MRS. LEANN B YOUNG (NPI# 1104835768) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104835768 |
| Entity Type | Individual |
| Full Name | MRS. LEANN B YOUNG |
| Credential | PAC |
| Practice Address |
8600 N Route 91 Suite 130 Peoria IL 61615 |
| Practice Telephone | 3096835059 |
| Practice Fax Number | 3096835446 |
| Mailing Telephone | 3096835059 |
| Mailing Fax Number | 3096835446 |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2008-08-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
085001383 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | RR MEDICARE GROUP MEMBER PTAN | P00608470 | 01 |
| IL | RAILROAD MEDICARE | 920006568 | 01 |
| IL | RR MEDICARE GROUP PTAN | CA4079 | 01 |
| IL | MEDICARE GROUP | 434110 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518201003 | Leann Young | Speech-Language Pathologist | 1019 3rd Ave S, Payette, ID 83661-2832 | 2012-11-21 |
| Street Address |
8600 N ROUTE 91 SUITE 130 |
| City | PEORIA |
| State | IL |
| Zip Code | 61615 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922028075 | Ingrid B. Peelle | Physical Therapist | 8600 N Route 91, Suite 240, Peoria, IL 61615-0000 | 2006-07-20 |
| 1659451060 | Stephen Hippler | Internal Medicine | 8600 N Route 91, Peoria, IL 61615 | 2006-10-17 |
| 1568542975 | Kathryn Mulcahey | Internal Medicine | 8600 N Route 91, Peoria, IL 61615 | 2006-10-17 |
| 1275613689 | James Adams | Internal Medicine | 8600 N Route 91, Peoria, IL 61615 | 2006-10-17 |
| 1184704595 | Vivian W. Salazar | Internal Medicine | 8600 N Route 91, Peoria, IL 61615 | 2006-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124627906 | Lance Jay Bucher | Occupational Therapist | 8600 Il-91, Peoria, IL 61615 | 2020-10-22 |
| 1093327496 | Angela Mitchell | Speech-Language Pathologist | 3903 W Ridgeview Dr, Peoria, IL 61615 | 2020-08-18 |
| 1578110680 | Emily E Buenting | Audiologist | 8600 Il Route 91, Suite 300, Peoria, IL 61615 | 2019-08-22 |
| 1730655572 | Sylwia M. Budzik | Physician Assistant | 8600 Illinois Rt. 91, Suite 300, Peoria, IL 61615 | 2018-10-19 |
| 1487169207 | Heather Hart | Registered Nurse | 9016 N. Scrimshaw Dr. Apt 104, Peoria, IL 61615 | 2017-12-04 |
| 1528586849 | Leanne Runyon | Speech-Language Pathologist | 10723 Collett Dr., Peoria, IL 61615 | 2017-09-07 |
| 1467974196 | Elizabeth A Mcleod | Nurse Practitioner | 8600 Illinois Route 91, Suite 130, Peoria, IL 61615 | 2017-07-14 |
| 1790223022 | Janet Warner | Counselor | 8914 North Prarie Court, Peoria, IL 61615 | 2017-02-07 |
| 1437524022 | Brooke Bisping | Dietitian, Registered | 7610 North Orange Prairie Road, Peoria, IL 61615 | 2015-12-08 |
| 1003292111 | Crystal Ann Casper | Dietitian, Registered | 7610 N Orange Prarie Road, Peoria, IL 61615 | 2015-07-31 |
| Find all providers in zip 61615 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194343897 | Alyssa Kay Poland | Physician Assistant | 10006 W Los Gatos Dr, Peoria, AZ 85383-3343 | 2020-07-08 |
| 1871155143 | Terry Craven Wood | Physician Assistant | 7645 W Donald Dr, Peoria, AZ 85383-3142 | 2019-07-08 |
| 1174956031 | Kindal Alysse Sweet | Physician Assistant | 7677 W Paradise Ln Apt 1128, Peoria, AZ 85382-4974 | 2013-08-14 |
| 1831246669 | Joseph B Earl | Physician Assistant | 7615 W Thunderbird Rd Ste 105, Peoria, AZ 85381-6083 | 2007-01-04 |
| 1275612681 | James Anthony Caruso | Physician Assistant | 9601 North Lindbergh Dr, # 230, Peoria, IL 61615 | 2006-11-04 |
| 1922103407 | Brady Paul Nelson | Physician Assistant | 13943 N . 91st Ave Building I, Peoria, AZ 85381-3692 | 2006-09-13 |
| 1689786444 | Bruce A Ropte | Physician Assistant | 21731 N. 77th Avenue, Peoria, AZ 85382 | 2006-08-31 |
| 1265543391 | Elizabeth D Moore | Physician Assistant | 8940 N Wood Sage Road, Peoria, IL 61615 | 2006-08-31 |
| 1174500581 | Janis Suzann Forch | Physician Assistant | 7615 W Thunderbird Rd, Ste 106, Peoria, AZ 85381-6083 | 2005-12-28 |
| 1508858754 | Kenneth B Caton | Physician Assistant | 9165 W Thunderbird Rd, Ste 100, Peoria, AZ 85381 | 2005-08-15 |
| Find all providers in PEORIA | ||||
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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.