MELINDA HENDERSON (NPI# 1679516561) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679516561 |
| Entity Type | Individual |
| Full Name | MELINDA HENDERSON |
| Credential | C-FNP |
| Practice Address |
7801 N Knoxville Ave Peoria IL 61614-2076 |
| Mailing Address |
5100 Reliable Parkway Chicago IL 60686-0001 |
| Practice Telephone | 3096926088 |
| Mailing Telephone | 3096926088 |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
IL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | HEALTH ALLIANCE | 073083 | 01 |
| IL | JOHN DEERE | IL01Q9 | 01 |
| IL | HEALTHLINK | 472310 | 01 |
| IL | BCBS PPO | 7215059 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760498943 | Melinda Henderson | Psychologist | 280 N Old Woodward Ave, Suite 200, Birmingham, MI 48009-5300 | 2006-07-31 |
| 1013966423 | Melinda Shaw Henderson | Family Medicine | 1208 Choctaw Trl, Brentwood, TN 37027 | 2006-05-10 |
| 1487771945 | Melinda C. Henderson | Nurse Practitioner | 4413 Us Highway 331 S, Defuniak Springs, FL 32435-6307 | 2007-03-22 |
| Street Address |
7801 N KNOXVILLE AVE |
| City | PEORIA |
| State | IL |
| Zip Code | 61614-2076 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891734257 | Mourad Alnatour | Pediatrics | 7801 N Knoxville Ave, Peoria, IL 61614-2076 | 2006-06-04 |
| 1093721573 | Rachana Sureka | Pediatrics | 7801 N Knoxville Ave, Peoria, IL 61614-2076 | 2006-08-01 |
| 1649285206 | Anuja Maini | Pediatrics | 7801 N Knoxville Ave, Peoria, IL 61614-2076 | 2006-07-30 |
| 1841232907 | Carol Miller | Registered Nurse | 7801 N Knoxville Ave, Peoria, IL 61614-2076 | 2006-06-12 |
| 1720029267 | Amy Christison | Pediatrics | 7801 N Knoxville Ave, Peoria, IL 61614-2076 | 2006-06-08 |
| 1689615163 | Thomas Halperin | Pediatrics | 7801 N Knoxville Ave, Peoria, IL 61614-2076 | 2006-06-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548818511 | Christine Svoboda | Social Worker | 6919 N Knoxville Ave Ste 100 and 202, Peoria, IL 61614 | 2019-09-03 |
| 1639649007 | Kathy Karouzos Counseling, LLC | Clinic/Center | 330 W. Ivy Ln., Peoria, IL 61614 | 2018-11-28 |
| 1205312790 | Kathleen Marie Hendricks | Nurse Practitioner | 2809 W Willow Knolls Dr, Peoria, IL 61614 | 2018-07-17 |
| 1629563937 | Mary Elizabeth Cunningham | Counselor | 6219 N. Eldorado Dr., Peoria, IL 61614 | 2018-06-28 |
| 1861937955 | Angela Gilles | Social Worker | 6919 N Knoxville Ave Ste 100, Peoria, IL 61614 | 2016-12-27 |
| 1467994897 | Melissa Saxsma | Specialist | 5009 N Executive Dr, Peoria, IL 61614 | 2016-11-16 |
| 1902258874 | Rashid Plastic Surgery, LLC | Plastic Surgery | 804 W Trailcreek Drive, Peoria, IL 61614 | 2016-07-05 |
| 1215313143 | Melissa Lynn Phelan | Nurse Practitioner | 122 E Morningside Dr, Peoria, IL 61614 | 2015-08-03 |
| 1811380165 | All Ways Caring Services, Inc. | In Home Supportive Care | 6919 N Knoxville Ave, Suite 102, Peoria, IL 61614 | 2015-03-11 |
| 1568875920 | Schuler & Arkwell Orthodontic Partnership | Dentist | 2425 Cornerstone Ct. Ste. A, Peoria, IL 61614 | 2014-06-03 |
| Find all providers in zip 61614 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851721252 | Sarah Peterson | Nurse Practitioner | 2727 W Krause Ave, Unitypoint Health, In School Health At Harrison School, Peoria, IL 61605-2906 | 2013-11-21 |
| 1184696544 | Barbara L Johnston | Nurse Practitioner | 2338 N. Van Winkle Way, Suite 2200, Peoria, IL 61615 | 2006-02-01 |
| 1477189025 | Claudia Plumer | Nurse Practitioner | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-03-16 |
| 1972931640 | Manju Thomson | Nurse Practitioner | 10200 W Happy Valley Rd, Suite 125, Peoria, AZ 85383-2878 | 2013-10-16 |
| 1396183687 | Diana Warnecke | Nurse Practitioner | 420 Ne Glen Oak Ave, Ste 401, Peoria, IL 61603-3105 | 2013-06-07 |
| 1801162854 | Valley of The Sun Pediatrics, P.C. | Nurse Practitioner | 10200 W Happy Valley Rd, Ste 125, Peoria, AZ 85383-2878 | 2012-03-23 |
| 1972837003 | Monica Greenwald Dohrman | Nurse Practitioner | 7707 W Deer Valley Rd, Peoria, AZ 85382-2101 | 2009-09-22 |
| 1174772552 | Kristin A Kang | Nurse Practitioner | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2008-09-10 |
| 1932201795 | Patti Jo Peterson-balliet | Nurse Practitioner | 9059 W Lake Pleasant Pkwy, E-540, Peoria, AZ 85382-8336 | 2006-09-02 |
| 1699740902 | Kathryn Gensel | Nurse Practitioner | 420 Ne Glen Oak Ave Ste 401, Dept. of Pediatrics, Peoria, IL 61603-3168 | 2006-02-21 |
| 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.