Active NPI
Riffat Iftekhar, M.D.
- Pediatrics Physician
- Peoria, IL
National Provider Identifier
1629282546
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 2007011377
- Practice address
- 420 NE Glen Oak Ave
Suite 201
Peoria, IL 61603-3105 - Phone
- (888) 627-5673
- Fax
- (309) 683-5669
- NPI assigned
- May 9, 2007
- Last updated
- Jan 3, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 2007011377 | MO | Primary |
Addresses
Primary practice location
420 NE Glen Oak Ave
Suite 201
Peoria, IL 61603-3105
Mailing address
4115 W Vistaridge CT
Peoria, IL 61615-8955
Phone (309) 689-5419
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036.113738 | Other | IL | STATE MEDICAL LICENSE |
| 2007011377 | Other | MO | STATE MEDICAL LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saint Francis Medical Center | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Saint Francis Home Health
- Home Health Agency
- Peoria, IL
- NPI 1346281425
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1388707200000",
"number": "1629282546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4115 W VISTARIDGE CT",
"city": "PEORIA",
"state": "IL",
"postal_code": "616158955",
"telephone_number": "309-689-5419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "420 NE GLEN OAK AVE",
"address_2": "SUITE 201",
"city": "PEORIA",
"state": "IL",
"postal_code": "616033105",
"telephone_number": "888-627-5673",
"fax_number": "309-683-5669"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IFTEKHAR",
"first_name": "RIFFAT",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-09",
"last_updated": "2014-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MO",
"license": "2007011377",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE MEDICAL LICENSE",
"identifier": "036.113738",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE MEDICAL LICENSE",
"identifier": "2007011377",
"state": "MO"
}
],
"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 Jan 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.