KETAMINE WELLNESS CENTERS CHICAGO, LLC (NPI# 1508406588) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508406588 |
| Entity Type | Organization |
| Organization Name | KETAMINE WELLNESS CENTERS CHICAGO, LLC |
| Practice Address |
603 E Diehl Rd Naperville IL 60563-1452 |
| Mailing Address |
603 E Diehl Rd Ste 139 Naperville IL 60563-4905 |
| Practice Telephone | 8555389355 |
| Practice Fax Number | 8445389355 |
| Mailing Telephone | 8555389355 |
| Mailing Fax Number | 8445389355 |
| Enumeration Date | 2020-01-08 |
| Last Update Date | 2020-08-21 |
| Authorized Official Name | ANITA D JERGER (EXECUTIVE ASSISTANT) |
| Authorized Official Telephone | 8555389355 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | Nursing Service Providers | ||
| N | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 207L00000X | Anesthesiology | Allopathic & Osteopathic Physicians |
| Street Address |
603 E DIEHL RD |
| City | NAPERVILLE |
| State | IL |
| Zip Code | 60563-1452 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912989070 | Richard L Gelband | Chiropractor | 603 E Diehl Rd, Suite 135, Naperville, IL 60563-1452 | 2005-11-15 |
| 1770121063 | Fjorda Jusufi | Behavior Technician | 603 E Diehl Rd, Suite 123, Naperville, IL 60563 | 2019-12-17 |
| 1104472588 | Shagun Doshi | Behavior Technician | 603 E Diehl Rd, Naperville, IL 60563-1452 | 2019-08-12 |
| 1396306122 | Rebecca Viant | Behavioral Analyst | 603 E Diehl Rd, Naperville, IL 60563-1452 | 2019-06-24 |
| 1366006538 | Rebecca Benson | Behavior Technician | 603 E Diehl Rd, Naperville, IL 60563-1452 | 2019-04-23 |
| 1245704279 | Christian Herrera | Behavioral Analyst | 603 E Diehl Rd, Suite 123, Naperville, IL 60440 | 2019-01-12 |
| 1215407259 | Jocelyne Montoya | Behavior Technician | 603 E Diehl Rd, Naperville, IL 60563-1452 | 2018-12-03 |
| 1699243048 | Marina Ibrahim | Behavior Technician | 603 E Diehl Rd, Naperville, IL 60563-1452 | 2018-11-04 |
| 1285118455 | Aniyah Jones | Behavior Technician | 603 E Diehl Rd, Naperville, IL 60563-1452 | 2018-09-24 |
| 1831690510 | Amber Ciesielski | Behavior Technician | 603 E Diehl Rd, Naperville, IL 60563-1452 | 2018-02-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952902884 | Julia Ann Gottschalk | Nurse Practitioner | 1979 Mcdowell Rd, Unit 103, Naperville, IL 60563 | 2020-11-06 |
| 1700484847 | Lee Michael Harms I | Social Worker | 1952 Mcdowell Road, Suite 305, Naperville, IL 60563 | 2020-10-12 |
| 1881208478 | Poornima Swamy Gangaji | Dentist | 760 N, Illinois Rte 59, Ste100, Naperville, IL 60563 | 2020-09-01 |
| 1851901219 | Adiana Lebron | Social Worker | 2948 Artestian Road, Naperville, IL 60563 | 2020-07-31 |
| 1194342014 | Ingrid Lara | Behavioral Analyst | 1975 Mcdowell Rd #101, Naperville, IL 60563 | 2020-06-26 |
| 1396383030 | Jack Kelly | Assistant Behavior Analyst | 1975 Mcdowell Rd. #101, Naperville, IL 60563 | 2019-12-12 |
| 1316583529 | Arvind Ramakrishnan | Behavioral Analyst | 1975 Mcdowell Rd., Naperville, IL 60563 | 2019-11-22 |
| 1679115778 | Melissa Macias | Behavioral Analyst | 1975 Mcdowell Road, #101, Naperville, IL 60563 | 2019-10-10 |
| 1629619275 | Meghann Reid Vizintos | Physician Assistant | 1763 Freedom Dr Ste 117, Naperville, IL 60563 | 2019-10-04 |
| 1417413543 | Vikram Singh Cheema | Physician Assistant | 1335 North Mill Street, Naperville, IL 60563 | 2019-02-13 |
| Find all providers in zip 60563 | ||||
| Taxonomy Code | 207L00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery. |
| 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 Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316562481 | Douglas Dobson | Anesthesiology | 25w225 Plank Rd, Naperville, IL 60563-1607 | 2020-06-14 |
| 1790985349 | Kun Peng | Anesthesiology | 120 Spalding Dr Ste 308, Naperville, IL 60540 | 2007-07-23 |
| 1700972999 | Suada N Spirtovic | Anesthesiology | 40 Shuman Blvd, Naperville, IL 60563-8446 | 2006-10-05 |
| 1457464893 | Bradley Fine | Anesthesiology | 40 Shuman Blvd. Suite 275, West Central Anesthesiology Group Ltd., Naperville, IL 60563 | 2006-08-17 |
| 1366489155 | Kcmp Acupuncture, LLC | Anesthesiology | 3020 Tall Grass Dr, Naperville, IL 60564-8232 | 2006-06-01 |
| 1265490239 | James E. Wilson | Anesthesiology | 101 E 75th St, Suite 110, Naperville, IL 60565-1469 | 2006-05-01 |
| 1699750406 | Randa M Sawan | Anesthesiology | 1304 Dunrobin Rd, Naperville, IL 60540-8282 | 2005-12-14 |
| 1922498641 | Tom Wang | Anesthesiology | 801 S Washington St, Naperville, IL 60540-7430 | 2015-02-02 |
| 1841617818 | Jennifer Pathy | Anesthesiology | 801 S Washington St, Naperville, IL 60540-7499 | 2014-03-27 |
| 1730442773 | Kelli T Sekulovich | Anesthesiology | 801 S Washington St, Naperville, IL 60540-7430 | 2012-06-22 |
| Find all providers in NAPERVILLE | ||||
| City | NAPERVILLE |
| Zip Code | 60563 |
Please comment or provide details below to improve the information on KETAMINE WELLNESS CENTERS CHICAGO, LLC.
| 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.