NPIMap

Organization Active NPI

Patrick L Wyffels, MD, LTD

  • Specialist
  • Peoria, IL
National Provider Identifier
1518146380
Registry record updated Oct 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
PATRICK L WYFFELS, MD, LTD
Practice address
5401 N Knoxville Ave
Suite 302
Peoria, IL 61614-5098
Phone
(309) 589-0600
Fax
(309) 589-0602
NPI assigned
Oct 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2007

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

Authorized official

Name
Patrick Lynn Wyffels, M.D.NPI 1588726608
Title
President
Phone
(309) 589-0600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X IL Primary

Addresses

Primary practice location

5401 N Knoxville Ave
Suite 302
Peoria, IL 61614-5098

Mailing address

5401 N Knoxville Ave
Suite 302
Peoria, IL 61614-5098
Phone (309) 589-0600

National Provider Directory

National Provider Directory

Locations

5401 N Knoxville Ave
Ste 302
Peoria, IL 61614
Phone (309) 589-0600

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1193702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193702400000",
    "number": "1518146380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5401 N KNOXVILLE AVE",
            "address_2": "SUITE 302",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145098",
            "telephone_number": "309-589-0600",
            "fax_number": "309-589-0602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 N KNOXVILLE AVE",
            "address_2": "SUITE 302",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145098",
            "telephone_number": "309-589-0600",
            "fax_number": "309-589-0602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRICK L WYFFELS, MD, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-30",
        "last_updated": "2007-10-30",
        "status": "A",
        "authorized_official_last_name": "WYFFELS",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "309-589-0600",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Oct 30, 2007; 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.