METHODIST MEDICAL CENTER OF ILLINOIS (NPI# 1265966048) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265966048 |
| Entity Type | Organization |
| Organization Name | METHODIST MEDICAL CENTER OF ILLINOIS |
| Practice Address |
221 Ne Glen Oak Ave Peoria IL 61636-0001 |
| Practice Telephone | 3096725522 |
| Enumeration Date | 2017-04-18 |
| Last Update Date | 2020-02-14 |
| Authorized Official Name | STEPHEN M. CIRONE (REGIONAL MGR-REIMB/REV RECOGNITION) |
| Authorized Official Telephone | 3096724813 |
| Is Organization Subpart | Y |
| Parent Organization Name | METHODIST MEDICAL CENTER OF ILLINOIS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0002X |
Clinic/Center Specialization: Emergency Care |
IL | Ambulatory Health Care Facilities |
| 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 |
| 1124305636 | Methodist Medical Center of Illinois | Nurse Practitioner | 811 S Griswold St, Peoria, IL 61605-1458 | 2011-11-11 |
| 1184670663 | Methodist Medical Center of Illinois | Emergency Medicine | 120 Ne Glen Oak Ave, Suite 101, Peoria, IL 61603 | 2006-05-26 |
| 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 |
221 NE GLEN OAK AVE |
| City | PEORIA |
| State | IL |
| Zip Code | 61636-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851384135 | John Alan Howerton | Pharmacist | 221 Ne Glen Oak Ave, Peoria, IL 61636-0001 | 2005-08-23 |
| 1437750130 | Vanezza Buendia | Physical Therapist | 221 Ne Glen Oak Ave, Peoria, IL 61636-0001 | 2020-11-08 |
| 1306443056 | Austyn Powers | Nurse Practitioner | 221 Ne Glen Oak Ave, Peoria, IL 61636-0001 | 2020-10-06 |
| 1396357091 | Christopher Legan | Counselor | 221 Ne Glen Oak Ave, Peoria, IL 61636-0001 | 2020-08-24 |
| 1417575853 | Joseph Babione | Psychologist | 221 Ne Glen Oak Ave, Peoria, IL 61636-0001 | 2020-07-13 |
| 1811512411 | Methodist | Counselor | 221 Ne Glen Oak Ave, Peoria, IL 61636-0001 | 2020-06-10 |
| 1760003230 | Alexandra Bryan | Dietitian, Registered | 221 Ne Glen Oak Ave, Peoria, IL 61636-0001 | 2020-05-06 |
| 1467080523 | Dustin Dariusz Pilat | Student in an Organized Health Care Education/Training Program | 221 Ne Glen Oak Ave, Peoria, IL 61636-5027 | 2020-04-01 |
| 1295363505 | Abigail Brea Sebald | Student in an Organized Health Care Education/Training Program | 221 Ne Glen Oak Ave, Peoria, IL 61636-0001 | 2020-03-31 |
| 1790313054 | Elizabeth Alexandra Edwards | Student in an Organized Health Care Education/Training Program | 221 Ne Glen Oak Ave, Peoria, IL 61636-0001 | 2020-03-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962767376 | Aman Deep Singh | Psychiatry & Neurology | 221 Ne Glen Oak Ave. 7 West, Dept. of Psych. and Behavior Health., Peoria, IL 61636 | 2012-07-11 |
| 1932490075 | Christine Ann Wigginton | Radiology | 221 Ne Glen Oak Ave Dept Of, Peoria, IL 61636 | 2011-04-24 |
| 1568901544 | Stephanie Ann Sullivan | Nurse Anesthetist, Certified Registered | Unity Point Health Methodist, 221 Ne Glen Oak Avenue, Peoria, IL 61636-0001 | 2017-02-23 |
| 1073066155 | Caroline Vanaman | Counselor | 221 Ne Glen Oak Ave # 7w, Peoria, IL 61636-0001 | 2016-07-26 |
| 1497141758 | Amber Hemminger | Registered Nurse | 200 Ne Glen Oak Ave, Peoria, IL 61636-0001 | 2015-04-13 |
| 1326288812 | Bradley Reatherford | Registered Nurse | 221 Northeast Ave, Peoria, IL 61636-0001 | 2009-02-24 |
| 1386784155 | Eric Hawkins | Anesthesiology | 22i Ne Glen Oak Ave, Methodist Medical Center Anesthesiology, Peoria, IL 61636-0001 | 2007-02-08 |
| 1386659241 | Central Illinois Radiological Associates, Ltd. | Radiology | Osf St Francis Medical Ctr, 530 N.e. Glen Oak, Peoria, IL 61636-0001 | 2006-07-29 |
| 1659345007 | Mary C Bruell | Social Worker | Dept of Psychiatry, 221 Ne Glen Oak 7 West, Peoria, IL 61636-0001 | 2006-02-14 |
| 1245203280 | University of Illinois | Psychiatry & Neurology | Department of Psychiatry, 221 Ne Glen Oak 7 West, Peoria, IL 61636-0001 | 2006-02-09 |
| Find all providers in zip 61636 | ||||
| Taxonomy Code | 261QE0002X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Emergency Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295119808 | Advocate Christ Medical Center | Clinic/Center | 12997 Sunrise Dr, Lemont, IL 60439-4565 | 2015-07-13 |
| 1407245954 | First Care Express Care LLC | Clinic/Center | 10 Emerald Ter Ste C, Swansea, IL 62226-2310 | 2015-01-21 |
| 1083875751 | Tom Pearce Martin | Clinic/Center | 10900 Porter Ln, Junction, IL 62954-2200 | 2008-06-24 |
| 1306017256 | Danvers Emergency & Rescue Service | Clinic/Center | 208 E. Main St., Danvers, IL 61732-9197 | 2008-03-19 |
| 1023095437 | Community Medical Center of Western Illinois Inc | Clinic/Center | 1000 West Harlem Ave, Monmouth, IL 61462-1099 | 2005-12-28 |
| 1689001414 | Medical Surgical Group | Clinic/Center | 7456 S State Rd, Suite 104, Bedford Park, IL 60638-6623 | 2013-10-13 |
| 1902009186 | Nah Emergency Services Sc | Clinic/Center | 1044 N Francisco Ave, Chicago, IL 60622-2743 | 2007-06-06 |
| 1881763449 | Northern Illinois Emergency & Occp Med Spec | Clinic/Center | 701 W North Ave, Melrose Park, IL 60160-1612 | 2006-11-07 |
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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.