Elly J Fennell (NPI# 1114245958, PAC ID# 6103013602) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1114245958 |
| PAC ID by PECOS | 6103013602 |
| Professional Enrollment ID | I20101209000914 |
| Full Name | Elly J Fennell |
| Organization Legal Name | OSF MULTI-SPECIALTY GROUP |
| Address |
7303 N Knoxville Ave Peoria IL 61614-2017 |
| Phone Number | 3096914005 |
| Gender | F |
| Graduation Year | 2009 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 3678889789 |
| Number of Group Practice Members | 1106 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 140067 | OSF SAINT FRANCIS MEDICAL CENTER |
| 140162 | ST JOSEPH MEDICAL CENTER |
| 140161 | SAINT JAMES HOSPITAL |
| 140110 | OTTAWA REGIONAL HOSPITAL DBA OSF SAINT ELIZABETH MDL CTR |
| 140001 | GRAHAM HOSPITAL ASSOCIATION |
| Address | Phone | Organization |
|---|---|---|
| 7303 N Knoxville Ave, Peoria, IL 61614-2017 | 3096914005 | OSF MULTI-SPECIALTY GROUP |
| Organization Legal Name | OSF MULTI-SPECIALTY GROUP |
| Physicians | 1301 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Erin R Moody | Physician Assistant | Osf Multi-specialty Group | 9951 Rock Cut Xing, Loves Park, IL 61111-1999 |
| Christina S Chen Milhone | Pediatric Medicine | Osf Multi-specialty Group | 2806 N Knoxville Ave, Peoria, IL 61604-2870 |
| Katelyn J Stites | Nurse Practitioner | Osf Multi-specialty Group | 106 S 1st St, Fairbury, IL 61739-1509 |
| Andrea M Shewalter | Nurse Practitioner | Osf Multi-specialty Group | 535 Roxbury Rd, Rockford, IL 61107-5076 |
| Kathleen M Hendricks | Nurse Practitioner | Osf Multi-specialty Group | 2809 W Willow Knolls Dr, Peoria, IL 61614-8517 |
| Carrie B Finley | Nurse Practitioner | Osf Multi-specialty Group | 1209 Starfire Dr, Suite 2, Ottawa, IL 61350-1688 |
| Laine E Burek | Nurse Practitioner | Osf Multi-specialty Group | 1765 Bradford Ln, Normal, IL 61761-1296 |
| James C Plasky | Nurse Practitioner | Osf Multi-specialty Group | 6830 Villagreen Vw, Rockford, IL 61107-5639 |
| Jubilee C Phan | Urology | Osf Multi-specialty Group | 1001 Main St, Suite 400, Peoria, IL 61606-2036 |
| Sara K Rosenbery | Nurse Practitioner | Osf Multi-specialty Group | 515 Neglen Oak Ave, Suite 202, Peoria, IL 61603 |
| Street Address |
7303 N KNOXVILLE AVE |
| City | PEORIA |
| State | IL |
| Zip | 61614-2017 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Allison R Tanck | General Surgery | Osf Multi-specialty Group | 7303 N Knoxville Ave, Peoria, IL 61614-2017 |
| Chandler D Wilfong | General Surgery | Osf Multi-specialty Group | 7303 N Knoxville Ave, Peoria, IL 61614-2017 |
| Asif Quyyum | Colorectal Surgery (proctology) | Osf Multi-specialty Group | 7303 N Knoxville Ave, Peoria, IL 61614-2017 |
| Benjamin R Gerber | General Surgery | Osf Multi-specialty Group | 7303 N Knoxville Ave, Peoria, IL 61614-2017 |
| Gavish N Patel | General Surgery | Osf Multi-specialty Group | 7303 N Knoxville Ave, Peoria, IL 61614-2017 |
| Fred E Braastad | General Surgery | Osf Multi-specialty Group | 7303 N Knoxville Ave, Peoria, IL 61614-2017 |
| John K Paulsen | General Surgery | Osf Multi-specialty Group | 7303 N Knoxville Ave, Peoria, IL 61614-2017 |
| Kenneth A Hodel | Obstetrics/gynecology | Osf Multi-specialty Group | 7303 N Knoxville Ave, Peoria, IL 61614-2017 |
| 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 | NURSE PRACTITIONER |
| City + Specialty | PEORIA + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Elly J Fennell.
| 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.