Katherine Ann Beaudry (NPI# 1659667954, PAC ID# 3375789134) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DERMATOLOGY.
| Nation Provider ID (NPI) | 1659667954 |
| PAC ID by PECOS | 3375789134 |
| Professional Enrollment ID | I20150602002891 |
| Full Name | Katherine Ann Beaudry |
| Organization Legal Name | CENTRAL ILLINOIS DERMATOLOGY S C |
| Address |
5401 N Knoxville Ave Suite 115 Peoria IL 61614-5068 |
| Phone Number | 3096912903 |
| Gender | F |
| Medical School | PENNSYLVANIA STATE UNIVERSITY COLLEGE OF MEDICINE |
| Graduation Year | 2011 |
| Primary Specialty | DERMATOLOGY |
| Group Practice PAC ID | 2860463510 |
| Number of Group Practice Members | 4 |
| Accepts Medicare Assignment | M |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 140067 | OSF SAINT FRANCIS MEDICAL CENTER |
| 140209 | METHODIST MEDICAL CENTER OF ILLINOIS |
| Address | Phone | Organization |
|---|---|---|
| 5401 N Knoxville Ave, Suite 115, Peoria, IL 61614-5068 | 3096912903 | CENTRAL ILLINOIS DERMATOLOGY S C |
| Organization Legal Name | CENTRAL ILLINOIS DERMATOLOGY S C |
| Physicians | 4 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Christopher Todd Kroodsma | Dermatology | Central Illinois Dermatology S C | 5401 N Knoxville Ave, Suite 115, Peoria, IL 61614-5068 |
| Ashley Michelle Steffens | Dermatology | Central Illinois Dermatology S C | 5401 N Knoxville Ave, Suite 115, Peoria, IL 61614-5068 |
| Jamie L Frey | Dermatology | Central Illinois Dermatology S C | 5401 N Knoxville Ave, Suite 115, Peoria, IL 61614-5068 |
| Street Address |
5401 N KNOXVILLE AVE SUITE 115 |
| City | PEORIA |
| State | IL |
| Zip | 61614-5068 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Courtney Jaegle | Physician Assistant | Proctor Health Systems | 5401 N Knoxville Ave, Peoria, IL 61614-5021 |
| Marie Josee Thibault | Dermatology | Proctor Health Systems | 5401 N Knoxville Ave, Peoria, IL 61614-5021 |
| Barbara J Nall | Nurse Practitioner | Bochantin Obstetrics and Gynecology Services Ltd | 5401 N Knoxville Ave, Suite 308, Peoria, IL 61614-5089 |
| Monica L Everett | Physician Assistant | Proctor Health Systems | 5401 N Knoxville Ave, Peoria, IL 61614-5021 |
| Tamara L Olt | Obstetrics/gynecology | 5401 N Knoxville Ave, Suite 109, Peoria, IL 61614-5021 | |
| David Tennant | Family Medicine | Iowa Physicians Clinic Medical Foundation | 5401 N Knoxville Ave, Suite 204, Peoria, IL 61614-5021 |
| Robert Meister | Internal Medicine | Iowa Physicians Clinic Medical Foundation | 5401 N Knoxville Ave, Suite 204, Peoria, IL 61614-5021 |
| Robert Allan Lizer | Family Medicine | Proctor Health Systems | 5401 N Knoxville Ave, Peoria, IL 61614-5021 |
| George C Gilbert | Family Medicine | 5401 N Knoxville Ave, Suite 215, Peoria, IL 61614-5021 | |
| Timothy Lahood | Family Medicine | Iowa Physicians Clinic Medical Foundation | 5401 N Knoxville Ave, Suite 400, Peoria, IL 61614-5021 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kurt Michael Pepperell | Chiropractic | 3530 W Willow Knolls Dr, Peoria, IL 61614-1010 | |
| Caleb O Johnson | Physical Therapy | Accelerated Rehabilitation Centers Ltd | 3531 Willow Knolls Dr, Peoria, IL 61614-1078 |
| Lance A Reiman | Physical Therapy | Accelerated Rehabilitation Centers Ltd | 3531 Willow Knolls Dr, Peoria, IL 61614-1078 |
| Caitlin Marie Pribble | Physical Therapy | Accelerated Rehabilitation Centers Ltd | 3531 Willow Knolls Dr, Peoria, IL 61614-1078 |
| James L Swingler | Obstetrics/gynecology | 7501 N University St, Suite 113, Peoria, IL 61614-1234 | |
| Christine A Haynes | Chiropractic | Haynes Family Chiropractic Inc | 1921 W Willow Knolls Dr, Suite D, Peoria, IL 61614-1243 |
| Kyle J Haynes | Chiropractic | Haynes Family Chiropractic Inc | 1921 W Willow Knolls Dr, Suite D, Peoria, IL 61614-1243 |
| Christine Marie Fletcher | Qualified Speech Language Pathologist | Speech and Language Rehabilitation Service Ltd | 2001 W Willow Knolls Dr, Suite 106, Peoria, IL 61614-1262 |
| Danila L Mcasey | Qualified Speech Language Pathologist | Speech and Language Rehabilitation Service Ltd | 2001 W Willow Knolls Dr, Suite 106, Peoria, IL 61614-1262 |
| Keith A Kramer | Chiropractic | Kramer Chiropractic and Acupuncture | 2208 W Willow Knolls Rd, Peoria, IL 61614-1467 |
| Find all physicians in zip 61614 | |||
| City | PEORIA |
| Zip Code | 61614 |
| Specialty | DERMATOLOGY |
| City + Specialty | PEORIA + DERMATOLOGY |
Please comment or provide details below to improve the information on Katherine Ann Beaudry.
| 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.