OSF MULTI-SPECIALTY GROUP (NPI# 1124585534) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1124585534 |
Entity Type | Organization |
Organization Name | OSF MULTI-SPECIALTY GROUP |
Practice Address |
5209 W. War Memorial Drive Grand Prairie Mall Peoria IL 61615-9250 |
Practice Telephone | 3093085100 |
Practice Fax Number | 3093085103 |
Mailing Telephone | 3093085100 |
Mailing Fax Number | 3093085103 |
Enumeration Date | 2019-02-22 |
Last Update Date | 2019-02-22 |
Authorized Official Name | AMY M. KRANTZ (MANAGER STRATEGIC REIMBURSEMENT) |
Authorized Official Telephone | 3096552865 |
Is Organization Subpart | Y |
Parent Organization Name | OSF HEALTHCARE SYSTEM |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 332900000X | Non-Pharmacy Dispensing Site | Suppliers |
Other Name | Type Code |
---|---|
OSF Multi-Specialty Group Urgo Peoria Grand Prairie | Other Name - Individual/Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1497398648 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 853 W Jackson Plaza, Morton, IL 61550 | 2019-10-21 |
1902449382 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 1730 Bradford Ln, Normal, IL 61761-1297 | 2019-10-18 |
1215494620 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 3653 N Vermilion Dr, Danville, IL 61832 | 2019-02-22 |
1306303714 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 520 N Cunningham Avenue, 5 Points Shopping Center, Urbana, IL 61802 | 2019-02-22 |
1871050237 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 508 Iaa Dr, Bloomington, IL 61701-2216 | 2019-02-21 |
1518424969 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 2901 Columbus St, Ottawa, IL 61350-1009 | 2019-02-21 |
1083180830 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 2718 N Prospect Avenue, Champaign, IL 61822 | 2018-10-19 |
1548736390 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 133 Spinder Drive Ste 4015, East Peoria, IL 61611 | 2018-10-19 |
1831665611 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 211 Greenbriar Dr, Normal, IL 61761-2287 | 2018-10-18 |
1396211272 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 1715 N Division St Ste 4d5e, Morris, IL 60450-3100 | 2018-10-18 |
Street Address |
5209 W. WAR MEMORIAL DRIVE GRAND PRAIRIE MALL |
City | PEORIA |
State | IL |
Zip Code | 61615-9250 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1124627906 | Lance Jay Bucher | Occupational Therapist | 8600 Il-91, Peoria, IL 61615 | 2020-10-22 |
1093327496 | Angela Mitchell | Speech-Language Pathologist | 3903 W Ridgeview Dr, Peoria, IL 61615 | 2020-08-18 |
1578110680 | Emily E Buenting | Audiologist | 8600 Il Route 91, Suite 300, Peoria, IL 61615 | 2019-08-22 |
1730655572 | Sylwia M. Budzik | Physician Assistant | 8600 Illinois Rt. 91, Suite 300, Peoria, IL 61615 | 2018-10-19 |
1487169207 | Heather Hart | Registered Nurse | 9016 N. Scrimshaw Dr. Apt 104, Peoria, IL 61615 | 2017-12-04 |
1528586849 | Leanne Runyon | Speech-Language Pathologist | 10723 Collett Dr., Peoria, IL 61615 | 2017-09-07 |
1467974196 | Elizabeth A Mcleod | Nurse Practitioner | 8600 Illinois Route 91, Suite 130, Peoria, IL 61615 | 2017-07-14 |
1790223022 | Janet Warner | Counselor | 8914 North Prarie Court, Peoria, IL 61615 | 2017-02-07 |
1437524022 | Brooke Bisping | Dietitian, Registered | 7610 North Orange Prairie Road, Peoria, IL 61615 | 2015-12-08 |
1003292111 | Crystal Ann Casper | Dietitian, Registered | 7610 N Orange Prarie Road, Peoria, IL 61615 | 2015-07-31 |
Find all providers in zip 61615 |
Taxonomy Code | 332900000X |
Grouping | Suppliers |
Classification | Non-Pharmacy Dispensing Site |
A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1770125387 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 5901 N Prospect Rd, Peoria, IL 61614-4358 | 2019-10-15 |
1063986511 | Zjrd, LLC | Non-Pharmacy Dispensing Site | 13090 N 94th Dr Ste 212, Peoria, AZ 85381-4258 | 2019-01-17 |
1982170734 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 10408 N Centerway Dr Ste Cde, Peoria, IL 61615-1234 | 2018-10-19 |
1194138545 | The Pain Center of Arizona, PC | Non-Pharmacy Dispensing Site | 9401 W Thunderbird Rd, Suite 180, Peoria, AZ 85381-4233 | 2014-06-03 |
1396156139 | Banner Health | Non-Pharmacy Dispensing Site | 13640 N Plaza Del Rio Blvd, 3rd Floor, Suite 350, Peoria, AZ 85381-4846 | 2014-05-14 |
1932442928 | Afc of Peoria, Pllc | Non-Pharmacy Dispensing Site | 15256 N 75th Ave, Suite 360, Peoria, AZ 85381-4760 | 2013-03-28 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013520113 | Pmr Illinois Holding, LLC | Non-Pharmacy Dispensing Site | 600 E Sibley Blvd, Dolton, IL 60419-2599 | 2020-08-28 |
1386255123 | Dermatology Associates Ltd | Non-Pharmacy Dispensing Site | 13401 S Ridgeland Ave, Palos Heights, IL 60463-1898 | 2020-08-14 |
1497398648 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 853 W Jackson Plaza, Morton, IL 61550 | 2019-10-21 |
1902449382 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 1730 Bradford Ln, Normal, IL 61761-1297 | 2019-10-18 |
1073173134 | Shobhana Patodia | Non-Pharmacy Dispensing Site | 1111 Superior St Ste 206, Melrose Park, IL 60160-4156 | 2019-06-19 |
1215494620 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 3653 N Vermilion Dr, Danville, IL 61832 | 2019-02-22 |
1306303714 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 520 N Cunningham Avenue, 5 Points Shopping Center, Urbana, IL 61802 | 2019-02-22 |
1871050237 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 508 Iaa Dr, Bloomington, IL 61701-2216 | 2019-02-21 |
1518424969 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 2901 Columbus St, Ottawa, IL 61350-1009 | 2019-02-21 |
1386118057 | Derick Dermatology, LLC | Non-Pharmacy Dispensing Site | 263 Shuman Boulevard, Suite 125, Naperville, IL 60563 | 2019-01-16 |
Find all providers with the same taxonomy |
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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.