Ciwirc ( Central Illinois Work Injury Resource Center )

Primary specialty

Special HospitalTaxonomy code 284300000X

Legal business name

CIWIRC ( CENTRAL ILLINOIS WORK INJURY RESOURCE CENTER )

Practice address

736 SW Washington St Ste 2a
Peoria, IL 61602-1643

Phone

(309) 497-0300

Fax

(309) 497-0922

NPI assigned

May 17, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Matthew P Duvendack

Title

President

Phone

(309) 497-0300

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Denise Bungard, APRN

  • Family Nurse Practitioner
  • Peoria, IL
  • NPI 1316699945
  NPD (past)
• Tara Marie Evans

  • Occupational Health Nurse Practitioner
  • Peoria, IL
  • NPI 1518645613
  NPD (past)
• Susi Madrigal-Leon, FNP-C

  • Family Nurse Practitioner
  • Peoria, IL
  • NPI 1346902459
  NPD (past)
• Matthew R Carr, MD, APN

  • Internal Medicine Physician
  • Mobile, AL
  • NPI 1235418385
  NPD (past)
• Marc A Wyckoff

  • Physical Therapist
  • Orlando, FL
  • NPI 1639651870
  NPD (past)

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508073347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "736 SW WASHINGTON ST STE 2A",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616021643",
            "telephone_number": "309-497-0300",
            "fax_number": "309-497-0922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 SW WASHINGTON ST STE 2A",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616021643",
            "telephone_number": "309-497-0300",
            "fax_number": "309-497-0922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CIWIRC ( CENTRAL ILLINOIS WORK INJURY RESOURCE CENTER )",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DUVENDACK",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "309-497-0300",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "284300000X",
            "taxonomy_group": "",
            "desc": "Special Hospital",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kara Sue Cicciarelli, PHD, NCSP, LCP
• Scott Joseph Cicciarelli Jr.
• Sarah Cimei, PHARMD
• Brynn N Cinnamon, APN/CNP
• Gabriela Ciofoaia, M.D.
• CK-Caregivers, LLC
• Bailey Clarahan
• Clark Chiropractic Center, LLC
• Alyse B Clark, PT
• Jacob Clark

• Special Hospital in Peoria, IL
• Providers in Peoria, IL by specialty
• Special Hospital in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.