LILLIAN SANDIC JARDINE (NPI# 1720188956) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720188956 |
| Entity Type | Individual |
| Full Name | LILLIAN SANDIC JARDINE |
| Credential | MD |
| Practice Address |
5735 S Ironwood Rd South Bend IN 46614-9668 |
| Practice Telephone | 5742994847 |
| Practice Fax Number | 5742999073 |
| Mailing Telephone | 5742994847 |
| Mailing Fax Number | 5742999073 |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2015-06-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 4301072875 | MI | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 01061418A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 1720188956 | 05 |
| Street Address |
5735 S IRONWOOD RD |
| City | SOUTH BEND |
| State | IN |
| Zip Code | 46614-9668 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235441924 | Merl J. Mast | Nurse Practitioner | 5735 S Ironwood Rd, South Bend, IN 46614-9668 | 2010-07-09 |
| 1952519894 | Ambulatory Care Solutions | Nurse Practitioner | 5735 S Ironwood Rd, South Bend, IN 46614-9668 | 2007-05-21 |
| 1124114350 | Phoebe Lynn Ritter | Nurse Practitioner | 5735 S Ironwood Rd, South Bend, IN 46614-9668 | 2006-10-05 |
| 1538255609 | Alakananda R Kulkarni | Internal Medicine | 5735 S Ironwood Rd, South Bend, IN 46614-9668 | 2006-10-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417574013 | Hellen Gathesha | Nurse Practitioner | 2123 W Irvington Dr, South Bend, IN 46614 | 2020-06-30 |
| 1033759394 | Diane Galvas | Pharmacist | 1217 E. Ireland Rd., South Bend, IN 46614 | 2020-01-14 |
| 1730668690 | Julenne Henriquez-gil | Physical Therapist | 202 W Ireland Rd Ste 101a, South Bend, IN 46614 | 2018-08-11 |
| 1467747014 | Deidre A Coffey | Nurse Practitioner | 1025 Widener Ln, South Bend, IN 46614 | 2011-06-12 |
| 1588727655 | Wal-mart Stores East, Lp | Technician/Technologist | 700 W. Ireland Rd., South Bend, IN 46614 | 2006-12-19 |
| 1437262847 | Lori F Risser | Dentist | 734 E Ireland Rd, South Bend, IN 46614 | 2006-08-17 |
| 1912388018 | Laura Ellen Albright | Family Medicine | 2102 E Inwood Rd, South Bend, IN 46614 | 2015-06-15 |
| 1245626225 | Kathleen Kelley | Dermatology | 1815 E Ireland Rd, South Bend, IN 46614 | 2015-04-07 |
| 1073869806 | The Health and Hospital Corporation of Marion County | Skilled Nursing Facility | 1950 Ridgedale Rd, South Bend, IN 46614 | 2012-07-30 |
| 1326300666 | Kristine Marie Jones | Optometrist | 700 W Ireland Rd, South Bend, IN 46614 | 2012-06-12 |
| Find all providers in zip 46614 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285998146 | Thomas Larsen | Family Medicine | 4440 Portage Ave, South Bend, IN 46628-9570 | 2012-06-26 |
| 1316180318 | Paul Angelo Carl Macri | Family Medicine | 2012 Cedar St, South Bend, IN 46617-2542 | 2009-04-07 |
| 1285818591 | Jaroslaw Kuna | Family Medicine | 320 S Saint Joseph St Ste 300, South Bend, IN 46601-2308 | 2007-12-21 |
| 1013117472 | Ronald E Grow Inc | Family Medicine | 810 W Indiana Ave, South Bend, IN 46613-1828 | 2007-07-23 |
| 1124241211 | Trixy Franke | Family Medicine | 837 E. Cedar St., Ste 100, South Bend, IN 46617 | 2007-04-10 |
| 1225185739 | Michael J. O'connell D.o. Inc | Family Medicine | 17960 Cleveland Road, South Bend, IN 46635 | 2007-01-05 |
| 1679620579 | Mark R. Neff | Family Medicine | 804 Lancaster Dr, South Bend, IN 46614-2020 | 2007-01-04 |
| 1437216587 | David Wood Baxter | Family Medicine | 115 E Cripe St, South Bend, IN 46637-3402 | 2007-01-01 |
| 1477635944 | Alan Snell | Family Medicine | 837 East Cedar St., Ste 100, South Bend, IN 46617 | 2006-10-20 |
| 1437240694 | Brian Anthony Jacobs | Family Medicine | 610 N Michigan Street, Suite 308, South Bend, IN 46601 | 2006-09-27 |
| Find all providers in SOUTH BEND | ||||
| City | SOUTH BEND |
| Zip Code | 46614 |
Please comment or provide details below to improve the information on LILLIAN SANDIC JARDINE.
| 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.