NPIMap

Organization Active NPI

Central Illinois Friends of Pwa, Inc.

Doing business as Central Illinois Friends

  • Community Health Clinic/Center
  • Peoria, IL
National Provider Identifier
1447866900
Registry record updated Jan 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
Legal business name
CENTRAL ILLINOIS FRIENDS OF PWA, INC.
Doing business as
Central Illinois Friends
Practice address
2112 E War Memorial Dr
Peoria, IL 61614-8002
Phone
(309) 431-5880
NPI assigned
Sep 21, 2020
Last updated
Jan 23, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2026

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

Authorized official

Name
Deric Kimler
Title
Executive Director
Phone
(309) 671-2144

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X NU
Public Health or Welfare Agency 251K00000X NU
Voluntary or Charitable Agency 251V00000X NU
Community Health Clinic/Center 261QC1500X NU Primary
Community Health Nurse Practitioner 363LC1500X NU
Community/Behavioral Health Agency 251S00000X NU

Addresses

Primary practice location

2112 E War Memorial Dr
Peoria, IL 61614-8002

Mailing address

PO Box 5022
Peoria, IL 61601-5022
Phone (309) 671-2144

Other names 1

  • Central Illinois Friends Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Central Illinois Friends of Pwa Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

120 NE Glen Oak Ave
Ste 201
Peoria, IL 61603
Phone (309) 431-5880

NPI Registry JSON

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

{
    "created_epoch": "1600646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769126400000",
    "number": "1447866900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5022",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616015022",
            "telephone_number": "309-671-2144",
            "fax_number": "309-671-5108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2112 E WAR MEMORIAL DR",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616148002",
            "telephone_number": "309-431-5880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL ILLINOIS FRIENDS OF PWA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-21",
        "last_updated": "2026-01-23",
        "certification_date": "2026-01-23",
        "status": "A",
        "authorized_official_last_name": "KIMLER",
        "authorized_official_first_name": "DERIC",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "309-671-2144"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LC1500X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Community Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Central Illinois Friends",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2026; 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.