DR. TED A SOLOMON (NPI# 1689658775) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689658775 |
| Entity Type | Individual |
| Full Name | DR. TED A SOLOMON |
| Credential | M.D. |
| Practice Address |
200 E Pennsylvania Ave Suite 201 Peoria IL 61603-3089 |
| Practice Telephone | 3096557700 |
| Practice Fax Number | 3096248790 |
| Mailing Telephone | 3096557700 |
| Mailing Fax Number | 3096248790 |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2007-11-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | IL | Allopathic & Osteopathic Physicians |
| Street Address |
200 E PENNSYLVANIA AVE SUITE 201 |
| City | PEORIA |
| State | IL |
| Zip Code | 61603-3089 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912901711 | James W Bauer | Internal Medicine | 200 E Pennsylvania Ave, Ste 105, Peoria, IL 61603-3045 | 2005-06-09 |
| 1205473154 | Gargi Dnyanesh Gupte | Physician Assistant | 200 E Pennsylvania Ave, Peoria, IL 61603-3089 | 2019-12-10 |
| 1487127734 | Stephanie S Beckstrom | Nurse Practitioner | 200 E Pennsylvania Ave, Peoria, IL 61603-3089 | 2019-01-09 |
| 1174093009 | Katelyn M Johnson | Nurse Practitioner | 200 E Pennsylvania Ave, Peoria, IL 61603-3089 | 2018-12-04 |
| 1093298127 | Loan T Nguyen | Nurse Practitioner | 200 E Pennsylvania Ave, Peoria, IL 61603-3089 | 2018-09-14 |
| 1922580695 | Anna K Boyce | Audiologist | 200 E Pennsylvania Ave, Peoria, IL 61603-3089 | 2018-08-30 |
| 1033604855 | Caroline Marie Boczar | Audiologist | 200 E Pennsylvania Ave, Peoria, IL 61603-3089 | 2018-06-25 |
| 1831608991 | Laurel K Donaldson | Audiologist | 200 E Pennsylvania Ave, Peoria, IL 61603-3089 | 2017-09-21 |
| 1851818835 | Cynthia I Guede | Nurse Practitioner | 200 E Pennsylvania Ave, Peoria, IL 61603-3089 | 2017-08-29 |
| 1275986051 | Travis E. Towne | Social Worker | 200 E Pennsylvania Ave, Peoria, IL 61603-3089 | 2016-07-18 |
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| 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 |
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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 |
| 1538123468 | Peoria Urological Associates S.c | Urology | 7309 N Knoxville Ave, Peoria, IL 61614-2085 | 2006-04-17 |
| 1245294404 | Robert Stuart | Urology | 7309 N Knoxville Ave, Peoria, IL 61614-2085 | 2006-04-14 |
| 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.