DAWN CLARISSE TANNER (NPI# 1295898591) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295898591 |
| Entity Type | Individual |
| Full Name | DAWN CLARISSE TANNER |
| Other Name | DAWN CLARISSE JOHNSON |
| Credential | PA-C |
| Practice Address |
221 Ne Glen Oak Ave Peoria IL 61603-4307 |
| Mailing Address |
21276 Network Pl Chicago IL 60673-1212 |
| Practice Telephone | 3096725522 |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2011-07-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 085-002863 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | RRMCARE THRU CES | P00841537 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679800734 | Dawn A Tanner | Social Worker | 1100 Wilford Hall Loop Bldg 455459, Jbsa Lackland, TX 78236 | 2009-11-11 |
| 1104089606 | Dawn Terese Tanner | Internal Medicine | 27700 Medical Center Rd, Mission Viejo, CA 92691-6426 | 2008-07-03 |
| Street Address |
221 NE GLEN OAK AVE |
| City | PEORIA |
| State | IL |
| Zip Code | 61603-4307 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851384135 | John Alan Howerton | Pharmacist | 221 Ne Glen Oak Ave, Peoria, IL 61636-0001 | 2005-08-23 |
| 1437750130 | Vanezza Buendia | Physical Therapist | 221 Ne Glen Oak Ave, Peoria, IL 61636-0001 | 2020-11-08 |
| 1306443056 | Austyn Powers | Nurse Practitioner | 221 Ne Glen Oak Ave, Peoria, IL 61636-0001 | 2020-10-06 |
| 1396357091 | Christopher Legan | Counselor | 221 Ne Glen Oak Ave, Peoria, IL 61636-0001 | 2020-08-24 |
| 1417575853 | Joseph Babione | Psychologist | 221 Ne Glen Oak Ave, Peoria, IL 61636-0001 | 2020-07-13 |
| 1811512411 | Methodist | Counselor | 221 Ne Glen Oak Ave, Peoria, IL 61636-0001 | 2020-06-10 |
| 1760003230 | Alexandra Bryan | Dietitian, Registered | 221 Ne Glen Oak Ave, Peoria, IL 61636-0001 | 2020-05-06 |
| 1467080523 | Dustin Dariusz Pilat | Student in an Organized Health Care Education/Training Program | 221 Ne Glen Oak Ave, Peoria, IL 61636-5027 | 2020-04-01 |
| 1295363505 | Abigail Brea Sebald | Student in an Organized Health Care Education/Training Program | 221 Ne Glen Oak Ave, Peoria, IL 61636-0001 | 2020-03-31 |
| 1790313054 | Elizabeth Alexandra Edwards | Student in an Organized Health Care Education/Training Program | 221 Ne Glen Oak Ave, Peoria, IL 61636-0001 | 2020-03-31 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598362980 | Courtney Klein | Nurse Practitioner | 1306 N. Berkley Ave, Peoria, IL 61603 | 2020-10-08 |
| 1114588217 | Kong Xing Wang | Dentist | 320 East Armstrong Ave, Peoria, IL 61603 | 2019-06-28 |
| 1073015319 | Sara Kristine Rosenbery | Nurse Practitioner | 515 Ne Glen Oak Ave Ste 202, Peoria, IL 61603 | 2018-03-02 |
| 1861860058 | Jennifer Michelle Kelsey | Clinical Nurse Specialist | 420 Ne Glen Oak Avenue, Suite 401, Peoria, IL 61603 | 2015-09-04 |
| 1467859793 | Bonnie Lansing | Counselor | 617 N Gendale Avenue, Behavioral Health Adult Program, Peoria, IL 61603 | 2014-12-02 |
| 1639597172 | Jael K. Mahasi | Counselor | 1800 Ne Perry Avenue, Peoria, IL 61603 | 2014-04-02 |
| 1992054829 | Justin S Ferragut | Radiology | 530 Northeast Glen Oak Avenue, Peoria, IL 61603 | 2012-09-06 |
| 1780952994 | Syed Muhammad Tayyab | Internal Medicine | 828 Ne Glen Oak Ave Apt No208a, Peoria, IL 61603 | 2011-12-02 |
| 1528389079 | St. Francis Medical Center | General Acute Care Hospital | 530 N E Glen Oak Ave, Peoria, IL 61603 | 2010-06-18 |
| 1780810648 | Children's Home Association of Illinois | Voluntary or Charitable | 400 E. Frye, Peoria, IL 61603 | 2009-06-05 |
| Find all providers in zip 61603 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275148280 | Patricia Miriam Rus | Physician Assistant | 23615 N 105th Dr, Peoria, AZ 85383-1195 | 2020-09-15 |
| 1083235154 | Katlyn Coyer | Physician Assistant | 900 Main St Ste 530, Peoria, IL 61602-1005 | 2020-04-30 |
| 1114586690 | Courtney A Hitpas | Physician Assistant | 3120 N Bigelow St, Peoria, IL 61604-1628 | 2019-06-10 |
| 1689137671 | Jeffrey Benjamin Miessau | Physician Assistant | 7707 N Knoxville Ave Ste 200, Peoria, IL 61614-2020 | 2019-04-08 |
| 1417413337 | Michelle Nemeh | Physician Assistant | 6760 W Thunderbird Rd Ste 100, Peoria, AZ 85381-5048 | 2019-02-15 |
| 1730655572 | Sylwia M. Budzik | Physician Assistant | 8600 Illinois Rt. 91, Suite 300, Peoria, IL 61615 | 2018-10-19 |
| 1962977538 | Ashley Deyoung | Physician Assistant | 13943 N 91st Ave Ste F101, Peoria, AZ 85381-3689 | 2018-10-09 |
| 1326557141 | Melissa L. Kingston | Physician Assistant | 13760 N 93rd Ave Ste 201, Peoria, AZ 85381-4200 | 2017-09-25 |
| 1396196465 | Ayla Diamond | Physician Assistant | 9165 W Thunderbird Rd Ste 200, Peoria, AZ 85381-4847 | 2016-06-29 |
| 1336530948 | Carolina C. Castro | Physician Assistant | 13128 N. 94th Drive, Suite 100, Peoria, AZ 85381-4252 | 2015-02-18 |
| 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.