MR. DAVID A. PRIDDY (NPI# 1669416749) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669416749 |
| Entity Type | Individual |
| Full Name | MR. DAVID A. PRIDDY |
| Credential | PHD |
| Practice Address |
575 N Kellogg St Ste 4 Galesburg IL 61401-7609 |
| Practice Telephone | 3093430800 |
| Practice Fax Number | 3093430802 |
| Mailing Telephone | 3093430800 |
| Mailing Fax Number | 3093430802 |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2020-08-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TR0400X |
Psychologist Specialization: Rehabilitation |
071-003839 | IL | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | HEALTH ALLIANCE ID | 013154 | 01 |
| Street Address |
575 N KELLOGG ST STE 4 |
| City | GALESBURG |
| State | IL |
| Zip Code | 61401-7609 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679174973 | Jeff Engwall | Pharmacist | 359 Knox Square Drive, Galesburg, IL 61401 | 2020-11-03 |
| 1861962441 | Becky Cameron | Counselor | 2323 Windish Dr., Galesburg, IL 61401 | 2018-11-27 |
| 1295245496 | Aaron Thomas Wachtel | Dentist | 1172 Monroe Street, Galesburg, IL 61401 | 2017-10-03 |
| 1588182224 | Alicia Warren | Speech-Language Pathologist | 932 Harrison St., Galesburg, IL 61401 | 2017-09-01 |
| 1770986770 | Virginia G Kasser | Psychologist | 575 N Kellogg, Galesburg, IL 61401 | 2014-10-03 |
| 1063814309 | Lakshmi Kalyani Gudavalli | Physical Therapist | 275 E Carl Sandburg Drive, Marigold Rehabilitation, Galesburg, IL 61401 | 2014-09-18 |
| 1821350489 | James Eugene Tiller | Psychologist | 2101 Windish Drive, Galesburg, IL 61401 | 2012-06-11 |
| 1720285836 | Donald J. Regnier | Hearing Instrument Specialist | 4l Plaza, Suite 57, Galesburg, IL 61401 | 2007-07-02 |
| 1306066535 | Arnold John Minor | Dentist | 69 N Chambers St, Galesburg, IL 61401 | 2007-04-30 |
| 1114140373 | Community Residential Centers Inc | Intermediate Care Facility, Mentally Retarded | 239 S Cherry Street, Galesburg, IL 61401 | 2007-04-10 |
| Find all providers in zip 61401 | ||||
| Taxonomy Code | 103TR0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Rehabilitation |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629692280 | Rachel Anne Brokenshire | Psychologist | 10634 Fairfield St, Westchester, IL 60154-5106 | 2020-05-29 |
| 1902370299 | Julie Ann Marsh | Psychologist | 7120 W. William St., Decatur, IL 62522 | 2019-01-20 |
| 1477037133 | Hilltop Haven Inc | Psychologist | 2018 Il Route 173, Richmond, IL 60071-9628 | 2018-09-19 |
| 1518222967 | Aanchal Taneja | Psychologist | 3315 N Sheffield Ave, Apt 2, Chicago, IL 60657-2212 | 2012-07-11 |
| 1366482572 | Allen Walter Heinemann | Psychologist | 713 W Buckingham Pl, Chicago, IL 60657-6534 | 2006-06-07 |
| 1245742865 | Neurorehab Psychology Consultants, LLC | Psychologist | 419 Center St Ste C, Grayslake, IL 60030-1645 | 2017-11-05 |
| 1780062638 | Laurin Jarrold Mack | Psychologist | 710 S Paulina St, Suite 316a, Chicago, IL 60612-3808 | 2015-05-12 |
| 1982985859 | Jennifer Lynn Perez | Psychologist | 128 Washington Sq, Washington, IL 61571-2657 | 2011-09-06 |
| 1801063029 | Amber Nicole Tesman | Psychologist | 1801 Fox Dr, Champaign, IL 61820-7236 | 2008-05-15 |
| 1811167489 | Richard R Trezona Jr. | Psychologist | 345 E Superior St, Chicago, IL 60611-2654 | 2008-03-10 |
| 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.