DR. MYSORE N SHIVARAM (NPI# 1841238979) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1841238979 |
Entity Type | Individual |
Full Name | DR. MYSORE N SHIVARAM |
Credential | M.D. |
Practice Address |
6901 Cermak Rd Berwyn IL 60402-2160 |
Practice Telephone | 7084845660 |
Practice Fax Number | 7084840194 |
Mailing Telephone | 7084845660 |
Mailing Fax Number | 7084840194 |
Enumeration Date | 2006-06-02 |
Last Update Date | 2010-06-22 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207RA0401X |
Internal Medicine Specialization: Addiction Medicine |
036044121 | IL | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IL | 036044121 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1750318903 | Mysore S Shivaram | Orthopaedic Surgery | 7400 W Rawson Ave, #225, Franklin, WI 53132-8278 | 2006-06-26 |
Street Address |
6901 CERMAK RD |
City | BERWYN |
State | IL |
Zip Code | 60402-2160 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679888341 | Mysore N Shivaram Md Sc | Internal Medicine | 6901 Cermak Rd, Berwyn, IL 60402-2160 | 2010-08-18 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619586518 | Lisa K Anderson-shaw | Clinical Ethicist | Macneal Trinity Medical Cetner, 3249 Oak Park Avenue, Berwyn, IL 60402 | 2020-07-27 |
1922622380 | Ayesha Ikram | Internal Medicine | Macneal Hospital 3249 S. Oak Park Ave, Brewyn, IL 60402 | 2020-06-02 |
1598329146 | Eleanor Teoh | Student in an Organized Health Care Education/Training Program | Family Medicine, Macneal Family Medicine Center, 3231 Eucild Ave, 5th Floor, Berwyn, IL 60402 | 2019-04-30 |
1376013920 | Virginia Mireles | Behavior Technician | 2317 S. Home, Berwyn, IL 60402 | 2018-11-27 |
1245709047 | Saraswati Koirala | Dentist | 1227 S Harlem Ave Apt414, Berwyn, IL 60402 | 2018-11-21 |
1295204220 | Dental Town Ltd | Dentist | 7106 W Cermak Rd, Berwyn, IL 60402 | 2018-11-20 |
1396231684 | Toya M Gildart | Counselor | Pillars, 6415 Stanley Avenue, Berwyn, IL 60402 | 2018-07-10 |
1437655685 | Ana Luisa Desantiago | Social Worker | 3245 Grove Ave Ste 201, Berwyn, IL 60402 | 2018-04-04 |
1821520198 | Chetan Velagapudi | Student in an Organized Health Care Education/Training Program | 3231 S Euclid Avenue, Suite 203, Berwyn, IL 60402 | 2017-03-28 |
1174976567 | Sydney Talavera | Counselor | 6415 Stanley Ave., Berwyn, IL 60402 | 2016-07-20 |
Find all providers in zip 60402 |
Taxonomy Code | 207RA0401X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Addiction Medicine |
An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine. |
Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679888341 | Mysore N Shivaram Md Sc | Internal Medicine | 6901 Cermak Rd, Berwyn, IL 60402-2160 | 2010-08-18 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1033343132 | Richard Joseph Wallyn | Internal Medicine | 1300 Brassie Ave., Flossmoor, IL 60422-1812 | 2009-05-05 |
1477752160 | Arthur Hoffman | Internal Medicine | 2652 Broadway Ave, Evanston, IL 60201 | 2007-07-13 |
1659300796 | Abhin Singla | Internal Medicine | 801 N Larkin Ave Ste 101, Joliet, IL 60435 | 2006-07-01 |
1659342665 | Albert C Tanlim | Internal Medicine | 845 S 4th St, Roberts Clinic Ltd, Watseka, IL 60970-1628 | 2006-01-28 |
1184189672 | Calumet Counseling and Dui Services,inc | Internal Medicine | 1010 W 95th St, Chicago, IL 60643-1522 | 2019-02-08 |
1407395346 | Bhs Physician Services of Illinois PC | Internal Medicine | 1237 E 1600 North Rd, Gilman, IL 60938-6112 | 2017-02-13 |
1588929525 | Opioid Addiction Recovery Services PC | Internal Medicine | 755 S Milwaukee Ave, Suite 210, Libertyville, IL 60048-3253 | 2012-07-05 |
1376819565 | Sahar Eftekhar | Internal Medicine | 1 E Superior St Ste 306, Chicago, IL 60611-2595 | 2012-04-01 |
1942585468 | Ngu Md. Wellness Ltd. | Internal Medicine | 400 E Randolph St, Apt 2711, Chicago, IL 60601-7329 | 2011-10-15 |
1184934036 | Mary S Wenzel | Internal Medicine | 3730 N Lake Shore Dr, Chicago, IL 60613-4236 | 2010-10-13 |
Find all providers with the same taxonomy |
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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.