Methodist Medical Center of Illinois

Primary specialty

Psychiatric Hospital UnitTaxonomy code 273R00000X

License

0001594 Issued in IL

Legal business name

METHODIST MEDICAL CENTER OF ILLINOIS

Practice address

221 NE Glen Oak Ave
Peoria, IL 61636-0001

Phone

(309) 672-5522

Fax

(309) 671-2541

NPI assigned

May 11, 2006

Last updated

Feb 14, 2020By the provider in NPPES

Organization subpart

Yes

Parent organization

METHODIST MEDICAL CENTER OF ILLINOISAs reported in NPPES

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

Authorized official

Name

Stephen M. Cirone

Title

Regional MGR-Reimb/Rev Recognition

Phone

(309) 672-4813

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Methodist Medical Center of Illinois

  • General Acute Care Hospital
  • Peoria, IL
  • NPI 1164474755

  O20031126000494

  Same enrollment
• Methodist Medical Center of Illinois

  dba Methodist Medical Group

  • Family Medicine Physician
  • Peoria, IL
  • NPI 1184670663

  O20031126000494

  Same enrollment
• Methodist Medical Center of Illinois

  • Rehabilitation Hospital Unit
  • Peoria, IL
  • NPI 1982656575

  O20031126000494

  Same enrollment

Part of

Methodist Medical Center Il

Locations

Practitioners 104

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bassel Elia Abouzeid, MD

  • Obstetrics & Gynecology Physician
  • Peoria, IL
  • NPI 1376160846
  NPD
• Alexander Adler, MD

  • Cardiovascular Disease Physician
  • Peoria, IL
  • NPI 1912929118
  NPD
• Chaudhary Faizan Ahmed, M.D

  • Hospitalist Physician
  • Chicago, IL
  • NPI 1144637380
  NPD
• Robin A Alley, MD

  • Surgery Physician
  • Peoria, IL
  • NPI 1659689461
  NPD
• Sohiub Nizar Assaf, MD

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1598346918
  NPD
• James D Ausfahl, MD

  • Family Medicine Physician
  • Peoria Heights, IL
  • NPI 1518058619
  NPD
• Jasira Barrientos

  • Psychiatry Physician
  • Peoria, IL
  • NPI 1174150437
  NPD
• Reginald Bowman

  • Pediatrics Physician
  • Pekin, IL
  • NPI 1316101892
  NPD
• Kyle Fletcher Brown, M.D.

  • Emergency Medicine Physician
  • Peoria, IL
  • NPI 1891134151
  NPD
• Surya Teja Chaturvedula, M.D

  • Interventional Cardiology Physician
  • Peoria, IL
  • NPI 1801184767
  NPD
• Alyas P Chaudhry, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Downers Grove, IL
  • NPI 1184874620
  NPD
• Jianming Dong, MD

  • Neurology Physician
  • Peoria, IL
  • NPI 1619981305
  NPD

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581638400000",
    "number": "1275583155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616360001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616360001",
            "telephone_number": "309-672-5522",
            "fax_number": "309-671-2541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METHODIST MEDICAL CENTER OF ILLINOIS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "METHODIST MEDICAL CENTER OF ILLINOIS",
        "enumeration_date": "2006-05-11",
        "last_updated": "2020-02-14",
        "certification_date": "2020-02-14",
        "status": "A",
        "authorized_official_last_name": "CIRONE",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "REGIONAL MGR-REIMB/REV RECOGNITION",
        "authorized_official_telephone_number": "309-672-4813"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "IL",
            "license": "0001594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Methodist Medical Center of Illinois
• Methodist Medical Center of Illinois
• Methodist Medical Center of Illinois
• Methodist Medical Center of Illinois (Methodist Medical Group)
• Methodist Medical Center of Illinois
• Methodist Medical Center of Illinois (Methodist Emergency Services)
• Methodist Medical Center of Illinois (Carle Health Outpatient Dialysis Center)
• Methodist Medical Center of Illinois
• Methodist Medical Center of Illinois (MMG In School Health Trewyn)
• Methodist Medical Center of Illinois (Carle Health Peoria In School Health Richwoods)

• Psychiatric Hospital Unit in Peoria, IL
• Providers in Peoria, IL by specialty
• Psychiatric Hospital Unit in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.