Central Illinois Preventive Services LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

CENTRAL ILLINOIS PREVENTIVE SERVICES LLC

Practice address

1603 Tullamore Ave Ste a
Bloomington, IL 61704-9623

Phone

(309) 808-6407

NPI assigned

Aug 17, 2023

Last updated

Aug 17, 2023By the provider in NPPES

Organization subpart

Yes

Parent organization

CENTRAL ILLINOIS PREVENTIVE SERVICES LLCAs reported in NPPES

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

Authorized official

Name

Larry Overcash, MD

Title

Owner

Phone

(309) 696-9010

Specialties & licenses 1

Addresses

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

CLIA laboratory certificates

Tax ID family

Central Illinois Preventive Services LLC3 organizations share this tax ID, including this one

Part of

Central Illinois Preventive Services LLC

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Central Illinois Preventive Services LLC

  • Family Medicine Physician
  • Peoria, IL
  • NPI 1306349576
  NPD tax ID
• Central Illinois Preventive Services LLC

  • Family Medicine Physician
  • Davenport, IA
  • NPI 1326850587
  NPD tax ID

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Central Illinois Preventive Services LLC

  • Family Medicine Physician
  • Peoria, IL
  • NPI 1306349576
  NPPES parent name

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

{
    "created_epoch": "1692230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692230400000",
    "number": "1144003633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1603 TULLAMORE AVE STE A",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617049623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1603 TULLAMORE AVE STE A",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617049623",
            "telephone_number": "309-808-6407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL ILLINOIS PREVENTIVE SERVICES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CENTRAL ILLINOIS PREVENTIVE SERVICES LLC",
        "enumeration_date": "2023-08-17",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A",
        "authorized_official_last_name": "OVERCASH",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "309-696-9010",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Central Illinois Pediatric Associates LLC
• Central Illinois Speech Therapy
• Cep America-Illinois Hospitalists
• Cepamerica Illinois LLP
• Abigail G Cervantes, APN
• Chad Tattini, MD LLC

• Family Medicine Physician in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.