JORGE KATTAH (NPI# 1750489050) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750489050 |
| Entity Type | Individual |
| Full Name | JORGE KATTAH |
| Practice Address |
200 E Pennsylvania Ave Peoria IL 61603-3089 |
| Practice Telephone | 3096244000 |
| Practice Fax Number | 3096244010 |
| Mailing Telephone | 3096244000 |
| Mailing Fax Number | 3096244010 |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2016-02-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
036-096882 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036096882 | 05 |
| Street Address |
200 E PENNSYLVANIA AVE |
| 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 |
| 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 | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326244682 | Maria S. Parr | Psychiatry & Neurology | Osf Saint Francis Medical Center, 530 N.e.glen Oak Ave., Peoria, FL 61637 | 2007-06-25 |
| 1881815488 | Jacob Tony | Psychiatry & Neurology | 900 Main St Ste 250, Peoria, IL 61602-5006 | 2007-05-01 |
| 1861473076 | Dennis Q Mcmanus | Psychiatry & Neurology | 8600 N Il-91, Suite 110, Peoria, IL 61615 | 2005-11-07 |
| 1073503819 | Robert I(sa) Pfeffer | Psychiatry & Neurology | 3323 W Gloucester Ct, Peoria, IL 61615-2601 | 2005-10-24 |
| 1558366856 | Asad Ehtisham | Psychiatry & Neurology | 15396 N 83rd Ave Ste E, Peoria, AZ 85381-5627 | 2005-06-15 |
| 1700375854 | Maxwell Quincy Nyce | Psychiatry & Neurology | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2018-05-03 |
| 1396145264 | Envi Pllc | Psychiatry & Neurology | 15396 N 83rd Ave Ste E, Peoria, AZ 85381-5627 | 2014-08-28 |
| 1134535693 | Elias Samaha | Psychiatry & Neurology | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2014-07-05 |
| 1831504844 | Javad Alam | Psychiatry & Neurology | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2014-06-27 |
| 1285047977 | Deepak Reddy | Psychiatry & Neurology | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2014-06-10 |
| 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.