PEORIA UROLOGICAL ASSOCIATES S.C (NPI# 1538123468) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538123468 |
| Entity Type | Organization |
| Organization Name | PEORIA UROLOGICAL ASSOCIATES S.C |
| Practice Address |
7309 N Knoxville Ave Peoria IL 61614-2085 |
| Practice Telephone | 3096929898 |
| Mailing Telephone | 3096929898 |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. JOSEPH BANNO (CEO) |
| Authorized Official Telephone | 3096929898 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 208800000X | Urology | Allopathic & Osteopathic Physicians | ||
| X | 103TH0100X |
Psychologist Specialization: Health Service |
Behavioral Health & Social Service Providers |
| Street Address |
7309 N KNOXVILLE AVE |
| City | PEORIA |
| State | IL |
| Zip Code | 61614-2085 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982688669 | Lisa K Nielsen | Physician Assistant | 7309 N Knoxville Ave, Peoria, IL 61614-2085 | 2005-12-06 |
| 1962038356 | Joshua Michael Auer | Nurse Practitioner | 7309 N Knoxville Ave, Peoria, IL 61614-2085 | 2020-03-17 |
| 1932449691 | J&j Health Services LLC | Urology | 7309 N Knoxville Ave, Suite 200, Peoria, IL 61614-2085 | 2013-02-18 |
| 1649537986 | Lorie L Recar | Specialist/Technologist, Other | 7309 N Knoxville Ave, Ste. #2, Peoria, IL 61614-2085 | 2012-04-11 |
| 1659662070 | Erin Jean Overcash | Nurse Practitioner | 7309 N Knoxville Ave, Suite 300, Peoria, IL 61614-2085 | 2011-04-20 |
| 1427360809 | Laurie Mcatee | Nurse Anesthetist, Certified Registered | 7309 N Knoxville Ave, Peoria, IL 61614-2085 | 2010-07-13 |
| 1275869240 | Tracy L Schierer | Nurse Practitioner | 7309 N Knoxville Ave, Peoria, IL 61614-2085 | 2009-10-27 |
| 1942441225 | Laura L Wilson-brown | Physician Assistant | 7309 N Knoxville Ave, Peoria, IL 61614-2085 | 2009-03-16 |
| 1821244880 | Brian Arthur Elsesser | Nurse Anesthetist, Certified Registered | 7309 N Knoxville Ave, Peoria, IL 61614-2085 | 2008-08-11 |
| 1891715272 | Midwest Urological Group, Ltd. | Specialist | 7309 N Knoxville Ave, Peoria, IL 61614-2085 | 2006-07-20 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548818511 | Christine Svoboda | Social Worker | 6919 N Knoxville Ave Ste 100 and 202, Peoria, IL 61614 | 2019-09-03 |
| 1639649007 | Kathy Karouzos Counseling, LLC | Clinic/Center | 330 W. Ivy Ln., Peoria, IL 61614 | 2018-11-28 |
| 1205312790 | Kathleen Marie Hendricks | Nurse Practitioner | 2809 W Willow Knolls Dr, Peoria, IL 61614 | 2018-07-17 |
| 1629563937 | Mary Elizabeth Cunningham | Counselor | 6219 N. Eldorado Dr., Peoria, IL 61614 | 2018-06-28 |
| 1861937955 | Angela Gilles | Social Worker | 6919 N Knoxville Ave Ste 100, Peoria, IL 61614 | 2016-12-27 |
| 1467994897 | Melissa Saxsma | Specialist | 5009 N Executive Dr, Peoria, IL 61614 | 2016-11-16 |
| 1902258874 | Rashid Plastic Surgery, LLC | Plastic Surgery | 804 W Trailcreek Drive, Peoria, IL 61614 | 2016-07-05 |
| 1215313143 | Melissa Lynn Phelan | Nurse Practitioner | 122 E Morningside Dr, Peoria, IL 61614 | 2015-08-03 |
| 1811380165 | All Ways Caring Services, Inc. | In Home Supportive Care | 6919 N Knoxville Ave, Suite 102, Peoria, IL 61614 | 2015-03-11 |
| 1568875920 | Schuler & Arkwell Orthodontic Partnership | Dentist | 2425 Cornerstone Ct. Ste. A, Peoria, IL 61614 | 2014-06-03 |
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| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871752501 | Wendy Olson Padilla | Urology | 1001 Main St Ste 400, Peoria, IL 61606-2036 | 2008-06-06 |
| 1356317416 | Daniel Mark Riesenberg | Urology | 30037 N Whipsaw Rd, 101, Peoria, AZ 85383-5195 | 2006-02-27 |
| 1932449691 | J&j Health Services LLC | Urology | 7309 N Knoxville Ave, Suite 200, Peoria, IL 61614-2085 | 2013-02-18 |
| 1023308483 | Jubilee Phan | Urology | 1001 Main St Ste 400, Peoria, IL 61606-2036 | 2011-04-19 |
| 1578870556 | Michael E Longevin Mdsc | Urology | 5401 N Knoxville Ave, Suite 112, Peoria, IL 61614-5098 | 2010-09-11 |
| 1548297252 | Churphena Reid | Urology | 1001 Main St, Suite 201, Peoria, IL 61606-1907 | 2006-06-27 |
| 1497795504 | Sheldon D Roberts | Urology | 13640 N Plaza Del Rio Blvd, Ste 310, Peoria, AZ 85381-4846 | 2006-06-07 |
| 1982659991 | Affiliated Urology Specialists, Ltd. | Urology | 200 E Pennsylvania Ave, Suite 201, Peoria, IL 61603-3089 | 2006-05-24 |
| 1245294404 | Robert Stuart | Urology | 7309 N Knoxville Ave, Peoria, IL 61614-2085 | 2006-04-14 |
| 1679537831 | Giovanni Colombo | Urology | 7309 N Knoxville Ave, Peoria, IL 61614-2085 | 2006-04-14 |
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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.