DR. ELIZABETH ALEXANDRA EDWARDS (NPI# 1790313054) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790313054 |
| Entity Type | Individual |
| Full Name | DR. ELIZABETH ALEXANDRA EDWARDS |
| Credential | MD |
| Practice Address |
221 Ne Glen Oak Ave Peoria IL 61636-0001 |
| Mailing Address |
900 Main St Ste 720 Peoria IL 61602-5027 |
| Practice Telephone | 3094951640 |
| Mailing Telephone | 3094951640 |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2020-03-31 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114413986 | Elizabeth Jane Edwards | Occupational Therapist | 411 Woodlawn Ave, Greensboro, NC 27401-1750 | 2018-07-05 |
| 1316435373 | Elizabeth Anne Edwards | Speech-Language Pathologist | 1100 Dinwiddie Ave, Hopewell, VA 23860-5609 | 2018-04-25 |
| 1679075261 | Elizabeth Dawn Edwards | Case Manager/Care Coordinator | 710 S Broadway Ste 250, Walnut Creek, CA 94596-5234 | 2018-02-28 |
| 1952847949 | Elizabeth S Edwards | Counselor | 367 Riverside Dr Ste 102, Franklin, TN 37064-8985 | 2017-01-13 |
| 1730630351 | Elizabeth Edwards | Physical Therapy Assistant | 615 W Doerr Path, Hernando, FL 34442-6119 | 2016-10-19 |
| 1851755474 | Elizabeth Stevens Edwards | Marriage & Family Therapist | 5929 S Downs Dr, Raleigh, NC 27603-9280 | 2016-04-09 |
| 1992172936 | Elizabeth Hawkins Edwards | Art Therapist | 67 N 7th St Apt 1, Brooklyn, NY 11249-3005 | 2015-08-25 |
| 1275898918 | Elizabeth Ferretti Edwards | Registered Nurse | 105 John R Lovelace Dr, Suite 2, Batesville, MS 38606-7656 | 2012-07-09 |
| 1508135351 | Elizabeth Ann Edwards | Counselor | 509 Wildmeadow Dr, Edmond, OK 73003-3031 | 2011-12-23 |
| 1518274026 | Elizabeth R Edwards | Speech-Language Pathologist | 3925 Heathfield Ct, Zionsville, IN 46077-9191 | 2010-09-03 |
| Street Address |
221 NE GLEN OAK AVE |
| City | PEORIA |
| State | IL |
| Zip Code | 61636-0001 |
| 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 |
| 1285260414 | Daniel Logan Howell | Nurse Practitioner | 221 Ne Glen Oak Ave, Peoria, IL 61636-0001 | 2020-03-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962767376 | Aman Deep Singh | Psychiatry & Neurology | 221 Ne Glen Oak Ave. 7 West, Dept. of Psych. and Behavior Health., Peoria, IL 61636 | 2012-07-11 |
| 1932490075 | Christine Ann Wigginton | Radiology | 221 Ne Glen Oak Ave Dept Of, Peoria, IL 61636 | 2011-04-24 |
| 1568901544 | Stephanie Ann Sullivan | Nurse Anesthetist, Certified Registered | Unity Point Health Methodist, 221 Ne Glen Oak Avenue, Peoria, IL 61636-0001 | 2017-02-23 |
| 1073066155 | Caroline Vanaman | Counselor | 221 Ne Glen Oak Ave # 7w, Peoria, IL 61636-0001 | 2016-07-26 |
| 1497141758 | Amber Hemminger | Registered Nurse | 200 Ne Glen Oak Ave, Peoria, IL 61636-0001 | 2015-04-13 |
| 1326288812 | Bradley Reatherford | Registered Nurse | 221 Northeast Ave, Peoria, IL 61636-0001 | 2009-02-24 |
| 1386784155 | Eric Hawkins | Anesthesiology | 22i Ne Glen Oak Ave, Methodist Medical Center Anesthesiology, Peoria, IL 61636-0001 | 2007-02-08 |
| 1386659241 | Central Illinois Radiological Associates, Ltd. | Radiology | Osf St Francis Medical Ctr, 530 N.e. Glen Oak, Peoria, IL 61636-0001 | 2006-07-29 |
| 1659345007 | Mary C Bruell | Social Worker | Dept of Psychiatry, 221 Ne Glen Oak 7 West, Peoria, IL 61636-0001 | 2006-02-14 |
| 1245203280 | University of Illinois | Psychiatry & Neurology | Department of Psychiatry, 221 Ne Glen Oak 7 West, Peoria, IL 61636-0001 | 2006-02-09 |
| Find all providers in zip 61636 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821609751 | Amanda Ferreira | Student in an Organized Health Care Education/Training Program | 7421 W Shangri La Rd, Peoria, AZ 85345-5811 | 2020-08-13 |
| 1699396838 | Ashif Khaled Molla | Student in an Organized Health Care Education/Training Program | Osf St Francis Medical Center 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-04-28 |
| 1437779063 | Mena Henien | Student in an Organized Health Care Education/Training Program | 530 Ne Glen Oak Ave Bldg 5676, Peoria, IL 61637-0001 | 2020-04-23 |
| 1306465893 | Sarath Kumar Jaganathan Jaishankar | Student in an Organized Health Care Education/Training Program | 530 Ne Glenn Oak Avenue, Peoria, IL 61637-0001 | 2020-04-14 |
| 1952920522 | Phu Si Huynh | Student in an Organized Health Care Education/Training Program | 331 Fulton St Apt 302, Peoria, IL 61602-1436 | 2020-04-13 |
| 1730736604 | Gabriela C Isenia | Student in an Organized Health Care Education/Training Program | 9031 W Tonopah Dr, Peoria, AZ 85382-6445 | 2019-08-24 |
| 1831751643 | Noreen Khan | Student in an Organized Health Care Education/Training Program | 1501 W Coneflower Dr Apt 2212, Peoria, IL 61615-7465 | 2019-07-01 |
| 1174184527 | Manisha Tharoor | Student in an Organized Health Care Education/Training Program | 530 N.e Glen Oak Ave, Peoria, IL 61637 | 2019-06-26 |
| 1609436724 | Sriviji Senthil Kumaran | Student in an Organized Health Care Education/Training Program | 530. N.e Glen Oak Ave., Peoria, IL 61637 | 2019-06-20 |
| 1780240929 | Abuzar Ali Asif | Student in an Organized Health Care Education/Training Program | 530 N. E. Glen Oak Ave., Peoria, IL 61637 | 2019-05-14 |
| 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.