Methodist

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

METHODIST

Practice address

221 NE Glen Oak Ave
Peoria, IL 61636-0001

Phone

(309) 672-5604

NPI assigned

Jun 10, 2020

Organization subpart

No

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

Authorized official

Name

Mr. Christopher Legan, LCPC

Title

PHP Therapist

Phone

(309) 672-5604

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Unitypoint Health Methodist Doing business as

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

{
    "created_epoch": "1591747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591747200000",
    "number": "1811512411",
    "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",
            "telephone_number": "309-672-5604"
        },
        {
            "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": "309-672-5604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METHODIST",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-10",
        "last_updated": "2020-06-10",
        "certification_date": "2020-06-10",
        "status": "A",
        "authorized_official_last_name": "LEGAN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "PHP THERAPIST",
        "authorized_official_telephone_number": "309-672-5604",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCPC",
            "identifier": "180007159",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Unitypoint Health Methodist",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael S Merkley, M.D.
• Maria Meschewski, NP
• Ashley Messmer
• Kelley Marie Messmer, RPH
• Kelly C Messmore, M.S., CCC-SLP/L
• Methodist Medical Center of Illinois
• Methodist Medical Center of Illinois
• Methodist Medical Center of Illinois
• Methodist Medical Center of Illinois
• Methodist Medical Center of Illinois

• Mental Health Counselor in Peoria, IL
• Providers in Peoria, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.