DR. JUAN C. JIMENEZ (NPI# 1801992516) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801992516 |
| Entity Type | Individual |
| Full Name | DR. JUAN C. JIMENEZ |
| Credential | MD |
| Practice Address |
400 N Wall St Suite 402 Kankakee IL 60901-2940 |
| Practice Telephone | 8159327200 |
| Practice Fax Number | 8159357874 |
| Mailing Telephone | 8159327200 |
| Mailing Fax Number | 8159357874 |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2012-01-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207T00000X | Neurological Surgery | 036103254 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BC GROUP NUMBER | 4632039 | 01 |
| IL | 36103254 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295341337 | Juan Miguel Jimenez | Counselor | 713 Nw 139th St, Edmond, OK 73013-1912 | 2020-09-22 |
| 1235759788 | Juan Jimenez Jr. | Technician, Pathology | 1860 E 120th St, Los Angeles, CA 90059 | 2020-04-24 |
| 1376199760 | Juan M Jimenez | Assistant Behavior Analyst | 529 W 6th St, Port Angeles, WA 98362-5805 | 2019-08-13 |
| 1073836623 | Juan Antonio Jimenez | Urology | 18099 Lorain Ave Ste 141, Cleveland, OH 44111-5611 | 2010-03-10 |
| 1144414665 | Juan Ramon Jimenez | Anesthesiology | Carr 2 Km 129.3, Bo Victoria, Aguadilla, PR 00603 | 2007-08-28 |
| 1205046802 | Juan R Jimenez | Occupational Therapy Assistant | 75-59 263 Street, Glen Oaks, NY 11421 | 2007-05-23 |
| 1134245137 | Juan Francisco Jimenez | Acupuncturist | 4505 West Flagler Street, Suite 101, Miami, FL 33134 | 2007-03-21 |
| 1861400715 | Juan R Jimenez | Pediatrics | 48 Calle Henna, Urb El Cibao, Cobo Rojo, PR 00623 | 2006-08-04 |
| 1982643318 | Juan Carlos Jimenez | Surgery | 200 Ucla Medical Plz Ste 526, Los Angeles, CA 90095-0001 | 2006-06-04 |
| 1750340691 | Juan B Jimenez | Pediatrics | 15 Munoz Rivera St, Lares, PR 00669 | 2006-03-20 |
| Street Address |
400 N WALL ST SUITE 402 |
| City | KANKAKEE |
| State | IL |
| Zip Code | 60901-2940 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194781112 | Safwat G. Iskander | Pediatrics | 400 N Wall St, Suite 312, Kankakee, IL 60901-2940 | 2006-04-26 |
| 1982076329 | Cross Country Home Health LLC | Home Health | 400 N Wall St, Ste 308, Kankakee, IL 60901-2940 | 2015-10-26 |
| 1770905093 | Yalamanchili Obgyn Sc | Obstetrics & Gynecology | 400 N Wall St, Suite 403, Kankakee, IL 60901-2940 | 2014-01-07 |
| 1851683528 | Cheryl Ann Olofsson | Registered Nurse | 400 N Wall St, Suite 510, Kankakee, IL 60901-2940 | 2011-05-12 |
| 1982928917 | Adam M Weaver | Physician Assistant | 400 N Wall St, Suite 402, Kankakee, IL 60901-2940 | 2010-03-19 |
| 1962677450 | S David Lang Md Limited | Surgery | 400 N Wall St, Ste 410, Kankakee, IL 60901-2963 | 2008-04-25 |
| 1831229574 | Neurology Ltd | Psychiatry & Neurology | 400 N Wall St, #507, Kankakee, IL 60901-2965 | 2007-03-06 |
| 1740323096 | Oakside Corporation | Pharmacy | 400 N Wall St, Suite One, Kankakee, IL 60901-2940 | 2007-02-15 |
| 1891838314 | Thomas Paul Marcotte | Pharmacist | 400 N Wall St, Suite One, Kankakee, IL 60901-2940 | 2007-02-15 |
