Devashish Agarwal, M.D.
Individual provider Active NPI Family Medicine Physician · Peoria, IL
NPI 1841382298 · NPPES record last updated Nov 10, 2011
Key facts
- NPI
- 1841382298
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 036-114850 (IL)
- Practice address
- 1701 W. Garden Street
Peoria, IL 61605 - Phone
- (309) 680-7600
- Fax
- (309) 680-7637
- NPI assigned
- Sep 29, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 22
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Proctor Health Systems
Graham Hospital Association
Practice addresses (Care Compare)
201 N Cummings LN
Washington, IL 61571-2181
Phone (309) 444-3627
209 N Cummings LN
Washington, IL 61571-2181
Phone (309) 643-6185
210 W Walnut St
Canton, IL 61520-2444
Phone (309) 647-5240
5401 N Knoxville Ave
Peoria, IL 61614-5021
Hospital & facility affiliations
- Graham Hospital Association
- Graham Hospital Association
- Genesis Medical Center, Aledo
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20061107000151 | IL | Practitioner - Family Practice |
0648277590 | Reassigns benefits to 6 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-114850 | IL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carle Health Care Incorporated | Family Medicine | Current |
Accepting new patients |
| Genesis Medical Center, Aledo | Current |
Accepting new patients | |
| Proctor Health Systems | Family Medicine | Current |
Accepting new patients |
| Methodist Medical Center of Illinois | Current | Accepting new patients | |
| Genesis Medical Center, Aledo | Current |
Accepting new patients | |
| Proctor Health Systems | Family Medicine | Current |
Accepting new patients |
| Genesis Medical Center, Aledo | Current |
Accepting new patients |
Locations
1007 NW 3rd St
Aledo, IL 61231
Phone (309) 582-3701
409 NW 9th Ave
Aledo, IL 61231
Phone (309) 582-2227
2535 E Washington St
East Peoria, IL 61611
Phone (309) 694-6464
815 Main St
Ste A
Peoria, IL 61602
Phone (309) 672-4986
3915 Barring Trce
Peoria, IL 61615
Phone (309) 689-3030
221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281
815 Main St
Ste A1
Peoria, IL 61602
221 NE Glen Oak Ave
#100
Peoria, IL 61636
5401 N Knoxville Ave
Ste 400
Peoria, IL 61614
Phone (309) 691-6610
1120 E War Memorial Dr
Peoria Hts, IL 61616
Phone (309) 685-1774
611 W Park St
Urbana, IL 61801
Phone (217) 383-6941
Interoperability endpoints
- dagarwalmd388472@carlehiedirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036-114850 | IL | Yes |
Addresses
Primary practice location
1701 W. Garden Street
Peoria, IL 61605
Mailing address
1701 W. Garden Street
Peoria, IL 61605
Phone (309) 680-7600
Other providers in Peoria, IL
- Affiliated Urology Specialists, LTD.
- Affinity Dental Peoria LLC
- Affinity Women'S Health Care, SC
- Affordable Dentures- Peoria, P.C
- Ahmed Mohamed Agameya
- Juanita Rodriguez Aguila-Corrales
- Christopher Chibuike Agusi
- Justin Ahlman
- Benjamin Henry Ahlrichs
- Mansoor Ahmad
All providers in Peoria, IL · Family Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 10, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.