Individual provider Active NPI

Leela Dhanekula, M.D.

  • Clinical Cardiac Electrophysiology Physician
  • Peoria, IL
National Provider Identifier
1801826938
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
036094358 Issued in IL
Practice address
5405 N Knoxville Ave
Peoria, IL 61614-5016
Phone
(309) 691-4410
NPI assigned
Jul 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036094358 IL
Cardiovascular Disease Physician 207RC0000X 036094358 IL
Computed Tomography Radiologic Technologist 2471C3401X 036094358 IL
Clinical Cardiac Electrophysiology Physician 207RC0001X 036094358 IL Primary

Addresses

Primary practice location

5405 N Knoxville Ave
Peoria, IL 61614-5016

Mailing address

5405 N Knoxville Ave
Peoria, IL 61614-5016
Phone (309) 691-4410

Other identifiers 1

IdentifierTypeStateIssuer
036094358MedicaidIL

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
I20050224000606 IL Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology) 2163475674 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiac ElectrophysiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

444 Roxbury Rd
Rockford, IL 61107-5059
Phone (815) 398-3000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036094358ILMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Multi-Specialty Group Internal Medicine CurrentSince Jan 1, 2016 Accepting new patients

Locations

1505 Eastland Dr
Ste 110
Bloomington, IL 61701
Phone (309) 662-8231

1 Kish Hospital Dr
DeKalb, IL 60115
Phone (815) 754-1521

1401 E 12th St
Mendota, IL 61342
Phone (815) 539-7461

610 Park Ave
Pekin, IL 61554
Phone (309) 346-7776

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

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

5405 N Knoxville Ave
Peoria, IL 61614
Phone (309) 691-4410

444 Roxbury Rd
#12471
Rockford, IL 61107

444 Roxbury Rd
Rockford, IL 61107
Phone (815) 395-9196

1850 Gateway Dr
Sycamore, IL 60178
Phone (815) 217-3252

Organizations & group practices 2

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740528000000",
    "number": "1801826938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5405 N KNOXVILLE AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145016",
            "telephone_number": "309-691-4410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5405 N KNOXVILLE AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145016",
            "telephone_number": "309-691-4410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DHANEKULA",
        "first_name": "LEELA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036094358",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036094358",
            "primary": false
        },
        {
            "code": "2471C3401X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Computed Tomography",
            "state": "IL",
            "license": "036094358",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "IL",
            "license": "036094358",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036094358",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.