NPIMap

Individual provider Active NPI

William H Dunn, MD

  • Radiation Oncology Physician
  • Peoria, IL
National Provider Identifier
1669447504
Registry record updated Feb 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
036136811 Issued in IL
Practice address
530 NE Glen Oak Ave
Peoria, IL 61637-6163
Phone
(309) 655-2000
NPI assigned
Feb 22, 2006
Last updated
Feb 20, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 036136811 IL Primary
Radiation Oncology Physician 2085R0001X 2014006591 MO

Addresses

Primary practice location

530 NE Glen Oak Ave
Peoria, IL 61637-6163

Mailing address

530 NE Glen Oak Ave
Peoria, IL 61637-6163

Other identifiers 1

IdentifierTypeStateIssuer
104740334MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140827002362 MO Practitioner - Radiation Oncology 5991740540 Reassigns benefits to 1 organization
I20150211001465 IL Practitioner - Radiation Oncology 5991740540 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Medical University of South Carolina College of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urology of St Louis IncGroup PAC ID 6204723786, 112 clinicians
Mt. Vernon Radiation Therapy CenterGroup PAC ID 2163439498, 5 clinicians

Practice addresses (Care Compare)

12855 N 40 Dr
Suite 375
Saint Louis, MO 63141-8657
Phone (314) 567-6071

4115 Veterans Memorial Dr
Mount Vernon, IL 62864-6262
Phone (618) 241-1827

6812 State Route 162 200
Maryville, IL 62062-8562
Phone (618) 288-0900

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036136811ILMDRadiation Oncology Physician
2014006591MOMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rockford Health Physicians CurrentSince Dec 18, 2014 Accepting new patients
St. Mary's Hospital, Centralia, Illinois CurrentSince Sep 1, 2017 Accepting new patients
St. Mary's Hospital, Centralia, Illinois Radiation Oncology CurrentSince Sep 1, 2017 Accepting new patients
Physician Services Corporation of Southern Illinois Inc. CurrentSince Jun 1, 2026 Accepting new patients
Mt Vernon Radiation Therapy Center CurrentSince Feb 1, 2026 Accepting new patients
Urology of St. Louis, Inc. Past Accepting new patients

Locations

400 N Pleasant Ave
Centralia, IL 62801
Phone (618) 436-5221

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

7420 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-3155

4115 Veterans Memorial Dr
Mount Vernon, IL 62864
Phone (618) 241-1827

4225 Lincolnshire Dr
Ste B
Mount Vernon, IL 62864

2300 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-5510

Organizations & group practices 7

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 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": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487548800000",
    "number": "1669447504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616376163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616376163",
            "telephone_number": "309-655-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNN",
        "first_name": "WILLIAM",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2017-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "IL",
            "license": "036136811",
            "primary": true
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MO",
            "license": "2014006591",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104740334",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.