DR. HOMER C. PENA (NPI# 1336367697) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336367697 |
| Entity Type | Individual |
| Full Name | DR. HOMER C. PENA |
| Credential | M.D. |
| Practice Address |
100 Ne Randolph Ave Peoria IL 61606-1919 |
| Mailing Address |
1005 W Nassau Dr Peoria IL 61615-1361 |
| Practice Telephone | 3096248525 |
| Practice Fax Number | 3096248524 |
| Mailing Telephone | 3096248528 |
| Mailing Fax Number | 3096248524 |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2083X0100X |
Preventive Medicine Specialization: Occupational Medicine |
IL | 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 |
| Find all providers in the same location | ||||
| 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 | 2083X0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Preventive Medicine |
| Specialization | Occupational Medicine |
| Occupational medicine focuses on the health of workers, including the ability to perform work; the physical, chemical, biological, and social environments of the workplace; and the health outcomes of environmental exposures. Practitioners in this field address the promotion of health in the work place, and the prevention and management of occupational and environmental injury, illness, and disability. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Preventive Medicine, 2007. http://www.abprevmed.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Preventive Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104944974 | Robert I Martin | Preventive Medicine | 1127 N North Street, Peoria, IL 61606 | 2007-03-27 |
| 1649820218 | Osf Multi-specialty Group | Preventive Medicine | 719 N William Kumpf Blvd, Peoria, IL 61605-2530 | 2019-09-16 |
| 1871039388 | Osf Healthcare System | Preventive Medicine | 719 N William Kumpf Blvd, Peoria, IL 61605-2530 | 2017-01-09 |
| 1568680643 | Stephen Lewis Goldman | Preventive Medicine | 100 Ne Adams St, Peoria, IL 61629-1410 | 2007-04-23 |
| 1558585000 | Paul Hodgins | Preventive Medicine | 100 Ne Adams St, Peoria, IL 61629-1410 | 2007-04-13 |
| 1831214006 | Richard K Burger | Preventive Medicine | 7400 W Olive Ave, Suite 123, Peoria, AZ 85345-8889 | 2007-03-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356816466 | Taylor Nicole Rich | Preventive Medicine | 2408 Hampshire Dr Apt 2, Champaign, IL 61820-1215 | 2018-10-05 |
| 1720517568 | Avrom Simon | Preventive Medicine | 128 S Aberdeen St Unit 5s, Chicago, IL 60607-1507 | 2017-06-06 |
| 1215332531 | Cheryl Culberson | Preventive Medicine | 350 Surryse Rd Ste 110, Lake Zurich, IL 60047-3217 | 2014-10-29 |
| 1497018493 | Brian Charles Svazas | Preventive Medicine | 211 Kenilworth Ave, Glen Ellyn, IL 60137-5324 | 2012-06-25 |
| 1205129764 | Zbigniev Durlak | Preventive Medicine | 9930 Stratford L, Palos Hills, IL 60465 | 2011-05-17 |
| 1609168657 | New Life Pentecostal Medical Clinic for The Uninsured Inc | Preventive Medicine | 183 N Schuyler Ave, Kankakee, IL 60901-3828 | 2011-05-10 |
| 1821305269 | Daniel Alexander Bakston | Preventive Medicine | 835 S. Wolcott Ave E-144, University of Illinois Medical Center, Chicago, IL 60612-4006 | 2010-09-07 |
| 1194951913 | Sonya Meyers | Preventive Medicine | 835 S Wolcott Ave # E144, Chicago, IL 60612-3748 | 2009-06-08 |
| 1073755021 | Afiz A. Taiwo, Md. Mph. S.c. | Preventive Medicine | 309 Pinehurst Dr, Palos Heights, IL 60463-2911 | 2009-04-06 |
| 1104077494 | William Dawson | Preventive Medicine | 700 Woodmere Ln, Glenview, IL 60025-4469 | 2008-10-04 |
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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.