KEIVAN SHALILEH


Address: 751 N Rutledge St, Springfield, IL 62702-4968
Phone: 2175458000

KEIVAN SHALILEH (NPI# 1700275385) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

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

Taxonomy

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

Office Location

Street Address 751 N RUTLEDGE ST
City SPRINGFIELD
State IL
Zip Code 62702-4968

Providers in the same location

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
Find all providers in the same location

Providers in the same zip code

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 Information

Taxonomy Code 207RC0200X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Critical Care Medicine

Taxonomy Definition

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.

Providers in the same taxonomy and city

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

Competitor

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City SPRINGFIELD
Zip Code 62702

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Dataset Information

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.

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