LINDA WILSON KLEMM (NPI# 1912233602) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912233602 |
| Entity Type | Individual |
| Full Name | LINDA WILSON KLEMM |
| Other Name | LINDA WILSON |
| Credential | FNP-BC |
| Practice Address |
1770 E Lake Shore Dr Suite 105 Decatur IL 62521-3832 |
| Mailing Address |
1025 S 6th St Springfield IL 62703-2403 |
| Practice Telephone | 2174283424 |
| Mailing Telephone | 2175287541 |
| Mailing Fax Number | 2175288962 |
| Enumeration Date | 2009-10-30 |
| Last Update Date | 2009-10-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
209007850 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1770 E LAKE SHORE DR SUITE 105 |
| City | DECATUR |
| State | IL |
| Zip Code | 62521-3832 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942292412 | David Anthony Jones | Family Medicine | 1770 E Lake Shore Dr, Suite 305, Decatur, IL 62521-3832 | 2005-08-19 |
| 1306314778 | Kristy Dawn Shafer | Nurse Practitioner | 1770 E Lake Shore Dr, Decatur, IL 62521-3832 | 2018-11-05 |
| 1902340730 | Annie Michele Smith | Social Worker | 1770 E Lake Shore Dr, #209, Decatur, IL 62521-3832 | 2016-12-13 |
| 1013319623 | Nicole Marie Lord | Nurse Practitioner | 1770 E Lake Shore Dr, #309, Decatur, IL 62521-3832 | 2014-09-25 |
| 1508110198 | Leslie Stanislaus Anewenah | Surgery | 1770 E Lake Shore Dr, Decatur, IL 62521-3832 | 2012-11-04 |
| 1063797108 | Laurel A Walton Do Sc | Obstetrics & Gynecology | 1770 E Lake Shore Dr, Ste 309, Decatur, IL 62521-3832 | 2011-10-20 |
| 1447532924 | Ahmad H Ahmad Md Sc | Internal Medicine | 1770 E Lake Shore Dr, Ste 201, Decatur, IL 62521-3832 | 2011-09-12 |
| 1265675490 | Jennifer Ross-barnett | Nurse Practitioner | 1770 E Lake Shore Dr, Suite 207, Decatur, IL 62521-3831 | 2009-04-17 |
| 1447403936 | Choudary V. Kavuri Md, Sc | Psychiatry & Neurology | 1770 E Lake Shore Dr, Suite 208, Decatur, IL 62521-3832 | 2008-10-28 |
| 1205098738 | Danxuan Long | Internal Medicine | 1770 E Lake Shore Dr, Decatur, IL 62521-3832 | 2008-06-26 |
| Find all providers in the same location | ||||
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|---|---|---|---|---|
| 1053927988 | Caleb David Braasch | Pharmacist | 1818 South Airport Rd, Decatur, IL 62521 | 2020-09-16 |
| 1295390490 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | Crossing Recovery Center, 495 East Central Ave, Decatur, IL 62521 | 2019-05-03 |
| 1396300638 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | 495 E Central Ave, Decatur, IL 62521 | 2019-05-02 |
| 1679138911 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | 495 East Central Ave, Decatur, IL 62521 | 2019-05-02 |
| 1154848034 | Zack Shaw | Physical Therapist | 4855-57 East 36, Decatur, IL 62521 | 2017-08-23 |
| 1790032852 | Prashant Morolia | Family Medicine | 4775 E Maryland St, Decatur, IL 62521 | 2012-08-08 |
| 1003188913 | Evergreen Place Decatur, LLC | Assisted Living Facility | 4825 E Evergreen Court, Decatur, IL 62521 | 2012-02-08 |
| 1104133099 | Suzette Marie Shafer | Occupational Therapy Assistant | 1790 S. Fairview Ave., Decatur, IL 62521 | 2010-09-13 |
| 1467784090 | Community Health Improvement Center | Clinic/Center | 1221 East Condit Street, Decatur, IL 62521 | 2010-02-08 |
| 1982839056 | Kelly Clark Dds PC | Dentist | 3737 Us Rt 36 E, Decatur, IL 62521 | 2009-05-19 |
| Find all providers in zip 62521 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
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| 1174156244 | Anne Marie Strickland | Nurse Practitioner | 3109 Vicksburg Pl Sw, Decatur, AL 35603-3107 | 2020-02-18 |
| 1174161822 | Allison Leanne Hall | Nurse Practitioner | 304 W Hay St Ste 312, Decatur, IL 62526-4170 | 2019-12-12 |
| 1396387866 | Elizabeth Nichole Mathews | Nurse Practitioner | 2301 S Fm 51 Ste 100, Decatur, TX 76234-3864 | 2019-10-16 |
| 1861040479 | Oladunni Funmi Faminu | Nurse Practitioner | 2701 N Decatur Rd # 2400, Decatur, GA 30033-5918 | 2019-08-27 |
| Find all providers in DECATUR | ||||
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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.