Neurology Clinic of Peoria SC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

042617586 Issued in IL

Legal business name

NEUROLOGY CLINIC OF PEORIA SC

Practice address

5401 N Knoxville Ave
Suite 414
Peoria, IL 61614-5098

Phone

(309) 692-9516

Fax

(309) 692-9530

NPI assigned

Jan 31, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Gene C Cheng, MD

Title

Director

Phone

(309) 692-9516

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243296000000",
    "number": "1376680363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5401 N KNOXVILLE AVE",
            "address_2": "SUITE 414",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145098",
            "telephone_number": "309-692-9516",
            "fax_number": "309-692-9530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 N KNOXVILLE AVE",
            "address_2": "SUITE 414",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145098",
            "telephone_number": "309-692-9516",
            "fax_number": "309-692-9530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROLOGY CLINIC OF PEORIA SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2009-05-26",
        "status": "A",
        "authorized_official_last_name": "CHENG",
        "authorized_official_first_name": "GENE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "309-692-9516",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "IL",
            "license": "042617586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036088131",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Molly Kathleen Nettles, OTR
• Stacey Neubert
• Kip Neuhoff, CRNA
• Neuro-Counseling PLLC
• Neurological Associates
• Neuromed Healthcare PLLC
• Neuropsychology Clinic PC
• Neurotherapy Institute, PLLC
• Mary Neville, DNP, CPNP-AC
• Whitney Raelene Neville, APN

• Medical Specialty Clinic/Center in Peoria, IL
• Providers in Peoria, IL by specialty
• Medical Specialty Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2009; 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.