Central Illinois Endoscopy Center, LLC

Primary specialty

Endoscopy Clinic/CenterTaxonomy code 261QE0800X

Legal business name

CENTRAL ILLINOIS ENDOSCOPY CENTER, LLC

Doing business as

Central Illinois Endoscopy Center

Practice address

1001 Main St
Ste 530
Peoria, IL 61606-1907

Phone

(309) 495-1144

NPI assigned

Feb 5, 2009

Last updated

Feb 5, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Catherine Emanuel

Title

Secretary/Treasurer

Phone

(309) 672-4846

Specialties & licenses 1

Addresses

Other names 1

• Central Illinois Endoscopy Center Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Listed as

Central Illinois Endoscopy Center LLCCCN 14C0001140

Medicare certification status

ActiveFrom the Provider of Services file

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Methodist Medical Center of Illinois

  • Emergency Care Clinic/Center
  • Peoria, IL
  • NPI 1265966048

  Member Of

  NPD member

Locations

Practitioners 3

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.

• Eliathamby Kuganeswaran, M.D.

  • Gastroenterology Physician
  • Peoria, IL
  • NPI 1073555488
  NPD (past)
• Maureen A Lillich, M.D.

  • Gastroenterology Physician
  • Peoria, IL
  • NPI 1497796700
  NPD (past)
• Abdullah Al-Rashdan, M.D.

  • Gastroenterology Physician
  • Memphis, TN
  • NPI 1588831721
  NPD (past)

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

{
    "created_epoch": "1233792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233792000000",
    "number": "1790924306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 MAIN ST",
            "address_2": "STE 530",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616061907",
            "telephone_number": "309-495-1144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 MAIN ST",
            "address_2": "STE 530",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616061907",
            "telephone_number": "309-495-1144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL ILLINOIS ENDOSCOPY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-05",
        "last_updated": "2009-02-05",
        "status": "A",
        "authorized_official_last_name": "EMANUEL",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_title_or_position": "SECRETARY/TREASURER",
        "authorized_official_telephone_number": "309-672-4846",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QE0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Endoscopy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Central Illinois Endoscopy Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Center for Pain Management & Rehab S. C .
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• Central Illinois Friends of Pwa, Inc.
• Central Illinois Friends of Pwa, Inc. (Central Illinois Friends)
• Central Illinois Friends of Pwa, Inc.
• Central Illinois Nerve Testing LTD

• Endoscopy Clinic/Center in Peoria, IL
• Providers in Peoria, IL by specialty
• Endoscopy Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.