Individual provider Active NPI

Valeria Claudia Benavides Lopez, M.D., M.P.H.

  • Pediatric Endocrinology Physician
  • Peoria, IL
National Provider Identifier
1043487192
Registry record updated Jul 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
036128563 Issued in IL
Practice address
530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone
(309) 624-3313
NPI assigned
May 8, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Endocrinology Physician 2080P0205X 036128563 IL Primary

Addresses

Primary practice location

530 NE Glen Oak Ave
Peoria, IL 61637-0001

Mailing address

530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone (309) 624-3313

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
I20110909002645 IL Practitioner - EndocrinologyPractitioner - Pediatric Medicine 2860662442 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036128563ILMDPediatric Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Board of Trustees of the University of Illinois CurrentSince Jul 19, 2011 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Feb 19, 2020 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Jul 19, 2011 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

7694 Solutions Ctr
Chicago, IL 60677

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

530 NE Glen Oak Ave
Peoria, IL 61637
Phone (309) 655-2553

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

1 Illini Dr
Peoria, IL 61605
Phone (309) 671-3000

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

Organizations & group practices 6

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": "1210204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312070400000",
    "number": "1043487192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616370001",
            "telephone_number": "309-624-3313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616370001",
            "telephone_number": "309-624-3313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENAVIDES LOPEZ",
        "first_name": "VALERIA",
        "middle_name": "CLAUDIA",
        "name_prefix": "Mrs.",
        "credential": "M.D., M.P.H.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-08",
        "last_updated": "2011-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "IL",
            "license": "036128563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.