ILLINOIS GASTROENTEROLOGY INSTITUTE, PLLC (NPI# 1649765835) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649765835 |
| Entity Type | Organization |
| Organization Name | ILLINOIS GASTROENTEROLOGY INSTITUTE, PLLC |
| Other Organization Name | PEORIA ANESTHESIA SERVICE |
| Practice Address |
1001 Main St Ste 500a Peoria IL 61606-2038 |
| Practice Telephone | 3094951121 |
| Mailing Telephone | 3094951121 |
| Enumeration Date | 2018-06-29 |
| Last Update Date | 2020-08-17 |
| Authorized Official Name | TERRY L BALDWIN (MD) |
| Authorized Official Telephone | 3096724980 |
| Is Organization Subpart | Y |
| Parent Organization Name | ILLINOIS GASTROENTEROLOGY INSTITUTE, PLLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 367500000X | Nurse Anesthetist, Certified Registered | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207L00000X | Anesthesiology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Peoria Anesthesia Service | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275575706 | Illinois Gastroenterology Institute, Pllc | Internal Medicine | 1001 Main St, Suite 500a, Peoria, IL 61606-1907 | 2006-06-11 |
| Street Address |
1001 MAIN ST STE 500A |
| City | PEORIA |
| State | IL |
| Zip Code | 61606-2038 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316492432 | Jennifer Greenwood | Nurse Practitioner | 1001 Main St Ste 500a, Peoria, IL 61606 | 2016-08-18 |
| 1942773155 | Connor Thomas Schuler | Physician Assistant | 1001 Main St Ste 500a, Peoria, IL 61606-2038 | 2019-01-10 |
| 1174025357 | Amy M Durst | Nurse Practitioner | 1001 Main St Ste 500a, Peoria, IL 61606 | 2018-03-05 |
| 1386158822 | Kerry Maloney | Nurse Practitioner | 1001 Main St Ste 500a, Peoria, IL 61606-2038 | 2017-11-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194292334 | Kelley Stork | Speech-Language Pathologist | 807 W Columbia Terrace, Peoria, IL 61606 | 2018-10-25 |
| 1689140519 | Emma Cristine Tully | Speech-Language Pathologist | 1619 W. Fredonia Ave, Peoria, IL 61606 | 2018-10-18 |
| 1104944974 | Robert I Martin | Preventive Medicine | 1127 N North Street, Peoria, IL 61606 | 2007-03-27 |
| 1023062312 | Saint Francis Medical Center | Physical Medicine & Rehabilitation | 100 Ne Randoph Street, Peoria, IL 61606 | 2006-05-20 |
| 1174573307 | Cpo Services, Inc | Prosthetic/Orthotic Supplier | 741 West Main Street, Peoria, IL 61606 | 2006-05-10 |
| 1538471099 | Jacob Royle Hopping | Surgery | 1001 Main St Ste 300, Peoria, IL 61606 | 2010-07-12 |
| 1881906410 | Heather Jefford | Clinical Nurse Specialist | 1001 Main St, 3rd Floor, Peoria, IL 61606 | 2010-07-12 |
| 1306874128 | David L Crawford | Surgery | 1001 Main Street, Suite 300, Peoria, IL 61606 | 2006-06-29 |
| 1205864170 | Norman C Estes | Surgery | 1001 Main Street, Suite 300, Peoria, IL 61606 | 2006-06-29 |
| 1093751257 | Julius P. Bonello | Surgery | 1001 Main Street, Suite 300, Peoria, IL 61606 | 2006-06-22 |
| Find all providers in zip 61606 | ||||
| Taxonomy Code | 207L00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871835793 | Robert Thompson Myers | Anesthesiology | 10303 N Spring Ln, Peoria, IL 61615-1349 | 2013-03-18 |
| 1528334729 | Deepak Raj Sharma | Anesthesiology | 10204 W Happy Valley Pkwy Ste 160, Peoria, AZ 85383-2880 | 2012-04-01 |
| 1093971574 | Adam Todd Kramer | Anesthesiology | 13090 N 94th Dr Ste 212, Peoria, AZ 85381-4258 | 2008-08-04 |
| 1134321540 | Drew Mark Davenport | Anesthesiology | 12874 W Dove Wing Way, Peoria, AZ 85383-2491 | 2007-06-05 |
| 1386784155 | Eric Hawkins | Anesthesiology | 22i Ne Glen Oak Ave, Methodist Medical Center Anesthesiology, Peoria, IL 61636-0001 | 2007-02-08 |
| 1184662884 | Abc Anesthesiologists Pllc | Anesthesiology | 10204 W Happy Valley Pkwy Ste 160b, Peoria, AZ 85383-2880 | 2006-06-03 |
| 1518918978 | Caridad Bravo-fernandez | Anesthesiology | 15262 N. 75th Avenue, Suite 400 Pain Solution Center, LLC, Peoria, AZ 85381-4762 | 2006-05-12 |
| 1245208685 | Anesthesia Specialties Alliance, S.c. | Anesthesiology | 7309 N. Knoxville Ave., Peoria, IL 61614 | 2006-03-10 |
| 1073501359 | Jeremy L Krock | Anesthesiology | 8600 N State Route 91, Suite 250, Peoria, IL 61615-9541 | 2005-10-11 |
| 1700424363 | Comet Anesthesia LLC | Anesthesiology | 13660 N 94th Dr # D-1, Peoria, AZ 85381-4836 | 2019-12-13 |
| 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.