METHODIST MEDICAL CENTER OF ILLINOIS (NPI# 1124305636) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124305636 |
| Entity Type | Organization |
| Organization Name | METHODIST MEDICAL CENTER OF ILLINOIS |
| Practice Address |
811 S Griswold St Peoria IL 61605-1458 |
| Mailing Address |
5100 Reliable Pkwy Chicago IL 60686-0051 |
| Practice Telephone | 3096858390 |
| Enumeration Date | 2011-11-11 |
| Last Update Date | 2020-02-14 |
| Authorized Official Name | STEPHEN M. CIRONE (REGIONAL MGR-REIMB/REV RECOGNITION) |
| Authorized Official Telephone | 3096724813 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LS0200X |
Nurse Practitioner Specialization: School |
Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780191437 | Methodist Medical Center of Illinois | Nurse Practitioner | 1615 N North St, Peoria, IL 61604-4131 | 2018-01-03 |
| 1629355060 | Methodist Medical Center of Illinois | Nurse Practitioner | 2702 W Krause Ave, Peoria, IL 61605-2905 | 2011-11-14 |
| 1184670663 | Methodist Medical Center of Illinois | Emergency Medicine | 120 Ne Glen Oak Ave, Suite 101, Peoria, IL 61603 | 2006-05-26 |
| 1265966048 | Methodist Medical Center of Illinois | Clinic/Center | 221 Ne Glen Oak Ave, Peoria, IL 61636-0001 | 2017-04-18 |
| 1447537881 | Methodist Medical Center of Illinois | Nurse Practitioner | 1419 S Folkers Ave, Peoria, IL 61605 | 2011-11-14 |
| 1326366790 | Methodist Medical Center of Illinois | Clinic/Center | 525 S Sweetbriar Dr, Chillicothe, IL 61523 | 2010-05-11 |
| 1407174873 | Methodist Medical Center of Illinois | Clinic/Center | 1112 5th St, Lacon, IL 61540 | 2010-05-11 |
| 1942528310 | Methodist Medical Center of Illinois | Clinic/Center | 223 E Main St, Princeville, IL 61559 | 2010-05-11 |
| 1710198379 | Methodist Medical Center of Illinois | Nurse Practitioner | 221 Ne Glen Oak Ave, Peoria, IL 61636-0001 | 2007-05-25 |
| 1821043365 | Methodist Medical Center of Illinois | Home Health | 221 Ne Glen Oak Ave, Peoria, IL 61636-0001 | 2006-05-23 |
| Street Address |
811 S GRISWOLD ST |
| City | PEORIA |
| State | IL |
| Zip Code | 61605-1458 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386131878 | Nicholas Anthony Helling | Physical Therapist | 518 W Romero B Garret Ave, Poeria, IL 61605 | 2018-04-19 |
| 1891241022 | Peoria Slf Lp | Assisted Living Facility | 518 West Romeo B. Garrett Avenue, Peoria, IL 61605 | 2016-08-28 |
| 1932479664 | Michelle L Whitelow | Nurse Practitioner | 711 W John Gwynn Jr. Avenue, Peoria, IL 61605 | 2012-01-11 |
| 1982852877 | Jason M Anane-sefah | Orthopaedic Surgery | 303 North Kumpf Boulevard, Peoria, IL 61605 | 2008-09-04 |
| 1902098908 | Calvary Elderly Home Help Program | Home Health | 1709 W Lincoln Ave, Peoria, IL 61605 | 2007-08-14 |
| 1023104437 | Thomas Anderson | Optometrist | 710 W Third Avenue, Peoria, IL 61605 | 2006-10-04 |
| 1841382298 | Devashish Agarwal | Family Medicine | 1701 W. Garden Street, Peoria, IL 61605 | 2006-09-29 |
| 1497763197 | Larry T Rolle | Pharmacist | 411 Martin Luther King Dr., Peoria, IL 61605 | 2006-08-04 |
| 1568404762 | Joseph P Kelly Iv | Physical Therapist | 303 N. Kumpf Blvd, Peoria, IL 61605 | 2006-06-12 |
| 1003861634 | Patrick William Elwood | Neurological Surgery | 719 N William Kumpf Blvd, Suite 100, Peoria, IL 61605 | 2006-05-23 |
| Find all providers in zip 61605 | ||||
| Taxonomy Code | 363LS0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | School |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861027526 | Brittani Freeman | Nurse Practitioner | 23127 N 91st Dr, Peoria, AZ 85383-4286 | 2020-03-03 |
| 1780191437 | Methodist Medical Center of Illinois | Nurse Practitioner | 1615 N North St, Peoria, IL 61604-4131 | 2018-01-03 |
| 1629355060 | Methodist Medical Center of Illinois | Nurse Practitioner | 2702 W Krause Ave, Peoria, IL 61605-2905 | 2011-11-14 |
| 1447537881 | Methodist Medical Center of Illinois | Nurse Practitioner | 1419 S Folkers Ave, Peoria, IL 61605 | 2011-11-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871982637 | Beth Allan | Nurse Practitioner | 701 College Rd, Lebanon, IL 62254-1291 | 2015-01-16 |
| 1891813473 | Sarah G Halm Lutterodt | Nurse Practitioner | 1625 E 75th St, Second Floor, Chicago, IL 60649-3603 | 2007-03-26 |
Please comment or provide details below to improve the information on METHODIST MEDICAL CENTER OF ILLINOIS.
| 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.