MS. ALICIA K CREMEENS (NPI# 1225364219) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225364219 |
| Entity Type | Individual |
| Full Name | MS. ALICIA K CREMEENS |
| Credential | PA-C |
| Practice Address |
2601 W Main St Carbondale IL 62901-1031 |
| Mailing Address |
Po Box 3988 Carbondale IL 62902-3988 |
| Practice Telephone | 6185495361 |
| Practice Fax Number | 6183514878 |
| Mailing Telephone | 6184575200 |
| Enumeration Date | 2009-10-26 |
| Last Update Date | 2020-10-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
085-003579 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | ILLINOIS PHYSICIAN LICENSE | 085.003579 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1340 Cedar Ct, Carbondale, IL 629015336 | 6184577821 | 6185293862 |
| 2601 W Main St, Carbondale, IL 629011031 | 6185495361 | 6183511287 |
| Street Address |
2601 W MAIN ST |
| City | CARBONDALE |
| State | IL |
| Zip Code | 62901-1031 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548261399 | Jeffrey M Lehman | Allergy & Immunology | 2601 W Main St, Carbondale, IL 62901-1031 | 2005-08-02 |
| 1043846421 | Lindsay B Casolari | Nurse Practitioner | 2601 W Main St, Carbondale, IL 62901-1031 | 2020-03-18 |
| 1194367318 | Jessica Oakley | Nurse Practitioner | 2601 W Main St, Carbondale, IL 62901-1031 | 2019-10-09 |
| 1609424399 | Alexis Korbar | Social Worker | 2601 W Main St, Carbondale, IL 62901-1031 | 2019-08-27 |
| 1184196883 | Leslie Ann Hickman | Nurse Practitioner | 2601 W Main St, Carbondale, IL 62901-1031 | 2018-12-19 |
| 1679041685 | Kirsten Anne Beyers | Social Worker | 2601 W Main St, Carbondale, IL 62901-1031 | 2018-11-07 |
| 1457834178 | Brittany Elizabeth Pierce | Nurse Practitioner | 2601 W Main St, Carbondale, IL 62901-1031 | 2018-09-09 |
| 1306322110 | Katharine Johnson | Social Worker | 2601 W Main St, Carbondale, IL 62901-1031 | 2018-07-15 |
| 1437699147 | Gina Gladson | Nurse Practitioner | 2601 W Main St, Carbondale, IL 62901-1031 | 2017-02-28 |
| 1902349863 | Sarah Elizabeth Ruth Shannon | Nurse Practitioner | 2601 W Main St, Carbondale, IL 62901 | 2016-11-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558961268 | Gerad Aaron Harsy | Pharmacist | Walmart Pharmcy, 1450 East Main St, Carbondale, IL 62901 | 2020-10-30 |
| 1437708674 | Board of Trustees of Southern Illinois University | Clinic/Center | 300 W Oak Street, Carbondale, IL 62901 | 2019-09-10 |
| 1306317383 | Rachael O Johnson | Nurse Practitioner | 404 S. Lewis Ln, Carbondale, IL 62901 | 2018-12-17 |
| 1740795194 | Megan Marie Zimmerman | Nurse Practitioner | 1100 W Diann Ln., Carbondale, IL 62901 | 2017-12-07 |
| 1295244242 | Amy Elizabeth Prudencio | Social Worker | 1301 E. Walnut Street, Carbondale, IL 62901 | 2017-09-21 |
| 1740708171 | Theresa Aleise Goodin | Speech-Language Pathologist | 1301 East Walnut Street, Carbondale, IL 62901 | 2017-09-06 |
| 1144762527 | Kathleen Chwalisz Rigney | Psychologist | 306 West Mill Street, Neurorestorative, Carbondale, IL 62901 | 2016-11-16 |
| 1285185173 | Shawnee Health Service and Development Corp | Social Worker | 404 S. Lewis Lane, Carbondale, IL 62901 | 2016-10-17 |
| 1437605094 | Arielle Greer | Nurse's Aide | 510 E. Russell St., A, Carbondale, IL 62901 | 2016-09-01 |
| 1518413863 | Complete Family Eyecare of Carbondale, PC | Optometrist | 1241 East Walnut Street, Carbondale, IL 62901 | 2016-08-28 |
| Find all providers in zip 62901 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336605237 | Macy L Henson | Physician Assistant | 305 W Jackson St Ste 200, Carbondale, IL 62901-1474 | 2019-02-15 |
| 1659741312 | Morgan Echols | Physician Assistant | 405 W Jackson St, Carbondale, IL 62901-1462 | 2015-10-06 |
| 1164774261 | Theresa Micknick | Physician Assistant | 165 Fallbrook St, Carbondale, PA 18433 | 2012-10-12 |
| 1255618237 | Alexis Elizabeth Lorinskas | Physician Assistant | 202 W Jackson St, Carbondale, IL 62901-1409 | 2011-11-04 |
| 1093025272 | Ann Bridget Diehl | Physician Assistant | 254 Brooklyn St, Carbondale, PA 18407-2824 | 2010-10-20 |
| 1376673582 | Ivy Jane Chalmers | Physician Assistant | 978 Euclid Ave, Carbondale, CO 81623-1820 | 2007-03-06 |
| 1962549790 | Jenifer Marie Chambless | Physician Assistant | 305 W Jackson St, Suite 200, Carbondale, IL 62901-1474 | 2007-01-31 |
| 1679511281 | Mary Rosenhauer | Physician Assistant | 1350 Cedar Ct, Carbondale, IL 62901-5336 | 2006-06-04 |
| 1972589919 | Max A Baier | Physician Assistant | 305 W Jackson St, Suite 200, Carbondale, IL 62901-1474 | 2005-12-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831707298 | Eliza Ballen | Physician Assistant | 335 Sylvan Rd, Lake Bluff, IL 60044-2562 | 2020-07-21 |
| 1477177947 | Rybecca Janovyak | Physician Assistant | 14432 High Rd, Lockport, IL 60441-9402 | 2020-06-01 |
| 1518591759 | Julie Jenkot | Physician Assistant | 333 N Michigan Ave Fl 14, Chicago, IL 60601-3901 | 2020-02-26 |
| 1801429873 | Hinjal D Jha | Physician Assistant | 22285 N Pepper Rd Ste 409, Lake Barrington, IL 60010-2542 | 2020-02-19 |
| 1770120222 | Alvina Shaikh | Physician Assistant | 4009 Warren Ave, Bellwood, IL 60104-2066 | 2019-12-03 |
| 1457997561 | Jasleen Mohini Singh | Physician Assistant | 1645a W School Street, Suite A, Clinic Entrance, Chicago, IL 60657 | 2019-11-24 |
| 1538705272 | Bethany Mae Frisby | Physician Assistant | 8630 W Golf Rd, Niles, IL 60714-5600 | 2019-11-18 |
| 1134761984 | Ella-marie Rakowski | Physician Assistant | 25 Acorn Dr, Hawthorn Woods, IL 60047-7407 | 2019-10-14 |
| 1467001859 | Timothy Omotayo Adesanya | Physician Assistant | Graham Correctional Center, 12078 Illinois Rte 185, Hilliboro, IL 62049 | 2019-09-09 |
| 1518514066 | Victoria Moore | Physician Assistant | 979 W Main St, West Dundee, IL 60118-2088 | 2019-08-20 |
| Find all providers with the same taxonomy | ||||
| City | CARBONDALE |
| Zip Code | 62901 |
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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.