DR. MARK MONTEFOLKA (NPI# 1114026754) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114026754 |
| Entity Type | Individual |
| Full Name | DR. MARK MONTEFOLKA |
| Credential | MD |
| Practice Address |
1120 E War Memorial Dr Peoria Heights IL 61616 |
| Practice Telephone | 3096850100 |
| Practice Fax Number | 3096850172 |
| Mailing Telephone | 3096850100 |
| Mailing Fax Number | 3096850172 |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 036110139 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | PIN | K09678 | 01 |
| Street Address |
1120 E WAR MEMORIAL DR |
| City | PEORIA HEIGHTS |
| State | IL |
| Zip Code | 61616 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255327631 | Stephen C Doughty | Internal Medicine | 1120 E War Memorial Dr, Peoria Heights, IL 61616-7757 | 2005-09-21 |
| 1629466743 | Lisa Friebohle | Nurse Practitioner | 1120 E War Memorial Dr, Peoria Heights, IL 61616-7757 | 2014-12-23 |
| 1659790350 | Kevin Spangler | Nurse Practitioner | 1120 E War Memorial Dr, Peoria Heights, IL 61616 | 2014-04-09 |
| 1518058619 | James D Ausfahl | Family Medicine | 1120 E War Memorial Dr, Peoria Heights, IL 61616-7757 | 2006-09-27 |
| 1700977667 | Ioan Mosoiu | Family Medicine | 1120 E War Memorial Dr, Peoria Heights, IL 61616-7757 | 2006-09-27 |
| 1932290780 | Josef Unhold | Family Medicine | 1120 E War Memorial Dr, Peoria Heights, IL 61616-7757 | 2006-09-27 |
| 1710078563 | Ronald Sumner | Family Medicine | 1120 E War Memorial Dr, Peoria Heights, IL 61616-7757 | 2006-09-27 |
| 1851482731 | Donald Habecker | Internal Medicine | 1120 E War Memorial Dr, Peoria Heights, IL 61616-7757 | 2006-09-27 |
| 1033200928 | Jumuna Patel | Family Medicine | 1120 E War Memorial Dr, Peoria Heights, IL 61616-7757 | 2006-09-27 |
| 1427149210 | Eldon Samuel | Family Medicine | 1120 E War Memorial Dr, Peoria Heights, IL 61616-7757 | 2006-09-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558748350 | Jennifer Lynn Kroll | Pediatrics | 1317 E Kelly Ave, Peoria Heights, IL 61616 | 2015-04-30 |
| 1649583485 | Aline Azar | Internal Medicine | 1120 E War Memorial Drive, Peoria Heights, IL 61616 | 2010-07-22 |
| 1417137217 | Reza Vakili | Dentist | 4450 N. Prospect Rd, Suite S5, Peoria Heights, IL 61616 | 2007-11-08 |
| 1588700348 | Sandra Kay Chatwood | Counselor | 3709 N Atlantic Ave, Peoria Heights, IL 61616 | 2007-01-29 |
| 1578619524 | Donald B Braunagel | Dentist | 924b F Glen Ave, Peoria Heights, IL 61616 | 2007-01-25 |
| 1417009481 | Jeffrey Scott Whitson | Dentist | 924 E Glen Ave, #b, Peoria Heights, IL 61616 | 2007-01-18 |
| 1003986019 | Sharshon Pharmacy. Inc. | Pharmacy | 4600 N. Prospect Rd., Suite 2, Peoria Heights, IL 61616 | 2006-11-08 |
| 1467683334 | Unlimited Advacare Systems, Inc | Durable Medical Equipment & Medical Supplies | 819 E London Ave, Peoria, IL 61616-1360 | 2009-07-27 |
| 1083759476 | Rose Garden Care Center Inc. | Skilled Nursing Facility | 1629 E Gardner Ln, Peoria Heights, IL 61616-3613 | 2007-02-21 |
| 1699317594 | Aperion Care Peoria Heights LLC | Durable Medical Equipment & Medical Supplies | 1629 E Gardner Ln, Peoria Heights, IL 61616-3613 | 2019-10-11 |
| Find all providers in zip 61616 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518058619 | James D Ausfahl | Family Medicine | 1120 E War Memorial Dr, Peoria Heights, IL 61616-7757 | 2006-09-27 |
| 1700977667 | Ioan Mosoiu | Family Medicine | 1120 E War Memorial Dr, Peoria Heights, IL 61616-7757 | 2006-09-27 |
| 1932290780 | Josef Unhold | Family Medicine | 1120 E War Memorial Dr, Peoria Heights, IL 61616-7757 | 2006-09-27 |
| 1710078563 | Ronald Sumner | Family Medicine | 1120 E War Memorial Dr, Peoria Heights, IL 61616-7757 | 2006-09-27 |
| 1033200928 | Jumuna Patel | Family Medicine | 1120 E War Memorial Dr, Peoria Heights, IL 61616-7757 | 2006-09-27 |
| 1427149210 | Eldon Samuel | Family Medicine | 1120 E War Memorial Dr, Peoria Heights, IL 61616-7757 | 2006-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053911495 | Moataz Barkat | Family Medicine | 3315 W 66th Pl, Chicago, IL 60629-3427 | 2020-10-26 |
| 1558969964 | Nicole Kerner | Family Medicine | 310 Brandy Dr, Mackinaw, IL 61755-9707 | 2020-10-16 |
| 1285232991 | Healthy Medical Inc | Family Medicine | 535 N. East St., Suite A, Bradley, IL 60915 | 2020-10-14 |
| 1558976589 | Jasmine Ashley Fowler | Family Medicine | 2416 N Lotus Ave, Chicago, IL 60639-1435 | 2020-09-15 |
| 1790390805 | Kimberly Hannah Kupferberg | Family Medicine | 1103 Schaeffer Rd, Long Grove, IL 60047-5153 | 2020-09-15 |
| 1194330977 | Home Doctors for You | Family Medicine | 670 Illinois Blvd, Hoffman Est, IL 60169-3363 | 2020-09-09 |
| 1245844489 | Jovita Zalwango Nassolo | Family Medicine | 116 1/2 N Benton St Apt 2d, Woodstock, IL 60098-3272 | 2020-09-04 |
| 1720699176 | Healing Hands Resource Center Streator | Family Medicine | 2128 S Central Park Ave, Chicago, IL 60623-3113 | 2020-08-10 |
| 1417565755 | Ghr Total Health and Consulting | Family Medicine | 11336 Mckenna Dr, Frankfort, IL 60423-8096 | 2020-07-22 |
| 1285251892 | Soe Lwin Oo | Family Medicine | 1625 E 75th St # 1, Chicago, IL 60649-3603 | 2020-06-30 |
| Find all providers with the same taxonomy | ||||
| City | PEORIA HEIGHTS |
| Zip Code | 61616 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.