NPIMap

Organization Active NPI

Good Health Medical Center S.C.

  • Family Medicine Physician
  • Peoria, IL
National Provider Identifier
1205947892
Registry record updated Apr 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036088753 Issued in IL
Legal business name
GOOD HEALTH MEDICAL CENTER S.C.
Practice address
4422 N Brandywine Dr
Peoria, IL 61614-5509
Phone
(309) 686-4422
Fax
(309) 686-4421
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2008

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

Authorized official

Name
Ziad Musaitif, D.O.NPI 1316909328
Title
Owner
Phone
(309) 686-4422

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 036088753 IL Primary

Addresses

Primary practice location

4422 N Brandywine Dr
Peoria, IL 61614-5509

Mailing address

PO Box 9284
Peoria, IL 61612-9284
Phone (309) 686-4422

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209081600000",
    "number": "1205947892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9284",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616129284",
            "telephone_number": "309-686-4422",
            "fax_number": "309-686-4421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4422 N BRANDYWINE DR",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145509",
            "telephone_number": "309-686-4422",
            "fax_number": "309-686-4421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD HEALTH MEDICAL CENTER S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2008-04-25",
        "status": "A",
        "authorized_official_last_name": "MUSAITIF",
        "authorized_official_first_name": "ZIAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "309-686-4422",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036088753",
            "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 Apr 25, 2008; 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.