JACINDA ANNE CORNICK (NPI# 1124121371) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124121371 |
| Entity Type | Individual |
| Full Name | JACINDA ANNE CORNICK |
| Credential | PA |
| Practice Address |
6501 N Sheridan Rd Peoria IL 61614-2932 |
| Practice Telephone | 3096928110 |
| Practice Fax Number | 3096928673 |
| Mailing Telephone | 3096928110 |
| Mailing Fax Number | 3096928673 |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
085-001587 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
6501 N SHERIDAN RD |
| City | PEORIA |
| State | IL |
| Zip Code | 61614-2932 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851374557 | Frank K Arnold | Physical Therapist | 6501 N Sheridan Rd, Peoria, IL 61614-2932 | 2005-11-28 |
| 1003377441 | Alexis Sands | Speech-Language Pathologist | 6501 N Sheridan Rd, Peoria, IL 61614-2932 | 2019-03-28 |
| 1134687056 | Brooke Kitts | Physical Therapist | 6501 N Sheridan Rd, Peoria, IL 61614-2932 | 2019-03-10 |
| 1467818393 | Jennifer E Mcgarry | Speech-Language Pathologist | 6501 N Sheridan Rd, Peoria, IL 61614-2932 | 2016-01-07 |
| 1740645910 | Brittan Ashley Rooney | Physical Therapist | 6501 N Sheridan Rd, Peoria, IL 61614-2932 | 2015-12-15 |
| 1295121549 | Jenny Shimon | Specialist | 6501 N Sheridan Rd, Peoria, IL 61614-2932 | 2015-04-14 |
| 1487049995 | Amy Ginzel | Registered Nurse | 6501 N Sheridan Rd, Peoria, IL 61614-2932 | 2015-04-01 |
| 1205224029 | Mary Peifer | Massage Therapist | 6501 N Sheridan Rd, Peoria, IL 61614-2932 | 2014-12-31 |
| 1700284254 | Jacqueline Mccalister | Physical Therapist | 6501 N Sheridan Rd, Peoria, IL 61614-2932 | 2014-12-16 |
| 1194123836 | Jane A. Golowski | Registered Nurse | 6501 N Sheridan Rd, Peoria, IL 61614-2932 | 2014-12-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548818511 | Christine Svoboda | Social Worker | 6919 N Knoxville Ave Ste 100 and 202, Peoria, IL 61614 | 2019-09-03 |
| 1639649007 | Kathy Karouzos Counseling, LLC | Clinic/Center | 330 W. Ivy Ln., Peoria, IL 61614 | 2018-11-28 |
| 1205312790 | Kathleen Marie Hendricks | Nurse Practitioner | 2809 W Willow Knolls Dr, Peoria, IL 61614 | 2018-07-17 |
| 1629563937 | Mary Elizabeth Cunningham | Counselor | 6219 N. Eldorado Dr., Peoria, IL 61614 | 2018-06-28 |
| 1861937955 | Angela Gilles | Social Worker | 6919 N Knoxville Ave Ste 100, Peoria, IL 61614 | 2016-12-27 |
| 1467994897 | Melissa Saxsma | Specialist | 5009 N Executive Dr, Peoria, IL 61614 | 2016-11-16 |
| 1902258874 | Rashid Plastic Surgery, LLC | Plastic Surgery | 804 W Trailcreek Drive, Peoria, IL 61614 | 2016-07-05 |
| 1215313143 | Melissa Lynn Phelan | Nurse Practitioner | 122 E Morningside Dr, Peoria, IL 61614 | 2015-08-03 |
| 1811380165 | All Ways Caring Services, Inc. | In Home Supportive Care | 6919 N Knoxville Ave, Suite 102, Peoria, IL 61614 | 2015-03-11 |
| 1568875920 | Schuler & Arkwell Orthodontic Partnership | Dentist | 2425 Cornerstone Ct. Ste. A, Peoria, IL 61614 | 2014-06-03 |
| Find all providers in zip 61614 | ||||
| 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.