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Search › Illinois › 1223G0001X

Jacey Thelen

NPI 1669303731 · on the registry since 2026

Practice

Address
838 W Glen Ave
Peoria, IL 61614
Phone
(309) 244-1655
Organisation at this address
Pine Glen Dental Group, Ltd
Pine Glen Dental Group, Ltd
Inferred from a shared address, not stated in the registry.
Clinicians at this address
4

Registry record

Primary taxonomy
1223G0001X
1223G0001X
Licence states on file
IL
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2026-05-27

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois