Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Natasha Victoria Rodriguez Mancebo, PA-C

Individual provider Physician Assistant · NPI 1588201115

Natasha Victoria Rodriguez Mancebo, PA-C is a Physician Assistant in Peoria, Illinois. Licensed in Illinois. Registered with an NPI since 2019.

Licensed in
IL
In the registry since
2019
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

711 W John Gwynn Ave
Peoria, IL 61605-2270
Phone: (309) 680-7600
Fax: (309) 671-2188
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 085007443 (IL)

Record details

NPI number1588201115
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedDecember 2, 2019
Last updated in NPPESDecember 2, 2019

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