Individual provider Active NPI

Jeffrey E. Stedwill, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Peoria, IL
National Provider Identifier
1497775373
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
036-096932 Issued in IL
Practice address
100 NE Randolph Ave
Peoria, IL 61606-1919
Phone
(309) 624-8550
Fax
(309) 624-8697
NPI assigned
Jul 20, 2006
Sex
Male
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
Physical Medicine & Rehabilitation Physician 208100000X 036-096932 IL Primary

Addresses

Primary practice location

100 NE Randolph Ave
Peoria, IL 61606-1919

Mailing address

530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone (309) 655-2000

Other identifiers 1

IdentifierTypeStateIssuer
815940OtherMEDICARE GROUP NO.

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
I20091023000246 IL Practitioner - Physical Medicine and Rehabilitation 4587701560 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Ohio State University College of Medicine, 1989
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)

200 E Pennsylvania Ave
Peoria, IL 61603-3089
Phone (309) 624-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-096932ILMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Francis Medical Center Current Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Saint Francis Medical Center CurrentSince Mar 10, 1998 Accepting new patients
Osf Multi-Specialty Group CurrentSince Oct 7, 2017 Accepting new patients
Saint Francis Medical Center Physical Medicine & Rehabilitation Current Accepting new patients
Saint Francis Medical Center Physical Medicine & Rehabilitation CurrentSince Mar 10, 1998 Accepting new patients
Saint Francis Medical Center Current Accepting new patients

Locations

2200 Fort Jesse Rd
Normal, IL 61761
Phone (309) 268-9300

719 N William Kumpf Blvd
Ste 100
Peoria, IL 61605
Phone (309) 624-9934

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

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

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

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

723 NE Glen Oak Ave
Peoria, IL 61603
Phone (309) 624-8749

200 E Pennsylvania Ave
Peoria, IL 61603
Phone (309) 624-4000

Organizations & group practices 7

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 2

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497775373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616370001",
            "telephone_number": "309-655-2000",
            "fax_number": "309-655-7869"
        },
        {
            "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": "309-624-8550",
            "fax_number": "309-624-8697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEDWILL",
        "first_name": "JEFFREY",
        "middle_name": "E.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IL",
            "license": "036-096932",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NO.",
            "identifier": "815940",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.