Active NPI
Methodist Medical Center of Illinois
- Skilled Nursing Facility
- Peoria, IL
National Provider Identifier
1073565669
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 0001594
- Legal business name
- METHODIST MEDICAL CENTER OF ILLINOIS
- Practice address
- 221 NE Glen Oak Ave
Peoria, IL 61636-0001 - Phone
- (309) 672-5522
- NPI assigned
- May 16, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Carrie McMillion
- Title
- Analyst - Financial Opeartions
- Phone
- (096) 724-8743
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 0001594 | IL | Primary |
Addresses
Primary practice location
221 NE Glen Oak Ave
Peoria, IL 61636-0001
Mailing address
221 NE Glen Oak Ave
Peoria, IL 61636-0001
Phone (309) 672-4874
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147737600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1581638400000",
"number": "1073565669",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "221 NE GLEN OAK AVE",
"city": "PEORIA",
"state": "IL",
"postal_code": "616360001",
"telephone_number": "309-672-4874",
"fax_number": "309-671-2541"
},
{
"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": "309-672-5522"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "METHODIST MEDICAL CENTER OF ILLINOIS",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-16",
"last_updated": "2020-02-14",
"certification_date": "2020-02-14",
"status": "A",
"authorized_official_last_name": "MCMILLION",
"authorized_official_first_name": "CARRIE",
"authorized_official_title_or_position": "ANALYST - FINANCIAL OPEARTIONS",
"authorized_official_telephone_number": "096-724-8743",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "IL",
"license": "0001594",
"primary": true
}
],
"identifiers": [],
"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 Feb 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.