Individual provider Active NPI

Mark Stivers, M.D.

  • Internal Medicine Physician
  • Bloomington, IL
National Provider Identifier
1417943523
Registry record updated Jul 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036.141995 Issued in IL
Practice address
207 E Hamilton Rd
Bloomington, IL 61704-7527
Phone
(309) 827-4090
NPI assigned
Sep 23, 2005
Last updated
Jul 18, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036.141995 IL Primary
Hospitalist Physician 208M00000X 036.141995 IL

Addresses

Primary practice location

207 E Hamilton Rd
Bloomington, IL 61704-7527

Mailing address

207 E Hamilton Rd
Bloomington, IL 61704-7527
Phone (309) 827-4090

Other identifiers 1

IdentifierTypeStateIssuer
866220MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170120002395 IL Practitioner - Internal MedicinePractitioner - Hospitalist 1951386184 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Southern Illinois University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Saint Anthonys Way
Alton, IL 62002-4568
Phone (618) 465-2571

1 Saint Elizabeth Blvd
O Fallon, IL 62269-1099
Phone (618) 234-2120

2200 E Washington St
Bloomington, IL 61701-4364
Phone (309) 662-5361

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036.141995ILMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Proctor Health Systems Internal Medicine Current Accepting new patients
Methodist Medical Center of Illinois CurrentSince Aug 12, 2019 Accepting new patients
Methodist Medical Center of Illinois CurrentSince Aug 12, 2019 Accepting new patients
Proctor Health Systems CurrentSince Aug 12, 2019 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Jan 23, 2017 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Cep America-Illinois Hospitalists, LLP Internal Medicine CurrentSince Jul 20, 2025 Accepting new patients
Cep America-Illinois Hospitalists Hospitalist CurrentSince Jul 20, 2025 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Proctor Health Systems CurrentSince Aug 12, 2019 Accepting new patients
Cep America-Illinois Hospitalists, LLP Internal Medicine Current Accepting new patients
Advocate Health & Hospitals Corporation CurrentSince Jan 23, 2017 Accepting new patients
Osf Multi-Specialty Group Internal Medicine CurrentSince Jun 11, 2023 Accepting new patients
Pekin Prohealth Inc Internal Medicine CurrentSince Aug 12, 2019 Accepting new patients
Methodist Medical Center of Illinois Current Accepting new patients
Life Care Centers of America, Inc. Past Accepting new patients
Central Coast in-Patient Consultants, Inc. Internal Medicine Past Accepting new patients
Phoenician Hospice LLC PastSince Apr 13, 2016 Accepting new patients
Life Care Physician Services, LLC Internal Medicine PastSince Jun 18, 2015 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1505 Eastland Dr
Ste 320
Bloomington, IL 61701
Phone (309) 661-2368

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

1 Saint Elizabeth Blvd
O Fallon, IL 62269
Phone 618234212012438

600 S 13th St
Pekin, IL 61554
Phone (309) 347-1151

221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281

221 NE Glen Oak Ave
Ste 514W
Peoria, IL 61636
Phone (309) 672-5733

5401 N Knoxville Ave
Ste 203
Peoria, IL 61614
Phone (309) 589-0600

5401 N Knoxville Ave
Ste 400
Peoria, IL 61614
Phone (309) 691-6610

815 Main St
Ste A
Peoria, IL 61602
Phone (309) 671-3000

815 Main St
Ste A1
Peoria, IL 61602

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

Organizations & group practices 19

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 19

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752796800000",
    "number": "1417943523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 E HAMILTON RD",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617047527",
            "telephone_number": "309-827-4090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 E HAMILTON RD",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617047527",
            "telephone_number": "309-827-4090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STIVERS",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-23",
        "last_updated": "2025-07-18",
        "certification_date": "2025-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036.141995",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036.141995",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "866220",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IL

Sources for this page

Verify at the official NPI Registry.