Gretchen L Kopec, M.D.

Primary specialty

Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X

License

036.148113 Issued in IL

Practice address

530 NE Glen Oak Ave
Peoria, IL 61637-1003

Phone

(309) 624-0615

NPI assigned

Apr 17, 2013

Last updated

Feb 3, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, IA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• The Board of Trustees of the University of Illinois

  • Anatomic Pathology Physician
  • Chicago, IL
  • NPI 1386863819
  Medicare reassignment NPD
• Genesis Health System

  dba Genesis Convenient Care Bettendorf

  • Clinic/Center
  • Bettendorf, IA
  • NPI 1497772008
  Medicare reassignment
• Board of Trustees of the University of Illinois

  dba Medical Service Plan at Peoria

  • Pediatrics Physician
  • Peoria, IL
  • NPI 1467425322
  NPD
• The Board of Trustees of the University of Illinois

  dba Occupational Health Service Institute (OHSI)

  • Occupational Medicine Physician
  • Chicago, IL
  • NPI 1043727571
  NPD
• Genesis Health System

  dba Genesis Health Group

  • Family Medicine Physician
  • Davenport, IA
  • NPI 1477654945
  NPD
• Genesis Health System

  dba Genesis Medical Center Dewitt

  • Critical Access Hospital
  • De Witt, IA
  • NPI 1649368523
  NPD
• Genesis Health System

  dba Genesis Medical Center Davenport

  • General Acute Care Hospital
  • Davenport, IA
  • NPI 1972542264
  NPD (past)

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

{
    "created_epoch": "1366156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643846400000",
    "number": "1063856342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3113 FALCON PT",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627117865",
            "telephone_number": "217-553-7424"
        },
        {
            "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": "616371003",
            "telephone_number": "309-624-0615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPEC",
        "first_name": "GRETCHEN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-17",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "IL",
            "license": "036.148113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yannis N Kolettis, M.D.
• Venkat Yashaswi Kondapalli
• Derek Koon
• Kathleen Koors
• Christopher Kopan
• Drew Dempsie Kortus, MD
• Sarah R Koscica, MD
• Justyna Anna Koscielniak, APRN, CNP
• Brett Anthony Kosowski, DO
• Anup Harish Kotadia, MD

• Neonatal-Perinatal Medicine Physician in Peoria, IL
• Providers in Peoria, IL by specialty
• Neonatal-Perinatal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.