NPIMap

Individual provider Active NPI

Douglas J Marshall, M.D.

  • Internal Medicine Physician
  • Morton, IL
National Provider Identifier
1477569499
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Practice address
110 N Main St
Morton, IL 61550-2024
Phone
(309) 266-8900
Fax
(309) 263-6788
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
Yes

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
Internal Medicine Physician 207R00000X IL Primary

Addresses

Primary practice location

110 N Main St
Morton, IL 61550-2024

Mailing address

110 N Main St
Morton, IL 61550-2024
Phone (309) 266-8900

Other identifiers 1

IdentifierTypeStateIssuer
09032033OtherILBLUE CROSS/BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040503000287 IL Practitioner - Internal Medicine 5092702092 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Southern Illinois University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proctor Health SystemsGroup PAC ID 3476440173, 131 clinicians
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

1909 N Morton Ave
Morton, IL 61550-1426
Phone (309) 263-4343

5401 N Knoxville Ave
Peoria, IL 61614-5021

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

815 Main St
Peoria, IL 61602-1076
Phone (309) 672-4977

815 Main St
Suite a
Peoria, IL 61602-1080
Phone (309) 672-4977

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036105264ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Medical Center of Illinois CurrentSince Jul 1, 2025 Accepting new patients
Carle Health Care Incorporated Internal Medicine CurrentSince Jan 1, 2026 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Pekin Hospital PastSince Aug 1, 2003 Accepting new patients

Locations

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

1909 N Morton Ave
Morton, IL 61550
Phone (309) 263-9124

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

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

815 Main St
Ste A1
Peoria, IL 61602

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

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

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

Interoperability endpoints

  • Direct secure messaging: dmarshallmd388562@carlehiedirect.net

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.

Hospital & facility affiliations 7

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477569499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 N MAIN ST",
            "city": "MORTON",
            "state": "IL",
            "postal_code": "615502024",
            "telephone_number": "309-266-8900",
            "fax_number": "309-263-6788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 N MAIN ST",
            "city": "MORTON",
            "state": "IL",
            "postal_code": "615502024",
            "telephone_number": "309-266-8900",
            "fax_number": "309-263-6788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "DOUGLAS",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "09032033",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morton, IL

Sources for this page

Verify at the official NPI Registry.