| Erica M Deford, PA | |
|
2805 N Knoxville Ave, Peoria, IL 61604-2869 | |
| (309) 624-9400 | |
| (309) 624-2280 |
| Full Name | Erica M Deford |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant - Medical |
| Location | 2805 N Knoxville Ave, Peoria, Illinois |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306020334 | NPI | - | NPPES |
| 809840 | Other | IL | MEDICARE GROUP PTAN |
| 776530 | Other | IL | MEDICARE GROUP PIN |
| 37-1221637 | Other | TAX ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AM0700X | Physician Assistant - Medical | 085003126 (Illinois) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Erica M Deford, PA 2805 N Knoxville Ave, Peoria, IL 61604-2869 Ph: (309) 624-9400 | Erica M Deford, PA 2805 N Knoxville Ave, Peoria, IL 61604-2869 Ph: (309) 624-9400 |
Ms. Courtney M Jaegle, PA Physician Assistant Medicare: May Accept Medicare Assignments Practice Location: 112 Ne Crescent Ave, Peoria, IL 61606 Phone: 309-672-4670 Fax: 309-672-4669 | |
Jacob Clark, Physician Assistant Medicare: Medicare Enrolled Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637 Phone: 309-655-2000 | |
Natalie Patty, Physician Assistant Medicare: Medicare Enrolled Practice Location: 5111 N Glen Park Place Rd, Peoria, IL 61614 Phone: 309-683-5700 | |
Rob Wimmer, P.A. Physician Assistant Medicare: Medicare Enrolled Practice Location: 7309 N Knoxville Ave, Peoria, IL 61614 Phone: 309-692-9898 | |
Benjamin Richard Tellier, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 723 Ne Glen Oak Ave, Peoria, IL 61603 Phone: 309-624-8749 Fax: 309-624-8870 | |
Abigail Rose Sutton, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 303 N William Kumpf Blvd, Peoria, IL 61605 Phone: 309-676-5546 Fax: 309-676-5045 | |
Richard S Seaboch, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 5405 N Knoxville Ave, Peoria, IL 61614 Phone: 309-691-4410 Fax: 309-589-2830 |