DR. JUSTIN EUGENE MITCHELL (NPI# 1689818098) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689818098 |
| Entity Type | Individual |
| Full Name | DR. JUSTIN EUGENE MITCHELL |
| Credential | D.O. |
| Practice Address |
2160 S 1st Ave Maywood IL 60153-3328 |
| Practice Telephone | 7082169000 |
| Mailing Telephone | 7082169000 |
| Enumeration Date | 2009-04-29 |
| Last Update Date | 2016-09-20 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
036.130251 | IL | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467951723 | Justin Mitchell | Physical Therapist | 843 Durham Rd Suite 110, Wake Forest, NC 27587 | 2018-02-01 |
| 1891225983 | Justin Scott Mitchell | Dentist | 14690 Nw 151st Blvd # 20, Alachua, FL 32615-5328 | 2017-06-12 |
| 1174720668 | Justin S. Mitchell | Orthopaedic Surgery | 12770 Edgemere Blvd Ste F, El Paso, TX 79938-4569 | 2007-06-28 |
| 1437603255 | Justin Mitchell | Counselor | 2575 Westgate Bldg 1, Pendleton, OR 97801-9613 | 2016-08-10 |
| 1255715686 | Justin Mitchell | Family Medicine | 200 2nd Ave Sw, Miami, OK 74354-6830 | 2015-07-15 |
| 1689095119 | Justin Mitchell | Social Worker | 5013 Wrightsville Ave, Wilmington, NC 28403-7045 | 2013-12-31 |
| 1558648147 | Justin Chayne Mitchell | Personal Emergency Response Attendant | 8651 Brier Creek Pkwy, Raleigh, NC 27617-7325 | 2011-11-09 |
| 1154649267 | Justin J Mitchell | Orthopaedic Surgery | 3111 Gundersen Dr, Onalaska, WI 54650-8447 | 2010-05-13 |
| 1790970697 | Justin Lee Mitchell | Internal Medicine | 4700 Waters Ave, Memorial Health Im Edu, Savannah, GA 31410 | 2007-09-13 |
| 1982804332 | Justin Corbin Mitchell | Physical Therapist | 1323 N A St, Wellington, KS 67152-4350 | 2007-07-24 |
| Street Address |
2160 S 1ST AVE |
| City | MAYWOOD |
| State | IL |
| Zip Code | 60153-3328 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174525489 | Michael Jm Raffin | Audiologist | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2005-06-01 |
| 1366049900 | Kenneth Bernard Jordan | Psychiatry & Neurology | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2020-10-06 |
| 1124634712 | Abhilasha Nitin Borkar | Pathology | 2160 S 1st Ave, Maywood, IL 60153 | 2020-09-18 |
| 1306450325 | Linda Ippolito | Nurse Practitioner | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2020-09-08 |
| 1194339135 | Meghan Henry | Nurse Practitioner | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2020-09-08 |
| 1194339911 | Victoria Leah Drozd | Student in an Organized Health Care Education/Training Program | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2020-08-31 |
| 1396357588 | Madison Schaefer | Nurse Practitioner | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2020-08-19 |
| 1134731375 | Otanthia S Williams-brady | Nurse Practitioner | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2020-08-19 |
| 1205454287 | Janet Nickels | Audiologist | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2020-07-07 |
| 1417574054 | Kathryn Clemans | Nurse Anesthetist, Certified Registered | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2020-06-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053933077 | Judie Noemie Hoilat | Internal Medicine | 2160 S 1st Avenue, Maywood, IL 60153 | 2020-05-13 |
| 1457972457 | Yuchen Zheng | Student in an Organized Health Care Education/Training Program | Department of Neurology, Loyola University Medical Cent, 2160 S. First Ave, Maywood, IL 60153 | 2020-04-30 |
| 1437779519 | Amna Amad Siddiqui | Student in an Organized Health Care Education/Training Program | 2160 S. First Avenue, Loyola University Medical Center, Maywood, IL 60153 | 2020-04-20 |
| 1982232211 | Brian Kurtz | Student in an Organized Health Care Education/Training Program | 2160 S First Ave, Bulding 105-suite 2840a, Maywood, IL 60153 | 2020-03-31 |
| 1902434947 | Saadiya Jabbar | Psychiatry & Neurology | Loyola University Medical Center, Building 105, Suite 1940, Maywood, IL 60153 | 2020-03-27 |
| 1558919472 | Linda Sue Moton | Technician | 10 South 15 Apt. 1, Maywood, IL 60153 | 2019-09-04 |
| 1760047518 | Braden Robert Dasovic | Student in an Organized Health Care Education/Training Program | 2160 S. First Avenue Building 105/room 2700, Department, Loyola Medical Center, Maywood, IL 60153 | 2019-05-07 |
| 1134680713 | Madeline Shaoyun Tiee | Orthopaedic Surgery | Loyola University Medical Center, 2160 S 1st Ave, Maywood, IL 60153 | 2019-03-27 |
| 1538629746 | Michael Murphy | Orthopaedic Surgery | 2160 S 1st Ave., Maguire Center, Dept of Ortho Surg, Maywood, IL 60153 | 2019-03-22 |
| 1053871681 | Michael V Padua | Psychiatry & Neurology | 2160 S 1st Ave Bldg, Maywood, IL 60153 | 2019-03-20 |
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| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| 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 |
|---|---|---|---|---|
| 1801080460 | Lena Brice Palmer | Internal Medicine | 2160 S. 1st Avenue, Building 54, Room 167, Maywood, IL 60153 | 2007-08-28 |
| 1831619527 | Ikponmwosa Enofe | Internal Medicine | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2017-06-22 |
| 1043744717 | Ingrid Beyruth Schwartz | Internal Medicine | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2017-04-19 |
| 1407387061 | Marcel Ghanim | Internal Medicine | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2017-03-24 |
| 1942651096 | Thomas Jan Konturek | Internal Medicine | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2016-06-29 |
| 1710372321 | Arshish Dua | Internal Medicine | 2160 S 1st Ave, Maywood, IL 60153 | 2015-03-31 |
| 1013250695 | Steven Hendler | Internal Medicine | 2160 S 1st Ave, Maywood, IL 60153 | 2013-04-01 |
| 1013273150 | Zuie Wakade | Internal Medicine | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2012-04-03 |
| 1184918294 | Lalitha Meenambal Sitaraman | Internal Medicine | 2160 S 1st Ave, Maywood, IL 60153 | 2011-06-06 |
| 1336438456 | Susanne Shokoohi | Internal Medicine | 2160 S 1st Ave, Building 54 Room 167, Maywood, IL 60153 | 2011-03-29 |
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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.