KATHLEEN MARIE HENDRICKS


Address: 2809 W Willow Knolls Dr, Peoria, IL 61614
Phone: 3096926604

KATHLEEN MARIE HENDRICKS (NPI# 1205312790) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1205312790
Entity Type Individual
Full Name KATHLEEN MARIE HENDRICKS
Credential APN
Practice Address 2809 W Willow Knolls Dr
Peoria
IL 61614
Mailing Address 2809 W Willow Knolls Dr
Peoria
IL 61614-8517
Practice Telephone 3096926604
Mailing Telephone 3096926604
Enumeration Date 2018-07-17
Last Update Date 2018-11-09
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363L00000X Nurse Practitioner 209017970 IL Physician Assistants & Advanced Practice Nursing Providers
N 363LF0000X Nurse Practitioner
Specialization: Family
041.415297 IL Physician Assistants & Advanced Practice Nursing Providers

Other Providers KATHLEEN HENDRICKS

NPI Name Taxonomy Address Enumeration
1376634352 Kathleen Betts Hendricks Social Worker 1 Freedom Way, Augusta, GA 30904-6258 2006-09-27

Office Location

Street Address 2809 W WILLOW KNOLLS DR
City PEORIA
State IL
Zip Code 61614

Providers in the same zip code

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
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
1801227707 Vikram Shah Pharmacist 801 W Lake Street, Kroger Pharmacy, Peoria, IL 61614 2013-12-03
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Taxonomy Information

Taxonomy Code 363L00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner

Taxonomy Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1962034215 Lia Doh Nurse Practitioner 8357 W Rosewood Ln, Peoria, AZ 85383-3869 2020-02-05
1285274027 Chauntel M Nessmith Nurse Practitioner 7540 W Jenan Dr, Peoria, AZ 85345-1367 2020-01-09
1003450925 Kimberly Ann Flores Nurse Practitioner 12118 W Avenida Del Rey, Peoria, AZ 85383-5819 2019-11-04
1821630666 Leesa K Jost Nurse Practitioner 8914 N Prairie Pointe Rd, Peoria, IL 61615-1574 2019-10-14
1942842018 Tamarra Lynn Subyantoro Nurse Practitioner 5114 N Glen Park Place Rd Ste 110, Peoria, IL 61614-4686 2019-10-10
1255981593 Eunmee Hong Nurse Practitioner 21369 N 79th Dr, Peoria, AZ 85382-4453 2019-09-18
1295297737 Tasha R Besser Nurse Practitioner 5114 N Glen Park Place Rd Ste 220, Peoria, IL 61614-4686 2019-04-03
1669936506 Kristin Danielle Downs Nurse Practitioner 10408 N Centerway Dr, Peoria, IL 61615-1234 2019-01-24
1538665609 Tara Moore Nurse Practitioner 10408 N Centerway Dr Ste Cde, Peoria, IL 61615-1234 2018-04-05
1467974196 Elizabeth A Mcleod Nurse Practitioner 8600 Illinois Route 91, Suite 130, Peoria, IL 61615 2017-07-14
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Competitor

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City PEORIA
Zip Code 61614

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Dataset Information

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.

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