MIDWEST PAIN & SPINE CENTER, LLC (NPI# 1679944334) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679944334 |
| Entity Type | Organization |
| Organization Name | MIDWEST PAIN & SPINE CENTER, LLC |
| Practice Address |
5401 N Knoxville Ave Suite 416 Peoria IL 61614-5098 |
| Practice Telephone | 3096927246 |
| Practice Fax Number | 3096927226 |
| Mailing Telephone | 3096927246 |
| Mailing Fax Number | 3096927226 |
| Enumeration Date | 2015-10-07 |
| Last Update Date | 2015-10-23 |
| Authorized Official Name | GAYLE MUCCIANTE (PRACTICE ADMINISTRATOR) |
| Authorized Official Telephone | 3096927246 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| Street Address |
5401 N KNOXVILLE AVE SUITE 416 |
| City | PEORIA |
| State | IL |
| Zip Code | 61614-5098 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871597450 | Edward A Rufus Jr | Internal Medicine | 5401 N Knoxville Ave, Suite 306, Peoria, IL 61614-5098 | 2005-06-10 |
| 1366984015 | Taylor Jeanette Simmons | Specialist/Technologist | 5401 N Knoxville Ave, Suite 103, Peoria, IL 61614-5098 | 2016-11-11 |
| 1518416254 | Illinois Regional Pain Institute | Nurse Practitioner | 5401 N Knoxville Ave, Suite 416, Peoria, IL 61614-5098 | 2016-09-22 |
| 1700331030 | Deb M Schleich | Nurse Practitioner | 5401 N Knoxville Ave, Suite 416, Peoria, IL 61614-5098 | 2016-08-16 |
| 1154876498 | Kimberly K Lopez | Nurse Practitioner | 5401 N Knoxville Ave, Suite 416, Peoria, IL 61614-5098 | 2016-08-16 |
| 1417320854 | Amy B Pheiffer | Clinical Nurse Specialist | 5401 N Knoxville Ave, Suite 109, Peoria, IL 61614-5098 | 2015-11-06 |
| 1558732370 | Leah Tabor | Specialist/Technologist, Other | 5401 N Knoxville Ave, Suite 117, Peoria, IL 61614 | 2015-10-20 |
| 1124495379 | Anne Webster | Nurse Practitioner | 5401 N Knoxville Ave, Suite 416, Peoria, IL 61614-5098 | 2015-08-24 |
| 1720461353 | Hometown Hearing & Audiology, Inc. | Audiologist | 5401 N Knoxville Ave, 116, Peoria, IL 61614-5011 | 2015-07-01 |
| 1255721502 | Peoria Hand Surgery, LLC | Orthopaedic Surgery | 5401 N Knoxville Ave, Suite 107, Peoria, IL 61614-5098 | 2015-01-26 |
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| 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 | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467994897 | Melissa Saxsma | Specialist | 5009 N Executive Dr, Peoria, IL 61614 | 2016-11-16 |
| 1023495199 | Judith Woehrle | Specialist | 8721 W Tonopah Dr, Peoria, AZ 85382-6402 | 2015-04-28 |
| 1699184606 | Denise M Brock | Specialist | 18969 N 83rd Ave, Suite 200, Peoria, AZ 85382-2844 | 2014-08-05 |
| 1326482076 | Corpo Bello Full Service Day Spa | Specialist | 1703 W Candletree Dr, Suite B, Peoria, IL 61614-1591 | 2013-04-24 |
| 1952698573 | Rashael D. Achinivu | Specialist | 24654 N Lake Pleasant Pkwy # 103-157, Peoria, AZ 85383-1359 | 2011-07-03 |
| 1174820633 | Three Paths Massage Therapy | Specialist | 5901 N Prospect Rd Ste 102, Peoria, IL 61614-4395 | 2011-02-18 |
| 1316171739 | Associated Orthopedics Sc | Specialist | 10326 N Juliet Ct, Peoria, IL 61615-1199 | 2009-05-13 |
| 1902040124 | Comprehensive Orthopedics, P. C. | Specialist | 5401 North Knoxville Ave, Suite 400, Peoria, IL 61614-5021 | 2009-05-01 |
| 1922250414 | Amy C Watt | Specialist | 507 E Armstrong Avenue, Peoria, IL 61603 | 2008-10-16 |
| 1467634477 | Richard M. Kootman M.d.,p.c. | Specialist | 13943 N. 91st Ave Bldg G, Peoria, AZ 85381-3687 | 2007-11-30 |
| 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.