IRENE P KASAMBIRA (NPI# 1699700989) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699700989 |
| Entity Type | Individual |
| Full Name | IRENE P KASAMBIRA |
| Credential | APN |
| Practice Address |
228 Ne Jefferson Peoria IL 61603 |
| Mailing Address |
Po Box 1346 Peoria IL 61654-1346 |
| Practice Telephone | 3095718000 |
| Practice Fax Number | 3096714695 |
| Mailing Telephone | 3096718000 |
| Mailing Fax Number | 3096714695 |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2016-02-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
209008305 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 364SP0807X |
Clinical Nurse Specialist Specialization: Psych/Mental Health, Child & Adolescent |
209002929 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
228 NE JEFFERSON |
| City | PEORIA |
| State | IL |
| Zip Code | 61603 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881630689 | Human Service Center | Clinic/Center | 228 Ne Jefferson, Peoria, IL 61603 | 2006-06-21 |
| 1417982703 | Ghassan Bitar | Psychiatry & Neurology | 228 Ne Jefferson, Peoria, IL 61603 | 2006-07-12 |
| 1093740318 | Arun C Pinto | Psychiatry & Neurology | 228 Ne Jefferson, Peoria, IL 61603 | 2006-07-12 |
| 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 | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821632126 | Mental Health Azforvets LLC | Nurse Practitioner | 20469 N 95th Dr, Peoria, AZ 85382-5133 | 2019-10-30 |
| 1881258416 | Tammy E. Hostetler | Nurse Practitioner | 14100 N 83rd Ave Ste 100, Peoria, AZ 85381-4621 | 2019-04-29 |
| 1811483480 | Kimberly Ann Cochran | Nurse Practitioner | 8194 W Deer Valley Rd Ste 106-516, Peoria, AZ 85382 | 2018-07-07 |
| 1992233977 | Jennifer Christine Alexander | Nurse Practitioner | 4215 N Prospect Rd, Peoria, IL 61616-7754 | 2017-06-02 |
| 1801322755 | Juan Gabriel Gomez | Nurse Practitioner | 8203 W Oraibi Dr, Apartment 1142, Peoria, AZ 85382-4680 | 2017-05-11 |
| 1538498738 | Ronnie Abush Brown-woodhull | Nurse Practitioner | Partners In Recovery - West Valley Clinic, 14100 W 83rd Avenue Ste 100, Peoria, AZ 85381 | 2009-12-17 |
| 1336307495 | Courtney Ann Keller | Nurse Practitioner | 9165 W Thunderbird Rd Suite 201, Peoria, AZ 85381-4847 | 2008-05-27 |
| 1730251034 | Lisa D'alessandro-betancourt | Nurse Practitioner | 11361 N 99th Ave Ste 200, Peoria, AZ 85345-5470 | 2006-11-14 |
| 1932713435 | Lori Sue Trilikis | Nurse Practitioner | 7317 N Willow Lake Ct, Peoria, IL 61614-8227 | 2020-09-02 |
| 1821614520 | Shawna Steffes | Nurse Practitioner | 11361 N 99th Ave, Peoria, AZ 85345-5470 | 2020-06-18 |
| 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.