MELISSA DELA TORRE (NPI# 1164912762) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164912762 |
| Entity Type | Individual |
| Full Name | MELISSA DELA TORRE |
| Other Name | MELISSA SHULTS |
| Credential | NP |
| Practice Address |
4306 N Sheridan Rd Peoria IL 61614 |
| Mailing Address |
4306 N Sheridan Rd Peoria IL 61614-5918 |
| Practice Telephone | 3096829000 |
| Practice Fax Number | 3092102042 |
| Mailing Telephone | 3096458687 |
| Mailing Fax Number | 3092102042 |
| Enumeration Date | 2018-05-18 |
| Last Update Date | 2019-03-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
AG0518002 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2426 W Cornerstone Ct Ste 100, Peoria, IL 616142400 | 3099663137 |
| Street Address |
4306 N SHERIDAN RD |
| City | PEORIA |
| State | IL |
| Zip Code | 61614 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710371935 | Realhealth Advanced Care Sc | Physical Medicine & Rehabilitation | 4306 N Sheridan Rd, Peoria, IL 61614-5918 | 2015-03-25 |
| 1629538657 | Robert David Buechner | Chiropractor | 4306 N Sheridan Rd, Peoria, IL 61614-5918 | 2019-03-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548818511 | Christine Svoboda | Social Worker | 6919 N Knoxville Ave Ste 100 and 202, Peoria, IL 61614 | 2019-09-03 |
| 1639649007 | Kathy Karouzos Counseling, LLC | Clinic/Center | 330 W. Ivy Ln., Peoria, IL 61614 | 2018-11-28 |
| 1205312790 | Kathleen Marie Hendricks | Nurse Practitioner | 2809 W Willow Knolls Dr, Peoria, IL 61614 | 2018-07-17 |
| 1629563937 | Mary Elizabeth Cunningham | Counselor | 6219 N. Eldorado Dr., Peoria, IL 61614 | 2018-06-28 |
| 1861937955 | Angela Gilles | Social Worker | 6919 N Knoxville Ave Ste 100, Peoria, IL 61614 | 2016-12-27 |
| 1467994897 | Melissa Saxsma | Specialist | 5009 N Executive Dr, Peoria, IL 61614 | 2016-11-16 |
| 1902258874 | Rashid Plastic Surgery, LLC | Plastic Surgery | 804 W Trailcreek Drive, Peoria, IL 61614 | 2016-07-05 |
| 1215313143 | Melissa Lynn Phelan | Nurse Practitioner | 122 E Morningside Dr, Peoria, IL 61614 | 2015-08-03 |
| 1811380165 | All Ways Caring Services, Inc. | In Home Supportive Care | 6919 N Knoxville Ave, Suite 102, Peoria, IL 61614 | 2015-03-11 |
| 1568875920 | Schuler & Arkwell Orthodontic Partnership | Dentist | 2425 Cornerstone Ct. Ste. A, Peoria, IL 61614 | 2014-06-03 |
| Find all providers in zip 61614 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891797767 | Colleen M. Gray | Nurse Practitioner | 8227 W Sweetwater Ave, Peoria, AZ 85381-4936 | 2005-08-11 |
| 1386129328 | Debra Sharene Corley | Nurse Practitioner | 9139 W Thunderbird Rd Ste 265, Peoria, AZ 85381-4922 | 2018-09-25 |
| 1033608872 | Melinda Bahler | Nurse Practitioner | 900 Main St Ste 630, Peoria, IL 61602-5024 | 2018-05-08 |
| 1669823068 | Kory Jackson | Nurse Practitioner | 900 Main St, Ste 100, Peoria, IL 61602-1005 | 2016-06-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316553472 | Nicholas Johnson | Nurse Practitioner | 8455 S Luella Ave, Chicago, IL 60617-1953 | 2020-09-23 |
| 1710592175 | Mary Maloney | Nurse Practitioner | 348 Westglen Dr, Glen Carbon, IL 62034-1002 | 2020-09-12 |
| 1134738800 | Benjamin Scott Hulfachor | Nurse Practitioner | 4143 N Central Park Ave Apt G, Chicago, IL 60618-2062 | 2020-07-28 |
| 1083222368 | Izolda Rosario | Nurse Practitioner | 501 W Lake St Ste 207, Elmhurst, IL 60126-1419 | 2020-07-22 |
| 1043832785 | Melanie Glander | Nurse Practitioner | 18357 Cowing Ct, Homewood, IL 60430-3332 | 2020-05-16 |
| 1699306902 | Ife Muyiwa-ojo | Nurse Practitioner | 729 E Carpenter St, Springfield, IL 62702-5321 | 2020-01-27 |
| 1962040345 | Doctors Orders Inc. | Nurse Practitioner | 5113 S Harper Ave Ste 2, Chicago, IL 60615-4119 | 2019-12-16 |
| 1801455993 | Parul Arora | Nurse Practitioner | 1717 W Congress Pkwy Ste 1125, Chicago, IL 60612-3809 | 2019-06-11 |
| 1891358222 | Kelly Jo Erke | Nurse Practitioner | 20830 N 1970 East Rd, Danville, IL 61834-6228 | 2019-04-22 |
| 1689136319 | Brittany Sue Borkowski | Nurse Practitioner | 5841 S Maryland Ave # W700, Chicago, IL 60637-1443 | 2019-04-02 |
| Find all providers with the same taxonomy | ||||
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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.