NEUROLOGY CLINIC OF PEORIA SC (NPI# 1376680363) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376680363 |
| Entity Type | Organization |
| Organization Name | NEUROLOGY CLINIC OF PEORIA SC |
| Practice Address |
5401 N Knoxville Ave Suite 414 Peoria IL 61614-5098 |
| Practice Telephone | 3096929516 |
| Practice Fax Number | 3096929530 |
| Mailing Telephone | 3096929516 |
| Mailing Fax Number | 3096929530 |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2009-05-26 |
| Authorized Official Name | DR. GENE C CHENG (DIRECTOR) |
| Authorized Official Telephone | 3096929516 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
042617586 | IL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036088131 | 05 |
| Street Address |
5401 N KNOXVILLE AVE SUITE 414 |
| City | PEORIA |
| State | IL |
| Zip Code | 61614-5098 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871597450 | Edward A Rufus Jr | Internal Medicine | 5401 N Knoxville Ave, Suite 306, Peoria, IL 61614-5098 | 2005-06-10 |
| 1366984015 | Taylor Jeanette Simmons | Specialist/Technologist | 5401 N Knoxville Ave, Suite 103, Peoria, IL 61614-5098 | 2016-11-11 |
| 1518416254 | Illinois Regional Pain Institute | Nurse Practitioner | 5401 N Knoxville Ave, Suite 416, Peoria, IL 61614-5098 | 2016-09-22 |
| 1700331030 | Deb M Schleich | Nurse Practitioner | 5401 N Knoxville Ave, Suite 416, Peoria, IL 61614-5098 | 2016-08-16 |
| 1154876498 | Kimberly K Lopez | Nurse Practitioner | 5401 N Knoxville Ave, Suite 416, Peoria, IL 61614-5098 | 2016-08-16 |
| 1417320854 | Amy B Pheiffer | Clinical Nurse Specialist | 5401 N Knoxville Ave, Suite 109, Peoria, IL 61614-5098 | 2015-11-06 |
| 1558732370 | Leah Tabor | Specialist/Technologist, Other | 5401 N Knoxville Ave, Suite 117, Peoria, IL 61614 | 2015-10-20 |
| 1679944334 | Midwest Pain & Spine Center, LLC | Specialist | 5401 N Knoxville Ave, Suite 416, Peoria, IL 61614-5098 | 2015-10-07 |
| 1124495379 | Anne Webster | Nurse Practitioner | 5401 N Knoxville Ave, Suite 416, Peoria, IL 61614-5098 | 2015-08-24 |
| 1720461353 | Hometown Hearing & Audiology, Inc. | Audiologist | 5401 N Knoxville Ave, 116, Peoria, IL 61614-5011 | 2015-07-01 |
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| 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 | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912342569 | Peoria Weightloss, LLC | Clinic/Center | 2426 W Cornerstone Ct Ste 100, Peoria, IL 61614-2400 | 2013-05-08 |
| 1952654154 | Ev Pain Specialists | Clinic/Center | 14100 N 83rd Ave Ste 260, Peoria, AZ 85381-5659 | 2012-10-25 |
| 1093943219 | Medshape Weight Loss Clinic, LLC | Clinic/Center | 7972 W Thunderbird Rd, 106, Peoria, AZ 85381-4903 | 2009-06-25 |
| 1083848188 | Susan J Cole, Md & Associates | Clinic/Center | 5401 N Knoxville Ave, Suite 107, Peoria, IL 61614-5098 | 2009-05-05 |
| 1881861953 | Surraj Medical Associates,pllc | Clinic/Center | 9401 W Thunderbird Rd, Suite 155, Peoria, AZ 85381-4233 | 2008-05-08 |
| 1033163761 | Proctor Health Systems | Clinic/Center | 5401 N Knoxville Ave, Suite 103, Peoria, IL 61614-5098 | 2006-05-19 |
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|---|---|---|---|---|
| 1295351062 | Sara M Gotheridge Md LLC | Clinic/Center | 630 Davis St Ste 301, Evanston, IL 60201-4480 | 2020-06-17 |
| 1407484645 | Macumber Medical Ltd | Clinic/Center | 3114 W Irving Park Rd Ste 1w, Chicago, IL 60618-3435 | 2020-04-01 |
| 1477181782 | Embassy Studios North | Clinic/Center | 6455 N Cicero Ave, Lincolnwood, IL 60712-3407 | 2020-03-31 |
| 1689226318 | Midway Spine and Joint Pain Physicians | Clinic/Center | 5720 S Pulaski Rd, Chicago, IL 60629-4435 | 2019-07-12 |
| 1215598891 | Vero Clinics | Clinic/Center | 1192 E Pershing Rd, Decatur, IL 62526-4753 | 2019-06-25 |
| 1497215933 | Activate Healthcare | Clinic/Center | 2010 N Damen Ave Unit F, Chicago, IL 60647-3286 | 2019-03-21 |
| 1033699467 | Healthpointe Medical Center Sc | Clinic/Center | 530 Fullerton Rd Ste B, Swansea, IL 62226-2970 | 2018-08-15 |
| 1740794882 | Highland Park Cvs, L.L.C. | Clinic/Center | 72 Airport Plz, Bethalto, IL 62010-1774 | 2017-11-28 |
| 1447764014 | Dr Courtney Drendel Inc | Clinic/Center | 515 Hamilton St # 100, Geneva, IL 60134-2138 | 2017-11-19 |
| 1699206599 | David M Conner M.d. | Clinic/Center | 9 Executive Woods Ct Ste 2, Swansea, IL 62226-2016 | 2017-03-22 |
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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.