Individual provider Active NPI

David Akerele, MD

  • Pediatrics Physician
  • Peoria, IL
National Provider Identifier
1073887527
Registry record updated Nov 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036128483 Issued in IL
Practice address
3525 N University St
Peoria, IL 61604-1324
Phone
(309) 886-9172
NPI assigned
Mar 1, 2012
Last updated
Nov 10, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036128483 IL Primary
Pediatric Infectious Diseases Physician 2080P0208X 036128483 IL

Addresses

Primary practice location

3525 N University St
Peoria, IL 61604-1324

Mailing address

PO Box 9727
Peoria, IL 61612-9727
Phone (309) 886-9172

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
I20120322000383 IL Practitioner - Pediatric Medicine 5991965337 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Medical Center of Illinois CurrentSince Sep 1, 2015 Accepting new patients
Methodist Medical Center of Illinois Pediatrics CurrentSince Sep 1, 2015 Accepting new patients
Methodist Medical Center of Illinois Current Accepting new patients

Locations

5100 Reliable Pkwy
Chicago, IL 60686
Phone (309) 672-4809

3915 Barring Trce
Peoria, IL 61615
Phone (309) 689-3030

815 Main St
Ste A
Peoria, IL 61602
Phone (309) 671-3000

815 Main St
Ste A1
Peoria, IL 61602

1120 E War Memorial Dr
Peoria Hts, IL 61616
Phone (309) 685-1774

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1330560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699574400000",
    "number": "1073887527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9727",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616129727",
            "telephone_number": "309-886-9172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3525 N UNIVERSITY ST",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616041324",
            "telephone_number": "309-886-9172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AKERELE",
        "first_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-01",
        "last_updated": "2023-11-10",
        "certification_date": "2023-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036128483",
            "primary": true
        },
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "IL",
            "license": "036128483",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.