SUSAN SPARKS (NPI# 1275994543) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275994543 |
| Entity Type | Individual |
| Full Name | SUSAN SPARKS |
| Credential | LCSW |
| Practice Address |
8500 N Knoxville Ave Peoria IL 61615-2079 |
| Mailing Address |
97 Eastgate Dr Washington IL 61571-9271 |
| Practice Telephone | 8007731682 |
| Practice Fax Number | 3097132898 |
| Mailing Telephone | 8007731682 |
| Mailing Fax Number | 3097132898 |
| Enumeration Date | 2016-03-15 |
| Last Update Date | 2016-03-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1041C0700X |
Social Worker Specialization: Clinical |
149.016759 | IL | Behavioral Health & Social Service Providers |
| Y | 1041S0200X |
Social Worker Specialization: School |
149.016759 | IL | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477861565 | Susan Sparks | Occupational Therapist | 5211 79th St, Lubbock, TX 79424-2832 | 2010-09-22 |
| 1598079618 | Susan Sparks | Radiologic Technologist | 31 E Butler Ave, Ambler, PA 19002-4513 | 2010-07-30 |
| 1386839892 | Susan Sparks | Registered Nurse | 516 Nizhoni Blvd, Gallup, NM 87301-5748 | 2007-09-07 |
| 1306066055 | Susan Lorraine Sparks | Contractor | 3840 Hulen St, Fort Worth, TX 76107-7277 | 2007-04-26 |
| 1184786816 | Susan Sparks | Speech-Language Pathologist | 402 91st Ave Ne, Everett, WA 98205-1530 | 2006-12-16 |
| 1881798445 | Susan Sparks | Medical Genetics | 1000 Blythe Blvd, Charlotte, NC 28203-5812 | 2006-09-12 |
| 1033179171 | Susan Wilkes Sparks | Specialist | 2228 Starling St, Brunswick, GA 31520-4200 | 2006-03-24 |
| 1003892183 | Susan M Sparks | Physical Therapist | 740 Williams St, Pittsfield, MA 01201-7463 | 2005-12-20 |
| Street Address |
8500 N KNOXVILLE AVE |
| City | PEORIA |
| State | IL |
| Zip Code | 61615-2079 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538503388 | Lindsay Alyne Stangeland | Behavioral Analyst | 8500 N Knoxville Ave, Suite A, Peoria, IL 61615-2079 | 2013-04-23 |
| 1508363649 | Mackenzie Laesch | Behavioral Analyst | 8500 N Knoxville Ave, Peoria, IL 61615-2079 | 2018-04-06 |
| 1821539529 | Jessica Rohwer | Social Worker | 8500 N Knoxville Ave, Peoria, IL 61615-2079 | 2017-03-14 |
| 1396106647 | Skill Sprout, LLC | Social Worker | 8500 N Knoxville Ave, Ste Ab, Peoria, IL 61615-2079 | 2016-03-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124627906 | Lance Jay Bucher | Occupational Therapist | 8600 Il-91, Peoria, IL 61615 | 2020-10-22 |
| 1093327496 | Angela Mitchell | Speech-Language Pathologist | 3903 W Ridgeview Dr, Peoria, IL 61615 | 2020-08-18 |
| 1578110680 | Emily E Buenting | Audiologist | 8600 Il Route 91, Suite 300, Peoria, IL 61615 | 2019-08-22 |
| 1730655572 | Sylwia M. Budzik | Physician Assistant | 8600 Illinois Rt. 91, Suite 300, Peoria, IL 61615 | 2018-10-19 |
| 1487169207 | Heather Hart | Registered Nurse | 9016 N. Scrimshaw Dr. Apt 104, Peoria, IL 61615 | 2017-12-04 |
| 1528586849 | Leanne Runyon | Speech-Language Pathologist | 10723 Collett Dr., Peoria, IL 61615 | 2017-09-07 |
| 1467974196 | Elizabeth A Mcleod | Nurse Practitioner | 8600 Illinois Route 91, Suite 130, Peoria, IL 61615 | 2017-07-14 |
| 1790223022 | Janet Warner | Counselor | 8914 North Prarie Court, Peoria, IL 61615 | 2017-02-07 |
| 1437524022 | Brooke Bisping | Dietitian, Registered | 7610 North Orange Prairie Road, Peoria, IL 61615 | 2015-12-08 |
| 1003292111 | Crystal Ann Casper | Dietitian, Registered | 7610 N Orange Prarie Road, Peoria, IL 61615 | 2015-07-31 |
| Find all providers in zip 61615 | ||||
| Taxonomy Code | 1041S0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | School |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366059818 | Amy D Ruckman | Social Worker | 407 S Edwards St, Altamont, IL 62411-1799 | 2020-09-29 |
| 1568080612 | Jordan Coleman | Social Worker | 1421 Marshall Ave, Mattoon, IL 61938-5341 | 2020-07-06 |
| 1164063632 | John Naret | Social Worker | 9130 S 52nd Ave, Oak Lawn, IL 60453-1799 | 2019-10-04 |
| 1306496393 | Marie Nagle | Social Worker | 6316 157th St, Oak Forest, IL 60452-2710 | 2019-09-12 |
| 1639641376 | Brandon Christensen | Social Worker | 110 Collins St, Joliet, IL 60432-2942 | 2018-12-19 |
| 1558847335 | Inner Balance Wellness | Social Worker | 303 E Army Trail Rd Ste 207, Bloomingdale, IL 60108-2143 | 2018-07-16 |
| 1538675244 | Mary Elizabeth Hall | Social Worker | 411 Stave Mill Rd, Murphysboro, IL 62966-4888 | 2017-12-18 |
| 1184133084 | Andrea Lynn Geis | Social Worker | 50 Blackwood Dr, Murphysboro, IL 62966-2937 | 2017-09-22 |
| 1295244242 | Amy Elizabeth Prudencio | Social Worker | 1301 E. Walnut Street, Carbondale, IL 62901 | 2017-09-21 |
| 1528587318 | Jaclyn Hood | Social Worker | 3945 Wehrman, Schiller Park, IL 60176 | 2017-09-13 |
| 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.