Individual provider Active NPI

John Eric Player, DO

  • Surgery Physician
  • Rockford, IL
National Provider Identifier
1285965905
Registry record updated Jun 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
036.133344 Issued in IL
Practice address
5668 E State St
Suite 1000
Rockford, IL 61108-2464
Phone
(815) 397-7900
Fax
(815) 397-7919
NPI assigned
Jan 20, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 54098-21 WI
Surgery Physician 208600000X 036.133344 IL Primary

Addresses

Primary practice location

5668 E State St
Suite 1000
Rockford, IL 61108-2464

Mailing address

5668 E State St
Suite 1000
Rockford, IL 61108-2464
Phone (815) 397-7900

Other identifiers 2

IdentifierTypeStateIssuer
61001OtherWIDEAN HEALTH INSURANCE
100008500MedicaidWI

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
I20140616001777 IL Practitioner - General Surgery 9931235801 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

2500 W Reynolds St
Pontiac, IL 61764-9774
Phone (309) 665-4729

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy33
Hernia repair - groin (open)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.133344ILMDSurgery Physician
54098-21WIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pekin Prohealth Inc CurrentSince Jan 7, 2019 Accepting new patients
Osf Multi-Specialty Group CurrentSince Nov 4, 2019 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients

Locations

215 E 1st St
Ste 117
Dixon, IL 61021
Phone (815) 285-5900

215 E 1st St
Ste 111
Dixon, IL 61021
Phone (815) 285-5477

600 S 13th St
#I
Pekin, IL 61554
Phone (309) 495-0200

600 S 13th St
Pekin, IL 61554
Phone (309) 347-1151

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

124 SW Adams St
Peoria, IL 61602
Phone (309) 655-2850

2500 W Reynolds St
Ste 207203205206
Pontiac, IL 61764

2500 W Reynolds St
Pontiac, IL 61764
Phone (815) 842-2828

5668 E State St
Ste 1000
Rockford, IL 61108
Phone (815) 229-7580

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1263945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372032000000",
    "number": "1285965905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5668 E STATE ST",
            "address_2": "SUITE 1000",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082464",
            "telephone_number": "815-397-7900",
            "fax_number": "815-397-7919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5668 E STATE ST",
            "address_2": "SUITE 1000",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082464",
            "telephone_number": "815-397-7900",
            "fax_number": "815-397-7919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLAYER",
        "first_name": "JOHN",
        "middle_name": "ERIC",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-20",
        "last_updated": "2013-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "54098-21",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036.133344",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEAN HEALTH INSURANCE",
            "identifier": "61001",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100008500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.