BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS (NPI# 1467425322) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467425322 |
| Entity Type | Organization |
| Organization Name | BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS |
| Other Organization Name | MEDICAL SERVICE PLAN AT PEORIA |
| Practice Address |
Medical Service Plan One Illini Dr Peoria IL 61656 |
| Mailing Address |
1 Illini Dr Peoria IL 61605-2576 |
| Practice Telephone | 3096713000 |
| Mailing Telephone | 3096718503 |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | WILLIAM R NICHOLAS (EXECUTIVE DIRECTOR OF MSP) |
| Authorized Official Telephone | 3124130573 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 207RI0200X |
Internal Medicine Specialization: Infectious Disease |
IL | Allopathic & Osteopathic Physicians | |
| X | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BCBS | 07215036 | 01 |
| IL | RAILROAD MEDICARE | CH0107 | 01 |
| Other Name | Type Code |
|---|---|
| Medical Service Plan at Peoria | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720555147 | Board of Trustees of The University of Illinois | Case Management | 3014 W 39th Pl, Chicago, IL 60632-2402 | 2018-10-24 |
| 1447390125 | Board of Trustees of The University of Illinois | Pharmacy | 722 W Maxwell St, Room 205 Mc 184, Chicago, IL 60607-5002 | 2007-02-08 |
| 1790704484 | Board of Trustees of The University of Illinois | Clinic/Center | 1059 W 13th St, Chicago, IL 60608-1526 | 2006-07-19 |
| 1790252047 | Board of Trustees of The University of Illinois | Case Management | 55 W Cermak Rd, Chicago, IL 60616-2001 | 2018-10-25 |
| 1295202554 | Board of Trustees of The University of Illinois | Case Management | 1628 W Washington Blvd, Chicago, IL 60612-2613 | 2018-10-25 |
| 1972070225 | Board of Trustees of The University of Illinois | Case Management | 2641 S Calumet Ave, Chicago, IL 60616-2901 | 2018-10-25 |
| 1720554264 | Board of Trustees of The University of Illinois | Case Management | 1220 S Wood St, Chicago, IL 60608-1202 | 2018-10-23 |
| 1770059156 | Board of Trustees of The University of Illinois | Case Management | 8131 S May St, Chicago, IL 60620-3007 | 2018-10-23 |
| 1558837922 | Board of Trustees of The University of Illinois | Case Management | 641 W 63rd St, Chicago, IL 60621-2032 | 2018-10-23 |
| 1184190548 | Board of Trustees of The University of Illinois | Case Management | 7037 S Stony Island Ave, Chicago, IL 60649-1905 | 2018-10-23 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS | 809 S Marshfield Ave Rm214, Chicago, IL 60612-4305 |
| System for Award Management (SAM) Entities | BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS, THE | 364 Henry Administration Bldg, Urbana, IL 61801 |
| Street Address |
MEDICAL SERVICE PLAN ONE ILLINI DR |
| City | PEORIA |
| State | IL |
| Zip Code | 61656 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881295541 | Britney Julia Durst | Nurse Practitioner | 5905 N Prospect Rd, Peoria, IL 61614-4311 | 2020-11-07 |
| 1538760525 | Ayomikun Ajulo | Technician | 7426 W Cheryl Dr, Peoria, AZ 85345-6723 | 2020-11-05 |
| 1932700929 | True Wellness Support Services | Community/Behavioral Health | 8936 W Villa Rita Dr, Peoria, AZ 85382-3021 | 2020-11-05 |
| 1386245397 | Lynsey Perera | Pharmacist | 7610 N Orange Prairie Rd, Peoria, IL 61615-9324 | 2020-11-05 |
| 1942801071 | Kathrine Sunstedt | Nurse Practitioner | 420 Ne Glen Oak Ave Ste 201, Peoria, IL 61603-3112 | 2020-11-04 |
| 1235730508 | Gheorghe Patrutescu | Assisted Living Facility | 16134 N 72nd Ln, Peoria, AZ 85382-4937 | 2020-11-03 |
| 1366042988 | Nicole Elizabeth Steen | Registered Nurse | 21751 N 86th Ln, Peoria, AZ 85382-2497 | 2020-11-01 |
| 1699375683 | Christopher Wayne Sharp | Pharmacist | 8062 W Eva St, Peoria, AZ 85345-7197 | 2020-10-28 |
| 1487254629 | Bernadette Bruha | Counselor | 10028 W Redbird Rd, Peoria, AZ 85383-3368 | 2020-10-27 |
| 1124627906 | Lance Jay Bucher | Occupational Therapist | 8600 Il-91, Peoria, IL 61615 | 2020-10-22 |
| Find all providers in PEORIA | ||||
| Taxonomy Code | 207RI0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Infectious Disease |
| An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942430418 | Nestor Varon Md PC | Internal Medicine | 29729 N 69th Ln, Peoria, AZ 85383-3185 | 2009-07-20 |
| 1255431409 | Joseph Knight | Internal Medicine | 9751 West Mcrae Way, Peoria, AZ 85382-2236 | 2006-09-25 |
| 1386698454 | Roger Edward Schmid | Internal Medicine | 29228 N 120th Ln, Peoria, AZ 85383-2401 | 2006-05-21 |
| 1043284649 | John Joseph Farrell | Internal Medicine | Department of Internal Medicine, 530 Ne Glen Oak Drive, Peoria, IL 61637-0001 | 2006-02-13 |
| 1376958215 | Kap Sum Foong | Internal Medicine | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2014-06-30 |
| 1568623049 | Joseph Kim | Internal Medicine | 530 Ne Glen Oak Ave, Peoria, IL 61637 | 2008-06-18 |
| 1962579623 | Sun Cities Medical Group PC | Internal Medicine | 9179 W Thunderbird Rd, Ste B105, Peoria, AZ 85381-4875 | 2006-11-29 |
| 1366406464 | Amardeep Sodhi | Internal Medicine | 9179 W Thunderbird Rd, Ste B105, Peoria, AZ 85381-4875 | 2006-04-14 |
| 1720049786 | Marlynn Patel | Internal Medicine | Dept of Internal Medicine, 530 Ne Glen Oak, Peoria, IL 61637-0001 | 2006-03-30 |
| 1891763082 | David Slagle | Internal Medicine | Dept of Internal Medicine, 530 Ne Glen Oak, Peoria, IL 61637-0001 | 2006-03-14 |
| Find all providers in PEORIA | ||||
Please comment or provide details below to improve the information on BOARD OF TRUSTEES OF THE UNIVERSITY 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.