CENTRAL ILLINOIS ENDOSCOPY CENTER, LLC (NPI# 1790924306) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790924306 |
| Entity Type | Organization |
| Organization Name | CENTRAL ILLINOIS ENDOSCOPY CENTER, LLC |
| Other Organization Name | CENTRAL ILLINOIS ENDOSCOPY CENTER |
| Practice Address |
1001 Main St Ste 530 Peoria IL 61606-1907 |
| Practice Telephone | 3094951144 |
| Mailing Telephone | 3094951144 |
| Enumeration Date | 2009-02-05 |
| Last Update Date | 2009-02-05 |
| Authorized Official Name | MRS. CATHERINE EMANUEL (SECRETARY/TREASURER) |
| Authorized Official Telephone | 3096724846 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0800X |
Clinic/Center Specialization: Endoscopy |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Central Illinois Endoscopy Center | Doing Business As Name - Organization |
| Street Address |
1001 MAIN ST STE 530 |
| City | PEORIA |
| State | IL |
| Zip Code | 61606-1907 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356719736 | Rachel Delong | Nurse Practitioner | 1001 Main St, Suite 300, Peoria, IL 61606-1907 | 2015-09-02 |
| 1730456914 | Justin Lee Fischer | Colon & Rectal Surgery | 1001 Main St, Ste 300, Peoria, IL 61606-2036 | 2011-11-16 |
| 1588956635 | Chadrick Ryan Evans | Surgery | 1001 Main St, Suite 300, Peoria, IL 61606-1907 | 2011-05-09 |
| 1518260199 | Jodi Renee Stoner | Clinical Nurse Specialist | 1001 Main St, Suite 200, Peoria, IL 61606-1907 | 2010-12-21 |
| 1881906410 | Heather Jefford | Clinical Nurse Specialist | 1001 Main St, 3rd Floor, Peoria, IL 61606 | 2010-07-12 |
| 1124344023 | Jamie Doubet | Registered Nurse | 1001 Main St, 3rd Floor, Peoria, IL 61606-1907 | 2010-04-16 |
| 1114258167 | Ryan M Dunn | Internal Medicine | 1001 Main St, Suite 200, Peoria, IL 61606-1907 | 2010-01-14 |
| 1134352842 | Illinois Specialty Physician Services At Osf, LLC | Internal Medicine | 1001 Main St, Ste 200, Peoria, IL 61606-1907 | 2009-08-27 |
| 1154555852 | Brynn N Cinnamon | Registered Nurse | 1001 Main St, Suite 500a, Peoria, IL 61606-1907 | 2009-05-08 |
| 1255587812 | Stephanie Cain | Clinical Nurse Specialist | 1001 Main St, 3rd Floor, Peoria, IL 61606-1907 | 2008-08-14 |
| Find all providers in the same location | ||||
| 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 |
| 1316492432 | Jennifer Greenwood | Nurse Practitioner | 1001 Main St Ste 500a, Peoria, IL 61606 | 2016-08-18 |
| 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 |
| 1174025357 | Amy M Durst | Nurse Practitioner | 1001 Main St Ste 500a, Peoria, IL 61606 | 2018-03-05 |
| 1538471099 | Jacob Royle Hopping | Surgery | 1001 Main St Ste 300, 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 |
| Find all providers in zip 61606 | ||||
| Taxonomy Code | 261QE0800X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Endoscopy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083972624 | Gastroenterology Services Endoscopy Suite, Ltd | Clinic/Center | 3825 Highland Ave Ste 203, Downers Grove, IL 60515-1561 | 2012-05-02 |
| 1144593369 | South Loop Endoscopy and Wellness Center LLC | Clinic/Center | 2334 S Wabash Ave, Chicago, IL 60616-2112 | 2012-02-18 |
| 1902017288 | Amg Endoscopy Center Ltd | Clinic/Center | 1105 W Park Ave Ste 1, Libertyville, IL 60048-2567 | 2007-05-25 |
| 1326310905 | G I Associates Endoscopy Ltd | Clinic/Center | 10500 S Cicero Ave, Oak Lawn, IL 60453-5205 | 2012-01-30 |
| 1962781252 | Ashland Avenue Gi, S.c. | Clinic/Center | 3004 N Ashland Ave, Chicago, IL 60657 | 2011-08-04 |
| 1427230416 | Summit Surgicare | Clinic/Center | 1s280 Summit Ave, Ct A, Oakbrook Terrace, IL 60181-3984 | 2007-11-30 |
| 1861513822 | Round Lake Medical Suites | Clinic/Center | 2 E Rollins Rd, Suite 108, Round Lake Beach, IL 60073-3808 | 2007-04-03 |
| 1457410094 | Kgo Gi Inc | Clinic/Center | 3004 N Ashland Ave, Chicago, IL 60657-3012 | 2006-12-08 |
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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.