Individual provider Active NPI

Ryan Sisson-Smith, MD

  • Internal Medicine Physician
  • Peoria, IL
National Provider Identifier
1548847015
Registry record updated Jul 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036170233 Issued in IL
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

Updated by the provider on Jul 10, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
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 Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20241202003457 IL Practitioner - HospitalistPractitioner - Internal MedicinePractitioner - Pediatric Medicine 9638575681 Reassigns benefits to 1 organization
I20250721001554 IN Practitioner - HospitalistPractitioner - Pediatric Medicine 9638575681 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine, Pediatric Medicine
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

LicenseStateTypeSpecialty
390200000XILMDEmergency Medicine Physician
036170233ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Jun 1, 2025 Accepting new patients
Franciscan Physician Network CurrentSince Jul 29, 2025 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jun 1, 2025 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Franciscan Physician Network Internal Medicine CurrentSince Jul 29, 2025 Accepting new patients
Osf Multi-Specialty Group Internal Medicine CurrentSince Nov 22, 2024 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.

Hospital & facility affiliations 1

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": "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

Verify at the official NPI Registry.