Central Illinois Preventive Services LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

CENTRAL ILLINOIS PREVENTIVE SERVICES LLC

Practice address

2426 W Cornerstone CT Ste 100
Peoria, IL 61614-2400

Phone

(309) 966-3137

NPI assigned

Mar 14, 2018

Organization subpart

No

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

Authorized official

Name

Larry F Overcash, MD

Title

Owner

Phone

(309) 696-9010

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Central Illinois Preventive Services LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Central Illinois Preventive Services LLC

  • Family Medicine Physician
  • Bloomington, IL
  • NPI 1144003633
  NPD tax ID
• Central Illinois Preventive Services LLC

  • Family Medicine Physician
  • Davenport, IA
  • NPI 1326850587
  NPD tax ID

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Central Illinois Preventive Services LLC

  • Family Medicine Physician
  • Bloomington, IL
  • NPI 1144003633
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Breeanon Theresa Stiers, FNP-C

  • Family Nurse Practitioner
  • Mackinaw, IL
  • NPI 1467244863
  NPD (past)

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

{
    "created_epoch": "1520985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737676800000",
    "number": "1306349576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 CIMMERON DR",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616117505",
            "telephone_number": "309-696-9010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2426 W CORNERSTONE CT STE 100",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616142400",
            "telephone_number": "309-966-3137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL ILLINOIS PREVENTIVE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-14",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A",
        "authorized_official_last_name": "OVERCASH",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "309-696-9010",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Central Illinois Friends of Pwa, Inc.
• Central Illinois Friends of Pwa, Inc.
• Central Illinois Friends of Pwa, Inc.
• Central Illinois Nerve Testing LTD
• Central Illinois Pathology, SC
• Central Illinois Radiation Oncology Physicians, LTD
• Central Illinois Radiological Associates, LTD.
• Central Illinois Rehabilitation Associates Inc SC
• Dexter Cervantes, O.T.
• Shinymol John Chacko, MD

• Family Medicine Physician in Peoria, IL
• Providers in Peoria, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.