Kristen Ann Chambers-Damm, M.D.
Individual provider Active NPI Internal Medicine Physician · Peoria, IL
NPI 1447485693 · NPPES record last updated Aug 8, 2012
Key facts
- NPI
- 1447485693
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 125055802 (IL)
- Practice address
- 8600 N. Route 91
Peoria, IL 61615 - Phone
- (309) 683-5050
- Fax
- (309) 683-5335
- NPI assigned
- May 18, 2009
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 6
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Heartland Community Health Clinic
Osf Multi-Specialty Group
Practice addresses (Care Compare)
1800 N Knoxville Ave
Suite a
Peoria, IL 61603-3005
Phone (309) 680-7600
8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050
Hospital & facility affiliations
- St. Francis Medical Center
- Saint Francis Medical Center
- Osf Saint Elizabeth MDL Ctr
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120730000184 | IL | Practitioner - Internal Medicine | 7113183534 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125055802 | IL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central PA Pharmacy LLC. | Current | Accepting new patients | |
| Osf Multi-Specialty Group | Internal Medicine | Current |
Accepting new patients |
Locations
1800 N Knoxville Ave
Ste A
Peoria, IL 61603
8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050
8600 State Route 91
Peoria, IL 61615
Phone (309) 683-5050
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 125055802 | IL | Yes |
Addresses
Primary practice location
8600 N. Route 91
Peoria, IL 61615
Mailing address
8600 N. Route 91
Peoria, IL 61615
Phone (309) 683-5050
Other providers in Peoria, IL
- Dexter Cervantes
- Shinymol John Chacko
- Amitoj Singh Chadha
- Deboshruti Chakraborty
- Shruti Chakravarthy
- Bradley A Chambers
- Champion Fitness, Inc
- Amanda Marie Champion
- Andrew Oakford Champion
- Daniel Chan
All providers in Peoria, IL · Internal Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 8, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.