Evalynne D Basso, | |
601 E Tripp Ave, Peoria, IL 61603-1221 | |
(309) 472-4643 | |
Not Available |
Full Name | Evalynne D Basso |
---|---|
Gender | Female |
Speciality | Nurse Practitioner |
Experience | 3 Years |
Location | 601 E Tripp Ave, Peoria, Illinois |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1720759830 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LF0000X | Nurse Practitioner - Family | 209.023675 (Illinois) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Saint Francis Medical Center | Peoria, IL | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Osf Multi-specialty Group | 3678889789 | 1552 |
Entity Name | Osf Multi-specialty Group |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1922445527 PECOS PAC ID: 3678889789 Enrollment ID: O20150904000279 |
Mailing Address | Practice Location Address |
---|---|
Evalynne D Basso, 601 E Tripp Ave, Peoria, IL 61603-1221 Ph: (309) 472-4643 | Evalynne D Basso, 601 E Tripp Ave, Peoria, IL 61603-1221 Ph: (309) 472-4643 |
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