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Osf Healthcare System

Organization Active NPI Family Medicine Physician · Henry, IL

NPI 1982311627 · NPPES record last updated Mar 18, 2024

Key facts

NPI
1982311627
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
OSF HEALTHCARE SYSTEM
Practice address
327 Edward St
Henry, IL 61537-1539
Phone
(309) 364-2002
NPI assigned
Nov 2, 2022
Organization subpart
No

Authorized official

Name
Robert C Sehring
Title
Chief Executive Officer
Phone
(309) 655-2850

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Corporate family (same tax ID) 49

Organizations that report the same tax identification number in the National Provider Directory.

View all 49

Practitioners 13

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20070503000249 IL Part B Supplier - Clinic/Group Practice 4284541806 Receives reassigned benefits from 99 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Monmouth, IL; Roseville, IL; Princeton, IL; Henry, IL

National Provider Directory

Tax ID family
Eastland Med Plaza Surg (50 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207Q00000X Yes

Addresses

Primary practice location

327 Edward St
Henry, IL 61537-1539

Mailing address

124 SW Adams St
Peoria, IL 61602-1308
Phone (309) 655-2850

Other identifiers

IdentifierTypeStateIssuer
999MedicaidIL

Other names

  • OSF Healthcare - Medical Group Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 18, 2024.

{
    "created_epoch": "1667347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710720000000",
    "number": "1982311627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 SW ADAMS ST",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616021308",
            "telephone_number": "309-655-2850",
            "fax_number": "309-655-4878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "327 EDWARD ST",
            "city": "HENRY",
            "state": "IL",
            "postal_code": "615371539",
            "telephone_number": "309-364-2002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OSF HEALTHCARE SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-02",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A",
        "authorized_official_last_name": "SEHRING",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "309-655-2850"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "999",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OSF Healthcare - Medical Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "OSF Healthcare - Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Henry, IL

All providers in Henry, IL · Family Medicine Physician in Illinois

Sources for this page

Verify at the official NPI Registry.