MERCY CLINIC SPECIALISTS SERVICES-ILLINOIS LLC (NPI# 1578017596) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578017596 |
| Entity Type | Organization |
| Organization Name | MERCY CLINIC SPECIALISTS SERVICES-ILLINOIS LLC |
| Practice Address |
2227 Vadalabene Dr Ste 200 Maryville IL 62062-5824 |
| Practice Telephone | 3143644347 |
| Enumeration Date | 2016-08-08 |
| Last Update Date | 2019-09-12 |
| Authorized Official Name | JEFFREY CIARAMITA (PRESIDENT) |
| Authorized Official Telephone | 3145251785 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 500051406 | 05 |
| Street Address |
2227 VADALABENE DR STE 200 |
| City | MARYVILLE |
| State | IL |
| Zip Code | 62062-5824 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043713886 | Mercy Clinic Surgical Specialists-illinois LLC | Surgery | 2227 Vadalabene Dr Ste 200, Maryville, IL 62062-5824 | 2018-03-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104325091 | Jennifer M Oyler | Physician Assistant | 6812 State Route 162 Suite 120, Maryville, IL 62062 | 2018-02-06 |
| 1710495965 | Sarah Elizabeth Barto | Family Medicine | 2133 Vadalabene Drive, Suite Sb, Maryville, IL 62062 | 2018-01-22 |
| 1104348085 | Lindsey Nicole Langendorf | Chiropractor | 62 Executive Plaza Ct, Maryville, IL 62062 | 2017-07-12 |
| 1043750540 | Gina Saal | Nurse Anesthetist, Certified Registered | 6800 Rt 162, Maryville, IL 62062 | 2017-03-02 |
| 1548657737 | Karen Michelle Bertels | Emergency Medicine | 6800 Il - 162, Maryville, IL 62062 | 2015-04-25 |
| 1811258148 | Debra Ann Hoelscher | Internal Medicine | 2102 Vadalabene, Maryville, IL 62062 | 2012-06-04 |
| 1538438445 | Casey Elizabeth Wiesemeyer | Speech-Language Pathologist | 2201 Copper Creek Rd, Maryville, IL 62062 | 2011-12-21 |
| 1407144819 | Norah Claire Farley Baker | Family Medicine | 10 Professional Park Dr., Maryville, IL 62062 | 2011-07-19 |
| 1891092474 | Kimberly M Schneider | Physician Assistant | 20b Professional Park Drive, Maryville, IL 62062 | 2011-02-17 |
| 1669782397 | Purandhri Patel | Physical Therapist | 6820 State Route 162, Maryville, IL 62062 | 2010-10-15 |
| Find all providers in zip 62062 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699956466 | Tennessee Cancer Specialists Pllc | Internal Medicine | 339 Bmh Physicians Office Building, Maryville, TN 37804-5820 | 2007-11-20 |
| 1154396182 | Syed M Arshad | Internal Medicine | 2227 Vadalabene Dr, Suite 100, Maryville, IL 62062-5823 | 2006-02-22 |
| 1184694333 | Matthew J Mccarty | Internal Medicine | 220 Bmh Cancer Center, Maryville, TN 37804 | 2006-01-23 |
| 1215118088 | Tennessee Cancer Specialists, Pllc | Internal Medicine | 907 E Lamar Alexander Pkwy, Blount Memorial Hospital, Maryville, TN 37804-5015 | 2007-11-20 |
| 1639149867 | S Spence Mccachren | Internal Medicine | 220 Bmh Cancer Center, Maryville, TN 37804 | 2006-01-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649831124 | Elena Vagia | Internal Medicine | 233 E Superior St Ste 1-061, Chicago, IL 60611-2913 | 2019-06-25 |
| 1194206367 | Illinois Cancer Specialists | Internal Medicine | 360 Station Dr Ste 201, Crystal Lake, IL 60014-7978 | 2018-08-27 |
| 1861986549 | Quincy Physicians & Surgeons Clinic, Sc | Internal Medicine | 3347 Broadway St, Quincy, IL 62301 | 2018-06-18 |
| 1730634700 | Liyun Huang | Internal Medicine | 17495 South La Grange Rd, Tinley Park, IL 60487 | 2016-08-19 |
| 1356793319 | Glenda Maria Delgado Ramos | Internal Medicine | 2160 S 1st Ave Ste 167, Maywood, IL 60153-3328 | 2016-07-01 |
| 1023403516 | Meghan Rebecca Steiner | Internal Medicine | 5841 S Maryland Ave # Mc-2115, Chicago, IL 60637 | 2015-04-01 |
| 1700270154 | Joseph Heng | Internal Medicine | 5841 S Maryland Ave # Mc1152, Chicago, IL 60637-1443 | 2015-03-24 |
| 1497148118 | Pinal Chokshi | Internal Medicine | 525 E Congress Pkwy Ste 300, Crystal Lake, IL 60014-6258 | 2015-03-05 |
| 1770998262 | Adventist Bolingbrook Hospital | Internal Medicine | 420 S Schmidt, Ste 230, Bolingbrook, IL 60440 | 2014-06-24 |
| 1003258583 | Luis David Sumoza | Internal Medicine | 1900 West Polk Suite 755, Chicago, IL 60612 | 2013-07-24 |
| Find all providers with the same taxonomy | ||||
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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.