Alissa Zimmerman Bennett, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

125062318 Issued in IL

Practice address

815 Main St
Peoria, IL 61602-1076

Phone

(309) 672-4977

NPI assigned

Jul 20, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1342742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342742400000",
    "number": "1174878672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 RELIABLE PKWY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606860051",
            "telephone_number": "309-672-4809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 MAIN ST",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616021076",
            "telephone_number": "309-672-4977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMAN BENNETT",
        "first_name": "ALISSA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-20",
        "last_updated": "2012-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": "125062318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Zhu, MD
• Hamid Mahmood Zia, M.D
• Michael J Zichterman, DDS
• Jared Ziegenbein, APRN, CPNP-AC
• Stephanie Lynn Zilch, RRT-NPS, ACCS
• Amy Zimmerman, APN
• Emily Zimmerman, RN, DNP, CPNP-AC
• Asma Zitouni
• Alexandra Ge Zodo, MD
• Emily Zoid, IBCLC

• Student in an Organized Health Care Education/Training Program in Peoria, IL
• Providers in Peoria, IL by specialty
• Student in an Organized Health Care Education/Training Program in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.