Active NPI
Ryan Sisson-Smith, MD
- Internal Medicine Physician
- Peoria, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 036170233
- Practice address
- 530 NE Glen Oak Ave
Peoria, IL 61637-0001 - Phone
- (130) 965-5200
- NPI assigned
- Mar 29, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 036170233 | IL | |
| Hospitalist Physician | 208M00000X | 01096883A | IN | |
| Student in an Organized Health Care Education/Training Program | 390200000X | 390200000X | IL | |
| Internal Medicine Physician | 207R00000X | 036170233 | IL | Primary |
Addresses
Primary practice location
530 NE Glen Oak Ave
Peoria, IL 61637-0001
Mailing address
2528 N College Ave
Indianapolis, IN 46205-4244
Phone (765) 860-6383
Other practice location 1
251 E Huron St Ste 16-738
Chicago, IL 60611-3055
Phone (312) 926-5924
Other practice location 2
12750 Saint Francis Dr
Crown Point, IN 46307-0264
Phone (219) 757-6005
Other names 1
- Ryan Christopher Smith
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Hospitalist
- Education
- Indiana University School of Medicine, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
251 E Huron St
Chicago, IL 60611-2908
Phone (312) 926-5924
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 390200000X | IL | MD | Emergency Medicine Physician |
| 036170233 | IL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northwestern Medical Faculty Foundation | Current | Accepting new patients | |
| Franciscan Physician Network | Current | Accepting new patients | |
| Northwestern Medical Faculty Foundation | Current | Accepting new patients | |
| Central PA Pharmacy LLC. | Current | Accepting new patients | |
| Franciscan Physician Network | Internal Medicine | Current | Accepting new patients |
| Osf Multi-Specialty Group | Internal Medicine | Current | Accepting new patients |
| Central Dupage Physician Group | Internal Medicine | Past | Accepting new patients |
Locations
Dept 5777
Carol Stream, IL 60122
251 E Huron St
Ste 16738
Chicago, IL 60611
Phone (312) 926-5924
660 N Westmoreland Rd
#302
Lake Forest, IL 60045
530 NE Glen Oak Ave
Peoria, IL 61637
Phone (309) 655-2553
8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050
5114 N Glen Park Place Rd
Ste 110
Peoria, IL 61614
Phone (309) 683-5600
1704 Lafayette Rd
Ste 4
Crawfordsvlle, IN 47933
Phone (765) 364-3120
12750 Saint Francis Dr
Crown Point, IN 46307
Phone (219) 738-2100
150 W Washington St
Shelbyville, IN 46176
Phone (317) 392-3211
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.
-
- Multi-Specialty Clinic/Center
- Carol Stream, IL
- NPI 1346235314
-
- Family Medicine Physician
- Indianapolis, IN
- NPI 1225327984
Internal Medicine
-
- Durable Medical Equipment & Medical Supplies
- Chicago, IL
- NPI 1417718479
-
- Internal Medicine Physician
- Peoria, IL
- NPI 1922445527
-
- Community/Retail Pharmacy
- Patton, PA
- NPI 1578541413
-
- Clinic/Center
- Lafayette, IN
- NPI 1992543250
-
- Family Medicine Physician
- Carol Stream, IL
- NPI 1033149844
Internal Medicine
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Chicago, IL
- NPI 1497859649
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616976000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752105600000",
"number": "1548847015",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2528 N COLLEGE AVE",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462054244",
"telephone_number": "765-860-6383"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "530 NE GLEN OAK AVE",
"city": "PEORIA",
"state": "IL",
"postal_code": "616370001",
"telephone_number": "130-965-5200"
}
],
"practiceLocations": [
{
"address_1": "251 E Huron St Ste 16-738",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606113055",
"country_code": "US",
"telephone_number": "312-926-5924",
"fax_number": "312-926-6134",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "12750 Saint Francis Dr",
"address_purpose": "LOCATION",
"city": "Crown Point",
"state": "IN",
"postal_code": "463070264",
"country_code": "US",
"telephone_number": "219-757-6005",
"fax_number": "219-681-6823",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SISSON-SMITH",
"first_name": "RYAN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-03-29",
"last_updated": "2025-07-10",
"certification_date": "2025-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IL",
"license": "036170233",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "IN",
"license": "01096883A",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "IL",
"license": "390200000X",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "036170233",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "RYAN",
"last_name": "SMITH",
"middle_name": "CHRISTOPHER",
"credential": "MD",
"code": "1",
"type": "Former Name"
}
]
}
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 Jul 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.