Accolade Healthcare of East Peoria, LLC

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

Legal business name

ACCOLADE HEALTHCARE OF EAST PEORIA, LLC

Practice address

500 Centennial Dr
East Peoria, IL 61611-4912

Phone

(309) 694-9865

NPI assigned

Sep 8, 2022

Last updated

Sep 8, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Moshe Freedman

Title

Manager

Phone

(973) 557-3339

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1662595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662595200000",
    "number": "1982325825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 CENTENNIAL DR",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616114912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 CENTENNIAL DR",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616114912",
            "telephone_number": "309-694-9865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACCOLADE HEALTHCARE OF EAST PEORIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-08",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A",
        "authorized_official_last_name": "FREEDMAN",
        "authorized_official_first_name": "MOSHE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "973-557-3339"
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oxygen Equipment & Supplies (DME) in East Peoria, IL
• Providers in East Peoria, IL by specialty
• Oxygen Equipment & Supplies (DME) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2022; 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.