Provider Demographics
NPI:1538138318
Name:TEAR, SHARON A (NP)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:A
Last Name:TEAR
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:A
Other - Last Name:TRUEDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1701 W. GARDEN STREET
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61605-3531
Mailing Address - Country:US
Mailing Address - Phone:309-680-7600
Mailing Address - Fax:309-676-5506
Practice Address - Street 1:228 NE JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61603-3802
Practice Address - Country:US
Practice Address - Phone:309-680-7600
Practice Address - Fax:309-680-7637
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209-001332363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL07215036OtherBCBS
ILIL01G3OtherJOHN DEERE
IL07215036OtherBCBS