Ebs Sports

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Legal business name

EBS SPORTS

Practice address

1019 W Lake Ave
Peoria, IL 61614-5933

Phone

(309) 202-2955

NPI assigned

Nov 12, 2007

Last updated

Nov 12, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Gregory Dennis Eberle, ATC

Title

Athletic Trainer / Owner

Phone

(309) 202-2955

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1194825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194825600000",
    "number": "1770763302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 W LAKE AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145933",
            "telephone_number": "309-202-2955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1019 W LAKE AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145933",
            "telephone_number": "309-202-2955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EBS SPORTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-12",
        "last_updated": "2007-11-12",
        "status": "A",
        "authorized_official_last_name": "EBERLE",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "DENNIS",
        "authorized_official_title_or_position": "ATHLETIC TRAINER / OWNER",
        "authorized_official_telephone_number": "309-202-2955",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ATC"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alesia Eaton, NNP
• Amanda M Eaton, MD
• Julie L Eaton, LCPC, CADC
• Susan Kay Eaton, MSW
• Gregory Dennis Eberle, ATC
• William C Eby, M.D.
• Eckert & Associates
• Joel Oliver Eckert, PSY D
• Katie Eckert
• Sequoia Eckwood

• Athletic Trainer in Peoria, IL
• Providers in Peoria, IL by specialty
• Athletic Trainer in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2007; 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.