Individual provider Active NPI

Sarah Zallek

  • Neurology Physician
  • Peoria, IL
National Provider Identifier
1467543942
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
036-097849 Issued in IL
Practice address
100 NE Randolph Ave
Peoria, IL 61606-1919
Phone
(309) 624-8500
Fax
(309) 655-8552
NPI assigned
Sep 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 036-097849 IL Primary

Addresses

Primary practice location

100 NE Randolph Ave
Peoria, IL 61606-1919

Mailing address

100 NE Randolph Ave
Peoria, IL 61606-1919
Phone (309) 624-8500

Other identifiers 1

IdentifierTypeStateIssuer
036097849MedicaidIL

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
I20051101000600 IL Practitioner - Sleep MedicinePractitioner - Neurology 8022035781 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Sleep MedicineAlso: Neurology
Education
Rush Medical College of Rush University, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone (877) 464-6640

Hospital & facility affiliations

  • Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-097849ILMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Jan 1, 2016 Accepting new patients
Saint Francis Medical Center Current Accepting new patients
Saint Francis Medical Center CurrentSince Jun 7, 2010 Accepting new patients

Locations

210 W Walnut St
Canton, IL 61520
Phone (309) 647-5240

530 NE Glen Oak Ave
Peoria, IL 61637
Phone (309) 655-2553

100 NE Randolph Ave
Peoria, IL 61606
Phone (309) 624-8500

530 Neglen Oak Ave
Peoria, IL 61637
Phone (877) 464-6640

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

Organizations & group practices 4

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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467543942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 NE RANDOLPH AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616061919",
            "telephone_number": "309-624-8500",
            "fax_number": "309-655-8552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NE RANDOLPH AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616061919",
            "telephone_number": "309-624-8500",
            "fax_number": "309-655-8552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZALLEK",
        "first_name": "SARAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "036-097849",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036097849",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.