ELSBURGH CLARKE JR. (NPI# 1689637217) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1689637217 |
Entity Type | Individual |
Full Name | ELSBURGH CLARKE JR. |
Credential | MD |
Practice Address |
221 Ne Glen Oak Ave Peoria IL 61603-4307 |
Mailing Address |
21276 Network Pl Chicago IL 60673-1212 |
Practice Telephone | 3096725522 |
Mailing Telephone | 8774854474 |
Enumeration Date | 2006-04-06 |
Last Update Date | 2009-08-18 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207P00000X | Emergency Medicine | 036103700 | IL | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IL | BCBS | 36103700 | 01 |
IL | RAILROAD MEDICARE | P00196870 | 01 |
IL | 036103700 | 05 |
Street Address |
221 NE GLEN OAK AVE |
City | PEORIA |
State | IL |
Zip Code | 61603-4307 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851384135 | John Alan Howerton | Pharmacist | 221 Ne Glen Oak Ave, Peoria, IL 61636-0001 | 2005-08-23 |
1437750130 | Vanezza Buendia | Physical Therapist | 221 Ne Glen Oak Ave, Peoria, IL 61636-0001 | 2020-11-08 |
1306443056 | Austyn Powers | Nurse Practitioner | 221 Ne Glen Oak Ave, Peoria, IL 61636-0001 | 2020-10-06 |
1396357091 | Christopher Legan | Counselor | 221 Ne Glen Oak Ave, Peoria, IL 61636-0001 | 2020-08-24 |
1417575853 | Joseph Babione | Psychologist | 221 Ne Glen Oak Ave, Peoria, IL 61636-0001 | 2020-07-13 |
1811512411 | Methodist | Counselor | 221 Ne Glen Oak Ave, Peoria, IL 61636-0001 | 2020-06-10 |
1760003230 | Alexandra Bryan | Dietitian, Registered | 221 Ne Glen Oak Ave, Peoria, IL 61636-0001 | 2020-05-06 |
1467080523 | Dustin Dariusz Pilat | Student in an Organized Health Care Education/Training Program | 221 Ne Glen Oak Ave, Peoria, IL 61636-5027 | 2020-04-01 |
1295363505 | Abigail Brea Sebald | Student in an Organized Health Care Education/Training Program | 221 Ne Glen Oak Ave, Peoria, IL 61636-0001 | 2020-03-31 |
1790313054 | Elizabeth Alexandra Edwards | Student in an Organized Health Care Education/Training Program | 221 Ne Glen Oak Ave, Peoria, IL 61636-0001 | 2020-03-31 |
Find all providers in the same location |
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 | 207P00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Emergency Medicine |
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1205367802 | Medexpress Urgent Care Illinois, P.C. | Emergency Medicine | 5038 N Big Hollow Road, Peoria, IL 61615-3510 | 2017-03-24 |
1285049296 | Julia Hutchison | Emergency Medicine | 530 Ne Glen Oak Ave # Sfnb2624, Peoria, IL 61637-0001 | 2014-06-27 |
1891134151 | Kyle Fletcher Brown | Emergency Medicine | Osf Saint Francis Medical Center 530 Ne Glen Oak Ave, North Building 2620, Peoria, IL 61637-0001 | 2013-06-20 |
1366673436 | Joseph William Hauter | Emergency Medicine | 830 Ne Glen Oak Ave, Peoria, IL 61637 | 2009-08-06 |
1437380748 | Jeremy R Monroe | Emergency Medicine | 530 Glen Oak, Osf St Francis Medical Center, Peoria, IL 61637 | 2009-08-04 |
1568624708 | Brandon C Begley | Emergency Medicine | 540 Ne Glen Oak Ave, Peoria, IL 61603 | 2008-06-30 |
1114119880 | Suhail Khan | Emergency Medicine | Osf Stfrancis Medical Center Dept of Emergency Medicine, 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2007-08-15 |
1962601351 | Tony Yun Hsu | Emergency Medicine | 3517 W Willow Knolls Dr, 1-f, Peoria, IL 61614-1090 | 2007-07-16 |
1053518092 | Michael M Raso | Emergency Medicine | 1115 N Bourland Ave, Peoria, IL 61606-1210 | 2007-07-02 |
1184670663 | Methodist Medical Center of Illinois | Emergency Medicine | 120 Ne Glen Oak Ave, Suite 101, Peoria, IL 61603 | 2006-05-26 |
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.