LUKE DAVID VICKERS (NPI# 1700388014) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700388014 |
| Entity Type | Individual |
| Full Name | LUKE DAVID VICKERS |
| Practice Address |
Loyola University Medical Center 2160 S. First Avenue Maywood IL 60153 |
| Mailing Address |
2160 S 1st Ave Maywood IL 60153-3328 |
| Practice Telephone | 7083273041 |
| Practice Fax Number | 7083273489 |
| Enumeration Date | 2018-03-02 |
| Last Update Date | 2018-06-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
018.002073 | IL | Dental Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
LOYOLA UNIVERSITY MEDICAL CENTER 2160 S. FIRST AVENUE |
| City | MAYWOOD |
| State | IL |
| Zip Code | 60153 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679654040 | Guliz Barkan | Pathology | Loyola University Medical Center, 2160 S First Ave 101 1740, Maywood, IL 60153 | 2006-10-18 |
| 1528520442 | Jenna Berndt | Pediatrics | Loyola University Medical Center, 2160 S. First Ave. Maguire 3rd Floor, Maywood, IL 60153 | 2019-04-01 |
| 1124598909 | Stela Lapic | Nurse Practitioner | Loyola University Medical Center, 2160 South 1st Avenue, Maywood, IL 60153-3328 | 2018-12-05 |
| 1801389515 | Nicole Mary Raucci | Nurse Practitioner | Loyola University Medical Center, 2160 S. First Avenue, Maywood, IL 60153 | 2018-06-08 |
| 1558867556 | Gregory Joseph Klazura | Surgery | Loyola University Medical Center, 2160 S. First Avenue, Ems Bld. 3210, Maywood, IL 60153 | 2018-03-30 |
| 1346506839 | Gregory Aubert | Internal Medicine | Loyola University Medical Center, 2160 S 1st Avenue, Maywood, IL 60153 | 2012-04-09 |
| 1366648081 | Lukas M Nystrom | Orthopaedic Surgery | Loyola University Medical Center, 2160 South First Avenue, Maywood, IL 60153-3328 | 2007-06-21 |
| 1326106865 | John F Moran | Internal Medicine | Loyola University Medical Center, (luh - North Ent., Rm7604), Maywood, IL 60153 | 2006-12-05 |
| 1386713725 | Louis G Mercuri | Dentist | Loyola University Medical Center, 2160 S First Ave 101 1740, Maywood, IL 60153 | 2006-11-07 |
| 1497824908 | Mehdat Gabriel | Nuclear Medicine | Loyola University Medical Center, Mcgaw Ent., Rm. 47, Maywood, IL 60153 | 2006-11-07 |
| Find all providers in the same location | ||||
| 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 |
| Find all providers in zip 60153 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104260314 | Cameron James Walker | Dentist | 2160 S 1st Ave Rm 1814, Maywood, IL 60153-3328 | 2013-04-18 |
| 1336220466 | Michael A Costello | Dentist | 949 Spring Valley Rd, Maywood, NJ 07607 | 2006-10-17 |
| 1275093775 | Neil A Thomas | Dentist | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2019-03-21 |
| 1972006914 | Michael Jeffrey Harrison | Dentist | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2018-03-15 |
| 1427551050 | Pooja Garg | Dentist | 2160 S 1st Ave, Maywood, IL 60153 | 2018-03-09 |
| 1417497850 | Thomas Evan Backeris | Dentist | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2017-03-05 |
| 1992151682 | Eric Safranski | Dentist | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2016-05-11 |
| 1013301993 | Nicholas Peretti | Dentist | 2160 S 1st Ave, Bldg. 105 Suite 1814, Maywood, IL 60153-3328 | 2015-03-27 |
| 1639411747 | Gary Anthony Forgach | Dentist | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2013-03-27 |
| 1619221827 | New Jersey Center for Oral & Maxillofacial Surgery | Dentist | 949 Spring Valley Rd, Maywood, NJ 07607-1452 | 2012-11-09 |
| Find all providers in MAYWOOD | ||||
Please comment or provide details below to improve the information on LUKE DAVID VICKERS.
| 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.