NPIMap

Individual provider Active NPI

Christine C Perks, MD

  • Cardiovascular Disease Physician
  • Peoria, IL
National Provider Identifier
1033383070
Registry record updated Sep 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
036110175 Issued in IL
Practice address
5405 N Knoxville Ave
Peoria, IL 61614-5016
Phone
(309) 691-4410
Fax
(309) 692-4730
NPI assigned
Apr 22, 2008
Last updated
Sep 28, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 036110175 IL Primary

Addresses

Primary practice location

5405 N Knoxville Ave
Peoria, IL 61614-5016

Mailing address

5405 N Knoxville Ave
Peoria, IL 61614-5016
Phone (309) 691-4410

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040903001233 IL Practitioner - Cardiovascular Disease (Cardiology) 0042286635 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Southern Illinois University School of Medicine, 2000
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)

5405 N Knoxville Ave
Peoria, IL 61614-5065
Phone (309) 691-4410

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036110175ILMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mason Hospital District CurrentSince Sep 20, 2022 Accepting new patients
Pekin Memorial Hospital CurrentSince Dec 26, 2011 Accepting new patients
Pekin Memorial Hospital CurrentSince Dec 26, 2011 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Mason Hospital District CurrentSince Sep 20, 2022 Accepting new patients
Mason Hospital District Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Jan 1, 2016 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

180 S Main St
Canton, IL 61520
Phone (309) 647-5240

615 N Promenade St
Havana, IL 62644
Phone (309) 543-6600

3422 Court St
#B
Pekin, IL 61554

600 S 13th St
Pekin, IL 61554
Phone (309) 347-1151

610 Park Ave
Pekin, IL 61554
Phone (309) 346-7776

5405 N Knoxville Ave
Peoria, IL 61614
Phone (309) 691-4410

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

Organizations & group practices 8

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

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475020800000",
    "number": "1033383070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5405 N KNOXVILLE AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145016",
            "telephone_number": "309-691-4410",
            "fax_number": "309-692-4730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5405 N KNOXVILLE AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145016",
            "telephone_number": "309-691-4410",
            "fax_number": "309-692-4730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERKS",
        "first_name": "CHRISTINE",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-22",
        "last_updated": "2016-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036110175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.