Individual provider Active NPI

Steven R Evelhoch, MD

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Peoria, IL
National Provider Identifier
1972667160
Registry record updated Apr 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
036170882 Issued in IL
Practice address
530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone
(309) 624-4012
Fax
(309) 624-3323
NPI assigned
Dec 21, 2006
Last updated
Apr 14, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2026

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

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 58017 MN
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 43784 TN
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 036170882 IL Primary
Otolaryngology Physician 207Y00000X 42940-20 WI
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 9125 TN
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X S16 MN
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 08452 IA
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 37013 IA
Plastic and Reconstructive Surgery Physician 2086S0122X 37013 IA
Plastic and Reconstructive Surgery Physician 2086S0122X 43784 TN
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 3558 WI

Addresses

Primary practice location

530 NE Glen Oak Ave
Peoria, IL 61637-0001

Mailing address

530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone (309) 624-4012

Other practice location 1

752 N High Point Rd
Madison, WI 53717
Phone (608) 824-4000

Other practice location 2

855 Mankato Ave
Winona, MN 55987-4868
Phone (507) 454-3680

Other practice location 3

545 E Johnson St
Fond Du Lac, WI 54935-2856
Phone (920) 924-9090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MN, IL3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20050301000429 WI Practitioner - Maxillofacial SurgeryPractitioner - Oral SurgeryPractitioner - Emergency Medicine 0143273201 Reassigns benefits to 2 organizations
I20070220000585 MN Practitioner - Oral SurgeryPractitioner - Maxillofacial SurgeryPractitioner - Dentist 0143273201 Reassigns benefits to 2 organizations
I20130522000164 IL Practitioner - Plastic and Reconstructive SurgeryPractitioner - Maxillofacial Surgery 0143273201 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive SurgeryAlso: Maxillofacial Surgery
Education
Creighton University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone (309) 655-2000

530 Neglen Oak Ave
Peoria, IL 61637-0001
Phone (309) 624-8818

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

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3558WIMDChiropractor
08452IAMDOral and Maxillofacial Surgery (Dentist)
9125TNMDOral and Maxillofacial Surgery (Dentist)
036170882ILMDOral & Maxillofacial Surgery (D.M.D.)
S16MNMDOral & Maxillofacial Surgery (D.M.D.)
43784TNMDOral & Maxillofacial Surgery (D.M.D.)

Practice roles

OrganizationSpecialtyStatusNew patients
MCHS Hospitals Inc CurrentSince Mar 1, 2018 Accepting new patients
Minnesota Oral and Facial Surgery PLLC Oral and Maxillofacial Surgery CurrentSince Aug 1, 2025 Accepting new patients
Winona Health Services CurrentSince Jul 29, 2013 Accepting new patients
MCHS Hospitals Inc CurrentSince Mar 1, 2018 Accepting new patients
Karen Potaczek, D.D.S., P.C. Oral & Maxillofacial Surgery Past Accepting new patients
Allendale County Hospital Board Past Accepting new patients
Dental Associates LTD of Wisconsin Oral and Maxillofacial Surgery Past Accepting new patients
Dental Assosiates Past Accepting new patients
Renew Cosmetic and Reconstructive Surgery, PC Plastic and Reconstructive Surgery PastSince Mar 20, 2008 Accepting new patients
Illinios Valley Oral Surgeons, P.C. Past Accepting new patients
Lakes Regional Oral & Maxillofacial Surgery, PC Oral and Maxillofacial Surgery PastSince Feb 14, 2008 Accepting new patients
Oral & Maxillofacial Surgery Assoc PC Past Accepting new patients

Locations

2380 Troop Dr
Unit 202
Sartell, MN 56377
Phone (320) 257-9555

855 Mankato Ave
Winona, MN 55987
Phone (507) 454-3680

1000 Starr Ave
Eau Claire, WI 54703
Phone (715) 858-4850

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

1000 N Oak Ave
Ste 100
Marshfield, WI 54449
Phone (715) 221-8718

900 Illinois Ave
Stevens Point, WI 54481
Phone (715) 342-7500

Organizations & group practices 15

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776124800000",
    "number": "1972667160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616370001",
            "telephone_number": "309-624-4012",
            "fax_number": "309-624-3323"
        },
        {
            "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": "309-624-4012",
            "fax_number": "309-624-3323"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "752 N High Point Rd",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "53717",
            "country_code": "US",
            "telephone_number": "608-824-4000",
            "fax_number": "608-824-4868",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "855 Mankato Ave",
            "address_purpose": "LOCATION",
            "city": "Winona",
            "state": "MN",
            "postal_code": "559874868",
            "country_code": "US",
            "telephone_number": "507-454-3680",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "545 E Johnson St",
            "address_purpose": "LOCATION",
            "city": "Fond Du Lac",
            "state": "WI",
            "postal_code": "549352856",
            "country_code": "US",
            "telephone_number": "920-924-9090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVELHOCH",
        "first_name": "STEVEN",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2026-04-14",
        "certification_date": "2026-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MN",
            "license": "58017",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "TN",
            "license": "43784",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "IL",
            "license": "036170882",
            "primary": true
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WI",
            "license": "42940-20",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TN",
            "license": "9125",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "MN",
            "license": "S16",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IA",
            "license": "08452",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "IA",
            "license": "37013",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "IA",
            "license": "37013",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "TN",
            "license": "43784",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WI",
            "license": "3558",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.