METHODIST MEDICAL CENTER OF ILLINOIS (NPI# 1407174873) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407174873 |
| Entity Type | Organization |
| Organization Name | METHODIST MEDICAL CENTER OF ILLINOIS |
| Other Organization Name | METHODIST MEDICAL GROUP AT LACON |
| Practice Address |
1112 5th St Lacon IL 61540 |
| Mailing Address |
5100 Reliable Pkwy Chicago IL 60686-0001 |
| Practice Telephone | 3092462676 |
| Practice Fax Number | 3092463574 |
| Enumeration Date | 2010-05-11 |
| 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 |
|---|---|---|---|---|---|
| N | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Methodist Medical Group at Lacon | Doing Business As Name - Organization |
| 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 |
| 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 |
| 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 |
1112 5TH ST |
| City | LACON |
| State | IL |
| Zip Code | 61540 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609883867 | Ruth Smith | Nurse Practitioner | 1112 5th St, Lacon, IL 61540-1353 | 2006-08-01 |
| 1497221543 | Iowa Physicians Clinic Medical Foundation | Clinic/Center | 1112 5th St, Lacon, IL 61540-1353 | 2018-10-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114024064 | Dale R Fleming | Chiropractor | 225 Fifth Street, Lacon, IL 61540 | 2006-09-20 |
| 1821274796 | Beth Ann Mckee, D.c. | Chiropractor | 1109 Fifth St, Lacon, IL 61540-0226 | 2008-01-10 |
| 1497863997 | Beth Ann Mckee | Chiropractor | 1109 5th St, Lacon, IL 61540-0226 | 2006-08-26 |
| 1790772309 | St Joseph Nursing Home Inc | Nursing Facility/Intermediate Care Facility | 401 9th St, Lacon, IL 61540-1140 | 2005-09-29 |
| 1447889886 | Lacon Rehab and Nursing LLC | Skilled Nursing Facility | 401 9th St, Lacon, IL 61540-1140 | 2020-04-07 |
| 1578580189 | John J Geiser | Optometrist | 114 5th St, Lacon, IL 61540-1206 | 2006-07-17 |
| 1124533047 | Kimberly Ann Yee | Optometrist | 114 5th St, Lacon, IL 61540-1206 | 2017-12-14 |
| 1508043290 | John J Geiser O.d. | Eyewear Supplier (Equipment, not the service) | 114 5th St, Lacon, IL 61540-1206 | 2008-01-25 |
| 1427193895 | Tracy Jo Parsh | Chiropractor | 331 5th St, Lacon, IL 61540-1209 | 2007-02-21 |
| 1235462565 | Active Health Chiropractic, P.C. | Chiropractor | 331 5th St, Lacon, IL 61540-1209 | 2009-09-18 |
| Find all providers in zip 61540 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053911495 | Moataz Barkat | Family Medicine | 3315 W 66th Pl, Chicago, IL 60629-3427 | 2020-10-26 |
| 1558969964 | Nicole Kerner | Family Medicine | 310 Brandy Dr, Mackinaw, IL 61755-9707 | 2020-10-16 |
| 1285232991 | Healthy Medical Inc | Family Medicine | 535 N. East St., Suite A, Bradley, IL 60915 | 2020-10-14 |
| 1558976589 | Jasmine Ashley Fowler | Family Medicine | 2416 N Lotus Ave, Chicago, IL 60639-1435 | 2020-09-15 |
| 1790390805 | Kimberly Hannah Kupferberg | Family Medicine | 1103 Schaeffer Rd, Long Grove, IL 60047-5153 | 2020-09-15 |
| 1194330977 | Home Doctors for You | Family Medicine | 670 Illinois Blvd, Hoffman Est, IL 60169-3363 | 2020-09-09 |
| 1245844489 | Jovita Zalwango Nassolo | Family Medicine | 116 1/2 N Benton St Apt 2d, Woodstock, IL 60098-3272 | 2020-09-04 |
| 1720699176 | Healing Hands Resource Center Streator | Family Medicine | 2128 S Central Park Ave, Chicago, IL 60623-3113 | 2020-08-10 |
| 1417565755 | Ghr Total Health and Consulting | Family Medicine | 11336 Mckenna Dr, Frankfort, IL 60423-8096 | 2020-07-22 |
| 1285251892 | Soe Lwin Oo | Family Medicine | 1625 E 75th St # 1, Chicago, IL 60649-3603 | 2020-06-30 |
| Find all providers with the same taxonomy | ||||
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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.