DR. M. TERESA C. FRASER (NPI# 1093928566) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1093928566 |
Entity Type | Individual |
Full Name | DR. M. TERESA C. FRASER |
Credential | M.D. |
Practice Address |
1701 W. Garden Street Peoria IL 61605-3531 |
Mailing Address |
1701 W. Garden Street Heartland Community Health Clinic Peoria IL 61605-3531 |
Practice Telephone | 3096807600 |
Practice Fax Number | 3096807637 |
Mailing Telephone | 3096807600 |
Mailing Fax Number | 3096765506 |
Enumeration Date | 2007-05-08 |
Last Update Date | 2010-08-09 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
036-088897 | IL | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IL | 036088897 | 05 | |
IL | MEDICARE GROUP # | 809840 | 01 |
Street Address |
1701 W. GARDEN STREET |
City | PEORIA |
State | IL |
Zip Code | 61605-3531 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1841382298 | Devashish Agarwal | Family Medicine | 1701 W. Garden Street, Peoria, IL 61605 | 2006-09-29 |
1922168293 | Yvonne M Mccall | Physician Assistant | 1701 W. Garden Street, Peoria, IL 61605-3531 | 2006-12-09 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386131878 | Nicholas Anthony Helling | Physical Therapist | 518 W Romero B Garret Ave, Poeria, IL 61605 | 2018-04-19 |
1891241022 | Peoria Slf Lp | Assisted Living Facility | 518 West Romeo B. Garrett Avenue, Peoria, IL 61605 | 2016-08-28 |
1932479664 | Michelle L Whitelow | Nurse Practitioner | 711 W John Gwynn Jr. Avenue, Peoria, IL 61605 | 2012-01-11 |
1982852877 | Jason M Anane-sefah | Orthopaedic Surgery | 303 North Kumpf Boulevard, Peoria, IL 61605 | 2008-09-04 |
1902098908 | Calvary Elderly Home Help Program | Home Health | 1709 W Lincoln Ave, Peoria, IL 61605 | 2007-08-14 |
1023104437 | Thomas Anderson | Optometrist | 710 W Third Avenue, Peoria, IL 61605 | 2006-10-04 |
1497763197 | Larry T Rolle | Pharmacist | 411 Martin Luther King Dr., Peoria, IL 61605 | 2006-08-04 |
1568404762 | Joseph P Kelly Iv | Physical Therapist | 303 N. Kumpf Blvd, Peoria, IL 61605 | 2006-06-12 |
1003861634 | Patrick William Elwood | Neurological Surgery | 719 N William Kumpf Blvd, Suite 100, Peoria, IL 61605 | 2006-05-23 |
1639148356 | William G Nulty | Pediatrics | One Illini Dr, Medical Service Plan, Peoria, IL 61605 | 2006-03-15 |
Find all providers in zip 61605 |
Taxonomy Code | 2084N0400X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Psychiatry & Neurology |
Specialization | Neurology |
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1326244682 | Maria S. Parr | Psychiatry & Neurology | Osf Saint Francis Medical Center, 530 N.e.glen Oak Ave., Peoria, FL 61637 | 2007-06-25 |
1881815488 | Jacob Tony | Psychiatry & Neurology | 900 Main St Ste 250, Peoria, IL 61602-5006 | 2007-05-01 |
1861473076 | Dennis Q Mcmanus | Psychiatry & Neurology | 8600 N Il-91, Suite 110, Peoria, IL 61615 | 2005-11-07 |
1073503819 | Robert I(sa) Pfeffer | Psychiatry & Neurology | 3323 W Gloucester Ct, Peoria, IL 61615-2601 | 2005-10-24 |
1558366856 | Asad Ehtisham | Psychiatry & Neurology | 15396 N 83rd Ave Ste E, Peoria, AZ 85381-5627 | 2005-06-15 |
1700375854 | Maxwell Quincy Nyce | Psychiatry & Neurology | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2018-05-03 |
1396145264 | Envi Pllc | Psychiatry & Neurology | 15396 N 83rd Ave Ste E, Peoria, AZ 85381-5627 | 2014-08-28 |
1134535693 | Elias Samaha | Psychiatry & Neurology | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2014-07-05 |
1831504844 | Javad Alam | Psychiatry & Neurology | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2014-06-27 |
1285047977 | Deepak Reddy | Psychiatry & Neurology | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2014-06-10 |
Find all providers in PEORIA |
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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.