Organization Active NPI

Cardinal Medical Group, LTD.

  • Multi-Specialty Clinic/Center
  • Peoria, IL
National Provider Identifier
1992829485
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
CARDINAL MEDICAL GROUP, LTD.
Practice address
6339 N Big Hollow Rd
Peoria, IL 61615-2907
Phone
(309) 693-3315
Fax
(309) 693-9385
NPI assigned
Mar 19, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Michael A Shadley
Title
Administrator
Phone
(309) 693-8611

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X IL Primary

Addresses

Primary practice location

6339 N Big Hollow Rd
Peoria, IL 61615-2907

Mailing address

6339 N Big Hollow Rd
Peoria, IL 61615-2907
Phone (309) 693-3315

National Provider Directory

National Provider Directory

Locations (25 of 102)

2 Saint Anthonys Way
Alton, IL 62002
Phone (618) 462-2222

710 College Ave
Alton, IL 62002

1001 Rivian Mtwy
Bloomington, IL 61705
Phone (309) 828-0806

1001 Rivian Mtwy
Ste 1100
Bloomington, IL 61705

1003 N Rivian Mtwy
Bloomington, IL 61705

210 Saint Joseph Dr
Ste 2
Bloomington, IL 61701

302 Saint Joseph Dr
Bloomington, IL 61701
Phone (309) 662-5361

508 Iaa Dr
Bloomington, IL 61701
Phone (309) 451-2080

7945 S Harlem Ave
Burbank, IL 60459
Phone (708) 907-4355

7601 S Cicero Ave
Unit P0A
Chicago, IL 60652

311 N 4th St
Chillicothe, IL 61523
Phone (309) 274-4336

707 N Logan Ave
#1267
Danville, IL 61832

707 N Logan Ave
Ste 102
Danville, IL 61832

800 N Logan Ave
Danville, IL 61832
Phone (217) 431-4080

812 N Logan Ave
#12627
Danville, IL 61832

812 N Logan Ave
Ste 130
Danville, IL 61832

102 S Hennepin Ave
Ste 102
Dixon, IL 61021

102 S Hennepin Ave
Ste 103
Dixon, IL 61021
Phone (815) 284-7733

102 S Hennepin Ave
Ste 130
Dixon, IL 61021

215 E 1st St
#215
Dixon, IL 61021
Phone (815) 209-7270

215 E 1st St
Ste 105
Dixon, IL 61021
Phone (815) 285-5603

215 E 1st St
Ste 121
Dixon, IL 61021

215 E 1st St
Ste 212
Dixon, IL 61021
Phone (815) 285-5843

215 E 1st St
Ste 310
Dixon, IL 61021
Phone (815) 285-5801

215 E 1st St
Ste 326
Dixon, IL 61021
Phone (815) 285-5800

Practitioners & affiliated clinicians

Practitioners 1,272

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 1,272

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992829485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6339 N BIG HOLLOW RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616152907",
            "telephone_number": "309-693-3315",
            "fax_number": "309-693-9385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6339 N BIG HOLLOW RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616152907",
            "telephone_number": "309-693-3315",
            "fax_number": "309-693-9385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDINAL MEDICAL GROUP, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHADLEY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "309-693-8611",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.