ERICA M DEFORD


Address: 2805 N Knoxville Ave, Peoria, IL 61604-2869
Phone: 3096249400

ERICA M DEFORD (NPI# 1306020334) 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) 1306020334
Entity Type Individual
Full Name ERICA M DEFORD
Other Name ERICA M PLATTNER
Credential PA
Practice Address 2805 N Knoxville Ave
Peoria
IL 61604-2869
Practice Telephone 3096249400
Practice Fax Number 3096242280
Mailing Telephone 3096249400
Mailing Fax Number 3096242280
Enumeration Date 2007-12-27
Last Update Date 2009-10-02
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AM0700X Physician Assistant
Specialization: Medical
085003126 IL Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
TAX ID 37-1221637 01
IL MEDICARE GROUP PIN 776530 01
IL MEDICARE GROUP PTAN 809840 01

Office Location

Street Address 2805 N KNOXVILLE AVE
City PEORIA
State IL
Zip Code 61604-2869

Providers in the same location

NPI Name Taxonomy Address Enumeration
1639168222 Gloria Isabel Diaz Internal Medicine 2805 N Knoxville Ave, Peoria, IL 61604-2869 2005-10-17
1982985339 Scott A Gonia Clinical Nurse Specialist 2805 N Knoxville Ave, Peoria, IL 61604-2869 2011-08-30
1467575092 Melissa J. Dye Clinical Nurse Specialist 2805 N Knoxville Ave, Peoria, IL 61604-2869 2007-04-09
1912097205 Michael F. Shekleton Internal Medicine 2805 N Knoxville Ave, Peoria, IL 61604-2869 2006-10-15
1447351077 Fritz-henry Volmar Internal Medicine 2805 N Knoxville Ave, Suite 209, Peoria, IL 61604-2869 2006-09-26
1790727410 Susan M Mettille Physician Assistant 2805 N Knoxville Ave, Peoria, IL 61604-2869 2006-06-11
1881635605 Michael D Cashman Internal Medicine 2805 N Knoxville Ave, Peoria, IL 61604-2869 2006-06-10

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1205357928 Nydia I Rodriguez Nurse's Aide 3305 N Finnell Ave, Peoria, IL 61604 2017-07-03
1720327976 Brin Diagnostics Inc. Clinical Medical Laboratory 3216 W Kenwood, West Peoria, IL 61604 2013-02-07
1225373715 Ngocyen Thi Ngo Pharmacist 2515 N Knoxville Avenue, Peoria, IL 61604 2012-12-10
1194027003 Schelly Chiropractic, Inc Chiropractor 1208 W Loucks, Peoria, IL 61604 2010-11-29
1770755852 Dental Sealants & More Dentist 2126 N. University St., Peoria, IL 61604 2008-03-28
1821266123 David L Krick Dentist 2022 N University, Peoria, IL 61604 2008-02-20
1568658409 Advanced Physicians Health Care, S.c. Chiropractor 1200 West Loucks Ave, Peoria, IL 61604 2007-09-24
1902006000 Noel Liu Dentist 3127 N. University St., Unit C, Peoria, IL 61604 2007-07-18
1568586386 Susan B Bordenave-bishop Dentist 2116 N. Sheridan, Peoria, IL 61604 2007-03-19
1174689897 Paul Anthony Amodeo Dentist 3100 N Dries Lane, Suite 301, Peoria, IL 61604 2006-12-28
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Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1194343897 Alyssa Kay Poland Physician Assistant 10006 W Los Gatos Dr, Peoria, AZ 85383-3343 2020-07-08
1871155143 Terry Craven Wood Physician Assistant 7645 W Donald Dr, Peoria, AZ 85383-3142 2019-07-08
1174956031 Kindal Alysse Sweet Physician Assistant 7677 W Paradise Ln Apt 1128, Peoria, AZ 85382-4974 2013-08-14
1831246669 Joseph B Earl Physician Assistant 7615 W Thunderbird Rd Ste 105, Peoria, AZ 85381-6083 2007-01-04
1275612681 James Anthony Caruso Physician Assistant 9601 North Lindbergh Dr, # 230, Peoria, IL 61615 2006-11-04
1922103407 Brady Paul Nelson Physician Assistant 13943 N . 91st Ave Building I, Peoria, AZ 85381-3692 2006-09-13
1689786444 Bruce A Ropte Physician Assistant 21731 N. 77th Avenue, Peoria, AZ 85382 2006-08-31
1265543391 Elizabeth D Moore Physician Assistant 8940 N Wood Sage Road, Peoria, IL 61615 2006-08-31
1174500581 Janis Suzann Forch Physician Assistant 7615 W Thunderbird Rd, Ste 106, Peoria, AZ 85381-6083 2005-12-28
1508858754 Kenneth B Caton Physician Assistant 9165 W Thunderbird Rd, Ste 100, Peoria, AZ 85381 2005-08-15
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Competitor

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City PEORIA
Zip Code 61604

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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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