JOSUE PORTILLO (NPI# 1912467119) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912467119 |
| Entity Type | Individual |
| Full Name | JOSUE PORTILLO |
| Practice Address |
2160 S 1st Ave Bldg 110 Maywood IL 60153-3328 |
| Mailing Address |
2160 S 1st Ave Maywood IL 60153-3328 |
| Practice Telephone | 7083272561 |
| Enumeration Date | 2019-03-22 |
| Last Update Date | 2019-06-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 125.075128 | IL | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | IL | Student, Health Care |
| Street Address |
2160 S 1ST AVE BLDG 110 |
| City | MAYWOOD |
| State | IL |
| Zip Code | 60153-3328 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972576833 | Edwin C. Mcgee | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2160 S 1st Ave Bldg 110, #6243, Maywood, IL 60153-3328 | 2006-02-10 |
| 1437617966 | Jeffrey Heiferman | Emergency Medicine | 2160 S 1st Ave Bldg 110, Maywood, IL 60153-3328 | 2019-03-04 |
| 1790280436 | Shannon Kathleen Sparrow | Emergency Medicine | 2160 S 1st Ave Bldg 110, Maywood, IL 60153-3328 | 2018-03-26 |
| 1437500345 | Ahmad Manshad | Internal Medicine | 2160 S 1st Ave Bldg 110, Maywood, IL 60153-3328 | 2016-06-22 |
| 1568625937 | Girish Venkataraman | Pathology | 2160 S 1st Ave Bldg 110, 2nd Flr. Pathology Rm 2222, Maywood, IL 60153-3328 | 2008-07-07 |
| 1285835413 | Amir Darki | Internal Medicine | 2160 S 1st Ave Bldg 110, Division of Cardiology,loyola University Medical Center, Maywood, IL 60153-3328 | 2007-05-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053933077 | Judie Noemie Hoilat | Internal Medicine | 2160 S 1st Avenue, Maywood, IL 60153 | 2020-05-13 |
| 1457972457 | Yuchen Zheng | Student in an Organized Health Care Education/Training Program | Department of Neurology, Loyola University Medical Cent, 2160 S. First Ave, Maywood, IL 60153 | 2020-04-30 |
| 1437779519 | Amna Amad Siddiqui | Student in an Organized Health Care Education/Training Program | 2160 S. First Avenue, Loyola University Medical Center, Maywood, IL 60153 | 2020-04-20 |
| 1982232211 | Brian Kurtz | Student in an Organized Health Care Education/Training Program | 2160 S First Ave, Bulding 105-suite 2840a, Maywood, IL 60153 | 2020-03-31 |
| 1902434947 | Saadiya Jabbar | Psychiatry & Neurology | Loyola University Medical Center, Building 105, Suite 1940, Maywood, IL 60153 | 2020-03-27 |
| 1558919472 | Linda Sue Moton | Technician | 10 South 15 Apt. 1, Maywood, IL 60153 | 2019-09-04 |
| 1760047518 | Braden Robert Dasovic | Student in an Organized Health Care Education/Training Program | 2160 S. First Avenue Building 105/room 2700, Department, Loyola Medical Center, Maywood, IL 60153 | 2019-05-07 |
| 1134680713 | Madeline Shaoyun Tiee | Orthopaedic Surgery | Loyola University Medical Center, 2160 S 1st Ave, Maywood, IL 60153 | 2019-03-27 |
| 1538629746 | Michael Murphy | Orthopaedic Surgery | 2160 S 1st Ave., Maguire Center, Dept of Ortho Surg, Maywood, IL 60153 | 2019-03-22 |
| 1053871681 | Michael V Padua | Psychiatry & Neurology | 2160 S 1st Ave Bldg, Maywood, IL 60153 | 2019-03-20 |
| Find all providers in zip 60153 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699304485 | Yana Klein | Emergency Medicine | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2020-04-03 |
| 1508494618 | Tallib Adam Karaze | Emergency Medicine | 2160 S 1st Ave, Emergency Department, Maywood, IL 60153-3328 | 2020-04-01 |
| 1679101448 | Andrew Thomas Reiter | Emergency Medicine | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2020-03-29 |
| 1356978316 | Cassandra Nichole Ward | Emergency Medicine | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2020-03-26 |
| 1518428994 | Travis Wassermann | Emergency Medicine | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2019-03-27 |
| 1972064855 | Andrea Anchen Yun | Emergency Medicine | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2019-03-25 |
| 1881154755 | Bailee Jacobsen | Emergency Medicine | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2019-03-25 |
| 1437617966 | Jeffrey Heiferman | Emergency Medicine | 2160 S 1st Ave Bldg 110, Maywood, IL 60153-3328 | 2019-03-04 |
| 1790280436 | Shannon Kathleen Sparrow | Emergency Medicine | 2160 S 1st Ave Bldg 110, Maywood, IL 60153-3328 | 2018-03-26 |
| 1447677455 | Travis Murphy | Emergency Medicine | 2160 S 1st Ave, 4300, Maywood, IL 60153-3328 | 2014-03-27 |
| Find all providers in MAYWOOD | ||||
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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.