NPIMap

Organization Active NPI

Lynne M Jalovec, MD, SC

  • Surgery Physician
  • Peoria, IL
National Provider Identifier
1093092470
Registry record updated Nov 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
042616753 Issued in IL
Legal business name
LYNNE M JALOVEC, MD, SC
Practice address
900 Main St
Suite 310
Peoria, IL 61602-1005
Phone
(309) 672-4174
Fax
(309) 672-4132
NPI assigned
Nov 13, 2011
Last updated
Nov 13, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2011

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

Authorized official

Name
Dr. Lynne M Jalovec, MDNPI 1407963630
Title
President
Phone
(309) 672-4174

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 042616753 IL Primary

Addresses

Primary practice location

900 Main St
Suite 310
Peoria, IL 61602-1005

Mailing address

900 Main St
Suite 310
Peoria, IL 61602-1005
Phone (309) 672-4174

National Provider Directory

National Provider Directory

Locations

900 Main St
Ste 310
Peoria, IL 61602
Phone (309) 672-4174

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1321142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321142400000",
    "number": "1093092470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 MAIN ST",
            "address_2": "SUITE 310",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616021005",
            "telephone_number": "309-672-4174",
            "fax_number": "309-672-4132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 MAIN ST",
            "address_2": "SUITE 310",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616021005",
            "telephone_number": "309-672-4174",
            "fax_number": "309-672-4132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYNNE M JALOVEC, MD, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-13",
        "last_updated": "2011-11-13",
        "status": "A",
        "authorized_official_last_name": "JALOVEC",
        "authorized_official_first_name": "LYNNE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "309-672-4174",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "042616753",
            "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 Nov 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.