Individual provider Active NPI

Maria T Grosse-Perdekamp, MD

  • Hematology & Oncology Physician
  • Urbana, IL
National Provider Identifier
1124077714
Registry record updated May 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
036110021 Issued in IL
Practice address
509 W University Ave
Urbana, IL 61801-1645
Phone
(217) 383-6636
Fax
(217) 383-3466
NPI assigned
May 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 036110021 IL Primary

Addresses

Primary practice location

509 W University Ave
Urbana, IL 61801-1645

Mailing address

611 W Park St
BWPC
Urbana, IL 61801-2529
Phone (217) 383-6792

Other identifiers 1

IdentifierTypeStateIssuer
036110021MedicaidIL

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
I20031126000568 IL Practitioner - Hematology/OncologyPractitioner - Internal Medicine 5597660993 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Internal Medicine
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians
Carle West Physician Group IncGroup PAC ID 8921420308, 282 clinicians

Practice addresses (Care Compare)

200 Lerna Rd S
Mattoon, IL 61938-9388
Phone (217) 258-5900

2204 Eastland Dr
Bloomington, IL 61704-3567
Phone (309) 663-0222

2512 Hurst Dr
Suite 130
Mattoon, IL 61938-9200
Phone (217) 258-5900

407 E Vernon Ave
Normal, IL 61761-3813
Phone (309) 451-8500

509 W University Ave
Urbana, IL 61801-1645
Phone (217) 383-3010

611 W Park St
Urbana, IL 61801-2500

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

701 E Orange St
Hoopeston, IL 60942-1801
Phone (217) 283-5531

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Carle West Physician Group Inc CurrentSince Mar 27, 2025 Accepting new patients
Hoopeston Community Memorial Hospital CurrentSince Oct 1, 2019 Accepting new patients
Hoopeston Community Memorial Hospital Current Accepting new patients
Hoopeston Community Memorial Hospital CurrentSince Oct 1, 2019 Accepting new patients
Carle Health Care Incorporated CurrentSince Jan 9, 2012 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Carle Health Care Incorporated Past Accepting new patients
Cancer Care Specialists of Central Illinois, S.C Past Accepting new patients

Locations

2204 Eastland Dr
Bloomington, IL 61704
Phone (309) 662-9461

3310 Fields South Dr
Champaign, IL 61822
Phone (217) 417-2352

1120 N Melvin St
Gibson City, IL 60936
Phone (217) 355-1684

701 E Orange St
Hoopeston, IL 60942
Phone (217) 283-5531

837 E Orange St
Hoopeston, IL 60942
Phone (217) 283-5530

2512 Hurst Dr
Ste 130
Mattoon, IL 61938
Phone (217) 258-5900

407 E Vernon Ave
Normal, IL 61761
Phone (309) 451-2231

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

509 W University Ave
Urbana, IL 61801
Phone (217) 383-3010

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432598400000",
    "number": "1124077714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W PARK ST",
            "address_2": "BWPC",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012529",
            "telephone_number": "217-383-6792",
            "fax_number": "217-383-3466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 W UNIVERSITY AVE",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618011645",
            "telephone_number": "217-383-6636",
            "fax_number": "217-383-3466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSE-PERDEKAMP",
        "first_name": "MARIA",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-09",
        "last_updated": "2015-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "IL",
            "license": "036110021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036110021",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Urbana, IL

Sources for this page

Verify at the official NPI Registry.