KATHLEEN F SCHLACK (NPI# 1821369596) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821369596 |
| Entity Type | Individual |
| Full Name | KATHLEEN F SCHLACK |
| Credential | APN, CNS |
| Practice Address |
200 E Pennsylvania Ave Peoria IL 61603-3089 |
| Practice Telephone | 3096554184 |
| Practice Fax Number | 3096248876 |
| Mailing Telephone | 3096554184 |
| Mailing Fax Number | 3096248876 |
| Enumeration Date | 2012-01-26 |
| Last Update Date | 2012-01-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364S00000X | Clinical Nurse Specialist | 209-009335 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| 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 |
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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 |
| Find all providers in zip 61603 | ||||
| Taxonomy Code | 364S00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| A registered nurse who, through a graduate degree program in nursing, or through a formal post-basic education program or continuing education courses and clinical experience, is expert in a specialty area of nursing practice within one or more of the components of direct patient/client care, consultation, education, research and administration. |
| Notes: Sources: American Nurses Association, American Nurses Credentialing Center, 1996 Certification Catalogue and The Interagency Conference on Nursing Statistics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861860058 | Jennifer Michelle Kelsey | Clinical Nurse Specialist | 420 Ne Glen Oak Avenue, Suite 401, Peoria, IL 61603 | 2015-09-04 |
| 1144564188 | Melanie Ann Reeves | Clinical Nurse Specialist | 530 Ne Glen Oak Ave Po Box G13, Peoria, IL 61637-0001 | 2012-11-15 |
| 1720694094 | Katelynn M Madden | Clinical Nurse Specialist | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-09-21 |
| 1730713546 | Kim M Scott | Clinical Nurse Specialist | 8940 N Wood Sage Rd, Peoria, IL 61615-7822 | 2020-03-02 |
| 1063936573 | Cheryl Herrmann | Clinical Nurse Specialist | 112 Ne Crescent Ave, Peoria, IL 61606-1901 | 2017-07-27 |
| 1477903797 | Lindsey Swischuk | Clinical Nurse Specialist | 114 W Stratford Dr, Peoria, IL 61614-7301 | 2016-06-17 |
| 1407259559 | Carissa Gorham | Clinical Nurse Specialist | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2014-10-03 |
| 1184026940 | Emily Mckenna | Clinical Nurse Specialist | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2014-09-23 |
| 1295141471 | Kara Lynn Marino | Clinical Nurse Specialist | 900 Main St Ste 100, Peoria, IL 61602-5003 | 2014-07-08 |
| 1841638855 | Sharon Marie Damron | Clinical Nurse Specialist | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2013-06-12 |
| 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.