PEORIA OBSTETRICS & GYNECOLOGY, S.C. (NPI# 1477672020) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477672020 |
| Entity Type | Organization |
| Organization Name | PEORIA OBSTETRICS & GYNECOLOGY, S.C. |
| Practice Address |
900 Main St Ste 660 Peoria IL 61602-1060 |
| Practice Telephone | 3096874230 |
| Practice Fax Number | 3092727704 |
| Mailing Telephone | 3096874230 |
| Mailing Fax Number | 3092727704 |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2009-01-26 |
| Authorized Official Name | MRS. PAULA M CLARK (PRACTICE ADMINISTRATOR) |
| Authorized Official Telephone | 3096874242 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 036084069 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036111906 | 05 | |
| IL | 036065639 | 05 | |
| IL | 036108543 | 05 | |
| IL | 036098292 | 05 | |
| IL | 036044919 | 05 | |
| IL | 036062138 | 05 | |
| IL | 036084069 | 05 |
| Street Address |
900 MAIN ST STE 660 |
| City | PEORIA |
| State | IL |
| Zip Code | 61602-1060 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043205644 | Dana Humes Goff | Advanced Practice Midwife | 900 Main St Ste 660, Peoria, IL 61602-1060 | 2005-09-20 |
| 1659672129 | Peoria Obstetrics & Gynecology of Central Illinois | Obstetrics & Gynecology | 900 Main St Ste 660, Peoria, IL 61602-1060 | 2010-11-15 |
| 1902107733 | Boyd Obstetrics & Gynecology of Central Illinois | Obstetrics & Gynecology | 900 Main St Ste 660, Peoria, IL 61602-1060 | 2010-11-10 |
| 1063745404 | Kimberly A. Cheek | Nurse Practitioner | 900 Main St Ste 660, Peoria, IL 61602-1060 | 2009-09-17 |
| 1245358381 | Boyd Obstetrics & Gynecology, S.c. | Obstetrics & Gynecology | 900 Main St Ste 660, Peoria, IL 61602-1060 | 2007-03-27 |
| 1326099805 | Lindsey M Fritz | Nurse Practitioner | 900 Main St Ste 660, Peoria, IL 61602-1060 | 2006-05-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720574676 | Critical Care Rx, LLC | Pharmacy | 126 Oak St, Peoria, IL 61602 | 2018-07-03 |
| 1235675836 | Cheryl Beckman | Registered Nurse | 211 Fulton Street, Suite 207, One Technology Plaza, Peoria, IL 61602 | 2017-01-06 |
| 1063957942 | Rosemary Ince | Registered Nurse | 211 Fulton St. Suite 207, One Technology Plaza, Peoria, IL 61602 | 2016-12-30 |
| 1962674820 | Lisa Jean Burckhartzmeyer | Psychiatry & Neurology | 228 Ne Jefferson St, Peoria, IL 61602 | 2008-03-31 |
| 1669503587 | Jill Larson | Counselor | 330 Sw Washington Street, Peoria, IL 61602 | 2007-03-09 |
| 1265407399 | Cardiac Consultants Sc | Internal Medicine | 900 Main Street, Suite 320, Peoria, IL 61602 | 2006-02-22 |
| 1013364470 | Rafal Szymczuk | Student in an Organized Health Care Education/Training Program | 900 Main Street, Suite 720, Peoria, IL 61602 | 2016-05-16 |
| 1043693831 | Kari Beth Watts | Family Medicine | 815 Main St, Peoria, IL 61602 | 2015-06-30 |
| 1881072791 | Kristen Dent | Family Medicine | 815 Main St, Peoria, IL 61602 | 2015-05-12 |
| 1023422797 | Andrew Wang | Psychiatry & Neurology | 900 Main St Ste 580, Peoria, IL 61602 | 2014-06-20 |
| Find all providers in zip 61602 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083097000 | Pilar Mckay Rainey | Obstetrics & Gynecology | 530 Ne Glen Oak, Peoria, IL 61634-0001 | 2015-07-08 |
| 1881084838 | Pinnacle Women's Center LLC | Obstetrics & Gynecology | 15396 N 83rd Ave Ste F100, Peoria, AZ 85381 | 2015-01-29 |
| 1124468129 | Kaleb L. Jacobs | Obstetrics & Gynecology | 6708 N. Knoxville Ave, Suite 1, Peoria, IL 61614 | 2013-07-05 |
| 1093062077 | Rejuv David Kindred, PC | Obstetrics & Gynecology | 2806 N Knoxville Ave, Peoria, IL 61604-2870 | 2012-08-09 |
| 1528368875 | Couri Center for Gynecology and Integrative Womens Health Sc | Obstetrics & Gynecology | 6708 North Knoxville Ave, Suite 1, Peoria, IL 61614 | 2010-11-02 |
| 1376787523 | Vanessa Marie Cameron | Obstetrics & Gynecology | 8600 N Sate Route 91, Suite 330, Peoria, IL 61615 | 2009-04-30 |
| 1437311651 | Marquia T Redden-grier | Obstetrics & Gynecology | 21755 N 77th Ave, Suite E-1200, Peoria, AZ 85382-2111 | 2008-06-29 |
| 1023298916 | Edward C Luan Md Sc | Obstetrics & Gynecology | 7620 N University St Ste 108, Peoria, IL 61614-8300 | 2007-11-07 |
| 1881893212 | Xochitl Lorena Garcia | Obstetrics & Gynecology | 2901 N. Knoxville Ave, Peoria, IL 61603-1747 | 2007-07-16 |
| 1881810224 | Ali Azadi | Obstetrics & Gynecology | Star Clinic/star Urogynecology, 14155 N 83rd Ave, Bld 6, Suite 138, Peoria, AZ 85381 | 2007-04-17 |
| 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.