BRYCIE WEIDEN (NPI# 1003425786) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003425786 |
| Entity Type | Individual |
| Full Name | BRYCIE WEIDEN |
| Credential | PSY.D. |
| Practice Address |
515 Ne Glen Oak Ave Ste 101 Peoria IL 61603-3167 |
| Mailing Address |
2341 Emerald Ln Yorkville IL 60560-3055 |
| Practice Telephone | 3096557378 |
| Enumeration Date | 2020-07-28 |
| Last Update Date | 2020-07-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | Behavioral Health & Social Service Providers |
| Street Address |
515 NE GLEN OAK AVE STE 101 |
| City | PEORIA |
| State | IL |
| Zip Code | 61603-3167 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013037373 | Tamara Marie Lott | Counselor | 515 Ne Glen Oak Ave Ste 101, Osf Saint Francis Medical Center, Peoria, IL 61603-3167 | 2007-03-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598362980 | Courtney Klein | Nurse Practitioner | 1306 N. Berkley Ave, Peoria, IL 61603 | 2020-10-08 |
| 1114588217 | Kong Xing Wang | Dentist | 320 East Armstrong Ave, Peoria, IL 61603 | 2019-06-28 |
| 1073015319 | Sara Kristine Rosenbery | Nurse Practitioner | 515 Ne Glen Oak Ave Ste 202, Peoria, IL 61603 | 2018-03-02 |
| 1861860058 | Jennifer Michelle Kelsey | Clinical Nurse Specialist | 420 Ne Glen Oak Avenue, Suite 401, Peoria, IL 61603 | 2015-09-04 |
| 1467859793 | Bonnie Lansing | Counselor | 617 N Gendale Avenue, Behavioral Health Adult Program, Peoria, IL 61603 | 2014-12-02 |
| 1639597172 | Jael K. Mahasi | Counselor | 1800 Ne Perry Avenue, Peoria, IL 61603 | 2014-04-02 |
| 1992054829 | Justin S Ferragut | Radiology | 530 Northeast Glen Oak Avenue, Peoria, IL 61603 | 2012-09-06 |
| 1780952994 | Syed Muhammad Tayyab | Internal Medicine | 828 Ne Glen Oak Ave Apt No208a, Peoria, IL 61603 | 2011-12-02 |
| 1528389079 | St. Francis Medical Center | General Acute Care Hospital | 530 N E Glen Oak Ave, Peoria, IL 61603 | 2010-06-18 |
| 1780810648 | Children's Home Association of Illinois | Voluntary or Charitable | 400 E. Frye, Peoria, IL 61603 | 2009-06-05 |
| Find all providers in zip 61603 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174927172 | Christopher Simpson | Clinical Neuropsychologist | 10184 W Happy Valley Rd, Suite 190, Peoria, AZ 85383-1254 | 2014-10-20 |
| 1891800603 | Shanna Marie Kurth | Clinical Neuropsychologist | 3100 N Dries Ln, Ste 303, Peoria, IL 61604-1265 | 2006-08-20 |
| 1649723990 | Eric Aune | Clinical Neuropsychologist | 530 Ne Glen Oak Ave, Children's Hospital of Illinois, Peoria, IL 61637-0001 | 2016-08-03 |
| 1053658377 | Benjamin Joseph Richter | Clinical Neuropsychologist | 515 Ne Glen Oak Ave, Suite 101, Peoria, IL 61637-3167 | 2013-01-07 |
| 1740459429 | Amy Serin | Clinical Neuropsychologist | 10200 W Happy Valley Rd, Suite A135, Peoria, AZ 85383-2878 | 2008-02-26 |
| 1659553444 | Neuropsychology Clinic PC | Clinical Neuropsychologist | 3100 N Dries Ln, Ste 303, Peoria, IL 61604-1265 | 2007-12-04 |
| 1659396505 | Michele R. Verda | Clinical Neuropsychologist | 420 Ne Glen Oak Ave, 401, Peoria, IL 61603-3105 | 2006-07-13 |
| 1962456764 | Saint Francis Medical Center | Clinical Neuropsychologist | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2006-05-19 |
| 1831181726 | Dietra Duffala Teichmann | Clinical Neuropsychologist | 5401 N Knoxville Ave, Suite 217, Peoria, IL 61614-5098 | 2005-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477183556 | Michelle Yvonne Kibby-faglier | Clinical Neuropsychologist | 285 Lake Indian Hills Dr, Carbondale, IL 62902-6184 | 2020-01-17 |
| 1003456708 | David Jackson | Clinical Neuropsychologist | 6 Parkway North Blvd, Deerfield, IL 60015-2522 | 2020-01-10 |
| 1649830159 | Natalie Berger | Clinical Neuropsychologist | 1645 W Jackson Blvd Ste 203, Chicago, IL 60612-3227 | 2019-06-17 |
| 1043877475 | Sarah Mailander Dyer | Clinical Neuropsychologist | 900 Royal Heights Rd Ste 14, Belleville, IL 62226-5457 | 2019-05-21 |
| 1639655632 | Julia Digangi | Clinical Neuropsychologist | 920 N York Rd, Hinsdale, IL 60521-2996 | 2018-07-13 |
| 1891211710 | Kenneth Vicencio | Clinical Neuropsychologist | 4100 Healthway Drive, Aurora, IL 60504 | 2017-08-22 |
| 1538690466 | Kathleen Ares | Clinical Neuropsychologist | 4440 W 95th, Suite 1200h, Oak Lawn, IL 60453 | 2017-03-22 |
| 1225575871 | Israel Gross | Clinical Neuropsychologist | 1934 W. Roscoe St., #4, Chicago, IL 60657 | 2017-01-20 |
| 1013462829 | Ann Westcot Jordan | Clinical Neuropsychologist | 21037 Benjamin Dr, Shorewood, IL 60404-0612 | 2016-08-22 |
| 1740638915 | Elizabeth Regina Tuminello Hartman | Clinical Neuropsychologist | 1875 Dempster St Ste 520, Park Ridge, IL 60068-1130 | 2016-05-29 |
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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.