Individual provider Active NPI

Charles Aprahamian, MD

  • Pediatric Surgery Physician
  • Peoria, IL
National Provider Identifier
1033323902
Registry record updated Feb 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
036130844 Issued in IL
Practice address
420 NE Glen Oak Ave
Suite 201
Peoria, IL 61603-3105
Phone
(309) 655-3800
Fax
(309) 655-3948
NPI assigned
May 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 036130844 IL
Pediatric Surgery Physician 2086S0120X 036130844 IL Primary

Addresses

Primary practice location

420 NE Glen Oak Ave
Suite 201
Peoria, IL 61603-3105

Mailing address

420 NE Glen Oak Ave
Suite 201
Peoria, IL 61603-3105
Phone (309) 655-3800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121102000435 IL Practitioner - General SurgeryPractitioner - Other (Physician) 0244481059 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Medical College of Wisconsin, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

420 NE Glen Oak Ave
Peoria, IL 61603-3106
Phone (309) 655-2343

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Osf Multi-Specialty Group CurrentSince Jan 1, 2016 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Carle Health Care Incorporated Past Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

1505 Eastland Dr
Bloomington, IL 61701
Phone (309) 663-2100

302 Saint Joseph Dr
Bloomington, IL 61701
Phone (309) 662-5361

515 Valley View Dr
Moline, IL 61265

1050 E Norris Dr
Ottawa, IL 61350
Phone (815) 431-5757

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

420 NE Glen Oak Ave
Peoria, IL 61603
Phone (309) 655-2343

420 NE Glen Oak Ave
Ste 201
Peoria, IL 61603
Phone (309) 655-3800

2524 Farragut Dr
Springfield, IL 62704
Phone (217) 726-9020

1405 W Park St
Urbana, IL 61801
Phone (217) 337-3240

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1033323902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 NE GLEN OAK AVE",
            "address_2": "SUITE 201",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616033105",
            "telephone_number": "309-655-3800",
            "fax_number": "309-655-3948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 NE GLEN OAK AVE",
            "address_2": "SUITE 201",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616033105",
            "telephone_number": "309-655-3800",
            "fax_number": "309-655-3948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "APRAHAMIAN",
        "first_name": "CHARLES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-10",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036130844",
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "IL",
            "license": "036130844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.