DR. MICHAEL J BLACCONIERE (NPI# 1801977269) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801977269 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL J BLACCONIERE |
| Credential | PH.D. |
| Practice Address |
Hines Va Hospital 5th Ave & Roosevelt Rd Hines IL 60141 |
| Mailing Address |
1339 Margret St Des Plaines IL 60018-1522 |
| Practice Telephone | 7082022656 |
| Mailing Telephone | 8478276641 |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
71004033 | IL | Behavioral Health & Social Service Providers |
| Street Address |
HINES VA HOSPITAL 5TH AVE & ROOSEVELT RD |
| City | HINES |
| State | IL |
| Zip Code | 60141 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790739415 | Darrell Richard Nemec | Nurse Anesthetist, Certified Registered | Hines Va Hospital, Hines, IL 60141 | 2006-05-19 |
| 1750588471 | Gauri Khatkhate | Psychiatry & Neurology | Hines Va Hospital, Hines, IL 60141 | 2007-06-27 |
| 1659573368 | Vera Jean Cook | Occupational Therapist | Hines Va Hospital, Hines, IL 60141 | 2007-06-04 |
| 1346339470 | Jeffery P. Naour | Internal Medicine | Hines Va Hospital, Hines, IL 60141 | 2006-10-12 |
| 1326136037 | Jeffrey Ronald Kanofsky | Internal Medicine | Hines Va Hospital, Fifth Avenue & Roosevelt Road, Hines, IL 60141 | 2006-10-10 |
| 1497843353 | Robert S Chimis | Psychologist | Hines Va Hospital, Mental Health Clinic (116a3), Hines, IL 60141 | 2006-10-10 |
| 1811085798 | Lonnie C Edwards IIi | Internal Medicine | Hines Va Hospital, 5th & Roosevelt, Hines, IL 60141 | 2006-10-10 |
| 1578656450 | Sudha Bhoopalam | Internal Medicine | Hines Va Hospital, Hines, IL 60141 | 2006-10-02 |
| 1366542359 | Kristin Margaret Kirchwehm | Specialist/Technologist | Hines Va Hospital, Building 113, Hines, IL 60141 | 2006-09-22 |
| 1811094253 | Jamie Louise Ogarek | Specialist/Technologist | Hines Va Hospital, Building 113, Hines, IL 60141-5000 | 2006-09-20 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992273056 | Donizetti Razo | Social Worker | 5000 S. Fifth Avenue, Building 228, Room 4078, Hines, IL 60141 | 2018-11-07 |
| 1558838086 | Michael Calia | Social Worker | Patient Advocate Office #122, Edward Hines Jr. Va Hospital, 5000 S. 5th Avenue, Hines, IL 60141 | 2018-11-02 |
| 1639684640 | David Alan Edwards | Specialist/Technologist | 5000 S 5ht Ave, Building 113, Hines, IL 60141 | 2017-12-13 |
| 1689189706 | Joseph Jorgenson | Rehabilitation Practitioner | Hines Brc Bld 113, 5000 S 5th Ave, 124, Hines, IL 60141 | 2017-12-12 |
| 1154836823 | Kristy Bassett | Social Worker | 5000 S 5th Ave Bldg 2284n, Hines, IL 60141 | 2017-12-04 |
| 1396269387 | Aaron Jerome Brown | Kinesiotherapist | 5000 S 5th. Ave., Hines, IL 60141 | 2017-08-01 |
| 1932454634 | Michael Ladra Marquez | Physical Therapist | 5000 South 5th Ave., Edward Hines Jr. Va Hospital, Hines, IL 60141 | 2012-07-18 |
| 1437489713 | Linda Christime Bronski | Social Worker | Fifth Ave and Roosevelt Ave Bldg 228, Edward Hines Jr Va Hospital, Hines, IL 60141 | 2010-01-08 |
| 1700113859 | Sarah Jean Ostrowski | Recreation Therapist | 2100 S 5th Ave, Hines, IL 60141 | 2009-11-11 |
| 1841447299 | Narayanarao Madamala | Pharmacist | Hines Consolidated Mail Out Pharmacy, Building 37nw, Hines, IL 60141 | 2008-08-27 |
| Find all providers in zip 60141 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245593433 | Amanda C Taylor | Psychologist | 5000 S 5th Ave # 116b, Hines, IL 60141-3030 | 2012-06-21 |
| 1285714535 | Amanda Marie Urban | Psychologist | 5th Ave. and Roosevelt, Hines, IL 60141 | 2006-10-17 |
| 1386741015 | Rene Pichler-mowry | Psychologist | 5000 S. 5th Ave (psychology 116b), Hines, IL 60141-5000 | 2006-09-17 |
| 1891891230 | Kathleen Marie Richard | Psychologist | Edward Hines Jr. Veterans Administration Hospital, 5th Avenue and Roosesvelt Road, Hines, IL 60141 | 2006-09-15 |
| 1861506248 | William Jeffrey Canar | Psychologist | Hines Va, Sci Center, Bldg 128, Hines Va, Sci Center, Bldg 128, Hines, IL 60141-5000 | 2006-08-19 |
| 1659485019 | Caroline King Hawk | Psychologist | 1 Fifth Avenue & Roosevelt Road, Hines Va Hospital, Sci Center Building 128, Hines, IL 60141 | 2006-08-19 |
| 1578570941 | Richard L Greenblatt | Psychologist | Hines Va Hospital, 1st Ave & Roosevelt Road, Psychology Service (116b), Hines, IL 60141-5000 | 2006-08-01 |
| 1801832076 | Ronald F Cunat | Psychologist | Hines Va Medical Center, Ambulatory Care Comp and Pension, Hines, IL 60141 | 2006-06-22 |
| 1114982451 | Kelly Phipps Maieritsch | Psychologist | 5th & Roosevelt Rd, Hines, IL 60141 | 2006-04-19 |
| 1922646108 | Michael Niznikiewicz | Psychologist | 5000 S 5th Ave Bldg 128, Hines, IL 60141-3030 | 2019-12-18 |
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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.