Individual provider Active NPI

Christina Marie Pica, D.O.

  • Pediatrics Physician
  • Peoria, IL
National Provider Identifier
1750580718
Registry record updated Jul 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
125.053367 Issued in IL
Practice address
St Francis Medical Center, Dept of Pediatrics
530 NE Glen Oak Avenue
Peoria, IL 61637-0001
Phone
(309) 655-2274
NPI assigned
Jul 11, 2007
Last updated
Jul 11, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 125.053367 IL Primary

Addresses

Primary practice location

St Francis Medical Center, Dept of Pediatrics
530 NE Glen Oak Avenue
Peoria, IL 61637-0001

Mailing address

301 W Chestnut St
Fairbury, IL 61739-1415
Phone (314) 452-2146

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
I20110307000518 IL Practitioner - Pediatric Medicine 8426230830 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.053367ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Jan 3, 2017 Accepting new patients
Heartland Community Health Clinic Past Accepting new patients

Locations

3375 N Seminary St
Galesburg, IL 61401
Phone (309) 343-5114

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

530 Neglen Oak Ave
Peoria, IL 61637
Phone (877) 464-6640

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

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1184112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184112000000",
    "number": "1750580718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 W CHESTNUT ST",
            "city": "FAIRBURY",
            "state": "IL",
            "postal_code": "617391415",
            "telephone_number": "314-452-2146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ST FRANCIS MEDICAL CENTER, DEPT OF PEDIATRICS",
            "address_2": "530 NE GLEN OAK AVENUE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616370001",
            "telephone_number": "309-655-2274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICA",
        "first_name": "CHRISTINA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-11",
        "last_updated": "2007-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "125.053367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.