DR. MARC C THEVENIN JR. PC (NPI# 1588179311) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588179311 |
| Entity Type | Organization |
| Organization Name | DR. MARC C THEVENIN JR. PC |
| Practice Address |
5116 N Big Hollow Rd Ste 101 Peoria IL 61615-3514 |
| Mailing Address |
Po Box 3189 Syracuse NY 13220-3189 |
| Practice Telephone | 3096742000 |
| Enumeration Date | 2017-12-01 |
| Last Update Date | 2017-12-01 |
| Authorized Official Name | MARC THEVENIN (OWNER) |
| Authorized Official Telephone | 3096742000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Street Address |
5116 N BIG HOLLOW RD STE 101 |
| City | PEORIA |
| State | IL |
| Zip Code | 61615-3514 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124627906 | Lance Jay Bucher | Occupational Therapist | 8600 Il-91, Peoria, IL 61615 | 2020-10-22 |
| 1093327496 | Angela Mitchell | Speech-Language Pathologist | 3903 W Ridgeview Dr, Peoria, IL 61615 | 2020-08-18 |
| 1578110680 | Emily E Buenting | Audiologist | 8600 Il Route 91, Suite 300, Peoria, IL 61615 | 2019-08-22 |
| 1730655572 | Sylwia M. Budzik | Physician Assistant | 8600 Illinois Rt. 91, Suite 300, Peoria, IL 61615 | 2018-10-19 |
| 1487169207 | Heather Hart | Registered Nurse | 9016 N. Scrimshaw Dr. Apt 104, Peoria, IL 61615 | 2017-12-04 |
| 1528586849 | Leanne Runyon | Speech-Language Pathologist | 10723 Collett Dr., Peoria, IL 61615 | 2017-09-07 |
| 1467974196 | Elizabeth A Mcleod | Nurse Practitioner | 8600 Illinois Route 91, Suite 130, Peoria, IL 61615 | 2017-07-14 |
| 1790223022 | Janet Warner | Counselor | 8914 North Prarie Court, Peoria, IL 61615 | 2017-02-07 |
| 1437524022 | Brooke Bisping | Dietitian, Registered | 7610 North Orange Prairie Road, Peoria, IL 61615 | 2015-12-08 |
| 1003292111 | Crystal Ann Casper | Dietitian, Registered | 7610 N Orange Prarie Road, Peoria, IL 61615 | 2015-07-31 |
| Find all providers in zip 61615 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013530187 | Core Family Dental, LLC | Dentist | 13460 N 94th Dr Ste K4, Peoria, AZ 85381-4249 | 2020-05-24 |
| 1982248084 | Westbrook Dental Center, P.a. | Dentist | 9276 W Union Hills Dr Ste A, Peoria, AZ 85382-8206 | 2019-10-31 |
| 1699318725 | Mint Dental Care LLC | Dentist | 8258 W Thunderbird Rd Ste 201, Peoria, AZ 85381-4777 | 2019-10-21 |
| 1548822497 | Katherine M Unes | Dentist | 11323 N Pawnee Rd, Peoria, IL 61615-9796 | 2019-07-01 |
| 1992296073 | George S Hariri | Dentist | 7777 W Deer Valley Rd Ste 160, Peoria, AZ 85382-2104 | 2018-05-23 |
| 1619485869 | Thunderbird Dental Studio | Dentist | 9179 W Thunderbird Rd Ste 107, Peoria, AZ 85381-4875 | 2018-01-22 |
| 1629592423 | Jessica Leigh Howard | Dentist | 7966 W Thunderbird Rd Ste 101, Peoria, AZ 85381-4902 | 2017-08-02 |
| 1588193718 | Darren Anderson | Dentist | 28451 N Vistancia Blvd Ste 101, Peoria, AZ 85383-2090 | 2017-06-10 |
| 1962943290 | Optim Dental Peoria-1 LLC | Dentist | 1200 W Main St Ste 9, Peoria, IL 61606-1218 | 2017-03-20 |
| 1154772879 | Kristina Wilson | Dentist | 10184 W Happy Valley Rd Ste 195, Peoria, AZ 85383-1254 | 2016-06-23 |
| Find all providers in PEORIA | ||||
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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.