INTEGRAMED MEDICAL ILLINOIS, LLC (NPI# 1396169280) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396169280 |
| Entity Type | Organization |
| Organization Name | INTEGRAMED MEDICAL ILLINOIS, LLC |
| Practice Address |
5401 N Knoxville Ave Suite 102 Peoria IL 61614-5098 |
| Practice Telephone | 3096890411 |
| Mailing Telephone | 3096890411 |
| Enumeration Date | 2014-02-12 |
| Last Update Date | 2014-02-24 |
| Authorized Official Name | DR. SATISH VAYUVEGULA (PRESIDEN AND SECRETARY) |
| Authorized Official Telephone | 3096890411 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VE0102X |
Obstetrics & Gynecology Specialization: Reproductive Endocrinology |
IL | Allopathic & Osteopathic Physicians |
| Street Address |
5401 N KNOXVILLE AVE SUITE 102 |
| City | PEORIA |
| State | IL |
| Zip Code | 61614-5098 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871597450 | Edward A Rufus Jr | Internal Medicine | 5401 N Knoxville Ave, Suite 306, Peoria, IL 61614-5098 | 2005-06-10 |
| 1366984015 | Taylor Jeanette Simmons | Specialist/Technologist | 5401 N Knoxville Ave, Suite 103, Peoria, IL 61614-5098 | 2016-11-11 |
| 1518416254 | Illinois Regional Pain Institute | Nurse Practitioner | 5401 N Knoxville Ave, Suite 416, Peoria, IL 61614-5098 | 2016-09-22 |
| 1700331030 | Deb M Schleich | Nurse Practitioner | 5401 N Knoxville Ave, Suite 416, Peoria, IL 61614-5098 | 2016-08-16 |
| 1154876498 | Kimberly K Lopez | Nurse Practitioner | 5401 N Knoxville Ave, Suite 416, Peoria, IL 61614-5098 | 2016-08-16 |
| 1417320854 | Amy B Pheiffer | Clinical Nurse Specialist | 5401 N Knoxville Ave, Suite 109, Peoria, IL 61614-5098 | 2015-11-06 |
| 1558732370 | Leah Tabor | Specialist/Technologist, Other | 5401 N Knoxville Ave, Suite 117, Peoria, IL 61614 | 2015-10-20 |
| 1679944334 | Midwest Pain & Spine Center, LLC | Specialist | 5401 N Knoxville Ave, Suite 416, Peoria, IL 61614-5098 | 2015-10-07 |
| 1124495379 | Anne Webster | Nurse Practitioner | 5401 N Knoxville Ave, Suite 416, Peoria, IL 61614-5098 | 2015-08-24 |
| 1720461353 | Hometown Hearing & Audiology, Inc. | Audiologist | 5401 N Knoxville Ave, 116, Peoria, IL 61614-5011 | 2015-07-01 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548818511 | Christine Svoboda | Social Worker | 6919 N Knoxville Ave Ste 100 and 202, Peoria, IL 61614 | 2019-09-03 |
| 1639649007 | Kathy Karouzos Counseling, LLC | Clinic/Center | 330 W. Ivy Ln., Peoria, IL 61614 | 2018-11-28 |
| 1205312790 | Kathleen Marie Hendricks | Nurse Practitioner | 2809 W Willow Knolls Dr, Peoria, IL 61614 | 2018-07-17 |
| 1629563937 | Mary Elizabeth Cunningham | Counselor | 6219 N. Eldorado Dr., Peoria, IL 61614 | 2018-06-28 |
| 1861937955 | Angela Gilles | Social Worker | 6919 N Knoxville Ave Ste 100, Peoria, IL 61614 | 2016-12-27 |
| 1467994897 | Melissa Saxsma | Specialist | 5009 N Executive Dr, Peoria, IL 61614 | 2016-11-16 |
| 1902258874 | Rashid Plastic Surgery, LLC | Plastic Surgery | 804 W Trailcreek Drive, Peoria, IL 61614 | 2016-07-05 |
| 1215313143 | Melissa Lynn Phelan | Nurse Practitioner | 122 E Morningside Dr, Peoria, IL 61614 | 2015-08-03 |
| 1811380165 | All Ways Caring Services, Inc. | In Home Supportive Care | 6919 N Knoxville Ave, Suite 102, Peoria, IL 61614 | 2015-03-11 |
| 1568875920 | Schuler & Arkwell Orthodontic Partnership | Dentist | 2425 Cornerstone Ct. Ste. A, Peoria, IL 61614 | 2014-06-03 |
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| Taxonomy Code | 207VE0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Reproductive Endocrinology |
| An obstetrician/gynecologist who is capable of managing complex problems relating to reproductive endocrinology and infertility. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487179495 | Midwest Reproductive Care LLC | Obstetrics & Gynecology | 900 Main St Ste 330, Peoria, IL 61602-5009 | 2017-08-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659995348 | Rinehart Fertility Center, S.c. | Obstetrics & Gynecology | 4400 W 95th St Ste 303, Oak Lawn, IL 60453-2659 | 2020-05-29 |
| 1982059275 | Vios Fertility Institute Chicago | Obstetrics & Gynecology | 1455 N Milwaukee Ave, Chicago, IL 60622-2015 | 2016-04-25 |
| 1477952026 | Jacob Moise | Obstetrics & Gynecology | 329 Bel Air Dr., Glenview, IL 60025 | 2014-08-20 |
| 1548682990 | Reproductive Solutions LLC | Obstetrics & Gynecology | 435 N Mulford Rd Ste 9, Rockford, IL 61107-5100 | 2014-01-19 |
| 1922443688 | Reproductive Health Specialists | Obstetrics & Gynecology | 1515 Essington Rd, Joliet, IL 60435-2879 | 2013-05-07 |
| 1689915258 | Davies Fertility and Ivf Specialists, Inc. | Obstetrics & Gynecology | 2601 Compass Rd Ste 114, Glenview, IL 60026-8077 | 2013-03-07 |
| 1215224159 | Barbara A Soltes Mdsc | Obstetrics & Gynecology | 12400 S Harlem Ave Ste 110, Palos Heights, IL 60463-1477 | 2011-06-29 |
| 1144526914 | Michael Charles Snabes | Obstetrics & Gynecology | 111 Barclay Blvd, Lincolnshire, IL 60069-3610 | 2011-01-26 |
| 1083932032 | Jennifer Erin Hirshfeld-cytron | Obstetrics & Gynecology | 676 N Saint Clair St Ste 1875, Chicago, IL 60611-2927 | 2010-05-13 |
| 1922330562 | Advanced Reproductive Health | Obstetrics & Gynecology | 1513 Essington Rd., Joliet, IL 60435 | 2010-02-08 |
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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.