Individual provider Active NPI

Eric Richard Black, M.D.

  • Psychiatry Physician
  • Springfield, IL
National Provider Identifier
1245323005
Registry record updated May 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036133840 Issued in IL
Practice address
901 W Jefferson St
Springfield, IL 62702-4833
Phone
(217) 545-8000
Fax
(217) 545-2275
NPI assigned
Oct 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 036133840 IL Primary

Addresses

Primary practice location

901 W Jefferson St
Springfield, IL 62702-4833

Mailing address

PO Box 19642
Springfield, IL 62794-9642
Phone (217) 545-8000

Other identifiers 1

IdentifierTypeStateIssuer
036133840MedicaidIL

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
I20140616000342 IL Practitioner - Psychiatry 8123242070 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Ohio State University College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

7317 N Willow Lake CT
Psychiatry Psychol
Peoria, IL 61614-8227
Phone (309) 683-7373

8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050

Hospital & facility affiliations

  • Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Siu Physicians & Surgeons, Inc CurrentSince Jul 1, 2014 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Siu Physicians & Surgeons, Inc Psychiatry CurrentSince Jul 1, 2014 Accepting new patients
Osf Multi-Specialty Group CurrentSince May 22, 2025 Accepting new patients
Board of Trustees of Southern Illinois University Past Accepting new patients

Locations

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

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

7317 N Willow Lake Ct
Peoria, IL 61614
Phone (309) 683-7373

751 N Rutledge St
Springfield, IL 62702
Phone (217) 545-0182

901 W Jefferson St
Springfield, IL 62702
Phone (217) 545-8229

319 E Madison St
Fl 3
Springfield, IL 62701
Phone (217) 545-7627

Organizations & group practices 5

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747872000000",
    "number": "1245323005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19642",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949642",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-2275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 W JEFFERSON ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627024833",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-2275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "ERIC",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036133840",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036133840",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.