Millicent Mutisya

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

1115 N North St Ste C
Peoria, IL 61606-1959

Phone

(309) 839-8984

NPI assigned

Feb 20, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1676851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676851200000",
    "number": "1891493797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 WATERMARK DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432157088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 N NORTH ST STE C",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616061959",
            "telephone_number": "309-839-8984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTISYA",
        "first_name": "MILLICENT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-20",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ziad Musaitif, DO
• Musculoskeletal Surgery Center, LLC
• Musculoskeletal Surgical Center
• Neha Choudary Muthavarapu, MD
• Marcus Ismedhi Mutidjo, APN
• Myeasyaccesshealthcare, PLLC
• Beth A Myers, CST
• Clifford Earl Myers, M.D.
• Debra Myers, FNPC
• Jordan Hadley Myers, MS

• Counselor in Peoria, IL
• Providers in Peoria, IL by specialty
• Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2023; 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.