| Inner Wellness Of Central Illinois Pllc | |
|
2511 N Main St East Peoria IL 61611 | |
| (309) 670-0459 | |
| (309) 670-0416 |
| Full Name | Inner Wellness Of Central Illinois Pllc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 2511 N Main St, East Peoria, Illinois |
| Authorized Official Name and Position | Jennifer Christine Alexander (MEDICAL DIRECTOR) |
| Authorized Official Contact | 3096700459 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Inner Wellness Of Central Illinois Pllc 2511 N Main St East Peoria IL 61611 Ph: (309) 670-0459 | Inner Wellness Of Central Illinois Pllc 2511 N Main St East Peoria IL 61611 Ph: (309) 670-0459 |
| NPI Number | 1871164442 |
|---|---|
| Provider Enumeration Date | 07/06/2021 |
| Last Update Date | 08/13/2021 |
| Certification Date | 08/13/2021 |
| Medicare PECOS PAC ID | 7911387592 |
|---|---|
| Medicare Enrollment ID | O20220629003113 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871164442 | NPI | - | NPPES |
| 1992233977 | Other | IL | NPI |
| 1205098480 | Other | IL | NPI |
| 1205470168 | Other | NPI |
| Provider Name | Jennifer Alexander |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992233977 PECOS PAC ID: 7214294297 Enrollment ID: I20171129001891 |
| Provider Name | Lindsay Ryan Harms |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1205098480 PECOS PAC ID: 9739215690 Enrollment ID: I20240219002787 |
| Provider Name | Jasmine Jones |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1205470168 PECOS PAC ID: 8729468301 Enrollment ID: I20240220001451 |
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