Individual provider Active NPI

Abdul Rehman Sozzer, D.O.

  • Diagnostic Radiology Physician
  • Peoria, IL
National Provider Identifier
1922413111
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
036-147612 Issued in IL
Practice address
530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone
(309) 655-6384
Fax
(309) 655-7732
NPI assigned
Jun 25, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125065248 IL
Diagnostic Radiology Physician 2085R0202X DO-05343 IA
Diagnostic Radiology Physician 2085R0202X 036-147612 IL Primary

Addresses

Primary practice location

530 NE Glen Oak Ave
Peoria, IL 61637-0001

Mailing address

111 Oakwood Rd
East Peoria, IL 61611-1853
Phone (309) 740-4272

Other practice location 1

200 Hawkins Dr
Iowa City, IA 52242
Phone (319) 356-1616

Other practice location 2

530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone (309) 655-6384

Other practice location 3

105 E 9th St
Coralville, IA 52241-2209
Phone (319) 467-2000

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
I20200731000535 IL Practitioner - Diagnostic Radiology 1951622703 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Illinois Radiological Associates LTDGroup PAC ID 9436061827, 205 clinicians
Cira Michigan PCGroup PAC ID 7113355264, 89 clinicians
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

111 Oakwood Rd
East Peoria, IL 61611-1853
Phone (309) 740-4272

21 W624 Dorchester CT
Glen Ellyn, IL 60137-6412
Phone (906) 786-5707

8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050

Hospital & facility affiliations

  • Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067
  • Osf Saint Elizabeth MDL Ctr Hospital, Peru, IL, CCN 140110
  • Osf Saint Clare Medical Center Hospital, Princeton, IL, CCN 141337
  • St Joseph Medical Center Hospital, Bloomington, IL, CCN 140162
  • Saint James Hospital Hospital, Pontiac, IL, CCN 140161

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125065248ILMDInternal Medicine Physician
DO-05343IAMDDiagnostic Radiology Physician
036-147612ILMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central PA Pharmacy LLC. Current Accepting new patients
Central Illinois Radiological Associates, LTD. Diagnostic Radiology CurrentSince Dec 6, 2025 Accepting new patients
Osf Multi-Specialty Group Internal Medicine CurrentSince Aug 20, 2025 Accepting new patients
Cira Michigan PC Diagnostic Radiology CurrentSince Jan 1, 2026 Accepting new patients

Locations

5200 Reliable Pkwy
Chicago, IL 60686
Phone (309) 671-8748

12701 W 143rd St
Lockport, IL 60491
Phone (708) 364-6337

530 NE Glen Oak Ave
Peoria, IL 61637
Phone (309) 655-2553

530neglen Oak Ave
Peoria, IL 61636
Phone (309) 685-1054

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

111 Oakwood Rd
Peoria, IL 61611
Phone (586) 412-4144

Organizations & group practices 4

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 4

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": "1403654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1922413111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 OAKWOOD RD",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616111853",
            "telephone_number": "309-740-4272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616370001",
            "telephone_number": "309-655-6384",
            "fax_number": "309-655-7732"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Hawkins Dr",
            "address_purpose": "LOCATION",
            "city": "Iowa City",
            "state": "IA",
            "postal_code": "52242",
            "country_code": "US",
            "telephone_number": "319-356-1616",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "530 NE Glen Oak Ave",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "IL",
            "postal_code": "616370001",
            "country_code": "US",
            "telephone_number": "309-655-6384",
            "fax_number": "309-655-7732",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "105 E 9th St",
            "address_purpose": "LOCATION",
            "city": "Coralville",
            "state": "IA",
            "postal_code": "522412209",
            "country_code": "US",
            "telephone_number": "319-467-2000",
            "fax_number": "319-467-2410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOZZER",
        "first_name": "ABDUL",
        "middle_name": "REHMAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-25",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125065248",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IA",
            "license": "DO-05343",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036-147612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.