NPIMap

Organization Active NPI

Illinois Centers for Pain and Rehab, SC

  • Family Medicine Physician
  • Pekin, IL
National Provider Identifier
1689860975
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ILLINOIS CENTERS FOR PAIN AND REHAB, SC
Practice address
3400 Griffin Ave
Pekin, IL 61554-6241
Phone
(309) 347-4277
NPI assigned
Sep 20, 2007
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
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

Authorized official

Name
Mr. Volkan Sumer, D.O.NPI 1730185125
Title
Medical Director
Phone
(309) 347-4277

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

3400 Griffin Ave
Pekin, IL 61554-6241

Mailing address

3400 Griffin Ave
Pekin, IL 61554-6241
Phone (309) 347-4277

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040812001091 IL Part B Supplier - Clinic/Group Practice 7618949207 Receives reassigned benefits from 11 practitioners
Practice locations: Pekin, IL

National Provider Directory

National Provider Directory

Locations

3400 Griffin Ave
Pekin, IL 61554
Phone (309) 244-7700

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1190246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1689860975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 GRIFFIN AVE",
            "city": "PEKIN",
            "state": "IL",
            "postal_code": "615546241",
            "telephone_number": "309-347-4277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 GRIFFIN AVE",
            "city": "PEKIN",
            "state": "IL",
            "postal_code": "615546241",
            "telephone_number": "309-347-4277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLINOIS CENTERS FOR PAIN AND REHAB, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-20",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "SUMER",
        "authorized_official_first_name": "VOLKAN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "309-347-4277",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pekin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.