Provider Demographics
NPI:1093976169
Name:YOUMANS, AMANDA (DO)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:
Last Name:YOUMANS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 940
Mailing Address - Street 2:
Mailing Address - City:MORRIS
Mailing Address - State:IL
Mailing Address - Zip Code:60450-0940
Mailing Address - Country:US
Mailing Address - Phone:815-416-9208
Mailing Address - Fax:
Practice Address - Street 1:506 E SENECA PL
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61603
Practice Address - Country:US
Practice Address - Phone:309-669-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-21
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125052610207ZP0102X
IL036125159207ZF0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZF0201XAllopathic & Osteopathic PhysiciansPathologyForensic Pathology
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology