Individual provider Active NPI

Ramzi A Kilani, MD

  • Neonatal-Perinatal Medicine Physician
  • Peoria, IL
National Provider Identifier
1689631079
Registry record updated Feb 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
2000167732 Issued in MO
Practice address
221 NE Glen Oak Ave
Peoria, IL 61636-4619
Phone
(309) 672-5522
NPI assigned
Apr 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 2000167732 MO Primary

Addresses

Primary practice location

221 NE Glen Oak Ave
Peoria, IL 61636-4619

Mailing address

1000 Haddonfield Berlin Rd Ste 210
Voorhees, NJ 08043-3520
Phone (856) 782-2212

Other identifiers 2

IdentifierTypeStateIssuer
036085067MedicaidIL
2000167732OtherMOMO LICENSE

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
I20231012001768 IL Practitioner - Critical Care (Intensivists)Practitioner - Pediatric Medicine 7517966849 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois CurrentSince Aug 16, 2023 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Board of Trustees of the University of Illinois CurrentSince Aug 16, 2023 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Oct 1, 2023 Accepting new patients

Locations

7694 Solutions Ctr
Chicago, IL 60677

3333 N Seminary St
Galesburg, IL 61401
Phone (309) 344-3161

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

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

1 Illini Dr
Peoria, IL 61605
Phone (309) 671-3000

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550534400000",
    "number": "1689631079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 HADDONFIELD BERLIN RD STE 210",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080433520",
            "telephone_number": "856-782-2212",
            "fax_number": "856-782-2266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616364619",
            "telephone_number": "309-672-5522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILANI",
        "first_name": "RAMZI",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-28",
        "last_updated": "2019-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "MO",
            "license": "2000167732",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036085067",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MO LICENSE",
            "identifier": "2000167732",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.