NPIMap

Individual provider Active NPI

Alexa Miller

  • Family Medicine Physician
  • Eureka, IL
National Provider Identifier
1831610898
Registry record updated Aug 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036151215 Issued in IL
Practice address
105 S Major St
Eureka, IL 61530-1246
Phone
(309) 467-4691
Fax
(309) 467-6229
NPI assigned
Jun 29, 2017
Last updated
Aug 10, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X 036151215 IL Primary

Addresses

Primary practice location

105 S Major St
Eureka, IL 61530-1246

Mailing address

611 W Park St
Fapc
Urbana, IL 61801

Other identifiers 1

IdentifierTypeStateIssuer
125.071480OtherLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200522000809 IL Practitioner - Family Practice 2062833304 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lincoln Memorial University Medical Department, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

815 Main St
Suite a
Peoria, IL 61602-1080
Phone (309) 672-4977

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036151215ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carle Health Medical Group Family Medicine CurrentSince Oct 4, 2025 Accepting new patients
Methodist Medical Center of Illinois CurrentSince Oct 1, 2025 Accepting new patients
Carle Eureka Hospital Current Accepting new patients
Methodist Medical Center of Illinois Family Medicine CurrentSince Oct 1, 2025 Accepting new patients
Carle West Physician Group Inc Family Medicine CurrentSince Jul 1, 2020 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Jul 1, 2020 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Advocate Health & Hospitals Corporation CurrentSince Jul 1, 2020 Accepting new patients
Methodist Medical Center of Illinois Current Accepting new patients
Carle Health Care Incorporated Past Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

2204 Eastland Dr
Bloomington, IL 61704
Phone (309) 662-9461

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

105 S Major St
Eureka, IL 61530
Phone (309) 467-2371

221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281

3915 Barring Trce
Peoria, IL 61615
Phone (309) 689-3030

815 Main St
Ste A
Peoria, IL 61602
Phone (309) 671-3000

1120 E War Memorial Dr
Peoria Hts, IL 61616
Phone (309) 685-1774

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1498694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597017600000",
    "number": "1831610898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W PARK ST",
            "address_2": "FAPC",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "61801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 S MAJOR ST",
            "city": "EUREKA",
            "state": "IL",
            "postal_code": "615301246",
            "telephone_number": "309-467-4691",
            "fax_number": "309-467-6229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "ALEXA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-29",
        "last_updated": "2020-08-10",
        "certification_date": "2020-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036151215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "125.071480",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eureka, IL

Sources for this page

Verify at the official NPI Registry.