Rebecca Sue Pender, RN
Individual provider Active NPI Registered Nurse · Monmouth, IL
NPI 1720202369 · NPPES record last updated Apr 17, 2009
Key facts
- NPI
- 1720202369
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 077683 (IA)
- Practice address
- 219 E Euclid Ave
Monmouth, IL 61462-1247 - Phone
- (309) 734-9461
- Fax
- (309) 734-3909
- NPI assigned
- Apr 13, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 077683 | IA | MD | Registered Nurse |
| 041.246874 | IL | MD | Case Management Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bridgeway Inc | Past | Accepting new patients | |
| Bridgeway, Inc | Past | Accepting new patients | |
| Bridgeway Inc | Past | Accepting new patients | |
| Bridgeway, Inc | Past | Accepting new patients | |
| Bridgeway, Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 077683 | IA | Yes |
| Psychiatric/Mental Health Registered Nurse | 163WP0808X | 041.246874 | IL | |
| Case Management Registered Nurse | 163WC0400X | 041.246874 | IL |
Addresses
Primary practice location
219 E Euclid Ave
Monmouth, IL 61462-1247
Mailing address
1007 230TH St
Aledo, IL 61231-8533
Phone (309) 582-1116
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 041.246874 | Other | IL | R N LICENSE |
| 077683 | Other | IA | R N LICENSE |
| 370984175 | Other | IL | BWAY INC FEIN |
Other providers in Monmouth, IL
- Osf Healthcare System
- Osf Healthcare System
- Osf Healthcare System
- Pawprint Pathway Counseling, PLLC
- Ralph Peeler
- Personal Best Chiropractic, LLC
- Petersen Health Systems, Inc.
- Petersen Health Systems, Ins
- Julie Petersen
- Alan E Phillips
All providers in Monmouth, IL · Registered Nurse in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 17, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.