Provider Type Icon

DR. SAMUEL BRIAN MCINTYRE ED.D NPI 1386608008


NPI Information

NPI: 1386608008
Provider Name: DR. SAMUEL BRIAN MCINTYRE, ED.D
Classification: Psychologist - 103TH0100X
Entity Type: Individual

Specialization: Health Service

PECOS Registration: Yes

Address:
7309 N KNOXVILLE AVE
PEORIA, IL
ZIP 61614
Phone: (309) 692-9898
Get Directions

DR. Samuel Brian Mcintyre, ED.D is a health service psychologist in Peoria, IL with 37 years of experience. The provider is a psychologist, certified/licensed at the independent practice level in his/her state, who is duly trained and experienced in the delivery of direct, preventative, assessment, and therapeutic intervention services to individuals whose growth, adjustment, or functioning is actually impaired or is demonstrably at high risk of impairment (1974). DR. Samuel Brian Mcintyre, ED.D NPI is 1386608008. 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:

7309 N KNOXVILLE AVE
PEORIA, IL
ZIP 61614-085
Phone: (309) 692-9898
Fax: (309) 692-9055

The NPI 1386608008 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.

The enumeration date for this NPI number is 4/12/2006 and was last updated on 7/8/2007.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103TH0100XPsychologistHealth ServiceILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1K16938MEDICARE ID-TYPE UNSPECIFIEDILLINOIS
2S04566MEDICARE UPINILLINOIS

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: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.