CHRISTINE ANN WIGGINTON (NPI# 1932490075) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932490075 |
| Entity Type | Individual |
| Full Name | CHRISTINE ANN WIGGINTON |
| Other Name | CHRISTINE ANN GUSTAFSON |
| Credential | MD |
| Practice Address |
221 Ne Glen Oak Ave Dept Of Peoria IL 61636 |
| Mailing Address |
221 Ne Glen Oak Ave Dept Of Peoria IL 61636-0001 |
| Practice Telephone | 3096725582 |
| Mailing Telephone | 3096725582 |
| Enumeration Date | 2011-04-24 |
| Last Update Date | 2018-08-05 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
D0077712 | MD | Allopathic & Osteopathic Physicians |
| Street Address |
221 NE GLEN OAK AVE DEPT OF |
| City | PEORIA |
| State | IL |
| Zip Code | 61636 |
| 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 |
| 1154856607 | Shubhada Reddy | Psychiatry & Neurology | 221 Ne Glen Oak Ave, Peoria, IL 61636 | 2017-04-21 |
| 1649657685 | Nicholas Grieco | Internal Medicine | 221 Ne Glen Oak Ave, Peoria, IL 61636 | 2015-04-29 |
| 1659703759 | Dhaval Save | Internal Medicine | 221 Ne Glen Oak Ave, Peoria, IL 61636 | 2013-07-31 |
| 1164474755 | Methodist Medical Center of Illinois | General Acute Care Hospital | 221 Ne Glen Oak Ave, Peoria, IL 61636 | 2006-05-16 |
| 1871560623 | Minna Jinn O'leary | Psychiatry & Neurology | 221 Ne Glen Oak Ave, Peoria, IL 61636 | 2006-03-01 |
| 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 |
| Find all providers in zip 61636 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992054829 | Justin S Ferragut | Radiology | 530 Northeast Glen Oak Avenue, Peoria, IL 61603 | 2012-09-06 |
| 1932421591 | Smi Imaging, LLC | Radiology | 9125 W Thunderbird Rd, Suite 105, Peoria, AZ 85381-4920 | 2010-02-24 |
| 1972736163 | Smi Imaging, LLC | Radiology | 9403 W Thunderbird Rd, Peoria, AZ 85381-4825 | 2009-09-03 |
| 1184828360 | Jane Ho Maksimovic | Radiology | 2612 W Newman Pkwy, Peoria, IL 61604-2208 | 2007-06-12 |
| 1124030705 | Terry M Brady | Radiology | 411 Hamilton Blvd, 1824, Peoria, IL 61602-1144 | 2006-08-12 |
| 1275543456 | Kim V. Arellano-villarreal | Radiology | 401 Sw Water St, Peoria, IL 61602-1571 | 2006-08-09 |
| 1386659241 | Central Illinois Radiological Associates, Ltd. | Radiology | Osf St Francis Medical Ctr, 530 N.e. Glen Oak, Peoria, IL 61636-0001 | 2006-07-29 |
| 1538192828 | Central Illinois Radiological Associates, Ltd. | Radiology | 530 Ne Glen Oak Avenue, Peoria, IL 61637 | 2006-07-09 |
| 1265469399 | Brian A Holtan | Radiology | 31003 N 118th Ln, Peoria, AZ 85383-8240 | 2006-06-26 |
| 1992755870 | Jan Namyslowski | Radiology | 114 W Stratford Dr Ste E, Peoria, IL 61614-7300 | 2006-05-11 |
| 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.