UNIVERSITY OF ILLINOIS (NPI# 1245203280) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245203280 |
| Entity Type | Organization |
| Organization Name | UNIVERSITY OF ILLINOIS |
| Other Organization Name | MEDICAL SERVICE PLAN AT PEORIA |
| Practice Address |
Department of Psychiatry 221 Ne Glen Oak 7 West Peoria IL 61636-0001 |
| Mailing Address |
1 Illini Dr Peoria IL 61605-2576 |
| Practice Telephone | 3096718222 |
| Mailing Telephone | 3096718503 |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | WILLIAM R NICHOLAS (EXECUTIVE DIRECTOR OF MSP) |
| Authorized Official Telephone | 3124130573 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BCBS | 07215036 | 01 |
| Other Name | Type Code |
|---|---|
| Medical Service Plan at Peoria | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659431351 | University of Illinois | Public Health or Welfare | 2815 W Washington, Suite 300, Springfield, IL 62794-9481 | 2006-12-11 |
| 1861409450 | University of Illinois | Audiologist | 2001 S Oak St Ste B, Champaign, IL 61820-0912 | 2006-08-03 |
| 1962475996 | University of Illinois | Obstetrics & Gynecology | Dept. of Ob / Gyn, 530 Ne Glen Oak, Peoria, IL 61637-0001 | 2006-02-09 |
| 1174596225 | University of Illinois | Pediatrics | 515 Ne Glen Oak Ave, Pediatric Neurology, Peoria, IL 61603-3165 | 2006-02-09 |
| 1568433050 | University of Illinois | Pediatrics | St Jude Midwest Affiliate, 530 Ne Glen Oak, Peoria, IL 61637-0001 | 2006-02-01 |
| 1619948411 | University of Illinois | Pediatrics | Regional Development Center, 507 E Armstrong, Peoria, IL 61603 | 2006-01-30 |
| 1275817249 | University of Illinois | General Acute Care Hospital | 611 W Park St, Carle Forum, Urbana, IL 61801-2500 | 2011-10-07 |
| 1871725028 | University of Illinois | Internal Medicine | 840 S Wood St, Department of Medicine, M/c 787, Chicago, IL 60612-4325 | 2009-08-20 |
| 1962631010 | University of Illinois | Psychologist | 1747 W Roosevelt Rd, Chicago, IL 60608-1264 | 2009-07-10 |
| 1205002185 | University of Illinois | General Acute Care Hospital | 611 W Park St, Carle Forum Lower Level, Urbana, IL 61801-2500 | 2008-05-01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | UNIVERSITY OF ILLINOIS | 809 S Marshfield 9th Flr, Chicago, IL 60612-4305 |
| Oklahoma Business Registrations | UNIVERSITY OF ILLINOIS FOUNDATION | 1305 West Green St, Urbana, IL 61801 |
| System for Award Management (SAM) Entities | UNIVERSITY OF ILLINOIS RESEARCH PARK, LLC | 60 Hazelwood Dr, Champaign, IL 61820-7460 |
| Street Address |
DEPARTMENT OF PSYCHIATRY 221 NE GLEN OAK 7 WEST |
| City | PEORIA |
| State | IL |
| Zip Code | 61636-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962767376 | Aman Deep Singh | Psychiatry & Neurology | 221 Ne Glen Oak Ave. 7 West, Dept. of Psych. and Behavior Health., Peoria, IL 61636 | 2012-07-11 |
| 1932490075 | Christine Ann Wigginton | Radiology | 221 Ne Glen Oak Ave Dept Of, Peoria, IL 61636 | 2011-04-24 |
| 1154856607 | Shubhada Reddy | Psychiatry & Neurology | 221 Ne Glen Oak Ave, Peoria, IL 61636 | 2017-04-21 |
| 1649657685 | Nicholas Grieco | Internal Medicine | 221 Ne Glen Oak Ave, Peoria, IL 61636 | 2015-04-29 |
| 1659703759 | Dhaval Save | Internal Medicine | 221 Ne Glen Oak Ave, Peoria, IL 61636 | 2013-07-31 |
| 1164474755 | Methodist Medical Center of Illinois | General Acute Care Hospital | 221 Ne Glen Oak Ave, Peoria, IL 61636 | 2006-05-16 |
| 1871560623 | Minna Jinn O'leary | Psychiatry & Neurology | 221 Ne Glen Oak Ave, Peoria, IL 61636 | 2006-03-01 |
| 1568901544 | Stephanie Ann Sullivan | Nurse Anesthetist, Certified Registered | Unity Point Health Methodist, 221 Ne Glen Oak Avenue, Peoria, IL 61636-0001 | 2017-02-23 |
| 1073066155 | Caroline Vanaman | Counselor | 221 Ne Glen Oak Ave # 7w, Peoria, IL 61636-0001 | 2016-07-26 |
| 1497141758 | Amber Hemminger | Registered Nurse | 200 Ne Glen Oak Ave, Peoria, IL 61636-0001 | 2015-04-13 |
| Find all providers in zip 61636 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962767376 | Aman Deep Singh | Psychiatry & Neurology | 221 Ne Glen Oak Ave. 7 West, Dept. of Psych. and Behavior Health., Peoria, IL 61636 | 2012-07-11 |
| 1437438249 | Kapil Kiran Aedma | Psychiatry & Neurology | 900 Main St Ste 400, Peoria, IL 61602-1060 | 2011-08-10 |
| 1962674820 | Lisa Jean Burckhartzmeyer | Psychiatry & Neurology | 228 Ne Jefferson St, Peoria, IL 61602 | 2008-03-31 |
| 1366647521 | Andrew Jerome Lancia | Psychiatry & Neurology | 900 Main St Ste 720, Peoria, IL 61602-5027 | 2007-06-18 |
| 1710197827 | Mahasukh Shah | Psychiatry & Neurology | 5827 N Briarwood Ln, Peoria, IL 61614-4230 | 2007-05-23 |
| 1972620706 | Ronald Michael Schwartz | Psychiatry & Neurology | 9069 W Irma Ln, Peoria, AZ 85382-6481 | 2007-03-25 |
| 1386702595 | Christine Bowers | Psychiatry & Neurology | 4719 N Sheridan Road, Peoria, IL 61614 | 2006-12-04 |
| 1861584542 | Abraham Ramy Frenkel | Psychiatry & Neurology | 7317 N Willow Lake Ct, Peoria, IL 61614-8260 | 2006-09-29 |
| 1407948607 | Andrew Jon Heritch | Psychiatry & Neurology | 3116 N Dries Ln, #201, Peoria, IL 61604 | 2006-09-28 |
| 1205945912 | Shaukat Ali Khan | Psychiatry & Neurology | 5016 North University Street, Suite 104, Peoria, IL 61614-4763 | 2006-08-29 |
| Find all providers in PEORIA | ||||
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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.