| Adebimpe Favour Erebholo, NP | |
|
3300 N Main St, East Peoria, IL 61611-1562 | |
| (309) 698-8300 | |
| (309) 698-8303 |
| Full Name | Adebimpe Favour Erebholo |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Location | 3300 N Main St, East Peoria, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982214144 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163WN0300X | Registered Nurse - Nephrology | 041434445 (Illinois) | Secondary |
| 363L00000X | Nurse Practitioner | 209022026 (Illinois) | Primary |
| Entity Name | Vpa Of Texas Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1679510499 PECOS PAC ID: 7618911660 Enrollment ID: O20050610000702 |
| Entity Name | Signify Health Medical Associates Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1750845863 PECOS PAC ID: 2163764424 Enrollment ID: O20190520001486 |
| Mailing Address | Practice Location Address |
|---|---|
| Adebimpe Favour Erebholo, NP 3300 N Main St, East Peoria, IL 61611-1562 Ph: (309) 698-8300 | Adebimpe Favour Erebholo, NP 3300 N Main St, East Peoria, IL 61611-1562 Ph: (309) 698-8300 |
Delanie Lynn Fletcher, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 133 Spinder Dr, East Peoria, IL 61611 Phone: 309-308-5100 | |
Mrs. Deidra Diane Anderson, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 133 Spinder Dr, East Peoria, IL 61611 Phone: 309-308-5100 | |
Joshua A Larson, APRN, CNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 133 Spinder Dr Ste 4015, East Peoria, IL 61611 Phone: 309-308-5100 Fax: 309-308-5102 | |
Courtney Elizabeth Reubin, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 133 Spinder Dr, East Peoria, IL 61611 Phone: 309-308-5100 | |
Brittany Anne Mcgill, APRN, CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 133 Spinder Dr Ste 4015, East Peoria, IL 61611 Phone: 309-308-5100 Fax: 309-308-5102 | |
Mrs. Brandy J Coleman, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 133 Spinder Dr, East Peoria, IL 61611 Phone: 309-308-5100 | |
Kerri Jean Schafer, APN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 133 Spinder Dr, East Peoria, IL 61611 Phone: 309-308-5100 Fax: 309-308-5102 |