DR. UGONNA THOMAS ANTOINE NWANKWO (NPI# 1356661433) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356661433 |
| Entity Type | Individual |
| Full Name | DR. UGONNA THOMAS ANTOINE NWANKWO |
| Other Name | DR. UGO THOMAS NWANKWO |
| Credential | M.D. |
| Practice Address |
420 Ne Glen Oak Ave Ste 301 Peoria IL 61603-3169 |
| Practice Telephone | 3096553453 |
| Enumeration Date | 2010-06-11 |
| Last Update Date | 2018-11-02 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | MT197261 | PA | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | MT197261 | PA | Allopathic & Osteopathic Physicians |
| Y | 2080P0202X |
Pediatrics Specialization: Pediatric Cardiology |
MT197261 | PA | Allopathic & Osteopathic Physicians |
| Street Address |
420 NE GLEN OAK AVE STE 301 |
| City | PEORIA |
| State | IL |
| Zip Code | 61603-3169 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518991074 | Mark D Plunkett | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 420 Ne Glen Oak Ave Ste 301, Suite 301, Peoria, IL 61603-3169 | 2006-07-10 |
| 1487132874 | Karen S Mischler | Dietitian, Registered | 420 Ne Glen Oak Ave Ste 301, Peoria, IL 61603-3169 | 2018-07-30 |
| 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 | 2080P0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Cardiology |
| A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740483627 | Priti M. Patel | Pediatrics | 530 Ne Glenoak Ave, Peoria, IL 61603-3133 | 2007-06-07 |
| 1427057595 | David P Chan | Pediatrics | 420 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2005-07-20 |
| 1386081792 | Children's Hospital of Illinois Medical Group | Pediatrics | 420 Ne Glen Oak Ave, Ste 301, Peoria, IL 61603-3105 | 2013-05-24 |
| 1851644256 | Jeffrey William Orcutt Jr. | Pediatrics | 420 Ne Glen Oak Ave, Ste 301, Peoria, IL 61603-3105 | 2012-10-23 |
| 1013146067 | Saint Francis Medical Center | Pediatrics | 420 Ne Glen Oak Ave, Suite 304, Peoria, IL 61603-3105 | 2009-07-13 |
| 1770744799 | Osf Multispecialty Group Peoria LLC | Pediatrics | 420 Ne Glen Oak Ave, Ste 304, Peoria, IL 61603-3105 | 2008-06-23 |
| 1164689428 | Matthew T Bramlet | Pediatrics | 420 Ne Glen Oak Ave, Suite 301, Peoria, IL 61603-3105 | 2008-05-22 |
| 1497879290 | Cecilia Anne Albaro | Pediatrics | 420 Ne Glen Oak Ave, Suite 301, Peoria, IL 61603-3105 | 2007-03-19 |
| 1982798146 | William H Albers | Pediatrics | 420 Ne Glen Oak Ave, Suite 304, Peoria, IL 61603-3105 | 2006-10-03 |
| 1619061827 | Jitendra J Shah | Pediatrics | 420 Ne Glen Oak Ave, Suite 304, Peoria, IL 61603-3105 | 2006-10-03 |
| 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.