NPIMap

Individual provider Active NPI

Elsburgh Clarke Jr., MD

  • Emergency Medicine Physician
  • Peoria, IL
National Provider Identifier
1689637217
Registry record updated Aug 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036103700 Issued in IL
Practice address
221 NE Glen Oak Ave
Peoria, IL 61603-4307
Phone
(309) 672-5522
NPI assigned
Apr 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036103700 IL Primary

Addresses

Primary practice location

221 NE Glen Oak Ave
Peoria, IL 61603-4307

Mailing address

21276 Network PL
Chicago, IL 60673-1212
Phone (877) 485-4474

Other identifiers 3

IdentifierTypeStateIssuer
P00196870OtherILRAILROAD MEDICARE
36103700OtherILBCBS
036103700MedicaidIL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041028000552 IL Practitioner - Emergency Medicine 5991767303 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036103700ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hopedale Medical Foundation CurrentSince Jan 1, 2026 Accepting new patients
Emergency Medicine Physicians of Kankakee County, LLC Emergency Medicine Past Accepting new patients
Emergency Medicine Physicians of Guernsey County, LTD Emergency Medicine Past Accepting new patients
Emergency Medicine Physicians of Carteret County, PLLC Emergency Medicine Past Accepting new patients
Stephen C. Thompson, M.D.,S.C. Past Accepting new patients
Epmg of Illinois LLC Emergency Medicine Past Accepting new patients
Emergency Medicine Physicians of Iredell County, PLLC Emergency Medicine Past Accepting new patients
Emergency Medicine Physicians of Ohio County, PLLC Emergency Medicine Past Accepting new patients
Emergency Medicine Physicians of Lenoir County PLLC Emergency Medicine Past Accepting new patients
Emergency Medicine Physicians of Cook County LLC Emergency Medicine Past Accepting new patients

Locations

107 Tremont St
Hopedale, IL 61747
Phone (309) 343-1000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250553600000",
    "number": "1689637217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21276 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731212",
            "telephone_number": "877-485-4474"
        },
        {
            "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": "616034307",
            "telephone_number": "309-672-5522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "ELSBURGH",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-06",
        "last_updated": "2009-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036103700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00196870",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "36103700",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036103700",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.