NPIMap

Organization Active NPI

Heart of Illinois Obstetrics and Gynecology, S.C.

  • Obstetrics & Gynecology Physician
  • Bloomington, IL
National Provider Identifier
1942592118
Registry record updated Dec 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
036068939 Issued in IL
Legal business name
HEART OF ILLINOIS OBSTETRICS AND GYNECOLOGY, S.C.
Practice address
1505 Eastland Dr Ste 2200
Bloomington, IL 61701-7910
Phone
(309) 454-3456
Fax
(309) 454-6977
NPI assigned
May 6, 2011
Last updated
Dec 15, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2025

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

Authorized official

Name
Melissa G Georgas
Title
Practice Manager
Phone
(309) 838-6748

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 036068939 IL Primary

Addresses

Primary practice location

1505 Eastland Dr Ste 2200
Bloomington, IL 61701-7910

Mailing address

1505 Eastland Dr Ste 2200
Bloomington, IL 61701-7910
Phone (309) 454-3456

Other identifiers 6

IdentifierTypeStateIssuer
004750OtherHEALTH ALLIANCE
036068939MedicaidIL
1255700316OtherILABIGAIL CERVANTES NPI
557210OtherMEDICARE PTAN
1750321667OtherGENEVA A. PETERSEN NPI
1548206519OtherHAROLD NORD INDIVIDUAL NPI

Other names 1

  • Harold A. Nord Obstetrics and Gynecology, S.C. Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110810000593 IL Part B Supplier - Clinic/Group Practice 7416126313 Receives reassigned benefits from 6 practitioners
Practice locations: Bloomington, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1304640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765756800000",
    "number": "1942592118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 EASTLAND DR STE 2200",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617017910",
            "telephone_number": "309-454-3456",
            "fax_number": "309-454-6977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 EASTLAND DR STE 2200",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617017910",
            "telephone_number": "309-454-3456",
            "fax_number": "309-454-6977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEART OF ILLINOIS OBSTETRICS AND GYNECOLOGY, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-06",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A",
        "authorized_official_last_name": "GEORGAS",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "309-838-6748"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036068939",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "004750",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036068939",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ABIGAIL CERVANTES NPI",
            "identifier": "1255700316",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "557210",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GENEVA A. PETERSEN NPI",
            "identifier": "1750321667",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HAROLD NORD INDIVIDUAL NPI",
            "identifier": "1548206519",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Harold A. Nord Obstetrics and Gynecology, S.C.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Bloomington, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.