MIDWEST PODIATRY GROUP PC NPI 1184731663

NPI Information

  • NPI: 1184731663
  • Provider Name: MIDWEST PODIATRY GROUP, PC
  • Classification: Podiatrist - 213ES0103X
  • Specialization: Foot & Ankle Surgery
  • Entity Type: Organization
  • Address: 3827 N PROSPECT RD
    PEORIA, IL
    ZIP 61616
  • Phone: (309) 686-1000

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NPI Details

MIDWEST PODIATRY GROUP, PC is a foot and ankle surgery podiatrist in Peoria, IL. MIDWEST PODIATRY GROUP, PC NPI is 1184731663. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3827 N PROSPECT RD
PEORIA, IL
ZIP 61616-767
Phone: (309) 686-1000

The provider's authorized official is Donald Joe Sheller .
The authorized official title is President and has the following contact phone number (309) 686-1000.

The enumeration date for this NPI number is 8/23/2006 and was last updated on 3/17/2010.

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 License Number License State Primary
1213ES0103XPodiatristFoot & Ankle Surgery016003172ILLINOISYes

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
1205059MEDICARE ID-TYPE UNSPECIFIEDILLINOISGROUP PROVIDER NUMBER
24768490001MEDICARE NSCILLINOIS
3DA0891OTHERILLINOISRAILROAD MEDICARE
4016003172MEDICAIDILLINOIS

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: 11/21/2025

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