SHYRLENA L BOGARD (NPI# 1467615898) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467615898 |
| Entity Type | Individual |
| Full Name | SHYRLENA L BOGARD |
| Credential | MD |
| Practice Address |
920 West St Bldg B Peru IL 61354-2763 |
| Mailing Address |
1305 6th St Peru IL 61354-2759 |
| Practice Telephone | 8152232944 |
| Mailing Telephone | 8157805029 |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2015-07-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207VG0400X |
Obstetrics & Gynecology Specialization: Gynecology |
036126361 | IL | Allopathic & Osteopathic Physicians |
| N | 207VX0000X |
Obstetrics & Gynecology Specialization: Obstetrics |
036126361 | IL | Allopathic & Osteopathic Physicians |
| Y | 261Q00000X | Clinic/Center | 036.126361 | IL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036126361 | 05 |
| Street Address |
920 WEST ST BLDG B |
| City | PERU |
| State | IL |
| Zip Code | 61354-2763 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033114939 | Mark Allen Fernandez | Internal Medicine | 920 West St, Ste 311, Peru, IL 61354-2770 | 2005-06-16 |
| 1386199511 | Jennifer Leeann Olesen | Nurse Practitioner | 920 West St, Suite #311, Peru, IL 61354-2763 | 2016-08-17 |
| 1851764369 | Illinois Valley Community Hospital | Clinic/Center | 920 West St, Suite 311, Peru, IL 61354-2763 | 2015-11-05 |
| 1598138000 | Illinois Valley Community Hospital | Clinic/Center | 920 West St, Bldg B, Peru, IL 61354-2763 | 2015-11-05 |
| 1831521947 | Illinois Valley Community Hospital | Clinic/Center | 920 West St, Sutie 312, Peru, IL 61354-2763 | 2013-07-31 |
| 1467884650 | Illinois Valley Community Hospital | Clinic/Center | 920 West St, Suite 312, Peru, IL 61354-2763 | 2013-07-30 |
| 1073871893 | Ram L & Neelam Goel Ptr | Internal Medicine | 920 West St, Suite 116, Peru, IL 61354-2763 | 2012-04-30 |
| 1912295270 | Illinois Valley Community Hospital | Family Medicine | 920 West St, Suite 311, Peru, IL 61354-2763 | 2011-07-20 |
| 1710281787 | Illinois Valley Community Hospital | Clinic/Center | 920 West St, Suite 216, Peru, IL 61354-2763 | 2011-01-05 |
| 1699005678 | Angela Marie Vezzetti | Physician Assistant | 920 West St, Suite 312, Peru, IL 61354-2763 | 2010-01-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437750247 | Saida Samedova | Optometrist | 5255 Il-251, Peru, IL 61354 | 2020-11-06 |
| 1205469483 | Illinois Valley Community Hospital | Registered Nurse | 1403 Sixth Street, Peru, IL 61354 | 2020-02-17 |
| 1689228322 | Zhong Xue | Dentist | 5301 Il-251, Ste A, Peru, IL 61354 | 2019-07-31 |
| 1003281668 | Christopher Shane Smith | Physical Therapist | 1400 Midtown Road, Peru, IL 61354 | 2015-12-08 |
| 1770823197 | Muscle Pain Clinic Inc | Chiropractor | 4231 Progress Blvd Ste 4, Peru, IL 61354 | 2013-02-21 |
| 1306194451 | Vijaya Lakshmi Bathina | Dentist | 5301 Route 251, Peru, IL 61354 | 2012-08-21 |
| 1225305634 | Walgreens | Point of Service | 1033 Shooting Park Road, Peru, IL 61354 | 2011-11-30 |
| 1811293574 | Charles Riva | Physical Therapist | 4461 N. Progress Blvd., Peru, IL 61354 | 2011-01-28 |
| 1932403896 | Emerging Vision, Inc | Eyewear Supplier (Equipment, not the service) | 3940 Route 251, Peru Mall Suite F-1, Peru, IL 61354 | 2011-01-06 |
| 1457668170 | Illinois Valley Community Hospital | Nurse Practitioner | 5307 Route 251, Peru, IL 61354 | 2010-09-01 |
| Find all providers in zip 61354 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891976296 | Travel Center Clinics | Clinic/Center | 3130 May Rd, Peru, IL 61354-9618 | 2007-11-14 |
| 1356904163 | St Margaret's Hospital | Clinic/Center | 1650 Midtown Rd, Peru, IL 61354-1200 | 2019-04-17 |
| 1518439710 | Mac Chiropractic LLC | Clinic/Center | 3815 Progress Blvd Ste C, Peru, IL 61354-1188 | 2018-12-28 |
| 1831521947 | Illinois Valley Community Hospital | Clinic/Center | 920 West St, Sutie 312, Peru, IL 61354-2763 | 2013-07-31 |
| 1467884650 | Illinois Valley Community Hospital | Clinic/Center | 920 West St, Suite 312, Peru, IL 61354-2763 | 2013-07-30 |
| 1417117540 | Donahue Chiropractic Center | Clinic/Center | 1915 4th St, Suite 2, Peru, IL 61354-3361 | 2008-06-12 |
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| 1639787823 | Md Infusions, Pllc | Clinic/Center | 666 Dundee Rd Ste 1800, Northbrook, IL 60062-2727 | 2020-07-14 |
| 1407474083 | Staten Family Practice Pllc | Clinic/Center | 500 W Virginia Ave, Gillespie, IL 62033-1025 | 2020-07-09 |
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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.