Active NPI
Christine Bowers, MD
- Psychiatry Physician
- Peoria, IL
National Provider Identifier
1386702595
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 036073590
- Practice address
- 4719 N Sheridan Road
Peoria, IL 61614 - Phone
- (309) 685-7245
- Fax
- (309) 685-7247
- NPI assigned
- Dec 4, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 036073590 | IL | Primary |
Addresses
Primary practice location
4719 N Sheridan Road
Peoria, IL 61614
Mailing address
4719 N Sheridan Road
Peoria, IL 61614
Phone (309) 685-7245
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036073590 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036073590 | IL | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1270512000000",
"number": "1386702595",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4719 N SHERIDAN ROAD",
"city": "PEORIA",
"state": "IL",
"postal_code": "61614",
"telephone_number": "309-685-7245",
"fax_number": "309-685-7247"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4719 N SHERIDAN ROAD",
"city": "PEORIA",
"state": "IL",
"postal_code": "61614",
"telephone_number": "309-685-7245",
"fax_number": "309-685-7247"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOWERS",
"first_name": "CHRISTINE",
"name_prefix": "Mrs.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-04",
"last_updated": "2010-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IL",
"license": "036073590",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036073590",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Peoria, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.