RENEE L CARLSON (NPI# 1245322759) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245322759 |
| Entity Type | Individual |
| Full Name | RENEE L CARLSON |
| Credential | DT |
| Practice Address |
406 S Gosse Blvd Princeton IL 61356-1916 |
| Practice Telephone | 8158754548 |
| Practice Fax Number | 8158758602 |
| Mailing Telephone | 8158754548 |
| Mailing Fax Number | 8158758602 |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0006X |
Pediatrics Specialization: Developmental – Behavioral Pediatrics |
RC11700805P | IL | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659923654 | Renee Beth Carlson | Mastectomy Fitter | 111 E Water St, Decorah, IA 52101-1801 | 2019-07-10 |
| 1780817759 | Renee M. Carlson | Nurse Practitioner | 3004 Golf Rd Ste 103, Eau Claire, WI 54701-8794 | 2009-08-25 |
| 1356596415 | Renee Marie Carlson | Nurse Anesthetist, Certified Registered | 425 Pine Ridge Blvd Ste 211, Wausau, WI 54401-4123 | 2008-11-17 |
| 1497898845 | Renee E Carlson | Counselor | Rr 1 Box 41, 521 2nd St, Green Isle, MN 55338-9706 | 2007-02-15 |
| 1164515177 | Renee Carlson | Physical Therapist | 9404 Genesee Ave, Suite 310, La Jolla, CA 92037-1339 | 2006-10-02 |
| 1043270267 | Renee Dawn Carlson | Dentist | Unit 6180, Apo, AE 09604-0245 | 2006-03-23 |
| Street Address |
406 S GOSSE BLVD |
| City | PRINCETON |
| State | IL |
| Zip Code | 61356-1916 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164498689 | Shirley M Borys | Counselor | 406 S Gosse Blvd, Box 535, Princeton, IL 61356-1916 | 2006-02-24 |
| 1003287210 | Gateway Services, Inc | Day Training, Developmentally Disabled Services | 406 S Gosse Blvd, Princeton, IL 61356-1916 | 2015-10-14 |
| 1134599087 | Ashley Holcman | Counselor | 406 S Gosse Blvd, Gateway Services, Inc, Princeton, IL 61356-0535 | 2015-10-05 |
| 1861570723 | Cindy Penzenik | Physical Therapist | 406 S Gosse Blvd, Princeton, IL 61356-1916 | 2006-11-01 |
| 1154419455 | Agnes M Smith | Speech-Language Pathologist | 406 S Gosse Blvd, Princeton, IL 61356-1916 | 2006-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548698558 | Shelley Gorenz | Counselor | 1009 S. Main St., Princeton, IL 61356 | 2013-10-30 |
| 1780016626 | Jennifer Phillips | Pharmacist | 610 N. Main St., Princeton, IL 61356 | 2013-08-02 |
| 1477848521 | Princeton Prompt Care LLC | Clinic/Center | 2128 North Main Street, Princeton, IL 61356 | 2011-06-16 |
| 1306014196 | Lifefit Physical Rehab, Ltd. | Clinic/Center | 1225 N. Sixth St., Princeton, IL 61356 | 2008-02-14 |
| 1568669778 | Hawthorne Inn Supportive Living Facility | Assisted Living Facility | 136 N. Sixth St., Princeton, IL 61356 | 2007-06-29 |
| 1720209240 | Michelle Lee Mortensen | Music Therapist | 816 S. First St., Princeton, IL 61356 | 2007-05-01 |
| 1073733465 | Jarred Allen Farrell | Chiropractor | 682 East Peru Street, Princeton, IL 61356 | 2007-04-26 |
| 1952488397 | Donald R Marion | Optometrist | 2 Park Avenue West, Princeton, IL 61356 | 2006-11-01 |
| 1427138247 | Bruce Waldo Shriver | Dentist | 422 E Peru St, Princeton, IL 61356 | 2006-10-16 |
| 1871689612 | Jason A Monroe | Dentist | 334 Backbone Rd East, Princeton, IL 61356 | 2006-10-05 |
| Find all providers in zip 61356 | ||||
| Taxonomy Code | 2080P0006X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Developmental – Behavioral Pediatrics |
| A developmental-behavioral specialist is a pediatrician with special training and experience who aims to foster understanding and promotion of optimal development of children and families through research, education, clinical care and advocacy efforts. This physician assists in the prevention, diagnosis, and management of developmental difficulties and problematic behaviors in children and in the family dysfunctions that compromise children's development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed, 3/26/2008: definition corrected] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720625601 | Shane Rafferty | Pediatrics | 4852 N Rockwell St Apt 2, Chicago, IL 60625-6521 | 2019-12-10 |
| 1376930750 | Prudence Hartwell | Pediatrics | 5841 S Maryland Ave # Mc0900, Chicago, IL 60637 | 2015-04-23 |
| 1962841122 | Jessica Katz Edison | Pediatrics | 1555 Barrington Rd Lowr Level, Hoffman Estates, IL 60169-1019 | 2013-06-21 |
| 1942598891 | Sotiria E. Moschovis | Pediatrics | 6127 N. Leader Ave., Chicago, IL 60646 | 2011-07-13 |
| 1326335514 | Evora Juanita Brent | Pediatrics | 1000 Central St., Suite 800, Evanston, IL 60201-1780 | 2011-07-07 |
| 1720142995 | Peter Joseph Smith Sr. | Pediatrics | 950 E. 61st Street, Ssc, Suite 207, Chicago, IL 60637 | 2006-12-21 |
| 1619948411 | University of Illinois | Pediatrics | Regional Development Center, 507 E Armstrong, Peoria, IL 61603 | 2006-01-30 |
| 1912545542 | Neila Petrovic | Pediatrics | 603 E Diehl Rd Ste 123, Naperville, IL 60563-4908 | 2019-12-13 |
| 1538637905 | Isabel Krynski | Pediatrics | 740 Quail Ridge Dr, Westmont, IL 60559-6148 | 2018-11-05 |
| 1134644834 | Shevia Morris | Pediatrics | 5116 N Nordica Ave, Chicago, IL 60656-3606 | 2017-08-03 |
| 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.