SAINT FRANCIS MEDICAL CENTER (NPI# 1013146067) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013146067 |
| Entity Type | Organization |
| Organization Name | SAINT FRANCIS MEDICAL CENTER |
| Other Organization Name | CHILDREN'S HOSPITAL OF ILLINOIS MEDICAL GROUP |
| Practice Address |
420 Ne Glen Oak Ave Suite 304 Peoria IL 61603-3105 |
| Practice Telephone | 3096553453 |
| Mailing Telephone | 3096553453 |
| Enumeration Date | 2009-07-13 |
| Last Update Date | 2009-07-13 |
| Authorized Official Name | JAMES M MOORE (CEO) |
| Authorized Official Telephone | 3096552850 |
| Is Organization Subpart | Y |
| Parent Organization Name | OSF HEALTHCARE SYSTEM |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0202X |
Pediatrics Specialization: Pediatric Cardiology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| CHILDREN'S HOSPITAL OF ILLINOIS MEDICAL GROUP | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023574365 | Saint Francis Medical Center | Pediatrics | 2210 Barron Rd Ste 120, Poplar Bluff, MO 63901-1908 | 2019-02-12 |
| 1053844282 | Saint Francis Medical Center | Obstetrics & Gynecology | Rr 4 #4515, Piedmont, MO 63957-9417 | 2017-04-05 |
| 1023541265 | Saint Francis Medical Center | Family Medicine | 1212 Saint Francis Dr, Dexter, MO 63841-2769 | 2017-04-05 |
| 1366831943 | Saint Francis Medical Center | Family Medicine | 1212 Saint Francis Drive, Dexter, MO 63841-1212 | 2015-01-20 |
| 1457757767 | Saint Francis Medical Center | Family Medicine | 420 Piedmont Ave, Piedmont, MO 63957-1024 | 2014-11-13 |
| 1518372481 | Saint Francis Medical Center | Advanced Practice Midwife | 1702 N Kings Highway St, Cape Girardeau, MO 63701-2122 | 2014-06-30 |
| 1831523695 | Saint Francis Medical Center | General Acute Care Hospital | 150 South Mount Auburn Road, Suite 342, Cape Girardeau, MO 63703 | 2013-08-29 |
| 1932454956 | Saint Francis Medical Center | Family Medicine | 545 Broad Ridge, Jackson, MO 63755-3001 | 2012-07-16 |
| 1861711640 | Saint Francis Medical Center | Licensed Practical Nurse | 1300 W Commerce Dr, Ste 200, Peoria, IL 61615-1405 | 2010-05-19 |
| 1528198942 | Saint Francis Medical Center | Emergency Medicine | 211 St Francid Dr, Cape Girardeau, MO 63703 | 2007-03-06 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SAINT FRANCIS MEDICAL CENTER | 2620 W Faidley Ave, Grand Island, NE 68803-4205 |
| Street Address |
420 NE GLEN OAK AVE SUITE 304 |
| City | PEORIA |
| State | IL |
| Zip Code | 61603-3105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427057595 | David P Chan | Pediatrics | 420 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2005-07-20 |
| 1164062196 | Tiara J Mullen | Nurse Practitioner | 420 Ne Glen Oak Ave, Peoria, IL 61603-3106 | 2020-01-07 |
| 1700308996 | Amanda Matthews | Nurse Practitioner | 420 Ne Glen Oak Ave, Peoria, IL 61603 | 2017-07-10 |
| 1871026450 | Shari S Mulvey | Pediatrics | 420 Ne Glen Oak Ave, Peoria, IL 61603-3105 | 2017-04-10 |
| 1003268897 | Sandra L. Peach | Nurse Practitioner | 420 Ne Glen Oak Ave, Peoria, IL 61603-3105 | 2016-07-06 |
| 1083062285 | Heather A Boore | Clinical Nurse Specialist | 420 Ne Glen Oak Ave, Suite 401, Peoria, IL 61603 | 2016-05-27 |
