TRINITY HEALTH PROVIDER LLC (NPI# 1932763539) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932763539 |
| Entity Type | Organization |
| Organization Name | TRINITY HEALTH PROVIDER LLC |
| Practice Address |
4756 N Lamon Ave Chicago IL 60630-3840 |
| Mailing Address |
7331 N Lincoln Ave Ste 15 Lincolnwood IL 60712-1766 |
| Practice Telephone | 2245188124 |
| Practice Fax Number | 8889095815 |
| Mailing Telephone | 8479838356 |
| Mailing Fax Number | 8889095815 |
| Enumeration Date | 2019-04-29 |
| Last Update Date | 2019-04-29 |
| Authorized Official Name | RENATO M CUERVO (PRESIDENT) |
| Authorized Official Telephone | 2245188124 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
4756 N LAMON AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60630-3840 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972116499 | Highland Park Cvs LLC | Durable Medical Equipment & Medical Supplies | 4631 W Foster Ave, Chicago, IL 60630 | 2020-08-25 |
| 1811419476 | Jill Swartzmiller | Occupational Therapist | 5248 N Liano Ave, Chicago, IL 60630 | 2017-07-14 |
| 1588193908 | Vanessa Landa | Behavior Technician | 4831 N Mobile, Chicago, IL 60630 | 2017-06-08 |
| 1851753784 | Claudia Melendez | Counselor | 4935 N Kedvale Ave., 1st Flr., Chicago, IL 60630 | 2016-03-21 |
| 1174983795 | Cheryl Ann Howe | Speech-Language Pathologist | 4714 N. Laramie Ave., Chicago, IL 60630 | 2016-02-24 |
| 1740657055 | Nihar Shah | Pharmacist | 4010 W Lawrence, Chicago, IL 60630 | 2015-08-24 |
| 1326450966 | Robert E Placzek | Dentist | 5650 W. Lawrence Ave., Chicago, IL 60630 | 2014-06-02 |
| 1730426545 | Violet Bernadet Mcguane | Nurse Practitioner | 4801 N Central, Chicago, IL 60630 | 2013-01-14 |
| 1639455231 | Jinnah A Caluag | Pharmacist | 4010 W. Lawrence, Chicago, IL 60630 | 2011-10-26 |
| 1255616256 | Marcus Kim | Pharmacist | 4010 W. Lawrence Ave, Chicago, IL 60630 | 2011-10-21 |
| Find all providers in zip 60630 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053911495 | Moataz Barkat | Family Medicine | 3315 W 66th Pl, Chicago, IL 60629-3427 | 2020-10-26 |
| 1558976589 | Jasmine Ashley Fowler | Family Medicine | 2416 N Lotus Ave, Chicago, IL 60639-1435 | 2020-09-15 |
| 1720699176 | Healing Hands Resource Center Streator | Family Medicine | 2128 S Central Park Ave, Chicago, IL 60623-3113 | 2020-08-10 |
| 1285251892 | Soe Lwin Oo | Family Medicine | 1625 E 75th St # 1, Chicago, IL 60649-3603 | 2020-06-30 |
| 1124645700 | Timothy Alan Williams Jr. | Family Medicine | 1625 E 75th St Fl 1, Chicago, IL 60649-3603 | 2020-06-30 |
| 1194340026 | Kaysha Lynne Ribao | Family Medicine | 2116 S Springfield Ave, Chicago, IL 60623-2465 | 2020-06-16 |
| 1932724341 | Toni Kurian | Family Medicine | 1550 S Indiana Ave Apt 407, Chicago, IL 60605-4822 | 2020-06-11 |
| 1528689486 | Thurman J Robertson | Family Medicine | 1950 W. Polk Street, 7th Floor, Chicago, IL 60612-3714 | 2020-05-01 |
| 1629697297 | Lyndsey Danielle Johnson | Family Medicine | 2804 W Walton St, Chicago, IL 60622-4450 | 2020-04-13 |
| 1730708884 | Iruoma Genevieve Nwangwu | Family Medicine | 1950 W Polk Street, Chicago, IL 60612-3714 | 2020-04-09 |
| Find all providers in CHICAGO | ||||
Please comment or provide details below to improve the information on TRINITY HEALTH PROVIDER LLC.
| 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.