Active NPI
Leonela C Bastidas, MD
- Cardiovascular Disease Physician
- Peoria, IL
National Provider Identifier
1164157301
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 125085262
- Practice address
- 1 Illini Dr
Peoria, IL 61605-2576 - Phone
- (309) 671-3000
- NPI assigned
- Jul 21, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 125085262 | IL | Primary |
Addresses
Primary practice location
1 Illini Dr
Peoria, IL 61605-2576
Mailing address
1 Illini Dr
Peoria, IL 61605-2576
Phone (309) 671-3000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125085262 | IL | MD | Cardiovascular Disease Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1658361600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750377600000",
"number": "1164157301",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 ILLINI DR",
"city": "PEORIA",
"state": "IL",
"postal_code": "616052576",
"telephone_number": "309-671-3000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 ILLINI DR",
"city": "PEORIA",
"state": "IL",
"postal_code": "616052576",
"telephone_number": "309-671-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BASTIDAS",
"first_name": "LEONELA",
"middle_name": "C",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-21",
"last_updated": "2025-06-20",
"certification_date": "2025-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "IL",
"license": "125085262",
"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 Jun 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.