Individual provider Active NPI

Mary Amal Khoury Harvey, MD

  • Pediatrics Physician
  • Peoria, IL
National Provider Identifier
1215037890
Registry record updated Jul 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036-087846 Issued in IL
Practice address
6339 N Big Hollow Rd
Peoria, IL 61615-2907
Phone
(309) 691-3315
Fax
(309) 693-9385
NPI assigned
Sep 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036-087846 IL Primary

Addresses

Primary practice location

6339 N Big Hollow Rd
Peoria, IL 61615-2907

Mailing address

6339 N Big Hollow Rd
Peoria, IL 61615-2907
Phone (309) 691-3315

Other practice location 1

1045 W Stephenson St
Freeport, IL 61032-4864
Phone (815) 599-6000

Other identifiers 1

IdentifierTypeStateIssuer
036087846MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, SD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140603001552 IL Practitioner - Pediatric Medicine 9830312271 Reassigns benefits to 5 organizations
I20240627002840 SD Practitioner - Pediatric Medicine 9830312271 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-087846ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central PA Pharmacy LLC. Current Accepting new patients
Methodist Medical Center of Illinois Current Accepting new patients
Avera Queen of Peace Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Jan 23, 2023 Accepting new patients
Freeport Memorial Hospital CurrentSince Jan 1, 2024 Accepting new patients
Methodist Medical Center of Illinois CurrentSince Sep 1, 2015 Accepting new patients
Methodist Medical Center of Illinois Pediatrics CurrentSince Sep 1, 2015 Accepting new patients
Freeport Regional Health Care Foundation CurrentSince Jul 14, 2023 Accepting new patients
Heartland Community Health Clinic Past Accepting new patients

Locations

1045 W Stephenson St
Freeport, IL 61032
Phone (815) 599-6105

1800 N Knoxville Ave
Ste A
Peoria, IL 61603

120 NE Glen Oak Ave
Ste 400
Peoria, IL 61603
Phone (309) 671-3519

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

815 Main St
Ste A1
Peoria, IL 61602

815 Main St
Ste A
Peoria, IL 61602
Phone (309) 672-4986

600 N Rush St
Stockton, IL 61085
Phone (815) 235-3165

Interoperability endpoints

  • Direct secure messaging: mary.harvey@avera.sdhealthlink.net

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1159056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784246400000",
    "number": "1215037890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6339 N BIG HOLLOW RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616152907",
            "telephone_number": "309-691-3315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6339 N BIG HOLLOW RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616152907",
            "telephone_number": "309-691-3315",
            "fax_number": "309-693-9385"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1045 W Stephenson St",
            "address_purpose": "LOCATION",
            "city": "Freeport",
            "state": "IL",
            "postal_code": "610324864",
            "country_code": "US",
            "telephone_number": "815-599-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARVEY",
        "first_name": "MARY",
        "middle_name": "AMAL KHOURY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-24",
        "last_updated": "2026-07-17",
        "certification_date": "2026-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036-087846",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036087846",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.