Peoria Day Surgery Center LTD

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

7001449 Issued in IL

Legal business name

PEORIA DAY SURGERY CENTER LTD

Practice address

7309 N Knoxville Ave
Peoria, IL 61614-2085

Phone

(309) 692-9210

Fax

(309) 683-4208

NPI assigned

Apr 12, 2006

Last updated

Feb 25, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Justin R Ahlman, M.D.

Title

Ceo

Phone

(309) 692-9210

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Joseph Banno, M.D.

  • Urology Physician
  • Peoria, IL
  • NPI 1811951072
  NPD

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551052800000",
    "number": "1568426260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7309 N KNOXVILLE AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616142085",
            "telephone_number": "309-692-9210",
            "fax_number": "309-683-4208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7309 N KNOXVILLE AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616142085",
            "telephone_number": "309-692-9210",
            "fax_number": "309-683-4208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEORIA DAY SURGERY CENTER LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-12",
        "last_updated": "2019-02-25",
        "status": "A",
        "authorized_official_last_name": "AHLMAN",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "309-692-9210",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "IL",
            "license": "7001449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007001449",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Peoria Cnty BD for Care CFC 14
• Peoria County Board for the Care & Treatment of Persons With a Develop
• Peoria County Court Administration
• Peoria County Drugs, Inc (Medicap Pharmacy)
• Peoria County Rural Transportation
• Peoria Dental Care
• Peoria Dental LLC
• Peoria Ear, Nose and Throat Group, S.C.
• Peoria Eye Clinic, LTD
• Peoria Family Chiropractic LLC

• Ambulatory Surgical Clinic/Center in Peoria, IL
• Providers in Peoria, IL by specialty
• Ambulatory Surgical Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2019; 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.