npi first name mi last name taxonomy code specialty ... · pdf filenpi first name mi last name...

18
NPI First Name MI Last Name Taxonomy Code Specialty Address 1 Address 2 City State ZIP Code Phone 1598926818 Susan Abraham 207R00000X Internal medicine 2500 W Reynolds Street Pontiac IL 61764 8158422828 1871567495 Waleed A. Abraham 207R00000X Internal medicine 1505 Eastland Drive Suite 320 Bloomington IL 61701 3096623311 1275613689 James K. Adams 207R00000X Internal medicine 8600 North Route 91 Suite 130 Peoria IL 61615 3096835050 1548377559 Patience O. Adesida 207V00000X Obstetrics/gynecology 2500 W Reynolds Street Pontiac IL 61764 8158423567 1134173875 Subhashish Agarwal 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 3096552553 1538134960 Naresh K. Agarwal 207R00000X Internal medicine 8600 North Route 91 Suite 130 Peoria IL 61615 3096835050 1649293226 Anita Agarwal 207R00000X Internal medicine 5114 N Glen Park Place Peoria IL 61614 3096838100 1336142017 Yogesh K. Agarwal 207RC0000X Cardiology 1505 Eastland Drive Suite 330 Bloomington IL 61701 3096655800 1164641791 Iftekhar U. Ahmad 2085R0001X Radiation oncology 5666 E State Street Rockford IL 61108 8152272273 1720243025 Sameen Ahmad 2084P0800X Psychiatry 1207 Starfire Drive Mental Health Dept Ottawa IL 61350 8154315463 1639335078 Saroosh Ahmed 207P00000X Emergency medicine 5666 E State Street Rockford IL 61108 8153955261 1841468394 Khan I. Ahmed 207R00000X Internal medicine 530 N E Glen Oak Avenue Peoria IL 61637 3096248818 1972595296 Amy L. Ailes DiNello 363A00000X Physician assistant 698 Featherstone Road Suite 250 Rockford IL 61107 8153994404 1497879290 Cecilia A. Albaro 2080P0202X Cardiology 420 N E Glen Oak Avenue Suite 301 Peoria IL 61603 3096553453 1144256017 John Alexander 207R00000X Internal medicine 5666 E State Street Rockford IL 61108 8152262000 1700804028 Azra M. Ali 208M00000X Critical care (intensivists) 5666 E State Street Rockford IL 61108 8152262000 1497716823 Julie A. Alms DuBois 363L00000X Nurse practitioner 8800 North Route 91 Peoria IL 61615 3096835000 1679665020 Lynessa A. Alonso 208000000X Pediatric medicine 10 Saint Claire Court Suite 100 Washington IL 61571 3098864000 1588653935 Renee M. Alwan Percell 363A00000X Physician assistant 1701 E College Avenue Bloomington IL 61704 3096643000 1780604900 Anil Amin 208M00000X Critical care (intensivists) 5666 E State Street Rockford IL 61108 8152262000 1558500579 Cynthia A. Anagnos 363A00000X Physician assistant 1701 E College Avenue Bloomington IL 61704 3096643000 1194757831 Jeremiah S. Anders 208M00000X Critical care (intensivists) 530 N E Glen Oak Avenue Peoria IL 61637 3096248818 1942485735 Sameer Ansar 207R00000X Internal medicine 5668 E State Street Suite 2000 Rockford IL 61108 8152262000 1386736023 Jerry M. Antonini 207R00000X Internal medicine 1505 Eastland Drive Suite 320 Bloomington IL 61701 3096623311 1033323902 Charles J. Aprahamian 208600000X General surgery 420 N E Glen Oak Avenue Suite 201 Peoria IL 61603 3096552343 1568629822 Rosalyn M. Aranas 2084N0400X Neurology 535 Roxbury Rd. Rockford IL 61107 8153871717 1437249760 Kenneth L. Arnett 