KEVIN PATRICK PETERS (NPI# 1326525304) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1326525304 |
Entity Type | Individual |
Full Name | KEVIN PATRICK PETERS |
Practice Address |
5666 E State St Rockford IL 61108-2425 |
Mailing Address |
7228 W Farwell Ave Chicago IL 60631-1145 |
Practice Telephone | 8152662000 |
Mailing Telephone | 7737240019 |
Enumeration Date | 2018-07-23 |
Last Update Date | 2018-07-23 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
085006652 | IL | Physician Assistants & Advanced Practice Nursing Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1043877103 | Kevin Lee Peters | Counselor | 20 Ne 10th Ave, Portland, OR 97232-2916 | 2019-05-23 |
1083123038 | Kevin Peters | Nurse Practitioner | 444 N Eola Rd Ste 110, Aurora, IL 60502-9619 | 2017-09-21 |
Street Address |
5666 E STATE ST |
City | ROCKFORD |
State | IL |
Zip Code | 61108-2425 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1508849209 | Richard Emery Freeman | Neurological Surgery | 5666 E State St, Rockford, IL 61108-2425 | 2005-11-28 |
1881293348 | Salman Nafees | Nurse Anesthetist, Certified Registered | 5666 E State St, Rockford, IL 61108-2425 | 2020-10-25 |
1346856424 | Keely K Zunker | Nurse Practitioner | 5666 E State St, Rockford, IL 61108-2472 | 2020-09-23 |
1962026476 | Angie Youssef Hernandez | Student in an Organized Health Care Education/Training Program | 5666 E State St, Rockford, IL 61108-2425 | 2020-06-01 |
1568085710 | Kelsey Surowiec | Student in an Organized Health Care Education/Training Program | 5666 E State St, Rockford, IL 61108-2425 | 2020-05-22 |
1801415864 | Kyle R Clark | Physician Assistant | 5666 E State St, Rockford, IL 61108-2425 | 2020-04-10 |
1508495144 | Sadie Jae Pierce-mulligan | 5666 E State St, Rockford, IL 61108-2425 | 2020-04-06 | |
1376170183 | Nicole Ann O'neill | Dietitian, Registered | 5666 E State St, Rockford, IL 61108-2425 | 2020-03-24 |
1447884804 | Marissa Ann Giannangeli | Occupational Therapist | 5666 E State St, Rockford, IL 61108-2425 | 2020-02-25 |
1023659711 | Erin R. Moody | Physician Assistant | 5666 E State St, Rockford, IL 61108-2425 | 2019-10-03 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952862617 | Isr Enterprises, Inc. | Homemaker | 129 Phelps Ave, Bldg 10, Ste 1008, Rockford, IL 61108 | 2019-03-26 |
1003306465 | Adrienne Nicole Black | Behavior Technician | 519 Woodland Dr, Woodland Dr, Rockford, IL 61108 | 2018-05-11 |
1184085201 | Integrative Healing Center, LLC | Clinic/Center | 6019 Fincham Drive, Rockford, IL 61108 | 2016-03-17 |
1730547936 | Perryville Dentist PC | Dentist | 845 S Perryville Rd, Unit 119, Rockford, IL 61108 | 2016-02-02 |
1023489853 | Nicole Ping Ticknor | Counselor | 433 S. Phelps Ave., Suite 2, Rockford, IL 61108 | 2015-10-20 |
1275940348 | Northwest Home Care, Inc. | Home Health | 1437 S. Bell School Road, Suite 7, Rockford, IL 61108 | 2014-07-21 |
1487072922 | Alecia Greenlee | Psychiatry & Neurology | Rosecrance Community Mental Health, 3815 Harrison Avenue, Rockford, IL 61108 | 2014-04-02 |
1871925446 | Maria Laura Gustafson | Interpreter | 3208 Wesleyan Ave., Rockford, IL 61108 | 2013-08-06 |
1346582822 | Joseph Peevey | Pathology | 5666 E State Street, Department of Pathology, Rockford, IL 61108 | 2013-03-21 |
1134466923 | James Henry Peck | Hearing Instrument Specialist | 2424 Charles St, Rockford, IL 61108 | 2013-01-14 |
Find all providers in zip 61108 |
Taxonomy Code | 363AS0400X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Surgical Technologist |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1598217168 | Cindy Giurgiu | Physician Assistant | 5666 E State St, Rockford, IL 61108-2425 | 2016-10-31 |
1447682703 | Patrick Hoffmann | Physician Assistant | 5666 E State St, Rockford, IL 61108-2425 | 2013-08-08 |
1720286206 | Neurex Pllc | Physician Assistant | 1491 Stony Creek Way, Apt 2, Rockford, IL 61108-1210 | 2007-07-06 |
1629177647 | Daniel A Bentley | Physician Assistant | 1401 E State St, Rockford, IL 61104-2315 | 2006-09-22 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477169522 | Priority Assist Pllc | Physician Assistant | 48 Glenda Ln, Plano, IL 60545-9652 | 2020-09-23 |
1154944478 | Diana Goldak | Physician Assistant | 3855 N Parkway Dr Apt 3a, Northbrook, IL 60062-7218 | 2020-05-20 |
1033742580 | Colleen Courtney | Physician Assistant | 218 S Driftwood Trl, Mchenry, IL 60050-5454 | 2020-02-12 |
1326678962 | Nina Kodros | Physician Assistant | 301 Madison St Ste 280, Joliet, IL 60435-6672 | 2020-01-23 |
1689218190 | Jennifer Richman | Physician Assistant | 1890 Silver Cross Blvd Ste 410, New Lenox, IL 60451-9547 | 2019-10-29 |
1710547625 | Nadia Khan | Physician Assistant | 4543 N Malden St Apt 1s, Chicago, IL 60640-5687 | 2019-06-13 |
1962065516 | Jorge Mantilla | Physician Assistant | 5540 N Kimball Ave Apt 3e, Chicago, IL 60625-4674 | 2019-04-18 |
1013479955 | Leah Rae Prager | Physician Assistant | 4400 W. 95th St., Attn: Pediatric General Surgery, Oak Lawn, IL 60453 | 2019-04-01 |
1770041949 | Laura Ann Ryan | Physician Assistant | 840 S Wood St Ste 417, Chicago, IL 60612-4325 | 2019-03-06 |
1548739782 | Helen Finke | Physician Assistant | 880 W Central Rd Ste 3300, Arlington Heights, IL 60005-2366 | 2018-11-16 |
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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.