Individual provider Active NPI

Edward C Luan, M.D.

  • Obstetrics & Gynecology Physician
  • Peoria, IL
National Provider Identifier
1770596124
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Practice address
7620 N University St
Suite 108
Peoria, IL 61614-1297
Phone
(309) 692-5600
Fax
(309) 692-5601
NPI assigned
Aug 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X IL Primary

Addresses

Primary practice location

7620 N University St
Suite 108
Peoria, IL 61614-1297

Mailing address

7620 N University St
Suite 108
Peoria, IL 61614-1297
Phone (309) 692-5600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jan 3, 2017 through Jan 3, 2027

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-097805ILMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Edward C Luan MD SC Obstetrics & Gynecology CurrentSince Jul 21, 2003 Accepting new patients

Locations

7620 N University St
Ste 108
Peoria, IL 61614
Phone (309) 692-5600

7620 N University St
Ste 2
Peoria, IL 61614
Phone (309) 692-5600

Organizations & group practices 1

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": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1770596124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7620 N UNIVERSITY ST",
            "address_2": "SUITE 108",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616141297",
            "telephone_number": "309-692-5600",
            "fax_number": "309-692-5601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7620 N UNIVERSITY ST",
            "address_2": "SUITE 108",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616141297",
            "telephone_number": "309-692-5600",
            "fax_number": "309-692-5601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUAN",
        "first_name": "EDWARD",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.