PHYSICIAN MANAGEMENT SERVICES OF ILLINOIS, LLC (NPI# 1962935924) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962935924 |
| Entity Type | Organization |
| Organization Name | PHYSICIAN MANAGEMENT SERVICES OF ILLINOIS, LLC |
| Practice Address |
7900 N Milwaukee Ave Ste 2-33 Niles IL 60714-3240 |
| Mailing Address |
3113 Lawton Rd Ste 250 Orlando FL 32803-3517 |
| Practice Telephone | 8888298550 |
| Mailing Telephone | 8888298550 |
| Enumeration Date | 2017-04-06 |
| Last Update Date | 2019-09-20 |
| Authorized Official Name | BRETT KENEFICK (PRESIDENT) |
| Authorized Official Telephone | 8888298550 |
| Is Organization Subpart | Y |
| Parent Organization Name | VAXCARE CORPORATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 036.06653 | IL | Allopathic & Osteopathic Physicians |
| Street Address |
7900 N MILWAUKEE AVE STE 2-33 |
| City | NILES |
| State | IL |
| Zip Code | 60714-3240 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992277347 | Superior Nursing Services LLC | Registered Nurse | 8852 N. Milwaukee Ave, Niles, IL 60714 | 2018-12-26 |
| 1669904124 | Ralph N. Robbins D.d.s., Ltd. | Dentist | 241 Golf Mill Prof. Bldg. Suite 905, Niles, IL 60714 | 2017-04-03 |
| 1962947010 | The Thresholds | Community/Behavioral Health | 8842 Prospect Ave, Niles, IL 60714 | 2016-12-28 |
| 1548632367 | Kristine Pallarca | Pharmacist | 9000 W. Golf Rd, Niles, IL 60714 | 2015-10-21 |
| 1326421082 | Zuber Koya | Optometrist | 5762 W Touhy Ave, Niles, IL 60714 | 2015-06-30 |
| 1881074193 | Northwest Podiatry Center | Durable Medical Equipment & Medical Supplies | 7954 Oakton Avenue, Niles, IL 60714 | 2015-06-02 |
| 1184039430 | Care Plus Outpatient Therapy Inc. | Occupational Therapy Assistant | 8118 N Milwaukee Ave Ste 107, Niles, IL 60714 | 2014-06-25 |
| 1750704888 | Daniel Charles Smith | Social Worker | 241golf Mill Center Suite 708, Niles, IL 60714 | 2014-01-24 |
| 1285062356 | Benjamin Trukman | Physical Therapist | 8269 West Golf Rd, Niles, IL 60714 | 2013-10-28 |
| 1750643698 | Matthew James Howard | Pediatrics | 6450 W Touhy Ave, Niles, IL 60714 | 2012-06-15 |
| Find all providers in zip 60714 | ||||
| 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 |
|---|---|---|---|---|
| 1194378588 | Breann J Melago | Family Medicine | 1875 Taft Ave, Niles, OH 44446-4117 | 2019-07-24 |
| 1215459235 | John Mourad Zakhary | Family Medicine | 1951 Oak St, Niles, MI 49120-3738 | 2017-07-11 |
| 1609183045 | Peter F Mckay | Family Medicine | 2122 Robbins Ave Apt 138, Niles, OH 44446-3968 | 2010-09-07 |
| 1053559898 | Chicago Mental Health Day Program and Wellness Clinic | Family Medicine | 8926 Greenwood, Suite 167, Niles, IL 60714 | 2009-02-02 |
| 1710105671 | Margaret Marie Dolan | Family Medicine | 9016 W Heathwood Cir, Niles, IL 60714-5807 | 2007-04-23 |
| 1306967724 | Guntippar S Pratumngern | Family Medicine | 7255 N Caldwell Ave, Niles, IL 60714-4501 | 2007-04-03 |
| 1316079593 | Romeo Lagrosa | Family Medicine | 8965 W Golf Rd, Niles, IL 60714-5812 | 2007-03-12 |
| 1376690438 | Phillip Paul Malvasi | Family Medicine | 1017 Youngstown Warren Rd, Niles, OH 44446-4620 | 2007-01-04 |
| 1700981537 | Yang W Yeom | Family Medicine | 8965 Golf Road, Niles, IL 60714 | 2006-09-14 |
| 1679582001 | Charles H Rhodes | Family Medicine | 4 Long Meadow Village Dr, Suite 2, Niles, MI 49120-7809 | 2006-08-05 |
| Find all providers in NILES | ||||
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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.