ILLINOIS NEUROSCIENCE INSTITUTE (NPI# 1326485921) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326485921 |
| Entity Type | Organization |
| Organization Name | ILLINOIS NEUROSCIENCE INSTITUTE |
| Practice Address |
100 Ne Randolph Ave Peoria IL 61606-1919 |
| Mailing Address |
800 Ne Glen Oak Ave Peoria IL 61603-3255 |
| Practice Telephone | 8774646670 |
| Mailing Telephone | 3096552850 |
| Enumeration Date | 2013-05-23 |
| Last Update Date | 2013-05-23 |
| Authorized Official Name | KEVIN D SCHOEPLEIN (CEO) |
| Authorized Official Telephone | 3096552850 |
| Is Organization Subpart | Y |
| Parent Organization Name | OSF HEALTHCARE SYSTEM |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207T00000X | Neurological Surgery | Allopathic & Osteopathic Physicians |
| Street Address |
100 NE RANDOLPH AVE |
| City | PEORIA |
| State | IL |
| Zip Code | 61606-1919 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942220819 | Carrie A. Randell | Physical Therapist | 100 Ne Randolph Ave, Peoria, IL 61606-1919 | 2006-07-20 |
| 1497271035 | Ashley Nicole Workman | Nurse Practitioner | 100 Ne Randolph Ave, Peoria, IL 61606-1919 | 2017-08-15 |
| 1922544287 | Michael Holloway | Physical Therapist | 100 Ne Randolph Ave, Peoria, IL 61606-1919 | 2017-01-11 |
| 1710423033 | Lauren Raube | Physical Therapist | 100 Ne Randolph Ave, Peoria, IL 61606-1919 | 2017-01-10 |
| 1316482912 | Meredith Burd | Occupational Therapist | 100 Ne Randolph Ave, Peoria, IL 61606-1919 | 2017-01-05 |
| 1942745120 | Brittany Heidemann | Speech-Language Pathologist | 100 Ne Randolph Ave, Peoria, IL 61606-1919 | 2016-12-27 |
| 1518419233 | Pamela Madden | Nurse Practitioner | 100 Ne Randolph Ave, Peoria, IL 61606-1919 | 2016-10-28 |
| 1063885556 | Jenny Wagner | Nurse Practitioner | 100 Ne Randolph Ave, Peoria, IL 61606-1919 | 2015-11-05 |
| 1164813515 | Connie E. Zurski | Nurse Practitioner | 100 Ne Randolph Ave, Peoria, IL 61606-1919 | 2015-02-06 |
| 1932505302 | Sally N. Coyle | Nurse Practitioner | 100 Ne Randolph Ave, Peoria, IL 61606-1919 | 2014-11-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194292334 | Kelley Stork | Speech-Language Pathologist | 807 W Columbia Terrace, Peoria, IL 61606 | 2018-10-25 |
| 1689140519 | Emma Cristine Tully | Speech-Language Pathologist | 1619 W. Fredonia Ave, Peoria, IL 61606 | 2018-10-18 |
| 1316492432 | Jennifer Greenwood | Nurse Practitioner | 1001 Main St Ste 500a, Peoria, IL 61606 | 2016-08-18 |
| 1104944974 | Robert I Martin | Preventive Medicine | 1127 N North Street, Peoria, IL 61606 | 2007-03-27 |
| 1023062312 | Saint Francis Medical Center | Physical Medicine & Rehabilitation | 100 Ne Randoph Street, Peoria, IL 61606 | 2006-05-20 |
| 1174573307 | Cpo Services, Inc | Prosthetic/Orthotic Supplier | 741 West Main Street, Peoria, IL 61606 | 2006-05-10 |
| 1174025357 | Amy M Durst | Nurse Practitioner | 1001 Main St Ste 500a, Peoria, IL 61606 | 2018-03-05 |
| 1538471099 | Jacob Royle Hopping | Surgery | 1001 Main St Ste 300, Peoria, IL 61606 | 2010-07-12 |
| 1881906410 | Heather Jefford | Clinical Nurse Specialist | 1001 Main St, 3rd Floor, Peoria, IL 61606 | 2010-07-12 |
| 1306874128 | David L Crawford | Surgery | 1001 Main Street, Suite 300, Peoria, IL 61606 | 2006-06-29 |
| Find all providers in zip 61606 | ||||
| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003861634 | Patrick William Elwood | Neurological Surgery | 719 N William Kumpf Blvd, Suite 100, Peoria, IL 61605 | 2006-05-23 |
| 1295185056 | Thomas Morison Russell | Neurological Surgery | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2016-06-13 |
| 1700235280 | Nolan Winslow | Neurological Surgery | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2016-06-06 |
| 1790167559 | Daniel Vollhaber | Neurological Surgery | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2015-06-29 |
| 1053793315 | Max Kahn | Neurological Surgery | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2015-06-23 |
| 1720493000 | Sujit Bhimireddy | Neurological Surgery | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2014-06-25 |
| 1295173789 | Paul Miles Macmahon | Neurological Surgery | Osf St Francis Medical Ctr, 530 N.e. Glen Oak Ave, Peoria, IL 61637-0001 | 2013-06-06 |
| 1790122141 | Kendrick Dewayne Johnson | Neurological Surgery | Osf St Francis Medical Ctr, 530 N.e. Glen Oak Ave, Peoria, IL 61637-0001 | 2013-05-24 |
| 1043506942 | Derek Martinez | Neurological Surgery | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2011-06-20 |
| 1467765040 | Andres L Maldonado | Neurological Surgery | 200 E Pennsylvania Ave, Peoria, IL 61603-3089 | 2010-07-23 |
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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.