KEIVAN SHALILEH (NPI# 1700275385) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1700275385 |
Entity Type | Individual |
Full Name | KEIVAN SHALILEH |
Credential | MD |
Practice Address |
751 N Rutledge St Springfield IL 62702-4968 |
Mailing Address |
Po Box 19627 Springfield IL 62794-9627 |
Practice Telephone | 2175458000 |
Practice Fax Number | 2175454734 |
Mailing Telephone | 2175458000 |
Mailing Fax Number | 2175454734 |
Enumeration Date | 2015-01-20 |
Last Update Date | 2020-04-24 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
036-150264 | IL | Allopathic & Osteopathic Physicians |
N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
125069881 | IL | Allopathic & Osteopathic Physicians |
Street Address |
751 N RUTLEDGE ST |
City | SPRINGFIELD |
State | IL |
Zip Code | 62702-4968 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023011863 | Lucinda S Buescher | Dermatology | 751 N Rutledge St, Springfield, IL 62702-4909 | 2005-05-24 |
1831798933 | Robin E Simon | Nurse Practitioner | 751 N Rutledge St, Springfield, IL 62702-4968 | 2020-10-20 |
1891308185 | Whitney Ringer | Nurse Practitioner | 751 N Rutledge St, Springfield, IL 62702-4968 | 2020-08-26 |
1518581149 | Aliza Hasan | Dermatology | 751 N Rutledge St, Springfield, IL 62702-4968 | 2020-05-29 |
1215559943 | Sindhu Reddy Pisati | Psychiatry & Neurology | 751 N Rutledge St, Springfield, IL 62702-4968 | 2020-05-15 |
1205458270 | Paul Hyatt Guerin | Psychiatry & Neurology | 751 N Rutledge St, Springfield, IL 62702-4968 | 2020-05-13 |
1215597398 | Alireza Showraki | Internal Medicine | 751 N Rutledge St, Springfield, IL 62702-4968 | 2019-06-19 |
1881252013 | Andrew Paul Thaliath | Internal Medicine | 751 N Rutledge St, Springfield, IL 62702-4968 | 2019-06-03 |
1891352126 | Emily M Ackerman | Nurse Practitioner | 751 N Rutledge St, Springfield, IL 62702-4968 | 2019-05-22 |
1245725308 | Cory Edward Sykora | Psychiatry & Neurology | 751 N Rutledge St, Springfield, IL 62702-4968 | 2018-06-29 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1457866519 | Mohammad Jamal Uddin Ansari | Internal Medicine | 751 N Rutledge St Ste 400, Springfield, IL 62702 | 2017-12-11 |
1588105811 | Mickey Graphia | Surgery | 701 N 1st St # D346, Springfield, IL 62702 | 2017-03-20 |
1376908913 | Abdul Hannan | Internal Medicine | 315 W Carpenter St # B, Springfield, IL 62702 | 2015-12-28 |
1871986414 | Rachel Hoselton | Nurse Practitioner | 400 N 9th St Fl 4, Springfield, IL 62702 | 2015-03-06 |
1548697774 | Alyssa Wilson | Behavioral Analyst | 232 Bruns Lane, One Sparcenter Plaza, Springfield, IL 62702 | 2013-10-02 |
1174965446 | Amy Wilson | Speech-Language Pathologist | 2120 West Washington Street, Springfield, IL 62702 | 2013-07-26 |
1275898116 | Pele Boutrous Dina | Pediatrics | 415 N 9th St # 4w16, Springfield, IL 62702 | 2012-07-06 |
1427327733 | Brook D Croke | Genetic Counselor, MS | 400 N. 9th Street, 3rd Floor Clinic B, Springfield, IL 62702 | 2011-12-16 |
1629352604 | Renae M Sanchez | Pharmacist | 3216 East Clearlake Ave, Springfield, IL 62702 | 2011-10-07 |
1982915302 | William Leland Zelkovich | Radiology | 701 N 1st, Springfield, IL 62702 | 2010-06-30 |
Find all providers in zip 62702 |
Taxonomy Code | 207RC0200X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Critical Care Medicine |
An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. |
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 |
---|---|---|---|---|
1659313823 | Peter White Jr. | Internal Medicine | 751 N Rutledge St Rm 2100, Springfield, IL 62702-4968 | 2006-06-12 |
1558309898 | John R. Carlile | Internal Medicine | 1000 E. Primrose, #200, Springfield, MO 65807-5388 | 2006-06-02 |
1134166317 | Moin Ahmed Ranginwala | Internal Medicine | 2029 East High Street, Suite 101, Springfield, OH 45505 | 2006-05-31 |
1558311126 | Donald G Gumprecht | Internal Medicine | 543 W Miller St, Springfield, IL 62702-4978 | 2006-05-12 |
1083604870 | Chih Ming Chen | Internal Medicine | 2150 Main St, Springfield, MA 01104-3300 | 2005-10-24 |
1841608890 | Mohammad E Abu Hishmeh | Internal Medicine | 3300 Main Street, 2nd Fl, Suite B, Springfield, MA 01107-1112 | 2014-07-22 |
1316353428 | Debdoot Saha | Internal Medicine | 800 E Carpenter St, Springfield, IL 62769 | 2014-07-09 |
1528473758 | Ammar Syed | Internal Medicine | 1235 E Cherokee St Rm 194, Springfield, MO 65804-2203 | 2014-06-26 |
1710397781 | Olaoluwatomi Kehinde Lamikanra | Internal Medicine | 701 N 1st St, Springfield, IL 62781-0001 | 2014-04-30 |
1619390846 | Prashant Jagtap | Internal Medicine | 800 E Carpenter St, Springfield, IL 62769-1000 | 2014-01-23 |
Find all providers in SPRINGFIELD |
City | SPRINGFIELD |
Zip Code | 62702 |
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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.