Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Carissa Gorham

Individual provider Clinical Nurse Specialist · NPI 1407259559

Carissa Gorham is a Certified Clinical Nurse Specialist (Cns) in Peoria, Illinois. Qualified in 2014, 12 years ago. Practices with Osf Multi-Specialty Group, a 2,128-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
12
Licensed in
IL
In the registry since
2014

Practice location Address checks out

530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone: (309) 655-3000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Nurse Specialist (primary) Taxonomy 364S00000X · Licence 041338732 (IL)

Record details

NPI number1407259559
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedOctober 3, 2014
Last updated in NPPESOctober 3, 2014
Mailing address530 Ne Glen Oak Ave, Peoria, IL 61637-0001

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED CLINICAL NURSE SPECIALIST (CNS)
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Osf Multi-Specialty Group — 2128 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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