EBS SPORTS (NPI# 1770763302) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770763302 |
| Entity Type | Organization |
| Organization Name | EBS SPORTS |
| Practice Address |
1019 W Lake Ave Peoria IL 61614-5933 |
| Practice Telephone | 3092022955 |
| Mailing Telephone | 3092022955 |
| Enumeration Date | 2007-11-12 |
| Last Update Date | 2007-11-12 |
| Authorized Official Name | MR. GREGORY DENNIS EBERLE (ATHLETIC TRAINER / OWNER) |
| Authorized Official Telephone | 3092022955 |
| Authorized Official Credential | ATC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
IL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
1019 W LAKE AVE |
| City | PEORIA |
| State | IL |
| Zip Code | 61614-5933 |
| 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 |
| Find all providers in zip 61614 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912513367 | Kathryn Spicer | Specialist/Technologist | 7525 W Mary Jane Ln, Peoria, AZ 85382-4819 | 2020-09-21 |
| 1558847350 | Abel Eulogio Fernandez | Specialist/Technologist | 7733 W Crocus Dr, Peoria, AZ 85381-8522 | 2018-07-14 |
| 1770085995 | Gregory Lee Gaa | Specialist/Technologist | 7800 N Sommer St Ste 608, Peoria, IL 61615-1968 | 2018-03-03 |
| 1770096877 | Michelle Therese Novak | Specialist/Technologist | 2338 W Van Winkle Way Ste 3300, Peoria, IL 61615-7485 | 2017-11-10 |
| 1174058291 | Brooke Willette | Specialist/Technologist | 18210 N 92nd Ln, Peoria, AZ 85382-7707 | 2017-04-26 |
| 1528591351 | Michael R Utter | Specialist/Technologist | 8940 W Kathleen Rd, Peoria, AZ 85382-3727 | 2017-04-08 |
| 1164967394 | Bryan Anthony Thompson | Specialist/Technologist | 8819 W Echo Ln, Peoria, AZ 85345-7834 | 2016-12-26 |
| 1003279340 | Joseph Tarantino | Specialist/Technologist | 8131 W Paradise Ln, Peoria, AZ 85382-3826 | 2016-04-04 |
| 1689049256 | Taylor Coltrin | Specialist/Technologist | 6032 N Teal Wood Cir, Peoria, IL 61615-2231 | 2015-12-08 |
| 1598184988 | Hiroki Sato | Specialist/Technologist | 7631 W Comet Ave, Peoria, AZ 85345-6666 | 2014-04-14 |
| 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.