Antoine Dawalibi, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Practice address

6831 N Peartree LN
Peoria, IL 61615-2400

Phone

(309) 691-1250

NPI assigned

Jul 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in IL

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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

• Methodist Medical Center of Illinois

  • Rehabilitation Hospital Unit
  • Peoria, IL
  • NPI 1982656575
  Medicare reassignment NPD
• Proctor Health Systems

  • Family Medicine Physician
  • Peoria, IL
  • NPI 1134173917
  Medicare reassignment NPD
• Methodist Medical Center of Illinois

  • General Acute Care Hospital
  • Peoria, IL
  • NPI 1164474755
  NPD
• Methodist Medical Center of Illinois

  • Family Medicine Physician
  • Peoria, IL
  • NPI 1184670663
  NPD
• Proctor Health Systems

  • Rural Health Clinic/Center
  • Princeville, IL
  • NPI 1356057301

  Family Medicine

  NPD

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982618930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 RELIABLE PKWY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606860001",
            "telephone_number": "309-672-4809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6831 N PEARTREE LN",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616152400",
            "telephone_number": "309-691-1250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAWALIBI",
        "first_name": "ANTOINE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE",
            "identifier": "IL01B5",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PPO",
            "identifier": "7215059",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "472311",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0360962372",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "040290",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Megan Davis
• Molly Kay Davis, DO
• Rachael M Davis, M.D.
• Ronald Edwin Davis, M.D.
• Ryan James Davis, DMD, MS
• Erick Dru Dawalt, PHARM D
• Sophia Corrine Soleil Dawson, LSW, LCSW
• Jacob Day
• Meghan Eileen Day, OTR/L
• Tessa Marie Day, LCSW

• Family Medicine Physician in Peoria, IL
• Providers in Peoria, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.