Active NPI
Liz Edith Contreras, M.D.
- Pediatrics Physician
- Quincy, IL
National Provider Identifier
1295034890
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 036133646
- Practice address
- 927 Broadway St
Quincy, IL 62301-2719 - Phone
- (217) 223-8400
- NPI assigned
- Mar 22, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 35.099406 | OH | |
| Pediatrics Physician | 208000000X | 036133646 | IL | Primary |
Addresses
Primary practice location
927 Broadway St
Quincy, IL 62301-2719
Mailing address
927 Broadway St
Quincy, IL 62301-2719
Phone (217) 223-8400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036133646 | Other | IL | LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036133646 | IL | MD | Pediatrics Physician |
| 35.099406 | OH | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central PA Pharmacy LLC. | Current | Accepting new patients |
Locations
8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050
Interoperability endpoints
- liz.contreras.p11@direct.loraincountyhealth.nextgenshare.com
Organizations & group practices 1
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.
-
- Community/Retail Pharmacy
- Patton, PA
- NPI 1578541413
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1300752000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1386028800000",
"number": "1295034890",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "927 BROADWAY ST",
"city": "QUINCY",
"state": "IL",
"postal_code": "623012719",
"telephone_number": "217-223-8400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "927 BROADWAY ST",
"city": "QUINCY",
"state": "IL",
"postal_code": "623012719",
"telephone_number": "217-223-8400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONTRERAS",
"first_name": "LIZ",
"middle_name": "EDITH",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-03-22",
"last_updated": "2013-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "OH",
"license": "35.099406",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IL",
"license": "036133646",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "036133646",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Quincy, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.