Cameron, Dorthia D

Cameron, Dorthia D is an individual health care provider with primary practice located at 530 Ne Glen Oak Ave , Peoria IL 61637-0001. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Primary Care. Physician Assistants & Advanced Practice Nursing Providers / Primary Care is her primary health care specialty. Cameron, Dorthia D can be contacted via phone (309) 624-8820.

Contact Information

Primary practice address
530 Ne Glen Oak Ave Peoria IL 61637-0001
Phone: (309) 624-8820
Fax: (309) 624-8820
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 6647 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X 209030955 Illinois

Profile Details

NPI number 1669838496
LBN Legal business name Cameron, Dorthia D
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 9th, 2016
Last updated Jul 28th, 2025 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669838496 NPPES
Wisconsin MEDICAID 100054093

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