Tammie O Henderson (NPI# 1598164303, PAC ID# 0941529689) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1598164303 |
| PAC ID by PECOS | 0941529689 |
| Professional Enrollment ID | I20150501000491 |
| Full Name | Tammie O Henderson |
| Organization Legal Name | RIVERSIDE HEALTH SYSTEM |
| Address |
1701 E Court St Kankakee IL 60901-2670 |
| Phone Number | 8159359394 |
| Gender | F |
| Graduation Year | 2014 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 3274434717 |
| Number of Group Practice Members | 159 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 140186 | RIVERSIDE MEDICAL CENTER |
| 140155 | PRESENCE ST MARYS HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1701 E Court St, Kankakee, IL 60901-2670 | 8159359394 | RIVERSIDE HEALTH SYSTEM |
| Organization Legal Name | RIVERSIDE HEALTH SYSTEM |
| Physicians | 170 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mohammad Abdelhafez Issa | Physical Medicine and Rehabilitation | Riverside Health System | 375 N Wall St, P520, Kankakee, IL 60901-3493 |
| Jenna Nicole Sarna | Nurse Practitioner | Riverside Health System | 25711 S Egyptian Trail, Monee, IL 60449-8118 |
| Joshua Devereux Miller | Orthopedic Surgery | Riverside Health System | 400 Riverside Dr, Suite 2800, Bourbonnais, IL 60914-5004 |
| Marisa M Schrum | Nurse Practitioner | Riverside Health System | 106 B Watters Dr, Dwight, IL 60420-2200 |
| Timothy Warren Damrow | Family Medicine | Riverside Health System | 395 N Locust St, Manteno, IL 60950-1222 |
| Sana Hussain | Endocrinology | Riverside Health System | 100 Fitness Dr, Bourbonnais, IL 60914-9584 |
| Sarah Coyne | Nurse Practitioner | Riverside Health System | 401 N Wall St, Suite 206, Kankakee, IL 60901-2949 |
| Lori Cornelius | Nurse Practitioner | Riverside Health System | 720 Bs Crescent St, Gilman, IL 60938-1518 |
| Jessica M Azoff | Psychiatry | Riverside Health System | 500 N Wall Ste, Suite 200, Kankakee, IL 60901-2942 |
| Jonathan C Cotton | Orthopedic Surgery | Riverside Health System | 23120 S Lagrange Rd, Suite 200, Frankfort, IL 60423-7760 |
| Street Address |
1701 E COURT ST |
| City | KANKAKEE |
| State | IL |
| Zip | 60901-2670 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kaitlain Cavender | Nurse Practitioner | Riverside Health System | 1701 E Court St, Kankakee, IL 60901-2670 |
| Olatunji R Akintilo | Family Medicine | Riverside Health System | 1701 E Court St, Kankakee, IL 60901-2670 |
| Keyoma Jamerson | Nurse Practitioner | Riverside Health System | 1701 E Court St, Kankakee, IL 60901-2670 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Van H Do | Physical Medicine and Rehabilitation | Medical Services Ric | 836 W Wellington Ave, Chicago, IL 60901 |
| Jana M Wahlen | Qualified Audiologist | Riverside Health System | 43 Meadowview Ctr D, Kankakee, IL 60901-2041 |
| Robert A Raley | Podiatry | 70 Meadowview Ctr, Suite 401, Kankakee, IL 60901-2061 | |
| Harris Waheed | Family Medicine | 70 Meadowview Ctr, Suite 200, Kankakee, IL 60901-2063 | |
| Samuel G Deguzman | Internal Medicine | 450 N Kennedy Dr, Kankakee, IL 60901-2900 | |
| Lawrence C Wang | Diagnostic Radiology | Central Illinois Radiological Associates Ltd | 350 N Wall St, Kankakee, IL 60901-2901 |
| Brian Patrick Olofsson | Family Medicine | 350 N Wall, Kankakee, IL 60901-2901 | |
| Howard I Roth | Diagnostic Radiology | Central Illinois Radiological Associates Ltd | 350 N Wall St, Kankakee, IL 60901-2901 |
| Silas L Harrington | Anesthesiology | North American Partners In Anesthesia Illinois LLC | 350 N Wall St, Kankakee, IL 60901-2901 |
| Racheal M Patel | Certified Registered Nurse Anesthetist (crna) | North American Partners In Anesthesia Illinois LLC | 350 N Wall St, Kankakee, IL 60901-2901 |
| Find all physicians in zip 60901 | |||
| City | KANKAKEE |
| Zip Code | 60901 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | KANKAKEE + NURSE PRACTITIONER |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.