| 1336546969 | Jennifer A. Nelson | Nurse Practitioner | 420 Ne Glen Oak Ave, Suite 201, Peoria, IL 61603-3105 | 2014-11-25 |
| 1003219932 | Linda Schmidgall | Nurse Practitioner | 420 Ne Glen Oak Ave, Suite 200, Peoria, IL 61603-3105 | 2014-10-07 |
| 1164839692 | Gregory Puszkiewicz | Pharmacist | 420 Ne Glen Oak Ave, Peoria, IL 61603-3105 | 2014-07-16 |
| 1396183687 | Diana Warnecke | Nurse Practitioner | 420 Ne Glen Oak Ave, Ste 401, Peoria, IL 61603-3105 | 2013-06-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598362980 | Courtney Klein | Nurse Practitioner | 1306 N. Berkley Ave, Peoria, IL 61603 | 2020-10-08 |
| 1114588217 | Kong Xing Wang | Dentist | 320 East Armstrong Ave, Peoria, IL 61603 | 2019-06-28 |
| 1073015319 | Sara Kristine Rosenbery | Nurse Practitioner | 515 Ne Glen Oak Ave Ste 202, Peoria, IL 61603 | 2018-03-02 |
| 1861860058 | Jennifer Michelle Kelsey | Clinical Nurse Specialist | 420 Ne Glen Oak Avenue, Suite 401, Peoria, IL 61603 | 2015-09-04 |
| 1467859793 | Bonnie Lansing | Counselor | 617 N Gendale Avenue, Behavioral Health Adult Program, Peoria, IL 61603 | 2014-12-02 |
| 1639597172 | Jael K. Mahasi | Counselor | 1800 Ne Perry Avenue, Peoria, IL 61603 | 2014-04-02 |
| 1992054829 | Justin S Ferragut | Radiology | 530 Northeast Glen Oak Avenue, Peoria, IL 61603 | 2012-09-06 |
| 1780952994 | Syed Muhammad Tayyab | Internal Medicine | 828 Ne Glen Oak Ave Apt No208a, Peoria, IL 61603 | 2011-12-02 |
| 1528389079 | St. Francis Medical Center | General Acute Care Hospital | 530 N E Glen Oak Ave, Peoria, IL 61603 | 2010-06-18 |
| 1780810648 | Children's Home Association of Illinois | Voluntary or Charitable | 400 E. Frye, Peoria, IL 61603 | 2009-06-05 |
| Find all providers in zip 61603 | ||||
| Taxonomy Code | 2080P0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Cardiology |
| A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740483627 | Priti M. Patel | Pediatrics | 530 Ne Glenoak Ave, Peoria, IL 61603-3133 | 2007-06-07 |
| 1427057595 | David P Chan | Pediatrics | 420 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2005-07-20 |
| 1386081792 | Children's Hospital of Illinois Medical Group | Pediatrics | 420 Ne Glen Oak Ave, Ste 301, Peoria, IL 61603-3105 | 2013-05-24 |
| 1851644256 | Jeffrey William Orcutt Jr. | Pediatrics | 420 Ne Glen Oak Ave, Ste 301, Peoria, IL 61603-3105 | 2012-10-23 |
| 1770744799 | Osf Multispecialty Group Peoria LLC | Pediatrics | 420 Ne Glen Oak Ave, Ste 304, Peoria, IL 61603-3105 | 2008-06-23 |
| 1164689428 | Matthew T Bramlet | Pediatrics | 420 Ne Glen Oak Ave, Suite 301, Peoria, IL 61603-3105 | 2008-05-22 |
| 1497879290 | Cecilia Anne Albaro | Pediatrics | 420 Ne Glen Oak Ave, Suite 301, Peoria, IL 61603-3105 | 2007-03-19 |
| 1982798146 | William H Albers | Pediatrics | 420 Ne Glen Oak Ave, Suite 304, Peoria, IL 61603-3105 | 2006-10-03 |
| 1619061827 | Jitendra J Shah | Pediatrics | 420 Ne Glen Oak Ave, Suite 304, Peoria, IL 61603-3105 | 2006-10-03 |
| 1417041666 | Stephen E Bash | Pediatrics | 420 Ne Glen Oak Ave, Suite 304, Peoria, IL 61603-3105 | 2006-10-03 |
| Find all providers in PEORIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.