AMRUTA SURENDRA JAJU (NPI# 1205171709) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205171709 |
| Entity Type | Individual |
| Full Name | AMRUTA SURENDRA JAJU |
| Practice Address |
5401 N Knoxville Ave Ste 204 Peoria IL 61614-5021 |
| Practice Telephone | 3096831200 |
| Mailing Telephone | 3096831200 |
| Enumeration Date | 2012-12-10 |
| Last Update Date | 2017-10-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | I DO NOT HAVE | ZZ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | LICENSE | 036136462 | 01 |
| Street Address |
5401 N KNOXVILLE AVE STE 204 |
| City | PEORIA |
| State | IL |
| Zip Code | 61614-5021 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538518923 | Natalie Pedersen | Internal Medicine | 5401 N Knoxville Ave Ste 204, Peoria, IL 61614-5021 | 2016-06-07 |
| 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 | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841779063 | Chris Brooker Do Pllc | Internal Medicine | 7747 W Deer Valley Rd Ste 250, Peoria, AZ 85382-2124 | 2018-08-08 |
| 1447736665 | Artem Aesthestics & Wellness LLC | Internal Medicine | 9059 W Lake Pleasant Pkwy Ste C320, Peoria, AZ 85382-8394 | 2018-07-11 |
| 1568956670 | Mckenzie Elle Wylie | Internal Medicine | Unity Point Health 815 Main St, Suite C, Peoria, IL 61602-1080 | 2018-06-21 |
| 1013417617 | Elite Infusions LLC | Internal Medicine | 10252 W Villa Chula, Peoria, AZ 85383 | 2018-02-20 |
| 1518318005 | Jason Thomas Taylor | Internal Medicine | 538 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2016-06-26 |
| 1134508112 | Anthony Alexander Baldoni | Internal Medicine | Saint Francis Medical Center 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2015-05-25 |
| 1194133850 | Ashish Kumar Roy | Internal Medicine | 530 N.e. Glen Oak Ave, Peoria, IL 61637 | 2014-07-25 |
| 1083047401 | Paul Stuart Moots | Internal Medicine | 929 W Loire Ct, Apt 1211, Peoria, IL 61614-1850 | 2013-08-21 |
| 1386085975 | Amit Bhushan Sharma | Internal Medicine | 1505 N Peoria Ave # Appt806, Peoria, IL 61603-3140 | 2013-07-10 |
| 1285996926 | Jennifer Yeast | Internal Medicine | 6304 N Sheridan Rd, Peoria, IL 61614-3044 | 2012-06-08 |
| 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.