DR. JAYME KWAK (NPI# 1750776233) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750776233 |
| Entity Type | Individual |
| Full Name | DR. JAYME KWAK |
| Credential | M.D. |
| Practice Address |
2500 W Reynolds St Pontiac IL 61764-9774 |
| Practice Telephone | 8158422828 |
| Enumeration Date | 2015-04-01 |
| Last Update Date | 2019-06-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 036.149594 | IL | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | 036.149594 | IL | Allopathic & Osteopathic Physicians |
| Street Address |
2500 W REYNOLDS ST |
| City | PONTIAC |
| State | IL |
| Zip Code | 61764-9774 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790735421 | Saint James Hospital | Emergency Medicine | 2500 W Reynolds St, Pontiac, IL 61764-9774 | 2006-05-11 |
| 1003421660 | Emily Ruff | Occupational Therapist | 2500 W Reynolds St, Pontiac, IL 61764-9774 | 2020-09-10 |
| 1760012637 | Stacey M Merrill | Nurse Practitioner | 2500 W Reynolds St, Pontiac, IL 61764-9784 | 2020-01-20 |
| 1699325514 | Brittany Nicole Bursott | Nurse Practitioner | 2500 W Reynolds St, Pontiac, IL 61764-9774 | 2019-09-12 |
| 1912561960 | Tessa Claire Hayes | Nurse Practitioner | 2500 W Reynolds St, Pontiac, IL 61764-9774 | 2019-04-25 |
| 1346708435 | Karissa Ann Neihouser | Physical Therapist | 2500 W Reynolds St, Pontiac, IL 61764-9774 | 2019-03-07 |
| 1659848612 | Melissa Horning | Specialist/Technologist | 2500 W Reynolds St, Pontiac, IL 61764-9774 | 2018-10-29 |
| 1497221840 | Allison Lynn Perkins | Occupational Therapist | 2500 W Reynolds St, Pontiac, IL 61764-9774 | 2018-10-23 |
| 1255818258 | Justin Ray Hayes | Registered Nurse | 2500 W Reynolds St, Pontiac, IL 61764-9774 | 2018-07-23 |
| 1083104137 | Nicole M. Jack | Physician Assistant | 2500 W Reynolds St, Pontiac, IL 61764 | 2018-05-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497165211 | Barbara Kay Browning | Counselor | 310 E. Torrance Ave, Pontiac, IL 61764 | 2014-05-01 |
| 1407287121 | Institute for Human Resources of Livingston County, Il | Community/Behavioral Health | 301 E Torrance Ave, Pontiac, IL 61764 | 2013-12-05 |
| 1982031241 | Annette G Franzen | Psychologist | 700 W Lincoln St # 406, Pontiac, IL 61764 | 2013-10-02 |
| 1871739185 | Woodridge of Ponitac LLC | Assisted Living Facility | 120 North Deerfield Road, Pontiac, IL 61764 | 2008-12-17 |
| 1861601171 | William Earl Hammond | Chiropractor | 210b Ladd, Pontiac, IL 61764 | 2007-05-22 |
| 1932259983 | Amy Duffy | Counselor | 210 W Water St Ste 1, Pontiac, IL 61764 | 2007-01-11 |
| 1326123340 | Highland Park Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 1034 W. Reynolds Street, Pontiac, IL 61764 | 2006-10-26 |
| 1205932977 | Gary Merl Leverton | Dentist | 518 West Madison St, Pontiac, IL 61764 | 2006-09-16 |
| 1891899886 | Robert E Heins | Family Medicine | 520 West Madison, Madison Street Clinic PC, Pontiac, IL 61764 | 2006-09-11 |
| 1710081708 | Kenneth N Jordan | Family Medicine | 520 West Madison Street, Madison Street Clinic PC, Pontiac, IL 61764 | 2006-09-11 |
| Find all providers in zip 61764 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346702719 | Jasmeet Ricky Garcha | Internal Medicine | 44405 Woodward Ave Dept Of, Pontiac, MI 48341-5023 | 2019-04-03 |
| 1861995813 | Ahmed Alqaysi | Internal Medicine | 44405 Woodward Ave # H23, Pontiac, MI 48341-5023 | 2018-03-16 |
| 1144757949 | Israa Oday Ghanim Al-gburi | Internal Medicine | 44405 Woodward Ave, H-23, St. Joseph Mercy Oakland, Pontiac, MI 48341 | 2017-05-11 |
| 1558744920 | Aneeqa Dar | Internal Medicine | 830 Golf Dr, Appt 202, Pontiac, MI 48341-2380 | 2015-07-02 |
| 1689056434 | Kedareeshwar Sanjay Arukala | Internal Medicine | 44405 Woodward Ave # H-23, Pontiac, MI 48341-5023 | 2015-06-28 |
| 1376885087 | Orthopedic PC | Internal Medicine | 35 S Johnson St Ste 3f, Pontiac, MI 48341-1662 | 2013-03-20 |
| 1578869707 | Andrew Henry Tilden | Internal Medicine | 700 W Lincoln St, Pontiac, IL 61764-2323 | 2011-02-05 |
| 1598788176 | Lawrence J Cowsill | Internal Medicine | 950 University Dr, Pontiac, MI 48342-1865 | 2006-07-25 |
| 1760443600 | Robert Melvin Phillips Jr. | Internal Medicine | 35 South Johnson Street, Suite 1b, Pontiac, MI 48341 | 2006-03-30 |
| 1649262080 | Kay Alexa Robertson | Internal Medicine | 44200 Woodward Ave, Suite 205, Pontiac, MI 48341-5045 | 2005-08-22 |
| Find all providers in PONTIAC | ||||
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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.