DR. ITAI ROZOVSKY (NPI# 1720301690) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720301690 |
| Entity Type | Individual |
| Full Name | DR. ITAI ROZOVSKY |
| Credential | M.D. |
| Practice Address |
1717 W Kirby Ave # 104 Champaign IL 61821-5507 |
| Practice Telephone | 2179745979 |
| Practice Fax Number | 6025327841 |
| Mailing Telephone | 2179745979 |
| Mailing Fax Number | 6025327841 |
| Enumeration Date | 2010-03-08 |
| Last Update Date | 2012-08-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | MD035598E | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 102603212 | 05 |
| Street Address |
1717 W KIRBY AVE # 104 |
| City | CHAMPAIGN |
| State | IL |
| Zip Code | 61821-5507 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326532888 | Cunningham Children's Home of Urbana Il | Residential Treatment Facility, Emotionally Disturbed Children | 1303 N. Cunningham Avenue, Urbana, IL 61821 | 2018-06-19 |
| 1184008708 | Seunghyun Jae | Dentist | 1905 W Springfield Ave, Champaign, IL 61821 | 2015-07-14 |
| 1457698169 | Mohamad Ata | Registered Nurse | 1802 S. Mattis, Champaign, IL 61821 | 2013-01-15 |
| 1609124338 | Lolitia Rosanna Newman | Social Worker | 1508 Powers Ln., Champaign, IL 61821 | 2012-08-28 |
| 1679850887 | Kirk Donald Gohsman | Counselor | 106 S. Country Fair Drive, Suite C, Champaign, IL 61821 | 2011-11-16 |
| 1598054777 | Delbert William Nelson Jr. | Psychiatry & Neurology | 2115 Galen Dr, Champaign, IL 61821 | 2011-03-28 |
| 1790946929 | Rdi Vein LLC | Clinic/Center | 2502 Galen Drive, Suite 101, Champaign, IL 61821 | 2008-06-20 |
| 1366620064 | Advanced Aesthetics Surgery & Laser Center, P.C. | Clinic/Center | 2111 West Park Ct., Champaign, IL 61821 | 2008-02-05 |
| 1033398482 | Huey's Home Medical, Inc | Durable Medical Equipment & Medical Supplies | 1207 S Mattis Ave Ste 1, Champaign, IL 61821 | 2007-11-01 |
| 1265630537 | Elizabeth Catherine Tingley | Psychologist | Department of Psychiatry and Psychology-carle Physician, 1802 S. Mattis, Champaign, IL 61821 | 2007-07-06 |
| Find all providers in zip 61821 | ||||
| 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 |
|---|---|---|---|---|
| 1063671527 | George P. Savvas M.d., P.C. | Family Medicine | 212 W Springfield Ave, Champaign, IL 61820-4832 | 2008-06-09 |
| 1205000452 | Vasanthan G Naidu | Family Medicine | 504 S Draper Ave, Champaign, IL 61821-3842 | 2008-04-18 |
| 1639243868 | David J Fletcher | Family Medicine | 1806 N Market St, Champaign, IL 61822 | 2006-11-20 |
| 1568534907 | George Peter Savvas | Family Medicine | 212 West Springfield Avenue, Champaign, IL 61820-4832 | 2006-11-14 |
| 1639109879 | Joyce W Beitel | Family Medicine | 1701 W Curtis Road, Family Medicine/convenient Care, Champaign, IL 61822 | 2006-07-04 |
| 1235169426 | Stephanie(tess) A Bailey | Family Medicine | 1701 West Curtis, Champaign, IL 61822-9678 | 2006-07-03 |
| 1508895780 | Mahtab Tashakori | Family Medicine | 1802 South Mattis Ave, Champaign, IL 61821 | 2006-07-01 |
| 1972984698 | Elise Wessol | Family Medicine | 1813 W Kirby Ave Ste 120, Champaign, IL 61821 | 2015-06-18 |
| 1255711271 | Vishal Patel | Family Medicine | 1701 Curtis Rd, Champaign, IL 61822-9678 | 2015-06-04 |
| 1003223470 | Elizabeth A Ackerson | Family Medicine | 1701 Curtis Rd, Champaign, IL 61822-9678 | 2014-07-17 |
| Find all providers in CHAMPAIGN | ||||
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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.