Internal Medicine Group of Peoria SC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

INTERNAL MEDICINE GROUP OF PEORIA SC

Practice address

200 E Pennsylvania Ave
Ste 105
Peoria, IL 61603-3045

Phone

(309) 655-7888

NPI assigned

Jun 9, 2005

Organization subpart

No

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

Authorized official

Name

James W Bauer, M.D.NPI 1912901711

Title

President

Phone

(309) 655-7888

Specialties & licenses 1

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• James W Bauer, M.D.

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1912901711

  Internal Medicine

  NPD Authorized official
• Dean A Gravlin, M.D.

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1053315861

  Internal Medicine

  NPD

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188950400000",
    "number": "1972507747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E PENNSYLVANIA AVE",
            "address_2": "STE 105",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616033045",
            "telephone_number": "309-655-7888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E PENNSYLVANIA AVE",
            "address_2": "STE 105",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616033045",
            "telephone_number": "309-655-7888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE GROUP OF PEORIA SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-09",
        "last_updated": "2007-09-05",
        "status": "A",
        "authorized_official_last_name": "BAUER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "309-655-7888",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Institute of Physical and Medicine Rehabilitation
• Institute of Physical Medicine and Rehabilitation
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• Integrated Wellness
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• Umair Iqbal, M.D.
• Iris Home Health Services LLC
• John Michael Irish, MD
• Ironwood Counseling, LLC
• Tayyaba Irshad, M.D.

• All providers in Peoria, IL
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2007; 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.