KWABENA A BOATENG (NPI# 1639215312) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639215312 |
| Entity Type | Individual |
| Full Name | KWABENA A BOATENG |
| Credential | MD |
| Practice Address |
2321 N Wisconsin Ave Peoria IL 61603-5613 |
| Mailing Address |
2214 N University St Peoria IL 61604-3221 |
| Practice Telephone | 3096807600 |
| Practice Fax Number | 3096814681 |
| Mailing Telephone | 3096807669 |
| Mailing Fax Number | 3096818443 |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2020-08-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 036084514 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036084514 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2000 Glenwood Avenue, Lle Lower Level East, Joliet, IL 60435 | 8155530500 | 8155530505 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669678652 | Kwabena Boateng | Pharmacist | 1525 Sadler Rd, Fernandina Beach, FL 32034-4467 | 2007-06-26 |
| 1093328205 | Kwabena Boateng | Pharmacist | 8201 Annapolis Rd, New Carrollton, MD 20784-3016 | 2020-08-26 |
| Street Address |
2321 N WISCONSIN AVE |
| City | PEORIA |
| State | IL |
| Zip Code | 61603-5613 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992757322 | Christine L Tharenos | Family Medicine | 2321 N Wisconsin Ave, Peoria, IL 61603-5613 | 2006-05-16 |
| 1083142038 | Samantha Elizabeth Martin | Advanced Practice Midwife | 2321 N Wisconsin Ave, Peoria, IL 61603-5613 | 2017-06-02 |
| 1740725837 | Angela Marie Miller | Nurse Practitioner | 2321 N Wisconsin Ave, Peoria, IL 61603-5613 | 2016-12-27 |
| 1235505108 | Bethany Joy Winfrey Ferguson | Nurse Practitioner | 2321 N Wisconsin Ave, Peoria, IL 61603-5613 | 2015-08-14 |
| 1932587797 | Elizabeth Gabel | Family Medicine | 2321 N Wisconsin Ave, Peoria, IL 61603-5613 | 2015-05-13 |
| 1588075048 | Mary Jennifer Sue Meister | Social Worker | 2321 N Wisconsin Ave, Peoria, IL 61603-5613 | 2014-05-17 |
| 1972932317 | Meghan Jean Khaiser | Physician Assistant | 2321 N Wisconsin Ave, Peoria, IL 61603-5613 | 2013-11-06 |
| 1811326317 | Carolyn Ann Calhoun | Advanced Practice Midwife | 2321 N Wisconsin Ave, Peoria, IL 61603-5613 | 2013-11-05 |
| 1467658443 | Heartland Community Health Clinic | Clinic/Center | 2321 N Wisconsin Ave, Peoria, IL 61603-5613 | 2007-06-26 |
| 1356406144 | Laura Marie Fullerton | Nurse Practitioner | 2321 N Wisconsin Ave, Peoria, IL 61603 | 2006-12-22 |
| Find all providers in the same location | ||||
| 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 | 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.