PROCTOR HEALTH SYSTEMS (NPI# 1720223837) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720223837 |
| Entity Type | Organization |
| Organization Name | PROCTOR HEALTH SYSTEMS |
| Other Organization Name | PROCTOR MEDICAL GROUP SURGERY - C K SONG MD |
| Practice Address |
5401 N Knoxville Ave Ste 217 Peoria IL 61614-5098 |
| Mailing Address |
5401 N Knoxville Ave Ste 209 Peoria IL 61614-5098 |
| Practice Telephone | 3096911092 |
| Mailing Telephone | 3096911092 |
| Mailing Fax Number | 3096896092 |
| Enumeration Date | 2008-12-04 |
| Last Update Date | 2008-12-04 |
| Authorized Official Name | DENISE BRINKER (SYSTEM ANALYST) |
| Authorized Official Telephone | 3906896089 |
| Is Organization Subpart | Y |
| Parent Organization Name | PROCTOR HEALTH SYSTEMS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| PROCTOR MEDICAL GROUP SURGERY - C K SONG MD | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396923702 | Proctor Health Systems | Clinic/Center | 5401 N Knoxville Ave Ste 306, Peoria, IL 61614-5021 | 2008-02-07 |
| 1629022447 | Proctor Health Systems | Clinic/Center | 12315 N Knoxville Ave, Dunlap, IL 61525-9501 | 2006-05-19 |
| 1548460108 | Proctor Health Systems | Clinic/Center | 5401 N Knoxville Ave, Suite 209, Peoria, IL 61614-5098 | 2007-07-23 |
| 1033163761 | Proctor Health Systems | Clinic/Center | 5401 N Knoxville Ave, Suite 103, Peoria, IL 61614-5098 | 2006-05-19 |
| 1518910363 | Proctor Health Systems | Clinic/Center | 5401 N Knoxville Ave, Suite 218, Peoria, IL 61614-5098 | 2006-05-19 |
| 1306890108 | Proctor Health Systems | Clinic/Center | 5401 N Knoxville Ave, Suite 300, Peoria, IL 61614-5098 | 2006-05-19 |
| 1134173917 | Proctor Health Systems | Nurse Anesthetist, Certified Registered | 5401 N Knoxville Ave, Suite 209, Peoria, IL 61614-5098 | 2006-05-19 |
| 1740234533 | Proctor Health Systems | Clinic/Center | 210 N 4th St, Chillicothe, IL 61523-2058 | 2006-05-19 |
| 1437103231 | Proctor Health Systems | Clinic/Center | 1506 W Garfield Ave, Bartonville, IL 61607-1755 | 2006-05-19 |
| 1578515953 | Proctor Health Systems | Clinic/Center | 202 S Main St, Lacon, IL 61540-1416 | 2006-05-16 |
| Street Address |
5401 N KNOXVILLE AVE STE 217 |
| 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 |
| Find all providers in the same location | ||||
| 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 |
| Find all providers in zip 61614 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104341353 | Banner Peoria Surgery Center LLC | Clinic/Center | 13640 N Plaza Del Rio Blvd Ste 135, Peoria, AZ 85381-4846 | 2017-08-09 |
| 1285085068 | Valley Pain Centers of Arizona, LLC | Clinic/Center | 9242 W Union Hills Dr Ste 100, Peoria, AZ 85382-8218 | 2016-06-23 |
| 1700137650 | Olive Surgical Care, LLC | Clinic/Center | 8914 N 91st Ave, Suite 120, Peoria, AZ 85345-8390 | 2012-10-01 |
| 1972782845 | Nationalhealthcareinc | Clinic/Center | 7405 N University St, Peoria, IL 61614-1212 | 2007-10-29 |
| 1104957869 | Pain Solutions Center, LLC | Clinic/Center | 15262 N 75th Ave, Suite 400, Peoria, AZ 85381-4763 | 2007-03-07 |
| 1821141284 | Center for Health Ambulatory Surgery Center, LLC | Clinic/Center | 8800 Route 91 North, Peoria, IL 61615 | 2007-01-19 |
| 1528002219 | Pinnacle Surgery Center LLC | Clinic/Center | 6790 W Thunderbird Rd, Peoria, AZ 85381-5023 | 2006-06-15 |
| 1518498385 | Annmarie Klein | Clinic/Center | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2017-03-23 |
| 1023567260 | Ski Ambulatory Surgical Centers, LLC | Clinic/Center | 7362 W Thunderbird Rd, Suite 103, Peoria, AZ 85381-5028 | 2016-09-29 |
| 1790104248 | Metro Surgery Center, LLC | Clinic/Center | 6790 W Thunderbird Rd, Peoria, AZ 85381 | 2014-04-14 |
| Find all providers in PEORIA | ||||
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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.