PEORIA WEIGHTLOSS, LLC (NPI# 1912342569) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912342569 |
| Entity Type | Organization |
| Organization Name | PEORIA WEIGHTLOSS, LLC |
| Practice Address |
2426 W Cornerstone Ct Ste 100 Peoria IL 61614-2400 |
| Practice Telephone | 3099663137 |
| Mailing Telephone | 3099663137 |
| Enumeration Date | 2013-05-08 |
| Last Update Date | 2013-05-08 |
| Authorized Official Name | MR. KURTIS FREIDAG (OWNER) |
| Authorized Official Telephone | 3099663137 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
Ambulatory Health Care Facilities |
| Street Address |
2426 W CORNERSTONE CT STE 100 |
| City | PEORIA |
| State | IL |
| Zip Code | 61614-2400 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992263099 | Kristen Thompson | Nurse Practitioner | 2426 W Cornerstone Ct Ste 100, Peoria, IL 61614-2400 | 2019-03-07 |
| 1770072944 | Julie Belser | Nurse Practitioner | 2426 W Cornerstone Ct Ste 100, Peoria, IL 61614-2400 | 2018-05-03 |
| 1306349576 | Central Illinois Preventive Services LLC | Family Medicine | 2426 W Cornerstone Ct Ste 100, Peoria, IL 61614-2400 | 2018-03-14 |
| 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 | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952654154 | Ev Pain Specialists | Clinic/Center | 14100 N 83rd Ave Ste 260, Peoria, AZ 85381-5659 | 2012-10-25 |
| 1093943219 | Medshape Weight Loss Clinic, LLC | Clinic/Center | 7972 W Thunderbird Rd, 106, Peoria, AZ 85381-4903 | 2009-06-25 |
| 1083848188 | Susan J Cole, Md & Associates | Clinic/Center | 5401 N Knoxville Ave, Suite 107, Peoria, IL 61614-5098 | 2009-05-05 |
| 1881861953 | Surraj Medical Associates,pllc | Clinic/Center | 9401 W Thunderbird Rd, Suite 155, Peoria, AZ 85381-4233 | 2008-05-08 |
| 1376680363 | Neurology Clinic of Peoria Sc | Clinic/Center | 5401 N Knoxville Ave, Suite 414, Peoria, IL 61614-5098 | 2007-01-31 |
| 1033163761 | Proctor Health Systems | Clinic/Center | 5401 N Knoxville Ave, Suite 103, Peoria, IL 61614-5098 | 2006-05-19 |
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|---|---|---|---|---|
| 1295351062 | Sara M Gotheridge Md LLC | Clinic/Center | 630 Davis St Ste 301, Evanston, IL 60201-4480 | 2020-06-17 |
| 1407484645 | Macumber Medical Ltd | Clinic/Center | 3114 W Irving Park Rd Ste 1w, Chicago, IL 60618-3435 | 2020-04-01 |
| 1477181782 | Embassy Studios North | Clinic/Center | 6455 N Cicero Ave, Lincolnwood, IL 60712-3407 | 2020-03-31 |
| 1689226318 | Midway Spine and Joint Pain Physicians | Clinic/Center | 5720 S Pulaski Rd, Chicago, IL 60629-4435 | 2019-07-12 |
| 1215598891 | Vero Clinics | Clinic/Center | 1192 E Pershing Rd, Decatur, IL 62526-4753 | 2019-06-25 |
| 1497215933 | Activate Healthcare | Clinic/Center | 2010 N Damen Ave Unit F, Chicago, IL 60647-3286 | 2019-03-21 |
| 1033699467 | Healthpointe Medical Center Sc | Clinic/Center | 530 Fullerton Rd Ste B, Swansea, IL 62226-2970 | 2018-08-15 |
| 1740794882 | Highland Park Cvs, L.L.C. | Clinic/Center | 72 Airport Plz, Bethalto, IL 62010-1774 | 2017-11-28 |
| 1447764014 | Dr Courtney Drendel Inc | Clinic/Center | 515 Hamilton St # 100, Geneva, IL 60134-2138 | 2017-11-19 |
| 1699206599 | David M Conner M.d. | Clinic/Center | 9 Executive Woods Ct Ste 2, Swansea, IL 62226-2016 | 2017-03-22 |
| Find all providers with the same taxonomy | ||||
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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.