DR. RICHARD PEARL (NPI# 1457389272) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457389272 |
| Entity Type | Individual |
| Full Name | DR. RICHARD PEARL |
| Credential | M.D. |
| Practice Address |
420 Ne Glen Oak Ave Ste 201 Peoria IL 61603-3105 |
| Practice Telephone | 3096553800 |
| Mailing Telephone | 3096553800 |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0120X |
Surgery Specialization: Pediatric Surgery |
036098051 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BCBS | 7215166 | 01 |
| IL | 036098051-2 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780831404 | Richard Erwin Pearl | Orthopaedic Surgery | 50 East 77th St 1c, New York, NY 10075 | 2008-08-25 |
| 1750572087 | Richard William Pearl | Internal Medicine | 120 Ochsner Blvd Ste 160, Gretna, LA 70056 | 2007-08-01 |
| 1740384932 | Richard A Pearl | Psychiatry & Neurology | 45 Terry Road, Suite A, Smithtown, NY 11787 | 2006-09-11 |
| Street Address |
420 NE GLEN OAK AVE STE 201 |
| City | PEORIA |
| State | IL |
| Zip Code | 61603-3105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427057595 | David P Chan | Pediatrics | 420 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2005-07-20 |
| 1164062196 | Tiara J Mullen | Nurse Practitioner | 420 Ne Glen Oak Ave, Peoria, IL 61603-3106 | 2020-01-07 |
| 1700308996 | Amanda Matthews | Nurse Practitioner | 420 Ne Glen Oak Ave, Peoria, IL 61603 | 2017-07-10 |
| 1871026450 | Shari S Mulvey | Pediatrics | 420 Ne Glen Oak Ave, Peoria, IL 61603-3105 | 2017-04-10 |
| 1003268897 | Sandra L. Peach | Nurse Practitioner | 420 Ne Glen Oak Ave, Peoria, IL 61603-3105 | 2016-07-06 |
| 1083062285 | Heather A Boore | Clinical Nurse Specialist | 420 Ne Glen Oak Ave, Suite 401, Peoria, IL 61603 | 2016-05-27 |
| 1336546969 | Jennifer A. Nelson | Nurse Practitioner | 420 Ne Glen Oak Ave, Suite 201, Peoria, IL 61603-3105 | 2014-11-25 |
| 1003219932 | Linda Schmidgall | Nurse Practitioner | 420 Ne Glen Oak Ave, Suite 200, Peoria, IL 61603-3105 | 2014-10-07 |
| 1164839692 | Gregory Puszkiewicz | Pharmacist | 420 Ne Glen Oak Ave, Peoria, IL 61603-3105 | 2014-07-16 |
| 1396183687 | Diana Warnecke | Nurse Practitioner | 420 Ne Glen Oak Ave, Ste 401, Peoria, IL 61603-3105 | 2013-06-07 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598362980 | Courtney Klein | Nurse Practitioner | 1306 N. Berkley Ave, Peoria, IL 61603 | 2020-10-08 |
| 1114588217 | Kong Xing Wang | Dentist | 320 East Armstrong Ave, Peoria, IL 61603 | 2019-06-28 |
| 1073015319 | Sara Kristine Rosenbery | Nurse Practitioner | 515 Ne Glen Oak Ave Ste 202, Peoria, IL 61603 | 2018-03-02 |
| 1861860058 | Jennifer Michelle Kelsey | Clinical Nurse Specialist | 420 Ne Glen Oak Avenue, Suite 401, Peoria, IL 61603 | 2015-09-04 |
| 1467859793 | Bonnie Lansing | Counselor | 617 N Gendale Avenue, Behavioral Health Adult Program, Peoria, IL 61603 | 2014-12-02 |
| 1639597172 | Jael K. Mahasi | Counselor | 1800 Ne Perry Avenue, Peoria, IL 61603 | 2014-04-02 |
| 1992054829 | Justin S Ferragut | Radiology | 530 Northeast Glen Oak Avenue, Peoria, IL 61603 | 2012-09-06 |
| 1780952994 | Syed Muhammad Tayyab | Internal Medicine | 828 Ne Glen Oak Ave Apt No208a, Peoria, IL 61603 | 2011-12-02 |
| 1528389079 | St. Francis Medical Center | General Acute Care Hospital | 530 N E Glen Oak Ave, Peoria, IL 61603 | 2010-06-18 |
| 1780810648 | Children's Home Association of Illinois | Voluntary or Charitable | 400 E. Frye, Peoria, IL 61603 | 2009-06-05 |
| Find all providers in zip 61603 | ||||
| Taxonomy Code | 2086S0120X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Pediatric Surgery |
| A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124421680 | John Wesley | Surgery | 185 S Old Creek Rd, Vernon Hills, IL 60061-3134 | 2014-09-29 |
| 1407089923 | Angel Bassuk | Surgery | 9655 Woods Dr, Skokie, IL 60077-4418 | 2009-09-01 |
| 1417141904 | Erik Ryan Barthel | Surgery | 5841 S Maryland Ave # Mc4062, University of Chicago Medicine, Chicago, IL 60637-1447 | 2007-08-28 |
| 1467666081 | Connie Jean Rossini | Surgery | 1725 W Harrison St Ste 708, Chicago, IL 60612-3841 | 2007-05-10 |
| 1356394217 | Childrens Surgical Foundation Inc | Surgery | 225 E Chicago Ave # 114, Chicago, IL 60611-2991 | 2006-05-19 |
| 1154309284 | Ann Oconnor | Surgery | 25 N. Winfield Road, Winfield, IL 60190 | 2006-01-09 |
| 1356822050 | Lurie Childrens Surgical Foundation Inc | Surgery | 225 E Chicago Ave, Chicago, IL 60611-2991 | 2018-08-22 |
| 1649774803 | Rachael Sundland | Surgery | 5841 S Maryland Ave # Mc4062, Chicago, IL 60637-1443 | 2018-03-22 |
| 1245746213 | Chicagoland University Pediatric Surgery, LLC | Surgery | 2900 N Lake Shore Dr, Chicago, IL 60657-5640 | 2017-12-28 |
| 1558740563 | Edward Health Ventures | Surgery | 120 Spalding Dr, Ste 200, Naperville, IL 60540-6508 | 2015-05-22 |
| 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.