Irene P Kasambira, APN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

209008305 Issued in IL

Practice address

228 NE Jefferson
Peoria, IL 61603

Phone

(309) 571-8000

Fax

(309) 671-4695

NPI assigned

Jul 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454889600000",
    "number": "1699700989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1346",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616541346",
            "telephone_number": "309-671-8000",
            "fax_number": "309-671-4695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 NE JEFFERSON",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "61603",
            "telephone_number": "309-571-8000",
            "fax_number": "309-671-4695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASAMBIRA",
        "first_name": "IRENE",
        "middle_name": "P",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2016-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0807X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Child & Adolescent",
            "state": "IL",
            "license": "209002929",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209008305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elena Kapur, MD
• Todd J Karas, DPM
• Maria Karbowska-Jankowska
• Kailey Jean Karder, MSW
• Karen Gilmore Therapy and Coaching PLLC
• Ravindra Kashyap, M.D.
• Katherine Ann Kasper, M.D.
• Rabia Asif Kassim, DMD
• Peggy Kastelein, IBCLC
• Kathy Karouzos Counseling, LLC

• Psychiatric/Mental Health Nurse Practitioner in Peoria, IL
• Providers in Peoria, IL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2016; 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.