Illinois Hospital Medicine Associates PC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

ILLINOIS HOSPITAL MEDICINE ASSOCIATES PC

Practice address

530 NE Glen Oak Ave
Peoria, IL 61637-0001

Phone

(919) 426-3140

NPI assigned

Apr 1, 2016

Organization subpart

No

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

Authorized official

Name

Mark Gordon

Title

President

Phone

(865) 693-1000

Specialties & licenses 2

Addresses

Practitioners 1

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

• Marc Crescenzo, MD

  • Emergency Medicine Physician
  • Kenosha, WI
  • NPI 1881678993
  NPD

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

{
    "created_epoch": "1459468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459468800000",
    "number": "1376906867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5870 N HIATUS RD.",
            "address_2": "STE 200",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333216424",
            "telephone_number": "954-835-2848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616370001",
            "telephone_number": "919-426-3140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLINOIS HOSPITAL MEDICINE ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-01",
        "last_updated": "2016-04-01",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "865-693-1000"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tahir Ilahi, MD
• Illinois Alcohol and Drug Evaluation Service, Inc
• Illinois Cardiac Surgery Associates SC
• Illinois Gastroenterology Institute, PLLC
• Illinois Gastroenterology Institute, PLLC
• Illinois Mentor
• Illinois Neurological Institute-Physicians LLC
• Illinois Neurological Institute-Physicians LLC
• Illinois Neuroscience Institute
• Illinois Physicians Eyecare Group, S.C.

• Obstetrics & Gynecology Physician in Peoria, IL
• Providers in Peoria, IL by specialty
• Obstetrics & Gynecology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2016; 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.