JENNIFER MENDALUK (NPI# 1336706845) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336706845 |
| Entity Type | Individual |
| Full Name | JENNIFER MENDALUK |
| Credential | FNP, APN |
| Practice Address |
8940 N Wood Sage Rd Peoria IL 61615-7822 |
| Mailing Address |
1029 Hillview Dr Lemont IL 60439-4353 |
| Practice Telephone | 3092406040 |
| Mailing Telephone | 7085437875 |
| Enumeration Date | 2019-05-21 |
| Last Update Date | 2020-01-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 209019236 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
8940 N WOOD SAGE RD |
| City | PEORIA |
| State | IL |
| Zip Code | 61615-7822 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174522486 | Nguyet A Le-lindqwister | Internal Medicine | 8940 N Wood Sage Rd, Peoria, IL 61615-7822 | 2005-07-19 |
| 1548899834 | Kari A Breckenridge | Nurse Practitioner | 8940 N Wood Sage Rd, Peoria, IL 61615-7822 | 2020-04-07 |
| 1295364826 | Jessica Lemmerman | Nurse Practitioner | 8940 N Wood Sage Rd, Peoria, IL 61615-7822 | 2020-04-06 |
| 1992330583 | Heather R Pierce | Nurse Practitioner | 8940 N Wood Sage Rd, Peoria, IL 61615-7822 | 2020-03-04 |
| 1730713546 | Kim M Scott | Clinical Nurse Specialist | 8940 N Wood Sage Rd, Peoria, IL 61615-7822 | 2020-03-02 |
| 1609411743 | Holly Jo Delinski | Nurse Practitioner | 8940 N Wood Sage Rd, Peoria, IL 61615-7822 | 2019-11-13 |
| 1649825514 | Lindsey Lorraine Grys | Nurse Practitioner | 8940 N Wood Sage Rd, Peoria, IL 61615-7822 | 2019-08-07 |
| 1750843199 | Elizabeth M Berryman | Nurse Practitioner | 8940 N Wood Sage Rd, Peoria, IL 61615-7822 | 2019-04-04 |
| 1477010031 | Cynthia Salazar | Nurse Practitioner | 8940 N Wood Sage Rd, Peoria, IL 61615-7822 | 2019-03-01 |
| 1841764362 | Grace Elizabeth Hensold | Dietitian, Registered | 8940 N Wood Sage Rd, Peoria, IL 61615-7822 | 2019-01-17 |
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| 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 | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962034215 | Lia Doh | Nurse Practitioner | 8357 W Rosewood Ln, Peoria, AZ 85383-3869 | 2020-02-05 |
| 1285274027 | Chauntel M Nessmith | Nurse Practitioner | 7540 W Jenan Dr, Peoria, AZ 85345-1367 | 2020-01-09 |
| 1003450925 | Kimberly Ann Flores | Nurse Practitioner | 12118 W Avenida Del Rey, Peoria, AZ 85383-5819 | 2019-11-04 |
| 1821630666 | Leesa K Jost | Nurse Practitioner | 8914 N Prairie Pointe Rd, Peoria, IL 61615-1574 | 2019-10-14 |
| 1942842018 | Tamarra Lynn Subyantoro | Nurse Practitioner | 5114 N Glen Park Place Rd Ste 110, Peoria, IL 61614-4686 | 2019-10-10 |
| 1255981593 | Eunmee Hong | Nurse Practitioner | 21369 N 79th Dr, Peoria, AZ 85382-4453 | 2019-09-18 |
| 1295297737 | Tasha R Besser | Nurse Practitioner | 5114 N Glen Park Place Rd Ste 220, Peoria, IL 61614-4686 | 2019-04-03 |
| 1669936506 | Kristin Danielle Downs | Nurse Practitioner | 10408 N Centerway Dr, Peoria, IL 61615-1234 | 2019-01-24 |
| 1205312790 | Kathleen Marie Hendricks | Nurse Practitioner | 2809 W Willow Knolls Dr, Peoria, IL 61614 | 2018-07-17 |
| 1538665609 | Tara Moore | Nurse Practitioner | 10408 N Centerway Dr Ste Cde, Peoria, IL 61615-1234 | 2018-04-05 |
| 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.