John E Augspurger, M.D.

Individual provider Active NPI Family Medicine Physician · Peoria, IL

NPI 1376749002 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1376749002
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
Practice address
5815 N. Aspenwood Drive
#5205
Peoria, IL 61615
Phone
(309) 369-0972
NPI assigned
Jun 21, 2007
Sex
Male
Sole proprietor
Yes

Organizations & group practices 2

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
27665IAMDFamily Medicine Physician
036-069558ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Health System Family Medicine Past Accepting new patients
CGH Medical Center Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 27665 IA
Family Medicine Physician 207Q00000X IL Yes

Addresses

Primary practice location

5815 N. Aspenwood Drive
#5205
Peoria, IL 61615

Mailing address

5815 N. Aspenwood Drive
#5205
Peoria, IL 61615
Phone (309) 369-0972

Other providers in Peoria, IL

All providers in Peoria, IL · Family Medicine Physician in Illinois

Sources for this page

Verify at the official NPI Registry.