OA LABS CLINIC LLC. (NPI# 1538669510) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1538669510 |
Entity Type | Organization |
Organization Name | OA LABS CLINIC LLC. |
Practice Address |
6321 Fairview Ave Ste B Westmont IL 60559-2886 |
Practice Telephone | 6302350220 |
Practice Fax Number | 9853702321 |
Mailing Telephone | 6302350220 |
Mailing Fax Number | 9853702321 |
Enumeration Date | 2018-02-16 |
Last Update Date | 2018-06-16 |
Authorized Official Name | DR. NICHOLAS MATARAGAS (DIRECTOR OF MEDICINE) |
Authorized Official Telephone | 6302350220 |
Authorized Official Credential | MD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
336070137 | IL | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IL | H63416 | 05 |
Street Address |
6321 FAIRVIEW AVE STE B |
City | WESTMONT |
State | IL |
Zip Code | 60559-2886 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1598366874 | Rachel Stoffregen | Physical Therapist | 812 East Ogden Ave, Westmont, IL 60559 | 2020-11-04 |
1528672581 | Kera C Evans | Counselor | 414 Plaza Dr. Suite 301, Westmont, IL 60559 | 2020-09-06 |
1912403023 | Bianca J Dassinger | Social Worker | 750 Pasquinelli Drive, #204, Westmont, IL 60559 | 2018-04-05 |
1689192163 | Jeannie Marie Gorman | Nutritionist | 310 W. Burlington Ave, Westmont, IL 60559 | 2017-09-05 |
1326563248 | Bethany Juby | Psychologist | 825 N Cass Ave Ste 112, Westmont, IL 60559 | 2017-08-11 |
1861917189 | Marisa Raineri | Physical Therapist | 750 Pasquinelli Dr., #204, Westmont, IL 60559 | 2017-08-08 |
1093185209 | Kristin Kalivoda | Pharmacy Technician | 2 N. Cass Avenue, Westmont, IL 60559 | 2015-09-30 |
1780076679 | Katherine Celine Smith | Nurse Practitioner | 1010 Executive Drive, Suite 200, Westmont, IL 60559 | 2015-03-02 |
1841690898 | Kimberly Libby | Physical Therapist | 801 N Cass Ave Ste 100, Westmont, IL 60559 | 2014-08-27 |
1083036792 | Deborah Carsten | Counselor | 460 Quail Ridge Drive, Westmont, IL 60559 | 2014-01-15 |
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Taxonomy Code | 207RE0101X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Endocrinology, Diabetes & Metabolism |
An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems. |
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 |
---|---|---|---|---|
1356961304 | Wahid Kassar Md Ltd | Internal Medicine | 7447 W Talcott Ave Ste 444, Chicago, IL 60631-3715 | 2020-04-20 |
1245701812 | Chrysalis Health of Il P.C. | Internal Medicine | 402 Gardenia Ln, Buffalo Grove, IL 60089-1661 | 2018-12-07 |
1467920124 | Impact Physician Group, Illinois, LLC | Internal Medicine | 115 E South St Ste F, Plano, IL 60545-1595 | 2018-11-10 |
1457866519 | Mohammad Jamal Uddin Ansari | Internal Medicine | 751 N Rutledge St Ste 400, Springfield, IL 62702 | 2017-12-11 |
1356861496 | Javier Alcid Duron Tabora | Internal Medicine | 1725 W Harrison St Ste 250-a, Chicago, IL 60612-3841 | 2017-06-20 |
1336676923 | Villagemd Indiana, PC | Internal Medicine | 1 N Franklin St Ste 1205, Chicago, IL 60606 | 2017-05-15 |
1780135426 | Endocrine and Metabolic Center Inc | Internal Medicine | 280 Stonegate Rd, Algonquin, IL 60102-5600 | 2016-10-18 |
1174975601 | Bilal Shaikh | Internal Medicine | 1750 W Harrison St Ste 250, Chicago, IL 60612 | 2016-07-08 |
1316396294 | Melissa Faye Cohen | Internal Medicine | 835 S. Wolcott Street, Suite E625, M/c 640, Chicago, IL 60612 | 2016-06-10 |
1194107102 | Radhika Annam | Internal Medicine | 500 N. Maple St., Joslin Diabetes Center Affiliate At Hshs Medical Group, Effingham, IL 62401 | 2015-06-25 |
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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.