EVAN WALDER NPI 1891510731

NPI Information

  • NPI: 1891510731
  • Provider Name: EVAN WALDER
  • Classification: Nurse Practitioner - 363LA2100X
  • Specialization: Acute Care
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 221 NE GLEN OAK AVE
    PEORIA, IL
    ZIP 61636
  • Phone: (309) 672-5522

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NPI Details

Evan Walder is an acute care nurse practitioner in Peoria, IL. Evan Walder NPI is 1891510731. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

221 NE GLEN OAK AVE
PEORIA, IL
ZIP 61636-001
Phone: (309) 672-5522

The NPI 1891510731 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/16/2024 and was last updated on 11/16/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LA2100XNurse PractitionerAcute Care209031039ILLINOISYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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