Individual provider Active NPI

Eyad Michael Hanna, MD

  • Pediatric Gastroenterology Physician
  • Peoria, IL
National Provider Identifier
1306041660
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
036178729 Issued in IL
Practice address
420 NE Glen Oak Ave Ste 201
Peoria, IL 61603-3112
Phone
(309) 624-2277
NPI assigned
Jun 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X 37301 IA
Pediatric Gastroenterology Physician 2080P0206X 036178729 IL Primary
Pediatrics Physician 208000000X 37301 IA

Addresses

Primary practice location

420 NE Glen Oak Ave Ste 201
Peoria, IL 61603-3112

Mailing address

420 NE Glen Oak Ave Ste 201
Peoria, IL 61603-3112
Phone (309) 624-2277

Other practice location 1

200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 356-2950

Other identifiers 1

IdentifierTypeStateIssuer
70100OtherIAWELLMARK BCBS

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
I20260312000295 IL Practitioner - Pediatric MedicinePractitioner - Gastroenterology 5890887913 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Gastroenterology
Education
Washington University School of Medicine, 2000
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1 Illini Dr
Peoria, IL 61605-2516

124 SW Adams St
Peoria, IL 61602-1308

420 NE Glen Oak Ave
Suite 201
Peoria, IL 61603-3112

Merit-based Incentive Payment System (MIPS)

Final score
80.02 of 100Reported as group
Quality
75.68
Promoting interoperability
78
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036178729ILMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Osf Multi-Specialty Group CurrentSince Mar 2, 2026 Accepting new patients
State University of Iowa Past Accepting new patients
Floyd County Memorial Hospital Commission Past Accepting new patients

Locations

420 NE Glen Oak Ave
Ste 201
Peoria, IL 61603
Phone (309) 655-3800

Interoperability endpoints

  • Direct secure messaging: ehanna21855@uihcdirect.org

Organizations & group practices 4

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": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778630400000",
    "number": "1306041660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 NE GLEN OAK AVE STE 201",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616033112",
            "telephone_number": "309-624-2277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 NE GLEN OAK AVE STE 201",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616033112",
            "telephone_number": "309-624-2277"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Hawkins Dr",
            "address_purpose": "LOCATION",
            "city": "Iowa City",
            "state": "IA",
            "postal_code": "522421009",
            "country_code": "US",
            "telephone_number": "319-356-2950",
            "fax_number": "319-353-8967",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANNA",
        "first_name": "EYAD",
        "middle_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-18",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "IA",
            "license": "37301",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "IL",
            "license": "036178729",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IA",
            "license": "37301",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS",
            "identifier": "70100",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.