Active NPI
Charles Egley, MD
- Maternal & Fetal Medicine Physician
- Peoria, IL
National Provider Identifier
1063426054
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Maternal & Fetal Medicine Physician
- Practice address
- 221 NE Glen Oak Ave
Peoria, IL 61636-0001 - Phone
- (309) 672-4144
- NPI assigned
- Jul 28, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Maternal & Fetal Medicine Physician | 207VM0101X | IL | Primary |
Addresses
Primary practice location
221 NE Glen Oak Ave
Peoria, IL 61636-0001
Mailing address
5100 Reliable Pkwy
Chicago, IL 60686-0001
Phone (309) 672-4809
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 008414 | Other | IL | HEALTH ALLIANCE |
| 623719 | Other | IL | HEALTHLINK |
| 7215059 | Other | IL | BCBS PPO |
| 0360428782 | Medicaid | IL | |
| IL0148 | Other | IL | JOHN DEERE |
| 7777E | Other | IL | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1063426054",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5100 RELIABLE PKWY",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606860001",
"telephone_number": "309-672-4809"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "221 NE GLEN OAK AVE",
"city": "PEORIA",
"state": "IL",
"postal_code": "616360001",
"telephone_number": "309-672-4144"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EGLEY",
"first_name": "CHARLES",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207VM0101X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH ALLIANCE",
"identifier": "008414",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK",
"identifier": "623719",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PPO",
"identifier": "7215059",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0360428782",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "JOHN DEERE",
"identifier": "IL0148",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "7777E",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Peoria, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.