Individual provider Active NPI

John Coon, MD

  • Family Medicine Physician
  • Peoria, IL
National Provider Identifier
1437163540
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036048214 Issued in IL
Practice address
815 Main St
Suite B
Peoria, IL 61602-1076
Phone
(309) 672-4908
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X 036048214 IL
Family Medicine Physician 207Q00000X 036048214 IL Primary

Addresses

Primary practice location

815 Main St
Suite B
Peoria, IL 61602-1076

Mailing address

5100 Reliable Pkwy
Chicago, IL 60686-0001
Phone (309) 672-4809

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
I20031126000722 IL Practitioner - Family Practice 9234034661 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036048214ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Medical Center of Illinois Current Accepting new patients
Carle Health Care Incorporated Family Medicine CurrentSince Jan 1, 2026 Accepting new patients
Proctor Health Systems Family Medicine CurrentSince Nov 22, 2024 Accepting new patients
Proctor Health Systems Family Medicine CurrentSince Nov 22, 2024 Accepting new patients
Methodist Medical Center of Illinois Family Medicine CurrentSince Nov 22, 2024 Accepting new patients

Locations

5100 Reliable Pkwy
Chicago, IL 60686
Phone (309) 672-4809

2535 E Washington St
East Peoria, IL 61611
Phone (309) 694-6464

815 Main St
Ste B
Peoria, IL 61602
Phone (309) 672-4908

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

815 Main St
Ste A1
Peoria, IL 61602

815 Main St
Ste C
Peoria, IL 61602
Phone (309) 672-4986

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

3915 Barring Trce
Peoria, IL 61615
Phone (309) 689-3030

8914 N Knoxville Ave
Peoria, IL 61615
Phone (309) 691-9110

815 Main St
Ste A
Peoria, IL 61602
Phone (309) 672-4986

1120 E War Memorial Dr
Peoria Hts, IL 61616
Phone (309) 685-1774

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1437163540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 RELIABLE PKWY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606860001",
            "telephone_number": "309-672-4809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 MAIN ST",
            "address_2": "SUITE B",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616021076",
            "telephone_number": "309-672-4908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COON",
        "first_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "IL",
            "license": "036048214",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036048214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.