DR. TIFFANY ABREGO (NPI# 1114320413) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1114320413 |
Entity Type | Individual |
Full Name | DR. TIFFANY ABREGO |
Credential | PHD |
Practice Address |
900 Main St Ste 720 Peoria IL 61602-5027 |
Mailing Address |
79 W Alexandrine St Detroit MI 48201-2015 |
Practice Telephone | 3094951640 |
Mailing Telephone | 3138315355 |
Enumeration Date | 2014-09-30 |
Last Update Date | 2018-01-11 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
071.009388 | IL | Behavioral Health & Social Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IL | 071.009388 | 05 |
Street Address |
900 MAIN ST STE 720 |
City | PEORIA |
State | IL |
Zip Code | 61602-5027 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1366647521 | Andrew Jerome Lancia | Psychiatry & Neurology | 900 Main St Ste 720, Peoria, IL 61602-5027 | 2007-06-18 |
1912535287 | Jin-huon Jou | Student in an Organized Health Care Education/Training Program | 900 Main St Ste 720, Peoria, IL 61602-5027 | 2020-03-31 |
1376103259 | Jerri Jean Genovese | Social Worker | 900 Main St Ste 720, Peoria, IL 61602-5027 | 2019-06-13 |
1396205845 | Samicchya Adhikari | Psychiatry & Neurology | 900 Main St Ste 720, Peoria, IL 61602-5027 | 2019-03-21 |
1689029027 | Erik Masayuki Shipley | Psychiatry & Neurology | 900 Main St Ste 720, Peoria, IL 61602-5027 | 2016-05-03 |
1750761359 | Juan Romero Gaddi | Psychiatry & Neurology | 900 Main St Ste 720, Peoria, IL 61602-5027 | 2015-06-09 |
1316328982 | Kyla Nighohossian | Psychiatry & Neurology | 900 Main St Ste 720, Peoria, IL 61602-5027 | 2015-06-09 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1720574676 | Critical Care Rx, LLC | Pharmacy | 126 Oak St, Peoria, IL 61602 | 2018-07-03 |
1235675836 | Cheryl Beckman | Registered Nurse | 211 Fulton Street, Suite 207, One Technology Plaza, Peoria, IL 61602 | 2017-01-06 |
1063957942 | Rosemary Ince | Registered Nurse | 211 Fulton St. Suite 207, One Technology Plaza, Peoria, IL 61602 | 2016-12-30 |
1962674820 | Lisa Jean Burckhartzmeyer | Psychiatry & Neurology | 228 Ne Jefferson St, Peoria, IL 61602 | 2008-03-31 |
1669503587 | Jill Larson | Counselor | 330 Sw Washington Street, Peoria, IL 61602 | 2007-03-09 |
1265407399 | Cardiac Consultants Sc | Internal Medicine | 900 Main Street, Suite 320, Peoria, IL 61602 | 2006-02-22 |
1013364470 | Rafal Szymczuk | Student in an Organized Health Care Education/Training Program | 900 Main Street, Suite 720, Peoria, IL 61602 | 2016-05-16 |
1043693831 | Kari Beth Watts | Family Medicine | 815 Main St, Peoria, IL 61602 | 2015-06-30 |
1881072791 | Kristen Dent | Family Medicine | 815 Main St, Peoria, IL 61602 | 2015-05-12 |
1023422797 | Andrew Wang | Psychiatry & Neurology | 900 Main St Ste 580, Peoria, IL 61602 | 2014-06-20 |
Find all providers in zip 61602 |
Taxonomy Code | 103TC2200X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Psychologist |
Specialization | Clinical Child & Adolescent |
Definition to come... |
Notes: [1/1/2007: title modified] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417137274 | Cathy Lynn Bissett | Psychologist | 24654 N Lake Pleasant Pkwy Ste 103-497, Peoria, AZ 85383-1359 | 2007-11-09 |
1922075548 | Shauna L Gatten | Psychologist | 910 W Glen Avenue, Suite 2, Peoria, IL 61614-8807 | 2006-03-02 |
1174928410 | Meena Choi | Psychologist | 10184 W Happy Valley Rd, Suite Number 190, Peoria, AZ 85383-1254 | 2014-10-29 |
NPI | Name | Taxonomy | Address | Enumeration |
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1902441603 | Jasmine Dominique Jones | Psychologist | 19041 Willow Ave, Country Club Hills, IL 60478-5740 | 2019-11-18 |
1912483074 | Kristina Kochanova | Psychologist | 3380 Lacrosse Lane, Suites 106-107, Naperville, IL 60564 | 2018-07-12 |
1235647470 | Laurie Gayes Thompson | Psychologist | 225 E Chicago Ave # 2, Chicago, IL 60611-2991 | 2018-01-22 |
1558874891 | Claire Ashling Coyne | Psychologist | 225 E Chicago Ave # 10b, Chicago, IL 60611-2991 | 2017-11-08 |
1659721967 | Micah Ioffe | Psychologist | 1300 W Belmont Ave Ste 501, Chicago, IL 60657 | 2016-06-16 |
1609243856 | Humboldt Behavioral Health Group | Psychologist | 3317 W Le Moyne St, Chicago, IL 60651-2452 | 2015-08-24 |
1003156928 | Early Autism Project, Inc. | Psychologist | 599 Falling Waters Way, Lindenhurst, IL 60046-1703 | 2013-03-01 |
1659610491 | Alexandra M Psihogios | Psychologist | 1110 W Columbia Ave, Apt 1n, Chicago, IL 60626-4522 | 2013-02-13 |
1265781934 | Anthony Thomas Vesco | Psychologist | 225 E Chicago Ave # 10a, Chicago, IL 60611-2991 | 2012-09-10 |
1891044038 | Irma Porcic Khelghati | Psychologist | 1200 Harger Rd Ste 600, Oak Brook, IL 60523-1820 | 2012-09-04 |
Find all providers with the same taxonomy |
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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.