| 1356488621 | Regan Lane Kendregan | Family Medicine | 400 N Wall St, Ste 510, Kankakee, IL 60901-2940 | 2007-01-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558978841 | William Mitsos Dds | Dentist | 1291 S. 7th Ave, Kankakee, IL 60901 | 2020-09-30 |
| 1922653682 | Jody Mcguyer, Lcpc, Cadc Counseling Services, LLC | Counselor | 315 W. Court St., Kankakee, IL 60901 | 2019-08-08 |
| 1700346327 | Sarah Elizabeth Toma | Speech-Language Pathologist | 200 E Court St #708, Kankakee, IL 60901 | 2019-03-20 |
| 1710473160 | Small Talk Speech Services, LLC | Clinic/Center | 1439 W Vanmeter St, Kankakee, IL 60901 | 2018-07-09 |
| 1124538004 | Amy J Green | Physical Therapist | 350 N. Wall Street, Kankakee, IL 60901 | 2017-10-05 |
| 1013457514 | Elizabeth Ann Smith | Registered Nurse | 292 Charlton Lane, Kankakee, IL 60901 | 2017-03-02 |
| 1861931461 | Stacey E. Brown | Nurse Practitioner | 207 N. Schuyler Ave., Kankakee, IL 60901 | 2017-02-15 |
| 1417352105 | Provider Healthcare Services, Inc | Home Health | 555 South Schuyler, Suite 275, Kankakee, IL 60901 | 2014-10-24 |
| 1265850655 | Ronald George Testa | Dentist | 202 N. Schuyler Ave, Kankakee, IL 60901 | 2014-04-02 |
| 1245587898 | Mary Beth Wertz | Registered Nurse | 100 N Jeffery Street, Kankakee, IL 60901 | 2012-08-13 |
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| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295029510 | Nicholas Brandl Rossi | Neurological Surgery | 375 N Wall St Ste P530, Kankakee, IL 60901-3486 | 2011-06-03 |
| 1194035360 | Michel H. Malek, Md Sc | Neurological Surgery | 555 W Court St, Suite 412, Kankakee, IL 60901-3664 | 2010-10-20 |
| 1235235938 | Charles F. Harvey | Neurological Surgery | 400 N Wall St, Suite 304, Kankakee, IL 60901-2940 | 2006-09-16 |
| 1548374838 | Michel H Malek | Neurological Surgery | 555 W Court St, Suite 412, Kankakee, IL 60901-3664 | 2006-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871114371 | Justin Michael | Neurological Surgery | 701 N 1st St Ste D-319, Springfield, IL 62702-3757 | 2020-05-06 |
| 1023678638 | Matthew Weber | Neurological Surgery | 701 N 1st St, Suite D-319, Springfield, IL 61702 | 2019-06-17 |
| 1891281499 | Kamran Khan, Sc | Neurological Surgery | 1890 Silver Cross Blvd Ste 450, New Lenox, IL 60451-9518 | 2018-07-06 |
| 1881124030 | Denise Brunozzi | Neurological Surgery | 912 South Wood Street, 451 N - Hc 739, Chicago, IL 60612 | 2017-06-19 |
| 1407218365 | St Anthonys Physician Organization of Illinois | Neurological Surgery | 211 S Burns Ave, Sparta, IL 62286-1895 | 2016-03-22 |
| 1225455181 | Jehad Algharabli | Neurological Surgery | 2218 S Leavitt St, Chicago, IL 60608-4008 | 2014-03-27 |
| 1992041461 | Gursant Atwal | Neurological Surgery | University of Il Hospital & Health Science System, 1740 W Taylor St, Chicago, IL 60612 | 2013-01-02 |
| 1629321112 | James Bruce Mansfield | Neurological Surgery | 5 Loch Ln, South Barrington, IL 60010-9532 | 2012-10-21 |
| 1639445877 | Joseph R Rivas | Neurological Surgery | 511 W Belmont Ave, #32, Chicago, IL 60657-4663 | 2012-03-30 |
| 1356637722 | Melissa M Stamates | Neurological Surgery | 2650 Ridge Ave Fl 3, Evanston, IL 60201 | 2011-06-23 |
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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.