MS. MILDRED ELAINE SHAFER


Address: 530 Ne Glen Oak Ave, Peoria, IL 61637-0002
Phone: 3096836740

MS. MILDRED ELAINE SHAFER (NPI# 1215265327) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1215265327
Entity Type Individual
Full Name MS. MILDRED ELAINE SHAFER
Credential APN
Practice Address 530 Ne Glen Oak Ave
Peoria
IL 61637-0002
Mailing Address 7918 W Thornridge Dr
Mapleton
IL 61547-9347
Practice Telephone 3096836740
Practice Fax Number 3096836746
Mailing Telephone 3096836740
Mailing Fax Number 3096836746
Enumeration Date 2009-12-01
Last Update Date 2009-12-01
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LN0005X Nurse Practitioner
Specialization: Neonatal, Critical Care
209000900 IL Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 530 NE GLEN OAK AVE
City PEORIA
State IL
Zip Code 61637-0002

Providers in the same location

NPI Name Taxonomy Address Enumeration
1346235777 Jack Michael Gibson Obstetrics & Gynecology 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 2005-09-12
1053912188 Janie Clary Nurse Practitioner 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 2020-11-04
1265030548 Christina David Nurse Practitioner 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 2020-10-09
1033726831 Corry Lynn Rediger Occupational Therapist 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 2020-09-25
1720694094 Katelynn M Madden Clinical Nurse Specialist 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 2020-09-21
1568074474 Amanda Diane Beoletto Pharmacist 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 2020-08-21
1881212892 Mohammad Mousbah Al-tabbaa Student in an Organized Health Care Education/Training Program 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 2020-07-07
1750909693 Mohammad Gareeb Student in an Organized Health Care Education/Training Program 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 2020-07-07
1376160846 Bassel Elia Abouzeid Student in an Organized Health Care Education/Training Program 530 Ne Glen Oak Ave, Peoria, IL 61637 2020-07-01
1700403516 Christina Marie Spurgeon Nurse Practitioner 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 2020-06-26
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1780200865 Kuang Chuen Liu Pediatrics 530 Ne Glen Oak Ave, Peoria, Peoria, IL 61637 2020-06-24
1174184527 Manisha Tharoor Student in an Organized Health Care Education/Training Program 530 N.e Glen Oak Ave, Peoria, IL 61637 2019-06-26
1609436724 Sriviji Senthil Kumaran Student in an Organized Health Care Education/Training Program 530. N.e Glen Oak Ave., Peoria, IL 61637 2019-06-20
1780240929 Abuzar Ali Asif Student in an Organized Health Care Education/Training Program 530 N. E. Glen Oak Ave., Peoria, IL 61637 2019-05-14
1518328665 Jenna Bishop Dietitian, Registered 600 Ne Water Street, Peoria, IL 61637 2016-03-17
1194133850 Ashish Kumar Roy Internal Medicine 530 N.e. Glen Oak Ave, Peoria, IL 61637 2014-07-25
1265720510 Reuben Antony Pediatrics 530 Ne Glen Oak Ave., C/o Ms Suzy Lewellen, Peoria, IL 61637 2011-07-20
1366673436 Joseph William Hauter Emergency Medicine 830 Ne Glen Oak Ave, Peoria, IL 61637 2009-08-06
1437380748 Jeremy R Monroe Emergency Medicine 530 Glen Oak, Osf St Francis Medical Center, Peoria, IL 61637 2009-08-04
1326244682 Maria S. Parr Psychiatry & Neurology Osf Saint Francis Medical Center, 530 N.e.glen Oak Ave., Peoria, FL 61637 2007-06-25
Find all providers in zip 61637

Taxonomy Information

Taxonomy Code 363LN0005X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Neonatal, Critical Care

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1700403516 Christina Marie Spurgeon Nurse Practitioner 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 2020-06-26
1366979437 Michelle Dawn Cunningham Nurse Practitioner 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 2017-05-18
1982136271 Saint Francis Medical Center Nurse Practitioner 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 2017-03-28
1275958373 Brittany Welch Nurse Practitioner 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 2014-02-26
1609145853 Emily Liles Huamani Nurse Practitioner 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 2011-12-16
1023346582 Laura K Bowers Nurse Practitioner 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 2009-11-20
1053649574 Kathleen Jo Moersch Nurse Practitioner 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 2009-11-20
1679801187 Jan Marie Galbreath Nurse Practitioner 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 2009-11-20
1699002709 Denise Mary Cornell Nurse Practitioner 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 2009-11-10
1447586052 Angie Christine Onion Nurse Practitioner 530 Ne Glen Oak Ave, Peoria, IL 61603-3117 2009-11-02
Find all providers in PEORIA

Competitor

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City PEORIA
Zip Code 61637

Improve Information

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Dataset Information

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.

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