Mid-Central Ill Gastro

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

Legal business name

MID-CENTRAL ILL GASTRO

Practice address

2200 Jacobssen Dr
Suite B
Normal, IL 61761-5516

Phone

(309) 451-1123

Fax

(309) 451-1212

NPI assigned

Feb 7, 2007

Last updated

Aug 28, 2008By 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

Stephen S Matter, M.D.NPI 1134228224

Title

President

Phone

(309) 451-1123

Specialties & licenses 1

Addresses

Other names 1

• Mid-Central ILL Gast LTD Other name

Locations

Practitioners 1

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.

• Stephen S Matter, M.D.

  • Gastroenterology Physician
  • Normal, IL
  • NPI 1134228224
  Authorized official Same address or phone

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219881600000",
    "number": "1992845358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 JACOBSSEN DR",
            "address_2": "SUITE B",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617615516",
            "telephone_number": "309-451-1123",
            "fax_number": "309-451-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 JACOBSSEN DR",
            "address_2": "SUITE B",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617615516",
            "telephone_number": "309-451-1123",
            "fax_number": "309-451-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-CENTRAL ILL GASTRO",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2008-08-28",
        "status": "A",
        "authorized_official_last_name": "MATTER",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "309-451-1123",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mid-Central ILL Gast LTD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jana S Mercado, LCSW
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• Regina Lynn Meyer, PH.D.
• Michele M Carroll
• Mid-Illinois Hematology Oncology Associates LTD
• Midwest Allergy Sinus Asthma S.C.
• Angela Marie Mier, SLP
• John Migas, M.D.
• Dawn M Miller, SPEECH THERAPIST

• Gastroenterology Physician in Normal, IL
• Providers in Normal, IL by specialty
• Gastroenterology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2008; 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.