HEALTHWISE MEDICAL CLINIC LLC (NPI# 1720474885) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720474885 |
| Entity Type | Organization |
| Organization Name | HEALTHWISE MEDICAL CLINIC LLC |
| Practice Address |
8349 S Baltimore Ave Chicago IL 60617-2110 |
| Practice Telephone | 7739785291 |
| Mailing Telephone | 7739785291 |
| Enumeration Date | 2015-04-15 |
| Last Update Date | 2015-04-15 |
| Authorized Official Name | DR. MARIE MYRLANDE KERNIZAN (OWNER) |
| Authorized Official Telephone | 7739785291 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 036.099858 | IL | Allopathic & Osteopathic Physicians |
| Street Address |
8349 S BALTIMORE AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60617-2110 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871102921 | Manuel Lule | Physical Therapy Assistant | 9535 S Jeffery Boulevard, Chicago, IL 60617 | 2020-07-24 |
| 1083253546 | Vanaja Thotten | Internal Medicine | 8012 S.crandon Ave, Chicago, IL 60617 | 2020-01-02 |
| 1427527365 | Stony Island Dental PC | Dentist | 1600 E 93rd Street, Chicago, IL 60617 | 2018-11-21 |
| 1871060301 | Tamika Nicole Whitehead | Social Worker | 2822 East 83rd Street, Chicago, IL 60617 | 2018-11-02 |
| 1528543774 | Felicia Nwankwo | Nurse Practitioner | 2822 E 83rd Street Bradond Famiy Health Cener, Chicago, IL 60617 | 2018-10-03 |
| 1972099307 | David Phan | Optometrist | 1753 E 95th St Ste B-100, Chicago, IL 60617 | 2018-07-09 |
| 1831607340 | Pamela Evette Ewing | Counselor | 9145 S. Merrill Ave, Chicago, IL 60617 | 2018-01-18 |
| 1366976631 | Ali Mostafa Serhal | Radiology | 240 E. Huron St, Suite 1-203, Chicago, IL 60617 | 2017-04-13 |
| 1447784921 | 1915-25 95th St., LLC | Clinic/Center | 1915 E 95th St, Chicago, IL 60617 | 2017-04-12 |
| 1881140408 | Yeferson Laverde | Social Worker | 3062 East 31st, Chicago, IL 60617 | 2016-09-01 |
| Find all providers in zip 60617 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
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| 1952809451 | Josie M Abogast | General Practice | 3219 N. Clark St., Chicago, IL 60657 | 2018-01-30 |
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| 1215482567 | David John De Jong | General Practice | 226 W Willow St, Chicago, IL 60614-5716 | 2016-08-16 |
| 1578952321 | Joseph Lawrence Mcdevitt | General Practice | 2650 N Orchard St Apt 2f, Chicago, IL 60614-1576 | 2015-01-16 |
| 1548662851 | Healthjoy | General Practice | 208 W Huron St, Chicago, IL 60654-3913 | 2014-09-17 |
| 1629478359 | Alivio Medical Center | General Practice | 1450-1510 W. Cermak Road, Chicago, IL 60608 | 2014-08-29 |
| 1699193409 | Kenya R Thomas | General Practice | 1133 E 83rd St Unit 108, Chicago, IL 60619-6464 | 2014-03-31 |
| 1649612961 | Steven Craig Fox | General Practice | 125 North Halsted Street, Suite 303, Chicago, IL 60661-2156 | 2013-07-29 |
| Find all providers in CHICAGO | ||||
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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.