JESSICA L SECOR (NPI# 1164700183) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164700183 |
| Entity Type | Individual |
| Full Name | JESSICA L SECOR |
| Credential | M.D. |
| Practice Address |
7725 N Knoxville Ave Peoria IL 61614-2079 |
| Practice Telephone | 3094950250 |
| Practice Fax Number | 3096899035 |
| Mailing Telephone | 3094950240 |
| Mailing Fax Number | 3096899035 |
| Enumeration Date | 2011-07-25 |
| Last Update Date | 2020-06-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
36140614 | IL | Allopathic & Osteopathic Physicians |
| Street Address |
7725 N KNOXVILLE AVE |
| City | PEORIA |
| State | IL |
| Zip Code | 61614-2079 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184646317 | Robert Adams | Family Medicine | 7725 N Knoxville Ave, Peoria, IL 61614-2079 | 2006-07-24 |
| 1033497581 | Mariola Kabat | Clinical Nurse Specialist | 7725 N Knoxville Ave, Peoria, IL 61614-2079 | 2011-08-02 |
| 1215170246 | Illinois Surgical Specialists, Ltd | Surgery | 7725 N Knoxville Ave, Peoria, IL 61614-2079 | 2009-04-07 |
| 1154512291 | Sue Willis | Physical Therapy Assistant | 7725 N Knoxville Ave, Peoria, IL 61614-2079 | 2007-08-05 |
| 1700077849 | Rhonda Heaton | Physical Therapy Assistant | 7725 N Knoxville Ave, Peoria, IL 61614-2079 | 2007-08-05 |
| 1467571547 | Melissa Larson | Speech-Language Pathologist | 7725 N Knoxville Ave, Peoria, IL 61614-2079 | 2007-03-28 |
| 1316066582 | Brandi Osborn | Speech-Language Pathologist | 7725 N Knoxville Ave, Peoria, IL 61614-2079 | 2007-03-28 |
| 1801932496 | Lanae L Huang | Physical Therapist | 7725 N Knoxville Ave, Lower Level, Peoria, IL 61614-2079 | 2007-01-30 |
| 1538210869 | Alison A Salisbury | Physical Therapist | 7725 N Knoxville Ave, Peoria, IL 61614-2079 | 2007-01-15 |
| 1174539761 | John Miller | Family Medicine | 7725 N Knoxville Ave, Peoria, IL 61614-2079 | 2006-08-01 |
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| 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 |
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| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790049617 | Sonoran Vein and Endovascular LLC | Surgery | 9200 W Union Hills Dr, Ste A-103, Peoria, AZ 85382-8210 | 2012-06-25 |
| 1306043211 | Sean Benedict D'souza | Surgery | 9192 W Union Hills Dr, Peoria, AZ 85382-8208 | 2007-07-03 |
| 1912970617 | Dale M Geiss | Surgery | 515 Ne Glen Oak, Suite 105, Peoria, IL 61603-3167 | 2006-02-12 |
| 1265433882 | James Bertram Williams | Surgery | 2420 W Nebraska Ave, Peoria, IL 61604-3112 | 2005-08-04 |
| 1487281770 | Titan Medical Services, LLC | Surgery | 13660 N 94th Dr # D-1, Peoria, AZ 85381-4836 | 2020-03-25 |
| 1982929121 | Sammy Zakhary Md PC | Surgery | 15396 N 83rd Ave, Suite E, Peoria, AZ 85381-5622 | 2010-03-31 |
| 1699783886 | James R Debord | Surgery | 5409 N Knoxville Ave, Peoria, IL 61614-5016 | 2006-08-03 |
| 1962417485 | Cardiac Thoracic & Endovascular Therapies, S.c. | Surgery | 2420 W Nebraska Ave, Peoria, IL 61604-3112 | 2006-07-31 |
| 1063454197 | Andy C. Chiou | Surgery | 1001 Main Street, 3rd Floor, Peoria, IL 61606-2037 | 2006-06-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396267324 | Congress Vascular Center LLC | Surgery | 41 W Congress Pkwy Fl 1, Chicago, IL 60605-1531 | 2017-07-11 |
| 1043731300 | Elmwood Park Vascular Center LLC | Surgery | 7230 W North Ave Ste 108, Elmwood Park, IL 60707-4261 | 2017-06-27 |
| 1588105811 | Mickey Graphia | Surgery | 701 N 1st St # D346, Springfield, IL 62702 | 2017-03-20 |
| 1992126668 | Vascular Specialists LLC | Surgery | 20060 Governors Dr Ste 102, Olympia Fields, IL 60461-1099 | 2013-12-26 |
| 1588959548 | Patrick Michael Sullivan Neville | Surgery | 4600 Memorial Dr Ste 120, Belleville, IL 62226-5359 | 2011-06-17 |
| 1235454968 | Margaret Claire Rigamer | Surgery | 1901 W Harrison St Dept Of, Chicago, IL 60612-3714 | 2010-04-06 |
| 1215251541 | John V. White, Md, LLC | Surgery | 8816 W Dempster St, Niles, IL 60714-5109 | 2010-03-15 |
| 1710212733 | Vascular Surgery and Interpretation S.c. | Surgery | 3330 W 177th St Ste 2c1, Hazel Crest, IL 60429-2184 | 2009-10-08 |
| 1538391792 | Usa Vein Clinics of Chicago LLC | Surgery | 4141 Dundee Rd, Northbrook, IL 60062-2129 | 2009-08-20 |
| 1306010731 | Tanq, Inc. | Surgery | 18510 S Marilynn Ct, Mokena, IL 60448-9517 | 2008-04-16 |
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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.