Individual provider Active NPI

Muhammad Jawad Javed, M.D.

  • Neonatal-Perinatal Medicine Physician
  • Peoria, IL
National Provider Identifier
1699807685
Registry record updated Apr 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
036113743 Issued in IL
Practice address
530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone
(309) 634-9811
NPI assigned
Mar 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 01061033A IN
Neonatal-Perinatal Medicine Physician 2080N0001X 036113743 IL Primary

Addresses

Primary practice location

530 NE Glen Oak Ave
Peoria, IL 61637-0001

Mailing address

530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone (309) 634-9811

Other identifiers 1

IdentifierTypeStateIssuer
200908650MedicaidIN

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
I20081023000694 IL Practitioner - Pediatric Medicine 6103984844 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036113743ILMDNeonatal-Perinatal Medicine Physician
01061033AINMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Osf Multi-Specialty Group CurrentSince Sep 1, 2021 Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Mar 1, 2014 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Board of Trustees of the University of Illinois CurrentSince Mar 1, 2014 Accepting new patients
Osf Multi-Specialty Group CurrentSince Sep 1, 2021 Accepting new patients

Locations

7694 Solutions Ctr
Chicago, IL 60677

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

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

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

530 NE Glen Oak Ave
Peoria, IL 61637
Phone (309) 655-2553

Organizations & group practices 6

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": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240099200000",
    "number": "1699807685",
    "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": "616370001",
            "telephone_number": "309-634-9811"
        },
        {
            "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": "616370001",
            "telephone_number": "309-634-9811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAVED",
        "first_name": "MUHAMMAD",
        "middle_name": "JAWAD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-12",
        "last_updated": "2009-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "IN",
            "license": "01061033A",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "IL",
            "license": "036113743",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200908650",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.