KELLI DOHMAN (NPI# 1568791234) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568791234 |
| Entity Type | Individual |
| Full Name | KELLI DOHMAN |
| Practice Address |
530 Ne Glenoak Ave Peoria IL 61603-3117 |
| Mailing Address |
832 Patricia St Washington IL 61571-9296 |
| Practice Telephone | 3096552106 |
| Mailing Telephone | 6303363204 |
| Enumeration Date | 2009-12-09 |
| Last Update Date | 2009-12-09 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LN0000X |
Nurse Practitioner Specialization: Neonatal |
209007168 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
530 NE GLENOAK AVE |
| City | PEORIA |
| State | IL |
| Zip Code | 61603-3117 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740483627 | Priti M. Patel | Pediatrics | 530 Ne Glenoak Ave, Peoria, IL 61603-3133 | 2007-06-07 |
| 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 | 363LN0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Neonatal |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316299456 | Jesse Lee Henneberg | Nurse Practitioner | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2012-10-14 |
| 1114279841 | Jessica-lynn Marie Fulton | Nurse Practitioner | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2012-10-04 |
| 1891018891 | Janessa Michele Jenkins | Nurse Practitioner | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2010-03-04 |
| 1225351323 | Sharon Kay Leonard | Nurse Practitioner | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2010-03-04 |
| 1497911713 | Jeanne M Perino | Nurse Practitioner | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2008-08-06 |
| 1013173335 | Suzanne D Tietjen | Nurse Practitioner | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2008-08-06 |
| 1710143037 | Sharon A Klein | Nurse Practitioner | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2008-08-06 |
| 1417113739 | Julie Marie Strandberg | Nurse Practitioner | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2008-08-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699381707 | Jamie Kaye Summers | Nurse Practitioner | 522 Clover Ct, Gibson City, IL 60936-1901 | 2020-09-23 |
| 1447697032 | Jessica Sue Krause | Nurse Practitioner | 1750 W Harrison St Fl 6, Chicago, IL 60612-3825 | 2013-05-23 |
| 1164798641 | Kate M Reed | Nurse Practitioner | 25 Thorndale Ct, South Elgin, IL 60177-3202 | 2012-03-28 |
| 1982975694 | Tiffany Amber Deriggi | Nurse Practitioner | 3831 N Sacramento Ave, Apt 1, Chicago, IL 60618-3530 | 2012-01-26 |
| 1154590214 | Patricia Mary Lumb | Nurse Practitioner | 2600 Children's Plaza, Chicago, IL 60614 | 2008-02-22 |
| 1841468139 | Mimi Noelle Hussussian | Nurse Practitioner | Children's Memorial Hospital, 2300children's Plaza, Box #253, Chicago, IL 60614 | 2008-02-20 |
| 1366610107 | Patricia Freeman Stevens | Nurse Practitioner | 316 N Park Rd, La Grange Park, IL 60526-1801 | 2008-02-14 |
| 1225250723 | Carolyn Patricia Seng | Nurse Practitioner | 5721 S. Maryland Ave, Chicago, IL 60637 | 2007-05-03 |
| 1487767117 | Robert Anthony Wisdom | Nurse Practitioner | 4444 S Prairie Ave, Chicago, IL 60653-3208 | 2006-08-16 |
| 1538771340 | Jennifer Aileen Burkett | Nurse Practitioner | 225 E Chicago Ave, Chicago, IL 60611-2991 | 2020-08-21 |
| 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.