Individual
TAMMY SARMIENTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
530 NE GLEN OAK AVE, 4TH FLOOR NORTHBUILDING- PALLIATIVE CARE SERVICES, PEORIA, IL 61637-0001
(309) 624-1818
(309) 624-8820
Mailing address
530 NE GLEN OAK AVE, 4TH FLOOR NORTHBUILDING- PALLIATIVE CARE SERVICES, PEORIA, IL 61637-0001
(309) 624-1818
(309) 624-8820
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209-006726
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
809840
MEDICARE GROUP #
IL
01
—
CA4079
RR MEDICARE GROUP PTAN
IL
01
—
P00680131
RR MEDICARE MEMBER PTAN
IL
Enumeration date
09/04/2007
Last updated
04/30/2009
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