METHODIST MEDICAL CENTER OF ILLINOIS (NPI# 1790737385) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790737385 |
| 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 | 2006-05-16 |
| 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 | 251G00000X | Hospice Care, Community Based | 0001594 | IL | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE CROSS NUMBER | 116 | 01 |
| 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 |
| 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 |
| 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 | 251G00000X |
| Grouping | Agencies |
| Classification | Hospice Care, Community Based |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548825276 | Stillwater Hospice LLC | Hospice Care, Community Based | 9720 W Peoria Ave Ste 115, Peoria, AZ 85345-6132 | 2019-05-08 |
| 1184141301 | Billet Hospice Inc - Peoria | Hospice Care, Community Based | 6718 W Greenway Rd Ste 205, Peoria, AZ 85381-4582 | 2017-08-28 |
| 1306281076 | Banner Home Care Arizona | Hospice Care, Community Based | 8977 W Athens St, Peoria, AZ 85382-8170 | 2013-05-07 |
| 1043238975 | Hospice of The Valley | Hospice Care, Community Based | 9435 W Peoria Ave, Peoria, AZ 85345-6479 | 2006-07-18 |
| 1780638379 | Sun Health Hospice Care Services | Hospice Care, Community Based | 12740 N Plaza Del Rio Blvd, Suite B, Peoria, AZ 85381-8100 | 2006-05-19 |
| 1346725181 | Mountain View Hospice LLC | Hospice Care, Community Based | 8263 W Thunderbird Rd, Peoria, AZ 85381-4615 | 2018-09-27 |
| 1003277070 | United Healthy Permanente, Inc. | Hospice Care, Community Based | 13760 N 93rd Ave, Suite 105b, Peoria, AZ 85381-4201 | 2016-03-17 |
| 1104223106 | Divine Hospice and Palliative Care LLC | Hospice Care, Community Based | 16165 N 83rd Ave, Suite 237, Peoria, AZ 85382-5816 | 2014-11-20 |
| 1841607686 | V A Hospice 1 Inc | Hospice Care, Community Based | 6718 W Greenway Rd, Suite 205, Peoria, AZ 85381-4583 | 2014-07-14 |
| 1023049574 | Saint Francis Medical Center | Hospice Care, Community Based | 2265 W Altorfer Dr, Peoria, IL 61615-1807 | 2006-07-05 |
| 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.