Central Illinois Friends of Pwa, Inc.

Primary specialty

Community Health Nurse PractitionerTaxonomy code 363LC1500X

Legal business name

CENTRAL ILLINOIS FRIENDS OF PWA, INC.

Practice address

120 NE Glen Oak Ave Ste 201
Peoria, IL 61603-4315

Phone

(309) 431-5880

NPI assigned

Jan 23, 2026

Organization subpart

No

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

Authorized official

Name

Deric Kimler

Title

Executive Director

Phone

(309) 431-5880

Specialties & licenses 2

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 Friends of Pwa Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

• Central Illinois Friends of Pwa, Inc.

  • Community Health Clinic/Center
  • Peoria, IL
  • NPI 1447866900
  NPD tax ID
• Central Illinois Friends of Pwa, Inc.

  • Community Health Nurse Practitioner
  • Peoria, IL
  • NPI 1922945542
  NPD tax ID
• Central Illinois Friends of Pwa, Inc.

  • Community Health Clinic/Center
  • Galesburg, IL
  • NPI 1932058963
  NPD tax ID
• Central Illinois Friends of Pwa, Inc.

  • Community Health Nurse Practitioner
  • Normal, IL
  • NPI 1982553913
  NPD tax ID

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

{
    "created_epoch": "1769126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769126400000",
    "number": "1376492306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5022",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616015022",
            "telephone_number": "309-431-5880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 NE GLEN OAK AVE STE 201",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616034315",
            "telephone_number": "309-431-5880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL ILLINOIS FRIENDS OF PWA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-23",
        "last_updated": "2026-01-23",
        "certification_date": "2026-01-23",
        "status": "A",
        "authorized_official_last_name": "KIMLER",
        "authorized_official_first_name": "DERIC",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "309-431-5880"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LC1500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Community Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Central Il. Hearing Aid Centers, Inc.
• Central Illinois Agency on Aging, Inc.
• Central Illinois Dermatology, S.C.
• Central Illinois Endoscopy Center, LLC
• Central Illinois Family Eyecare LLC
• Central Illinois Friends of Pwa, Inc.
• Central Illinois Friends of Pwa, Inc.
• Central Illinois Nerve Testing LTD
• Central Illinois Pathology, SC
• Central Illinois Preventive Services LLC

• Community Health Nurse Practitioner in Peoria, IL
• Providers in Peoria, IL by specialty
• Community Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2026; 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.