Individual provider Active NPI

Chad M Conklin, MD

  • Family Medicine Physician
  • Peoria, IL
National Provider Identifier
1659395259
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036099516 Issued in IL
Practice address
3335 N Sterling Ave
Peoria, IL 61604-1837
Phone
(309) 687-5900
NPI assigned
Jul 27, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036099516 IL Primary

Addresses

Primary practice location

3335 N Sterling Ave
Peoria, IL 61604-1837

Mailing address

5100 Reliable Pkwy
Chicago, IL 60686-0001
Phone (309) 672-4809

Other identifiers 5

IdentifierTypeStateIssuer
7215059OtherILBCBS PPO
IL01D8OtherILJOHN DEERE
049802OtherILHEALTH ALLIANCE
080146523OtherILRAILROAD MEDICARE
475091OtherILHEALTHLINK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20100816000522 IL Practitioner - Family Practice 6507990389 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Southern Illinois University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians
Proctor Health SystemsGroup PAC ID 3476440173, 131 clinicians

Practice addresses (Care Compare)

2338 W Van Winkle Way
3300 Family Medicine North
Peoria, IL 61615-7485
Phone (309) 693-2020

5401 N Knoxville Ave
Suite 204
Peoria, IL 61614-5021
Phone (309) 683-1200

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

815 Main St
Peoria, IL 61602-1076
Phone (309) 672-4977

815 Main St
Suite a
Peoria, IL 61602-1080
Phone (309) 672-4977

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Proctor Health Systems Family Medicine CurrentSince May 6, 2016 Accepting new patients
Carle Health Medical Group Family Medicine CurrentSince Jan 1, 2026 Accepting new patients
Methodist Medical Center of Illinois CurrentSince Aug 14, 2003 Accepting new patients
Methodist Medical Center of Illinois Family Medicine CurrentSince Aug 14, 2003 Accepting new patients
Pekin Memorial Hospital CurrentSince Jun 1, 2015 Accepting new patients
Pekin Memorial Hospital Current Accepting new patients
Proctor Health Systems Family Medicine CurrentSince May 6, 2016 Accepting new patients
Epss LLC - Central Series CurrentSince Oct 30, 2017 Accepting new patients
Methodist Medical Center of Illinois Current Accepting new patients
Epss LLC - Central Series Past Accepting new patients
Deaconess Hospital Inc Past Accepting new patients

Locations

5100 Reliable Pkwy
Chicago, IL 60686
Phone (309) 672-4809

2535 E Washington St
East Peoria, IL 61611
Phone (309) 694-6464

600 S 13th St
Pekin, IL 61554
Phone (309) 347-1151

221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281

3335 N Sterling Ave
Peoria, IL 61604
Phone (309) 687-5900

3915 Barring Trce
Peoria, IL 61615
Phone (309) 689-3030

5401 N Knoxville Ave
Ste 204
Peoria, IL 61614
Phone (309) 683-1200

5401 N Knoxville Ave
Ste 400
Peoria, IL 61614
Phone (309) 691-6610

815 Main St
Ste A
Peoria, IL 61602
Phone (309) 671-3000

815 Main St
Ste A1
Peoria, IL 61602

8914 N Knoxville Ave
Peoria, IL 61615
Phone (309) 691-9110

1120 E War Memorial Dr
Peoria Hts, IL 61616
Phone (309) 685-1774

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Organizations & group practices 11

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.

Hospital & facility affiliations 6

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1659395259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 RELIABLE PKWY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606860001",
            "telephone_number": "309-672-4809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3335 N STERLING AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616041837",
            "telephone_number": "309-687-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONKLIN",
        "first_name": "CHAD",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036099516",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PPO",
            "identifier": "7215059",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE",
            "identifier": "IL01D8",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "049802",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080146523",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "475091",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.