NPIMap

Organization Active NPI

Methodist Medical Center of Illinois

  • Community Based Hospice Care Agency
  • Peoria, IL
National Provider Identifier
1790737385
Registry record updated Feb 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
0001594 Issued in IL
Legal business name
METHODIST MEDICAL CENTER OF ILLINOIS
Practice address
221 NE Glen Oak Ave
Peoria, IL 61636-0001
Phone
(309) 672-5522
NPI assigned
May 16, 2006
Organization subpart
Yes
Parent organization
METHODIST MEDICAL CENTER OF ILLINOISAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 14, 2020

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

Authorized official

Name
Stephen M. Cirone
Title
Regional MGR-Reimb/Rev Recognition
Phone
(309) 672-4813

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 0001594 IL Primary

Addresses

Primary practice location

221 NE Glen Oak Ave
Peoria, IL 61636-0001

Mailing address

221 NE Glen Oak Ave
Peoria, IL 61636-0001

Other identifiers 1

IdentifierTypeStateIssuer
116OtherILBLUE CROSS NUMBER

National Provider Directory

National Provider Directory
Part of
Methodist Medical Cente

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581638400000",
    "number": "1790737385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616360001"
        },
        {
            "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": "616360001",
            "telephone_number": "309-672-5522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METHODIST MEDICAL CENTER OF ILLINOIS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "METHODIST MEDICAL CENTER OF ILLINOIS",
        "enumeration_date": "2006-05-16",
        "last_updated": "2020-02-14",
        "certification_date": "2020-02-14",
        "status": "A",
        "authorized_official_last_name": "CIRONE",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "REGIONAL MGR-REIMB/REV RECOGNITION",
        "authorized_official_telephone_number": "309-672-4813"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "IL",
            "license": "0001594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS NUMBER",
            "identifier": "116",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.