MRS. ANGELA D GRAHAM (NPI# 1902105760) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902105760 |
| Entity Type | Individual |
| Full Name | MRS. ANGELA D GRAHAM |
| Other Name | MRS. ANGELA D GRAHAM |
| Credential | CPNP-AC |
| Practice Address |
530 Ne Glen Oak Ave Peoria IL 61637-0001 |
| Mailing Address |
205 Lincoln Rd Canton IL 61520-1040 |
| Practice Telephone | 3096552000 |
| Mailing Telephone | 3092510032 |
| Enumeration Date | 2011-03-19 |
| Last Update Date | 2011-03-19 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0222X |
Nurse Practitioner Specialization: Pediatrics, Critical Care |
209008727 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922371830 | Angela Carol Graham | Counselor | 6126 E. 32nd Pl., Crsok Calm Center, Tulsa, OK 74135 | 2012-02-23 |
| 1497031801 | Angela Graham | Counselor | 3021 Running Brook Dr, Joshua, TX 76058-5757 | 2011-10-30 |
| 1093790545 | Angela D Graham | Registered Nurse | 3375 Us Route 60, Huntington, WV 25705-2837 | 2005-12-07 |
| 1063055366 | Angela Marie-kai Graham | Behavioral Analyst | 600 N 1st St # 89101, Las Vegas, NV 89101-1904 | 2019-10-21 |
| 1598327330 | Angela Ferguson Graham | Registered Nurse | 159 Hartley Way, Pearisburg, VA 24134-2471 | 2019-07-02 |
| 1740746676 | Angela Graham | Technician | 3175 S Eastern Ave, Las Vegas, NV 89169-3308 | 2019-02-15 |
| 1396118402 | Angela Graham | Chore Provider | 4040 Presidential Blvd, 1918, Philadelphia, PA 19131-1727 | 2015-11-11 |
| Street Address |
530 NE GLEN OAK AVE |
| City | PEORIA |
| State | IL |
| Zip Code | 61637-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346235777 | Jack Michael Gibson | Obstetrics & Gynecology | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2005-09-12 |
| 1053912188 | Janie Clary | Nurse Practitioner | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-11-04 |
| 1265030548 | Christina David | Nurse Practitioner | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-10-09 |
| 1033726831 | Corry Lynn Rediger | Occupational Therapist | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-09-25 |
| 1720694094 | Katelynn M Madden | Clinical Nurse Specialist | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-09-21 |
| 1568074474 | Amanda Diane Beoletto | Pharmacist | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-08-21 |
| 1881212892 | Mohammad Mousbah Al-tabbaa | Student in an Organized Health Care Education/Training Program | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-07-07 |
| 1750909693 | Mohammad Gareeb | Student in an Organized Health Care Education/Training Program | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-07-07 |
| 1376160846 | Bassel Elia Abouzeid | Student in an Organized Health Care Education/Training Program | 530 Ne Glen Oak Ave, Peoria, IL 61637 | 2020-07-01 |
| 1700403516 | Christina Marie Spurgeon | Nurse Practitioner | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-06-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780200865 | Kuang Chuen Liu | Pediatrics | 530 Ne Glen Oak Ave, Peoria, Peoria, IL 61637 | 2020-06-24 |
| 1174184527 | Manisha Tharoor | Student in an Organized Health Care Education/Training Program | 530 N.e Glen Oak Ave, Peoria, IL 61637 | 2019-06-26 |
| 1609436724 | Sriviji Senthil Kumaran | Student in an Organized Health Care Education/Training Program | 530. N.e Glen Oak Ave., Peoria, IL 61637 | 2019-06-20 |
| 1780240929 | Abuzar Ali Asif | Student in an Organized Health Care Education/Training Program | 530 N. E. Glen Oak Ave., Peoria, IL 61637 | 2019-05-14 |
| 1518328665 | Jenna Bishop | Dietitian, Registered | 600 Ne Water Street, Peoria, IL 61637 | 2016-03-17 |
| 1194133850 | Ashish Kumar Roy | Internal Medicine | 530 N.e. Glen Oak Ave, Peoria, IL 61637 | 2014-07-25 |
| 1265720510 | Reuben Antony | Pediatrics | 530 Ne Glen Oak Ave., C/o Ms Suzy Lewellen, Peoria, IL 61637 | 2011-07-20 |
| 1366673436 | Joseph William Hauter | Emergency Medicine | 830 Ne Glen Oak Ave, Peoria, IL 61637 | 2009-08-06 |
| 1437380748 | Jeremy R Monroe | Emergency Medicine | 530 Glen Oak, Osf St Francis Medical Center, Peoria, IL 61637 | 2009-08-04 |
| 1326244682 | Maria S. Parr | Psychiatry & Neurology | Osf Saint Francis Medical Center, 530 N.e.glen Oak Ave., Peoria, FL 61637 | 2007-06-25 |
| Find all providers in zip 61637 | ||||
| Taxonomy Code | 363LP0222X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics, Critical Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942801071 | Kathrine Sunstedt | Nurse Practitioner | 420 Ne Glen Oak Ave Ste 201, Peoria, IL 61603-3112 | 2020-11-04 |
| 1154649598 | Cynthia D Read | Nurse Practitioner | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2010-05-10 |
| 1740507292 | Tara L Osman | Nurse Practitioner | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2010-04-23 |
| 1073842878 | Lisa M Pierce | Nurse Practitioner | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2009-12-08 |
| 1265660716 | Kelly Skender | Nurse Practitioner | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2009-06-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245837863 | Emily Anne Whitlow | Nurse Practitioner | 5023 W Agatite Ave Unit 1, Chicago, IL 60630-3907 | 2020-10-06 |
| 1508271727 | Amy Wilhelmi | Nurse Practitioner | 21 Carey Ln, Streamwood, IL 60107-6662 | 2014-06-26 |
| 1700115235 | Janis Marie Quinn | Nurse Practitioner | 225 E. Chicago Ave, Chicago, IL 60611-2605 | 2009-12-11 |
| 1629213624 | Karriann Marie Longtin | Nurse Practitioner | 400 S Kennedy Dr Ste 900, Bradley, IL 60915-2683 | 2008-12-05 |
| 1649272154 | Beth Nachtsheim Bolick | Nurse Practitioner | 1653 W Congress Pkwy, Chicago, IL 60612-3833 | 2005-08-15 |
| 1942828306 | Stephanie Allison Gierman | Nurse Practitioner | 225 E Chicago Ave, Chicago, IL 60611-2991 | 2020-07-11 |
| 1851925622 | Lauren Alyssa Shaughnessy | Nurse Practitioner | 4440 W 95th St, Oak Lawn, IL 60453-2600 | 2020-03-02 |
| 1326683236 | Brittany Brennan | Nurse Practitioner | 225 E Chicago Ave, Chicago, IL 60611-2991 | 2019-11-14 |
| 1093378986 | Trudy Jean Johnson | Nurse Practitioner | 5841 S Maryland Ave # Mc1145, Chicago, IL 60637-1443 | 2019-04-17 |
| 1730651167 | Kara Hildebrandt | Nurse Practitioner | 225 E Chicago Ave, Chicago, IL 60611-2991 | 2018-12-25 |
| Find all providers with the same taxonomy | ||||
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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.