Irene Thevatheril (NPI# 1336190529, PAC ID# 5092706754) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1336190529 |
| PAC ID by PECOS | 5092706754 |
| Professional Enrollment ID | I20040520001304 |
| Full Name | Irene Thevatheril |
| Organization Legal Name | ADVENTIST MIDWEST HEALTH |
| Address |
1325 Community Memorial Dr La Grange IL 60525-2659 |
| Phone Number | 7082458900 |
| Gender | F |
| Credential | MD |
| Medical School | BALTIMORE UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1998 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 2769790401 |
| Number of Group Practice Members | 32 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 140122 | HINSDALE HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1325 Community Memorial Dr, La Grange, IL 60525-2659 | 7082458900 | ADVENTIST MIDWEST HEALTH |
| 5201 Willow Springs Rd, La Grange, IL 60525-6537 | 7082458900 | ADVENTIST MIDWEST HEALTH |
| 3080 Ogden Ave, Suite 204, Lisle, IL 60532-1694 | 6307343044 | CORNERSTONE FAMILY HEALTH S.C. |
| Organization Legal Name | ADVENTIST MIDWEST HEALTH |
| Physicians | 24 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sarah Kay Welch | Family Medicine | Adventist Midwest Health | 5101 Willow Springs Rd, La Grange, IL 60525-2600 |
| Alyssa J Vest Hart | Family Medicine | Adventist Midwest Health | 120 N Oak St, Hinsdale, IL 60521-3829 |
| Leslie E Sleuwen | Family Medicine | Adventist Midwest Health | 135 N Oak St, Hinsdale, IL 60521-3860 |
| Leo J Koenig | Family Medicine | Adventist Midwest Health | 1325 Community Memorial Dr, La Grange, IL 60525-2659 |
| Daphne S Tessalee | Family Medicine | Adventist Midwest Health | 5101 Willow Springs Rd, La Grange, IL 60525-2600 |
| Charles E Burda | Psychiatry | Adventist Midwest Health | 120 N Oak St, Hinsdale, IL 60521-3829 |
| Kate K Gunnell | Family Medicine | Adventist Midwest Health | 135 N Oak St, Hinsdale, IL 60521-3860 |
| Antoinette B Lullo | Family Medicine | Adventist Midwest Health | 120 N Oak St, Hinsdale, IL 60521-3829 |
| Sheena Aleena Eettickal | Family Medicine | Adventist Midwest Health | 120 N Oak St, Hinsdale, IL 60521-3829 |
| Elizabeth Bockhold | Family Medicine | Adventist Midwest Health | 120 N Oak St, Hinsdale, IL 60521-3829 |
| Street Address |
1325 COMMUNITY MEMORIAL DR |
| City | LA GRANGE |
| State | IL |
| Zip | 60525-2659 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Leo J Koenig | Family Medicine | Adventist Midwest Health | 1325 Community Memorial Dr, La Grange, IL 60525-2659 |
| Lisa Lin | Nurse Practitioner | Adventist Midwest Health | 1325 Community Memorial Dr, La Grange, IL 60525-2659 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mark J Sedory | Podiatry | 132 N Catherine Ave, La Grange, IL 60525-1828 | |
| James J Cannon | Anesthesiology | Dupage Valley Anesthesiologists, Ltd. | 120 N La Grange Rd, La Grange, IL 60525-2040 |
| Sasha M Demos | Anesthesiology | Dupage Valley Anesthesiologists, Ltd. | 120 N La Grange Rd, La Grange, IL 60525-2040 |
| John M Bockrath | Urology | United Shockwave Services Ltd | 120 N La Grange Rd, La Grange, IL 60525-2040 |
| Davis P Yang | Family Medicine | Gottlieb Community Health Services Corporation | 125 N La Grange Rd, La Grange, IL 60525-2041 |
| Eliza J Pierko | Internal Medicine | Gottlieb Community Health Services Corporation | 125 N La Grange Rd, La Grange, IL 60525-2041 |
| Kristin L Ross | Registered Dietitian Or Nutrition Professional | Vhs of Illinois Inc | 125 N La Grange Rd, La Grange, IL 60525-2041 |
| Carolyn Gordon | Registered Dietitian Or Nutrition Professional | Vhs of Illinois Inc | 125 N La Grange Rd, La Grange, IL 60525-2041 |
| Kathryn E Wirth | Physical Therapy | Athletic and Therapeutic Institute of Naperville LLC | 1 N La Grange Rd Unit, Ati Physical Therapy, Lagrange, IL 60525-2047 |
| Erin Scheiber | Physical Therapy | Athletic and Therapeutic Institute of Naperville LLC | 1 N La Grange Rd Unit, Ati Physical Therapy, Lagrange, IL 60525-2047 |
| Find all physicians in zip 60525 | |||
| City | LA GRANGE |
| Zip Code | 60525 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | LA GRANGE + FAMILY MEDICINE |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.