Organization Active NPI

Desired Medical Services 2 LLC

  • Family Medicine Physician
  • Peoria, IL
National Provider Identifier
1346000361
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DESIRED MEDICAL SERVICES 2 LLC
Practice address
7820 N University St Ste 110
Peoria, IL 61614-8301
Phone
(708) 394-3296
NPI assigned
Mar 19, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

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

Authorized official

Name
Mrs. Katrina Smith
Title
Billing MGR
Phone
(855) 276-5212

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

7820 N University St Ste 110
Peoria, IL 61614-8301

Mailing address

7820 N University St Ste 110
Peoria, IL 61614-8301
Phone (708) 394-3296

National Provider Directory

National Provider Directory

Locations

7820 N University St
Ste 110
Peoria, IL 61614
Phone (708) 394-3296

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1710806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710806400000",
    "number": "1346000361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7820 N UNIVERSITY ST STE 110",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616148301",
            "telephone_number": "708-394-3296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7820 N UNIVERSITY ST STE 110",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616148301",
            "telephone_number": "708-394-3296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESIRED MEDICAL SERVICES 2 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-19",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "KATRINA",
        "authorized_official_title_or_position": "BILLING MGR",
        "authorized_official_telephone_number": "855-276-5212",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.