham, Il, Effingham, IL 62401 | 2013-09-09 |
| 1093140501 | Lifetime Dental Care of Maryland, Badger, P.C. | Dentist | 1200 Network Centre Drive, Suite #2, Effingham, IL 62401 | 2013-09-04 |
| 1689926487 | Wellness Loft Inc. | Counselor | 408 South 4th St., Effingham, IL 62401 | 2012-10-04 |
| 1598011470 | Patricia R. Diel | Social Worker | 444 S. Willow, Suite 7, Effingham, IL 62401 | 2012-07-30 |
| Find all providers in zip 62401 | ||||
| Taxonomy Code | 2086S0122X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Plastic and Reconstructive Surgery |
| A surgeon who specializes in plastic and reconstructive surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770831323 | Kevin A Calder | Surgery | 900 W Temple Ave, Effingham, IL 62401 | 2012-08-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467074617 | Dewolfe Aesthetic Services Sc | Surgery | 3357 N. Southport Aveune, Chicago, IL 60657 | 2020-05-11 |
| 1578068524 | Jw Operatory | Surgery | 1811 Saint Johns Ave Ste 100, Highland Park, IL 60035-5607 | 2018-03-29 |
| 1780198796 | Lin Plastic and Reconstructive Surgery Inc | Surgery | 730 W Couch Pl Unit 1409, Chicago, IL 60661-1383 | 2017-11-29 |
| 1750892923 | Alban Ingram Miller Jr. | Surgery | 1708 Foxborough Ct, Champaign, IL 61822-8503 | 2017-10-16 |
| 1972905545 | Jennifer Hein | Surgery | 2631 Williamsburg Ave Ste 102, Geneva, IL 60134-1108 | 2014-09-25 |
| 1093139909 | Swedishamerican Hospital | Surgery | 1639 N Alpine Rd Ste 400, Rockford, IL 61107 | 2014-02-12 |
| 1043559842 | Msa Alliance, LLC | Surgery | 1 Broadway Plz, Sparta, IL 62286-1800 | 2013-02-14 |
| 1518223791 | Hansel M Debartolo Jr Md Sc | Surgery | 11 Debartolo Dr., Sugar Grove, IL 60554 | 2012-04-02 |
| 1952692717 | Georgios Kokosis | Surgery | 1725 W Harrison St Ste 425, Chicago, IL 60612-3893 | 2011-04-28 |
| 1740596808 | Swedishamerican Hospital | Surgery | 6533 Lexus Dr, Rockford, IL 61108 | 2010-08-27 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DR. THEODORE D. FIFER.
| 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.