METHODIST MEDICAL CENTER OF ILLINOIS NPI 1184670663

NPI Information

NPI: 1184670663
Provider Name: METHODIST MEDICAL CENTER OF ILLINOIS

Doing Business As: METHODIST MEDICAL GROUP

Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
120 NE GLEN OAK AVE
SUITE 101
PEORIA, IL
ZIP 61603
Phone: (309) 671-8230
Get Directions

METHODIST MEDICAL CENTER OF ILLINOIS is a family medicine in Peoria, IL. The provider is 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. METHODIST MEDICAL CENTER OF ILLINOIS NPI is 1184670663. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Methodist Medical Group.

The provider's business location address is:

120 NE GLEN OAK AVE
SUITE 101
PEORIA, IL
ZIP 61603
Phone: (309) 671-8230
Fax: (309) 671-5118

The provider's authorized official is Stephen M. Cirone .
The authorized official title is Regional Mgr-reimb/rev Recognition and has the following contact phone number (309) 672-4813.

The enumeration date for this NPI number is 5/26/2006 and was last updated on 2/14/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	207P00000X	Emergency Medicine		No
2	207Q00000X	Family Medicine		Yes
3	207R00000X	Internal Medicine		No
4	207RG0300X	Internal Medicine	Geriatric Medicine	No
5	207RI0011X	Internal Medicine	Interventional Cardiology	No
6	207RR0500X	Internal Medicine	Rheumatology	No
7	207VM0101X	Obstetrics & Gynecology	Maternal & Fetal Medicine	No
8	208000000X	Pediatrics		No
9	208100000X	Physical Medicine & Rehabilitation		No
10	2084N0400X	Psychiatry & Neurology	Neurology	No
11	2084P0800X	Psychiatry & Neurology	Psychiatry	No
12	2084P0804X	Psychiatry & Neurology	Child & Adolescent Psychiatry	No
13	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery)		No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	7215059	OTHER	ILLINOIS	BCBS PPO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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