Methodist Medical Center of Illinois

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

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) 672-4887

Fax

(309) 671-2541

NPI assigned

May 23, 2006

Last updated

Dec 13, 2019By 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

Stephen M. Cirone

Title

Regional MGR-Reimb/Rev Recognition

Phone

(309) 672-4813

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576195200000",
    "number": "1821043365",
    "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": "309-672-5522",
            "fax_number": "309-671-2541"
        },
        {
            "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": "309-672-4887",
            "fax_number": "309-671-2541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METHODIST MEDICAL CENTER OF ILLINOIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2019-12-13",
        "certification_date": "2019-12-13",
        "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": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IL",
            "license": "0001594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER NUM.",
            "identifier": "9960",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Methodist Medical Center of Illinois (Carle Health Peoria In School Health Richwoods)
• Methodist Medical Center of Illinois
• Methodist Medical Center of Illinois (Methodist Anesthesia Services)
• Methodist Medical Center of Illinois (MMG In School Health Peoria High)
• Methodist Medical Center of Illinois
• Methodist Medical Center of Illinois
• Susan M Mettille, PA-C
• Ayman Metwaly
• Scott D Metzger, PHARM.D., R.PH.
• Kimberley N Metzloff, P.T.

• Home Health Agency in Peoria, IL
• Providers in Peoria, IL by specialty
• Home Health Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2019; 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.