ANDREA RENEE BEVOLO (NPI# 1932695251) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932695251 |
| Entity Type | Individual |
| Full Name | ANDREA RENEE BEVOLO |
| Credential | PA-C |
| Practice Address |
10330 S Roberts Rd Palos Hills IL 60465-1971 |
| Mailing Address |
19065 Hickory Creek Dr Ste 210 Mokena IL 60448-8597 |
| Practice Telephone | 7082377200 |
| Practice Fax Number | 7082377201 |
| Mailing Telephone | 7082377200 |
| Mailing Fax Number | 7082377201 |
| Enumeration Date | 2018-07-10 |
| Last Update Date | 2018-10-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 19065 Hickory Creek Dr Ste 210, Mokena, IL 604488597 | 7082377200 | 7082377201 |
| 2315 E 93rd St Ste 336, Chicago, IL 606173948 | 7082377200 | 7082377201 |
| Street Address |
10330 S ROBERTS RD |
| City | PALOS HILLS |
| State | IL |
| Zip Code | 60465-1971 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649261298 | Mark Kuklewicz | Physical Therapist | 10330 S Roberts Rd, Palos Hills, IL 60465-1971 | 2005-11-02 |
| 1316550957 | Sarah Catherine Probst | Physical Therapist | 10330 S Roberts Rd, Palos Hills, IL 60465-1971 | 2020-08-24 |
| 1720640030 | Tyler James Louviere | Physician Assistant | 10330 S Roberts Rd, Palos Hills, IL 60465-1971 | 2019-07-08 |
| 1982189189 | Michael Z Szypulinski | Physician Assistant | 10330 S Roberts Rd, Palos Hills, IL 60465-1971 | 2018-10-03 |
| 1720568207 | Jennifer Rose Applequist | Physician Assistant | 10330 S Roberts Rd, Palos Hills, IL 60465 | 2018-08-15 |
| 1720575970 | Kaitlin Dowling | Occupational Therapist | 10330 S Roberts Rd, Palos Hills, IL 60465-1971 | 2018-04-13 |
| 1346765377 | Jon Kelley Schwermer | Physician Assistant | 10330 S Roberts Rd, Palos Hills, IL 60465-1971 | 2017-08-10 |
| 1437517703 | Andrzej Waclaw | Occupational Therapist | 10330 S Roberts Rd, Palos Hills, IL 60465-1971 | 2016-02-02 |
| 1699144345 | Kristen M Andel | Physician Assistant | 10330 S Roberts Rd, Palos Hills, IL 60465-1971 | 2015-09-23 |
| 1649656968 | Rhonda Krisik | Physical Therapy Assistant | 10330 S Roberts Rd, Palos Hills, IL 60465-1971 | 2015-08-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306368774 | Cuttings Edge Medical Transit, Inc. | Non-emergency Medical Transport (VAN) | 10612 S Roberts Rd, Suite 10, Palos Hills, IL 60465 | 2017-07-07 |
| 1447781653 | Zain Rehman | Registered Nurse | 10571 Palos Pl, Unit A, Palos Hills, IL 60465 | 2017-03-21 |
| 1770956476 | Judita Slusnys | Nurse Practitioner | 11051 S. 84th Ave, Palos Hills, IL 60465 | 2015-11-04 |
| 1154755098 | Catherine D Moore | Counselor | 9962 Hill Terrence Building 23 Apt 212, Palos Hill, IL 60465 | 2013-08-28 |
| 1770866964 | Dominika Sekulska | Counselor | 10537 South Roberts Road, Palos Hills, IL 60465 | 2011-09-23 |
| 1851686950 | Metropolitan Family Services | Community Based Residential Treatment Facility, Mental Illness | 10537 Roberts Road, Palos Hill, IL 60465 | 2011-06-16 |
| 1205129764 | Zbigniev Durlak | Preventive Medicine | 9930 Stratford L, Palos Hills, IL 60465 | 2011-05-17 |
| 1962562322 | James D Michalarias | Dentist | 9900 S Roberts Rd, Palos Hills, IL 60465 | 2006-12-08 |
| 1912072729 | Illinois Wisconsin Sertoma Regional Center for Communicative Disorders | Speech-Language Pathologist | 10409 South Roberts Road, Palos Hills, IL 60465 | 2006-11-21 |
| 1831201235 | William George Revethis | Internal Medicine | 10400 Roberts Rd, Suite B, Palos Hills, IL 60465 | 2006-08-31 |
| Find all providers in zip 60465 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720640030 | Tyler James Louviere | Physician Assistant | 10330 S Roberts Rd, Palos Hills, IL 60465-1971 | 2019-07-08 |
| 1720568207 | Jennifer Rose Applequist | Physician Assistant | 10330 S Roberts Rd, Palos Hills, IL 60465 | 2018-08-15 |
| 1699144345 | Kristen M Andel | Physician Assistant | 10330 S Roberts Rd, Palos Hills, IL 60465-1971 | 2015-09-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477169522 | Priority Assist Pllc | Physician Assistant | 48 Glenda Ln, Plano, IL 60545-9652 | 2020-09-23 |
| 1154944478 | Diana Goldak | Physician Assistant | 3855 N Parkway Dr Apt 3a, Northbrook, IL 60062-7218 | 2020-05-20 |
| 1033742580 | Colleen Courtney | Physician Assistant | 218 S Driftwood Trl, Mchenry, IL 60050-5454 | 2020-02-12 |
| 1326678962 | Nina Kodros | Physician Assistant | 301 Madison St Ste 280, Joliet, IL 60435-6672 | 2020-01-23 |
| 1689218190 | Jennifer Richman | Physician Assistant | 1890 Silver Cross Blvd Ste 410, New Lenox, IL 60451-9547 | 2019-10-29 |
| 1710547625 | Nadia Khan | Physician Assistant | 4543 N Malden St Apt 1s, Chicago, IL 60640-5687 | 2019-06-13 |
| 1962065516 | Jorge Mantilla | Physician Assistant | 5540 N Kimball Ave Apt 3e, Chicago, IL 60625-4674 | 2019-04-18 |
| 1013479955 | Leah Rae Prager | Physician Assistant | 4400 W. 95th St., Attn: Pediatric General Surgery, Oak Lawn, IL 60453 | 2019-04-01 |
| 1770041949 | Laura Ann Ryan | Physician Assistant | 840 S Wood St Ste 417, Chicago, IL 60612-4325 | 2019-03-06 |
| 1548739782 | Helen Finke | Physician Assistant | 880 W Central Rd Ste 3300, Arlington Heights, IL 60005-2366 | 2018-11-16 |
| Find all providers with the same taxonomy | ||||
| City | PALOS HILLS |
| Zip Code | 60465 |
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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.