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Methodist Medical Center of Illinois

Organization Active NPI Rehabilitation Hospital Unit · Peoria, IL

NPI 1982656575 · NPPES record last updated Feb 14, 2020

Key facts

NPI
1982656575
Entity type
Organization (NPI type 2)
Primary specialty
Rehabilitation Hospital Unit 273Y00000X
License
0001594 (IL)
Legal business name
METHODIST MEDICAL CENTER OF ILLINOIS
Practice address
221 NE Glen Oak Ave
Peoria, IL 61636-0001
Phone
(309) 672-4813
NPI assigned
May 16, 2006
Organization subpart
Yes
Parent organization (as reported)
METHODIST MEDICAL CENTER OF ILLINOIS

Authorized official

Name
Stephen Cirone
Title
Regional MGR-Reimb/Rev Recognition
Phone
(309) 672-4813

Other NPIs on the same Medicare enrollment 3

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

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Practitioners 824

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

View all 824

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20031126000494 IL Part B Supplier - Clinic/Group Practice 1355259714 Receives reassigned benefits from 751 practitioners
3 other NPIs on this enrollment

National Provider Directory

Part of
Methodist Medical Cente

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X 0001594 IL Yes

Addresses

Primary practice location

221 NE Glen Oak Ave
Peoria, IL 61636-0001

Mailing address

221 NE Glen Oak Ave
Peoria, IL 61636-0001
Phone (309) 672-5522

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 14, 2020.

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581638400000",
    "number": "1982656575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616360001",
            "telephone_number": "309-672-5522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616360001",
            "telephone_number": "309-672-4813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METHODIST MEDICAL CENTER OF ILLINOIS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "METHODIST MEDICAL CENTER OF ILLINOIS",
        "enumeration_date": "2006-05-16",
        "last_updated": "2020-02-14",
        "certification_date": "2020-02-14",
        "status": "A",
        "authorized_official_last_name": "CIRONE",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "REGIONAL MGR-REIMB/REV RECOGNITION",
        "authorized_official_telephone_number": "309-672-4813"
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "IL",
            "license": "0001594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

All providers in Peoria, IL · Rehabilitation Hospital Unit in Illinois

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