Central Illinois Center for Wellness, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

CENTRAL ILLINOIS CENTER FOR WELLNESS, LLC

Practice address

2501 E College Ave Ste C
Bloomington, IL 61704-2484

Phone

(309) 807-5356

Fax

(309) 807-5291

NPI assigned

Oct 10, 2018

Organization subpart

No

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

Authorized official

Name

William John Ray, MDNPI 1689672859

Title

Physician/Owner

Phone

(309) 807-5356

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• William John Ray, M.D.

  • Internal Medicine Physician
  • Bloomington, IL
  • NPI 1689672859
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1539129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722470400000",
    "number": "1104391739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 E COLLEGE AVE STE C",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617042484",
            "telephone_number": "309-807-5356",
            "fax_number": "309-807-5291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 E COLLEGE AVE STE C",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617042484",
            "telephone_number": "309-807-5356",
            "fax_number": "309-807-5291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL ILLINOIS CENTER FOR WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-10",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A",
        "authorized_official_last_name": "RAY",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "309-807-5356",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Center for Comprehensive Services, Inc.
• Center for Cosmetic and Laser Surgery, LLC
• Center for Healing and Wellness PLLC
• Central Il Medical Equipment, Inc.
• Central Illinois Anesthesiology Associates, LTD
• Central Illinois Family Eyecare LLC
• Central Illinois Neuro Health Sciences, LTD..
• Central Illinois Neuroradiology, LTD
• Central Illinois Orthopedic Surgery II LLC.
• Central Illinois Orthopedic Surgery S.C.

• Primary Care Clinic/Center in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Primary Care Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.