Maternal Fetal Medicine Associates, S.C.

Primary specialty

Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X

Legal business name

MATERNAL FETAL MEDICINE ASSOCIATES, S.C.

Practice address

4911 N Executive Dr
Suite 200
Peoria, IL 61614-4896

Phone

(309) 683-6704

Fax

(309) 683-6722

NPI assigned

May 22, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Yolanda Renfroe, M.D.

Title

Secretarytreasurer

Phone

(309) 683-6704

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639389661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3873",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616123873",
            "telephone_number": "309-683-6704",
            "fax_number": "309-683-6722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4911 N EXECUTIVE DR",
            "address_2": "SUITE 200",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616144896",
            "telephone_number": "309-683-6704",
            "fax_number": "309-683-6722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATERNAL FETAL MEDICINE ASSOCIATES, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RENFROE",
        "authorized_official_first_name": "YOLANDA",
        "authorized_official_title_or_position": "SECRETARYTREASURER",
        "authorized_official_telephone_number": "309-683-6704",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Billy Ray Masco, MD
• Sean Masi, DO
• Joan L Mason, APN
• Vimal Master Sankar Raj, MD
• Trinity Hope Maston, LCPC
• Alexandra Mathern, M.D.
• Bruce Edward Mathes, DDS
• Nevin Abraham Mathew, PMHNP-BC
• Maureen L. Mathews
• Mangayarkarasi Mathiyazhagan, DDS

• Maternal & Fetal Medicine Physician in Peoria, IL
• Providers in Peoria, IL by specialty
• Maternal & Fetal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.