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

Kassandra Iva Marie Cooper, DO

Individual provider Emergency Medicine Physician · NPI 1710393913

Kassandra Iva Marie Cooper, DO is an Emergency Medicine in Peoria, Illinois. Qualified in 2014, 12 years ago. Practices with Permanente Medical Group Inc, a 10,941-clinician group and accepts Medicare assignment. Licensed in California and Illinois.

Years since qualifying
12
Licensed in
CA, IL
In the registry since
2014
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone: (309) 655-6710
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 20A15660 (CA)
Emergency Medicine Physician Taxonomy 207P00000X · Licence 125065930 (IL)

Record details

NPI number1710393913
Entity typeIndividual (Type 1)
GenderFemale
Credentials DO
Sole proprietorYes
NPI enumeratedJuly 8, 2014
Last updated in NPPESNovember 14, 2024
Certification dateNovember 14, 2024

Medicare enrollment

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

Medicare specialtyEMERGENCY MEDICINE
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Permanente Medical Group Inc — 10941 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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