Methodist Medical Center of Illinois

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

METHODIST MEDICAL CENTER OF ILLINOIS

Practice address

223 E Main St
Princeville, IL 61559

Phone

(309) 385-4371

Fax

(309) 385-2695

NPI assigned

May 11, 2010

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 2

Addresses

Other names 1

• Methodist Medical Group at Princeville Doing business as

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

{
    "created_epoch": "1273536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581638400000",
    "number": "1942528310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 RELIABLE PKWY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606860001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 E MAIN ST",
            "city": "PRINCEVILLE",
            "state": "IL",
            "postal_code": "61559",
            "telephone_number": "309-385-4371",
            "fax_number": "309-385-2695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METHODIST MEDICAL CENTER OF ILLINOIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-11",
        "last_updated": "2020-02-14",
        "certification_date": "2020-02-14",
        "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": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Methodist Medical Group at Princeville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jodie Anne Loesch, RN
• Ashley Irene Lynn, APN
• Dana Mareachen, M.S. CCC-SLP
• Kathleen Martin, F.N.P.
• Methodist Medical Center of Illinois
• Robert Joseph Peters, LCSW
• Princeville Cu SCH Dist 326
• Princeville Pharmacy LLC
• Proctor Health Systems
• Monica Martha Pulley

• Family Medicine Physician in Princeville, IL
• Providers in Princeville, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 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.