DR. WALID MAALOULI (NPI# 1912079609) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912079609 |
| Entity Type | Individual |
| Full Name | DR. WALID MAALOULI |
| Credential | M.D. |
| Practice Address |
6501 S Promontory Dr Chicago IL 60649-1003 |
| Practice Telephone | 7732565733 |
| Practice Fax Number | 7733636527 |
| Mailing Telephone | 7732565733 |
| Mailing Fax Number | 7733636527 |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2013-05-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
036089639 | IL | Allopathic & Osteopathic Physicians |
| N | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
43201 | MN | Allopathic & Osteopathic Physicians |
| Street Address |
6501 S PROMONTORY DR |
| City | CHICAGO |
| State | IL |
| Zip Code | 60649-1003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447261524 | Jennifer Lynn Miller | Pediatrics | 6501 S Promontory Dr, Chicago, IL 60649-1003 | 2006-08-11 |
| 1154920122 | Saja Froukh | Dietitian, Registered | 6501 S Promontory Dr, Chicago, IL 60649-1002 | 2020-10-21 |
| 1982201463 | Leilani Reyes | Nurse Practitioner | 6501 S Promontory Dr, Chicago, IL 60649-1002 | 2020-10-07 |
| 1417572603 | Mixi Lopez-corbin | Social Worker | 6501 S Promontory Dr, Chicago, IL 60649-1003 | 2020-06-12 |
| 1639798242 | Erika Joy Meier | Dietitian, Registered | 6501 S Promontory Dr, Chicago, IL 60649-1002 | 2020-04-14 |
| 1033757349 | Arianna Timko | Counselor | 6501 S Promontory Dr, Chicago, IL 60649-1002 | 2019-12-17 |
| 1992347637 | Allison Rosen | Occupational Therapist | 6501 S Promontory Dr, Chicago, IL 60649-1002 | 2019-10-15 |
| 1780236687 | Andrea Rehr | Physical Therapist | 6501 S Promontory Dr, Chicago, IL 60649-1003 | 2019-07-10 |
| 1821562810 | Haleigh Alexandria Nierman | Occupational Therapist | 6501 S Promontory Dr, Chicago, IL 60649-1003 | 2019-01-14 |
| 1700350766 | Codi Lesniewski | Physical Therapist | 6501 S Promontory Dr, Chicago, IL 60649-1002 | 2019-01-14 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386250199 | A Safe Haven, L.L.C. | Clinic/Center | 7342-46 S Kingston, Chicago, IL 60649 | 2020-09-17 |
| 1477178713 | Angela K Coleman | Counselor | 1955 E 71st Street, Chicago, IL 60649 | 2020-06-12 |
| 1245880715 | Familydoc Urgent Care LLC | Clinic/Center | 7201 S Stony Island Ave, Chicago, IL 60649 | 2019-09-17 |
| 1912498668 | Venessel N/a Woodson I | Radiology | 7674 S. Southshore Dr #1n, Chicago, IL 60649 | 2018-05-29 |
| 1689117764 | Susana Jimenez | Occupational Therapy Assistant | 2649 E. 75th St, Chicago, IL 60649 | 2016-11-22 |
| 1063863579 | Regina Whittmon | Driver | 7808 S Coles Ave Apt 3, Chicago, IL 60649 | 2016-06-27 |
| 1174912356 | Montsho Gallardo | Doula | 7653 S Coles Ave, Chicago, IL 60649 | 2015-01-12 |
| 1780922120 | April Ong | Physical Therapist | 6700 S Oglesby Ave, Apt 1906, Chicago, IL 60649 | 2013-01-18 |
| 1114288594 | Days Adult Day Care and Personal Care Providers Inc | Clinic/Center | 2455 E 75th St, Chicago, IL 60649 | 2012-06-02 |
| 1891064887 | Kevin Forrest | Occupational Therapist | 2425 E. 71st Street, Chicago, IL 60649 | 2011-12-20 |
| Find all providers in zip 60649 | ||||
| Taxonomy Code | 2080A0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Adolescent Medicine |
| A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417259979 | Adolescent and Young Adult Place Ltd | Pediatrics | 9 N Cicero Ave, Chicago, IL 60644-3602 | 2010-12-03 |
| 1942520671 | Cherie Priya Dhar | Pediatrics | 1440 N Dayton St Fl 3, Chicago, IL 60642-2644 | 2010-06-04 |
| 1649475377 | Lisa Kantz Simons | Pediatrics | 225 E Chicago Ave # Ms 161b, Chicago, IL 60611-2991 | 2007-06-21 |
| 1417966789 | Sudha V. Shah | Pediatrics | 1516 W Devon Ave, Chicago, IL 60660-1314 | 2006-08-05 |
| 1447259759 | Kimberly A. Koval | Pediatrics | 1030 N Clark St, Suite 400, Chicago, IL 60610-5467 | 2005-07-19 |
| 1235451402 | Felicia Scott | Pediatrics | 1725 W Harrison St, Suite 710, Chicago, IL 60612-3841 | 2010-02-15 |
| 1124260625 | Sonia Wengerhoff | Pediatrics | 2835 N Sheffield Ave, Suite 501, Chicago, IL 60657-5081 | 2009-03-30 |
| 1275773475 | My Pediatrics Associates LLC | Pediatrics | 2875 W 19th St, Chicago, IL 60623-3501 | 2009-02-27 |
| 1528233087 | Nava Segall Md Sc | Pediatrics | 4116 N Lincoln Ave, Chicago, IL 60618-3028 | 2008-04-25 |
| 1093934275 | The Board of Trustees of The University of Illinois | Pediatrics | 840 S Wood St, Chicago, IL 60612-4325 | 2007-04-25 |
| 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.