MRS. MARISSA NICOLE RUEBHAUSEN (NPI# 1962994483) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962994483 |
| Entity Type | Individual |
| Full Name | MRS. MARISSA NICOLE RUEBHAUSEN |
| Other Name | MS. MARISSA NICOLE COLLIER |
| Credential | NP-C |
| Practice Address |
375 N Wall St Ste P520 Kankakee IL 60901-3493 |
| Practice Telephone | 8159326632 |
| Practice Fax Number | 8159325760 |
| Mailing Telephone | 8159326632 |
| Mailing Fax Number | 8159325760 |
| Enumeration Date | 2018-05-31 |
| Last Update Date | 2020-06-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
209017604 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 400 Riverside Dr Ste 1600, Bourbonnais, IL 609145406 | 8158027090 | 8158027091 |
| Street Address |
375 N WALL ST STE P520 |
| City | KANKAKEE |
| State | IL |
| Zip Code | 60901-3493 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053419119 | Alyce F Jackson | Physical Medicine & Rehabilitation | 375 N Wall St Ste P520, Kankakee, IL 60901-3493 | 2006-09-20 |
| 1033539630 | Mohammad Abdelhafez Issa | Physical Medicine & Rehabilitation | 375 N Wall St Ste P520, Kankakee, IL 60901-3493 | 2014-04-22 |
| 1275952913 | Ekua Baidua Gilbert-baffoe | Physical Medicine & Rehabilitation | 375 N Wall St Ste P520, Kankakee, IL 60901-3493 | 2014-04-09 |
| 1649353970 | Med Peds Associates | Non-Pharmacy Dispensing Site | 375 N Wall St Ste P520, Kankakee, IL 60901-3493 | 2006-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558978841 | William Mitsos Dds | Dentist | 1291 S. 7th Ave, Kankakee, IL 60901 | 2020-09-30 |
| 1922653682 | Jody Mcguyer, Lcpc, Cadc Counseling Services, LLC | Counselor | 315 W. Court St., Kankakee, IL 60901 | 2019-08-08 |
| 1700346327 | Sarah Elizabeth Toma | Speech-Language Pathologist | 200 E Court St #708, Kankakee, IL 60901 | 2019-03-20 |
| 1710473160 | Small Talk Speech Services, LLC | Clinic/Center | 1439 W Vanmeter St, Kankakee, IL 60901 | 2018-07-09 |
| 1124538004 | Amy J Green | Physical Therapist | 350 N. Wall Street, Kankakee, IL 60901 | 2017-10-05 |
| 1013457514 | Elizabeth Ann Smith | Registered Nurse | 292 Charlton Lane, Kankakee, IL 60901 | 2017-03-02 |
| 1861931461 | Stacey E. Brown | Nurse Practitioner | 207 N. Schuyler Ave., Kankakee, IL 60901 | 2017-02-15 |
| 1417352105 | Provider Healthcare Services, Inc | Home Health | 555 South Schuyler, Suite 275, Kankakee, IL 60901 | 2014-10-24 |
| 1265850655 | Ronald George Testa | Dentist | 202 N. Schuyler Ave, Kankakee, IL 60901 | 2014-04-02 |
| 1245587898 | Mary Beth Wertz | Registered Nurse | 100 N Jeffery Street, Kankakee, IL 60901 | 2012-08-13 |
| Find all providers in zip 60901 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306310131 | Kaitlyn M Dewitt | Nurse Practitioner | 375 N Wall St Ste 510, Kankakee, IL 60901-3483 | 2019-01-15 |
| 1356898951 | Kevin Bryant | Nurse Practitioner | 341 N Saint Joseph Ave, Kankakee, IL 60901-2741 | 2016-09-01 |
| 1790105195 | Keyoma Donta Jamerson | Nurse Practitioner | 1701 E Court, Kankakee, IL 60901-3661 | 2014-04-24 |
| 1689757940 | Amy Ann Golyshko | Nurse Practitioner | 500 W Court Street, Provena St Marys Hospital Wound Healing Services, Kankakee, IL 60901 | 2006-10-23 |
| 1982797148 | Martha Gainer | Nurse Practitioner | 1 Dearborn Sq, Suite 600, Kankakee, IL 60901-3942 | 2006-10-02 |
| 1184244030 | Jennifer Lynn Mooi | Nurse Practitioner | 500 W Court St, Kankakee, IL 60901-3691 | 2020-04-21 |
| 1811521883 | Shana Marie Teske | Nurse Practitioner | 375 N Wall St Ste P310, Kankakee, IL 60901-3484 | 2020-02-27 |
| 1609437268 | Kshiti Manek | Nurse Practitioner | 350 N Wall St, Kankakee, IL 60901-2991 | 2019-06-25 |
| 1235618927 | Marisa M Schrum | Nurse Practitioner | 1701 E Court St, Kankakee, IL 60901-2670 | 2018-08-13 |
| 1588156152 | Kimberly K White | Nurse Practitioner | 500 W Court St, Kankakee, IL 60901 | 2018-05-30 |
| Find all providers in KANKAKEE | ||||
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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.