ACTIVATE HEALTHCARE - PEORIA PUBLIC SCHOOLS CLINIC (NPI# 1922646686) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922646686 |
| Entity Type | Organization |
| Organization Name | ACTIVATE HEALTHCARE - PEORIA PUBLIC SCHOOLS CLINIC |
| Other Organization Name | ACTIVATE HEALTHCARE. |
| Practice Address |
1524 W Glen Ave Peoria IL 61614-4692 |
| Mailing Address |
2010 N Damen Ave Chicago IL 60647-3284 |
| Practice Telephone | 3095120902 |
| Enumeration Date | 2019-12-12 |
| Last Update Date | 2020-03-05 |
| Authorized Official Name | DEBRA GEIHSLER (PRINCIPAL) |
| Authorized Official Telephone | 7736973144 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Activate Healthcare. | Doing Business As Name - Organization |
| Street Address |
1524 W GLEN AVE |
| City | PEORIA |
| State | IL |
| Zip Code | 61614-4692 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801866744 | Kim Keith Wiese | Physician Assistant | 1524 W Glen Ave, Peoria, IL 61614-4692 | 2006-01-24 |
| 1588802623 | Jason Ryan Benningfield | Chiropractor | 1524 W Glen Ave, Peoria, IL 61614-4692 | 2009-01-28 |
| 1285792085 | Mark K Werking, Dc, Sc | Chiropractor | 1524 W Glen Ave, Ste B, Peoria, IL 61614 | 2006-12-05 |
| 1154429744 | Benningfield & Associates, LLC | Chiropractor | 1524 W Glen Ave, Peoria, IL 61614-4692 | 2006-09-20 |
| 1750487047 | Meghan K Chockley | Physical Therapist | 1524 W Glen Ave, Peoria, IL 61614-4692 | 2006-09-15 |
| 1508838335 | Scott C Fenwick | Chiropractor | 1524 W Glen Ave, Peoria, IL 61614-4692 | 2006-02-06 |
| 1962474791 | Chad Timothy Walker | Chiropractor | 1524 W Glen Ave, Peoria, IL 61614-4692 | 2006-02-06 |
| 1437121258 | Robert Craig Benningfield | Chiropractor | 1524 W Glen Ave, Peoria, IL 61614-4692 | 2006-02-06 |
| 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 | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043851793 | Honorhealth Medical Group, LLC | Clinic/Center | 10230 W Happy Valley Pkwy Ste 200, Peoria, AZ 85383-4255 | 2019-10-03 |
| 1427419894 | E&a Solutions | Clinic/Center | 24656 North Lake Pleasant Parkway, St 103-288, Peoria, AZ 85373 | 2016-03-14 |
| 1902204191 | Trident Clinical Pllc | Clinic/Center | 20340 N Lake Pleasant Rd Ste 109, Peoria, AZ 85382-9713 | 2014-12-20 |
| 1225382476 | Premiere Medical Care Pllc | Clinic/Center | 8914 N 91st Ave Ste 100a, Peoria, AZ 85345-8390 | 2012-11-08 |
| 1124252127 | Partners In Recovery, LLC | Clinic/Center | 14100 N 83rd Ave Ste 100150, Peoria, AZ 85381-5658 | 2009-05-06 |
| 1659409290 | Eagle Family Medicine Sc | Clinic/Center | 2809 W Willow Knolls Suite C, Peoria, IL 61614-8259 | 2007-03-02 |
| 1821550310 | Country Doctor Inc | Clinic/Center | 13260 N 94th Dr Ste 102, Peoria, AZ 85381-4242 | 2019-04-03 |
| 1285966242 | Sun City Medical Specialists Ltd | Clinic/Center | 13460 N 94th Dr, H-1, Peoria, AZ 85381-4835 | 2010-02-02 |
| 1194825190 | Thomas F Kouri Internal Medicine Inc | Clinic/Center | 5401 N Knoxville Ave, Peoria, IL 61614-5098 | 2006-09-22 |
| 1306890108 | Proctor Health Systems | Clinic/Center | 5401 N Knoxville Ave, Suite 300, Peoria, IL 61614-5098 | 2006-05-19 |
| Find all providers in PEORIA | ||||
Please comment or provide details below to improve the information on ACTIVATE HEALTHCARE - PEORIA PUBLIC SCHOOLS CLINIC.
| 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.