MARK JENNINGS (NPI# 1356315246) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356315246 |
| Entity Type | Individual |
| Full Name | MARK JENNINGS |
| Credential | MD |
| Practice Address |
Pediatric Neurology 515 Ne Glen Oak #308 Peoria IL 61603 |
| Mailing Address |
1 Illini Dr Peoria IL 61605-2576 |
| Practice Telephone | 3096249844 |
| Mailing Telephone | 3096718503 |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 204D00000X | Neuromusculoskeletal Medicine & OMM | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | JOHN DEERE | IL01DP | 01 |
| IL | BCBS | 07215036 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437314002 | Mark Jennings | Case Manager/Care Coordinator | 303 Horseshoe Dr, Goldsboro, NC 27534-8715 | 2008-07-23 |
| 1598713166 | Mark Oliver Jennings | Psychiatry & Neurology | 7446 Shallowford Road, Suite 104, Chattanooga, TN 37341 | 2006-05-05 |
| 1578538955 | Mark R Jennings | Surgery | 3300 Mercy Health Blvd Ste 2010, Cincinnati, OH 45211-1103 | 2006-02-21 |
| 1396124988 | Mark William Jennings | Student in an Organized Health Care Education/Training Program | 2800 Main St, Bridgeport, CT 06606-4201 | 2015-05-28 |
| 1336379783 | Mark Byron Jennings | Internal Medicine | 1105 Central Expy N Ste 235, Allen, TX 75013-6135 | 2009-07-20 |
| 1164682688 | Mark Thomas Jennings | Internal Medicine | 1830 E Monument St, 5th Floor, Baltimore, MD 21287-0020 | 2008-06-10 |
| 1003915539 | Mark Randall Jennings | Internal Medicine | 2015 Jackson St, Anderson, IN 46016-4337 | 2006-09-21 |
| Street Address |
PEDIATRIC NEUROLOGY 515 NE GLEN OAK #308 |
| City | PEORIA |
| State | IL |
| Zip Code | 61603 |
| 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 | 204D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neuromusculoskeletal Medicine & OMM |
| The Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine physician directs special attention to the neuromusculoskeletal system and its interaction with other body systems. Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine encompasses increased knowledge and understanding of osteopathic principles and practice and heightened technical skills of osteopathic manipulative medicine, and integrates each of these into the management of pediatric, adolescent, adult, and geriatric patients. |
| Notes: Source: American Osteopathic Association, 2017 [7/1/2017: added definition] - Additional Resources: American Osteopathic Board of Neuromusculoskeletal Medicine, 2017, http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184973018 | Nca Holdings of Arizona, LLC | Neuromusculoskeletal Medicine & OMM | 13090 N 94th Dr, Suite 101, Peoria, AZ 85381-4256 | 2012-09-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639436330 | Christopher Sugihara Ngo | Neuromusculoskeletal Medicine & OMM | 2135 Dorothy Dr Ste 6, Belleville, IL 62223-7751 | 2012-04-19 |
| 1770749434 | Cheryl B Schwartz | Neuromusculoskeletal Medicine & OMM | 240 Saunders Road, Riverwoods, IL 60015-3835 | 2008-08-01 |
| 1114063989 | Gajda Sports Medical Center Ltd | Neuromusculoskeletal Medicine & OMM | 400 Lake Cook Road Suite 200c, Deerfield, IL 60015 | 2007-01-29 |
| 1750453858 | Carol Calhoun Williams | Neuromusculoskeletal Medicine & OMM | 124 E 8th St, Gibson City, IL 60936-1455 | 2006-11-14 |
| 1336225317 | Advantage Medical Group S.c. | Neuromusculoskeletal Medicine & OMM | 12770 S Harlem Ave, Palos Heights, IL 60463-2145 | 2006-10-31 |
| 1851485346 | Bernadette Goheen Kohn | Neuromusculoskeletal Medicine & OMM | 5404 W. Elm Street, Suite Q, Mchenry, IL 60050-4052 | 2006-10-02 |
| 1558462531 | Kurt P Heinking | Neuromusculoskeletal Medicine & OMM | 26520 Network Pl, Chicago, IL 60673-1265 | 2006-09-25 |
| 1669429908 | Lee Peter Bee | Neuromusculoskeletal Medicine & OMM | 107 W Franklin St, Sesser, IL 62884-1456 | 2006-05-30 |
| 1245293794 | James Randall Sigler | Neuromusculoskeletal Medicine & OMM | 909 W 3rd St, Mount Carmel, IL 62863-1718 | 2006-04-07 |
| 1841250339 | Edward A Trudeau | Neuromusculoskeletal Medicine & OMM | 319 E Madison St Ste 2a, Springfield, IL 62701-1035 | 2006-03-27 |
| Find all providers with the same taxonomy | ||||
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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.