Provider Demographics
NPI:1376787523
Name:CAMERON, VANESSA MARIE (DO)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:MARIE
Last Name:CAMERON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:VANESSA
Other - Middle Name:MARIE
Other - Last Name:YELTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:313 INDEPENDENCE DR
Mailing Address - Street 2:
Mailing Address - City:EAST PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61611-5563
Mailing Address - Country:US
Mailing Address - Phone:720-938-3450
Mailing Address - Fax:
Practice Address - Street 1:8600 N SATE ROUTE 91
Practice Address - Street 2:SUITE 330
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61615
Practice Address - Country:US
Practice Address - Phone:309-692-2025
Practice Address - Fax:309-692-2446
Is Sole Proprietor?:No
Enumeration Date:2009-04-30
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILAS3581875-409207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology