Individual provider Active NPI

Maryah Mansoor, MD

  • Rheumatology Physician
  • Peoria, IL
National Provider Identifier
1659684777
Registry record updated Apr 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
036172307 Issued in IL
Practice address
1800 N Knoxville Ave Ste E
Peoria, IL 61603-3005
Phone
(309) 308-0910
Fax
(309) 308-0919
NPI assigned
Jul 18, 2010
Last updated
Apr 10, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X MD482769 PA
Rheumatology Physician 207RR0500X C1-0011382 DE
Rheumatology Physician 207RR0500X 036172307 IL Primary
Rheumatology Physician 207RR0500X 75524 MN

Addresses

Primary practice location

1800 N Knoxville Ave Ste E
Peoria, IL 61603-3005

Mailing address

1800 N Knoxville Ave Ste E
Peoria, IL 61603-3005
Phone (309) 308-0910

Other practice location 1

PO Box A
Onamia, MN 56359-0807
Phone (320) 532-3154

Other practice location 2

501 West 14th Street, 5th Floor
S
Wilmington, DE 19801-1013
Phone (302) 320-2490

Other identifiers 1

IdentifierTypeStateIssuer
75524OtherMNMD LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE, MN, IA, IL, PA5 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 5

Enrollment IDStateProvider typePAC IDDetails
I20151022002518 DE Practitioner - Internal MedicinePractitioner - Rheumatology 4981827656 Reassigns benefits to 6 organizations
I20231211001828 MN Practitioner - Rheumatology 4981827656 Reassigns benefits to 2 organizations
I20240806002314 IA Practitioner - Rheumatology 4981827656 Reassigns benefits to 3 organizations
I20241028000562 IL Practitioner - RheumatologyPractitioner - Internal Medicine 4981827656 Reassigns benefits to 1 organization
I20260508003876 PA Practitioner - Internal Medicine 4981827656 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
RheumatologyAlso: Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD482769PAMDInternal Medicine Physician
C1-0011382DEMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Marengo Memorial Hospital Current Accepting new patients
Christiana Care Health Services Inc. Rheumatology CurrentSince Sep 7, 2015 Accepting new patients
Christiana Care Health Services Inc Internal Medicine CurrentSince Nov 27, 2016 Accepting new patients
Medical Associates Clinic P C CurrentSince May 25, 2024 Accepting new patients
Group Health, Inc. CurrentSince Nov 22, 2023 Accepting new patients
Mille Lacs Health System Current Accepting new patients
Marengo Memorial Hospital CurrentSince Jan 1, 2025 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Group Health, Inc. Current Accepting new patients
North Lincoln County Hospital District CurrentSince May 1, 2025 Accepting new patients
Christiana Care Health Services, Inc Current Accepting new patients
Marengo Memorial Hospital CurrentSince Jan 1, 2025 Accepting new patients
Christiana Care Health Services Inc CurrentSince Sep 7, 2015 Accepting new patients
Osf Multi-Specialty Group Internal Medicine CurrentSince Oct 17, 2024 Accepting new patients
Group Health, Inc. CurrentSince Nov 22, 2023 Accepting new patients

Locations

200 Hygeia Dr
Ste 2300
Newark, DE 19713
Phone (302) 623-7362

4735 Ogletown Stanton Rd
Ste 2201
Newark, DE 19713
Phone (302) 320-2490

4755 Ogletown Stanton Rd
Ste 5A43
Newark, DE 19718
Phone (302) 623-0188

1401 Foulk Rd
Ste 100B
Wilmington, DE 19803
Phone (302) 320-9440

501 W 14th St
Fl 5
Wilmington, DE 19801
Phone (302) 320-2490

1000 Langworthy St
Dubuque, IA 52001
Phone (563) 584-3455

1500 Associates Dr
Dubuque, IA 52002
Phone (563) 584-4100

300 W May St
Marengo, IA 52301
Phone (319) 462-8011

300 W May St
Ste A
Marengo, IA 52301
Phone (319) 642-5543

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

200 Elm St N
Onamia, MN 56359
Phone (320) 532-2750

110 Hospital Ln
Afton, WY 83110
Phone (208) 227-1137

901 Adams St
Afton, WY 83110
Phone (307) 885-5800

Organizations & group practices 20

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.

View all 20

Hospital & facility affiliations 4

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": "1279411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775779200000",
    "number": "1659684777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 N KNOXVILLE AVE STE E",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616033005",
            "telephone_number": "309-308-0910",
            "fax_number": "309-308-0919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 N KNOXVILLE AVE STE E",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616033005",
            "telephone_number": "309-308-0910",
            "fax_number": "309-308-0919"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "PO Box A",
            "address_purpose": "LOCATION",
            "city": "Onamia",
            "state": "MN",
            "postal_code": "563590807",
            "country_code": "US",
            "telephone_number": "320-532-3154",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "501 West 14th Street, 5th Floor",
            "address_2": "S",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "DE",
            "postal_code": "198011013",
            "country_code": "US",
            "telephone_number": "302-320-2490",
            "fax_number": "302-623-4395",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANSOOR",
        "first_name": "MARYAH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-18",
        "last_updated": "2026-04-10",
        "certification_date": "2026-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD482769",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "DE",
            "license": "C1-0011382",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "IL",
            "license": "036172307",
            "primary": true
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "MN",
            "license": "75524",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD LICENSE",
            "identifier": "75524",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.