207KA0200X Allergy / immunology 200 E Pennsylvania Avenue Suite 101 Peoria IL 61603 3096554184 1639464985 Garner A. Arnold 207L00000X Anesthesiology 1100 E Norris Drive Ottawa IL 61350 8154333100 1821439647 Suzanne M. Artale-Fritz 363LF0000X Nurse practitioner 444 Roxbury Road Rockford IL 61107 8153983000 1487851184 Teresa F. Asam-Jensen 208000000X Pediatric medicine 5101 N Executive Drive Peoria IL 61614 3096770700 1114051455 Julie E. Ashbacher 363LF0000X Nurse practitioner 5114 N Glen Park Place Peoria IL 61614 3096836600 1639166374 Tara Atta 207RC0000X Cardiology 444 Roxbury Road Rockford IL 61107 8153983000 1114038072 Linda M. Auer 207W00000X Ophthalmology 3315 N Seminary Street Galesburg IL 61401 3093441000 1750420758 Bhagat S. Aulakh 207R00000X Internal medicine 1001 N Main Street Peoria IL 61606 3096725682 1780669309 Sharon R. Austin 363LF0000X Nurse practitioner 104 E Bridge Street Streator IL 61364 8156732441 1952346231 Basem Awadh 207RR0500X Rheumatology 200 E Pennsylvania Avenue Suite 101 Peoria IL 61603 3096557900 1104813997 Sharon E. Aycock 363A00000X Physician assistant 200 E Pennsylvania Avenue Suite 105 Peoria IL 61603 3096557888 1013238609 Asfiya T. Azizuddin 390200000X Unknown supplier/provider specialty 9951 Rock Cut Crossing Loves Park IL 61111 8156398450 1124303730 Malinda M. Babcock 363L00000X Nurse practitioner 435 Maxine Drive Suites 3 & 4 Morton IL 61550 3092632424 1962431585 Mari B. Baker 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 3096552553 1902134208 Isabel Bales 363L00000X Nurse practitioner 530 N E Glen Oak Avenue Peoria IL 61637 3096248818 1467783290 Imran L. Balouch 207RG0100X Gastroenterology 2805 N Knoxville Avenue Peoria IL 61603 3096249400 1831230812 Timir S. Baman 207RC0001X Internal medicine 5405 N Knoxville Avenue Peoria IL 61614 3096914410 1831207174 Pia A. Bangcaya-Ong 208M00000X Critical care (intensivists) 5666 E State Street Rockford IL 61108 8152262000 1477580116 Lisa T. Barker 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 3096552553 1477587921 H. Trent Barnhart 207Q00000X Family practice 5666 E State Street Rockford IL 61108 8153994404 1316971823 Marco A. Barzallo 207RC0000X Cardiology 5405 N Knoxville Avenue Peoria IL 61614 3096914410 1417041666 Stephen E. Bash 2080P0202X Cardiology 420 N E Glen Oak Avenue Suite 301 Peoria IL 61603 3096553453 1538480603 Leopoldo M Basilico 207R00000X Internal medicine 1000 W Harlem Avenue Monmouth IL 61462 3097343141 1538480603 Leopoldo M Basilico 207R00000X Internal medicine 1000 W Harlem Avenue Monmouth IL 61462 3097343141 1538480603 Leopoldo M Basilico 207R00000X Internal medicine 1000 W Harlem Avenue Monmouth IL 61462 3097343141 1851387443 James R Battenburg 207Q00000X Family practice 1000 W Harlem Avenue Monmouth IL 61462 3097343141 1851387443 James R Battenburg 207Q00000X Family practice 1000 W Harlem Avenue Monmouth IL 61462 3097343141 1851387443 James R Battenburg 207Q00000X Family practice 1000 W Harlem Avenue Monmouth IL 61462 3097343141 1437465986 Paula S. Bauman 363LF0000X Nurse practitioner 4423 Manchester Drive Rockford IL 61109 8159218900 1780669804 Eleanor V. Bautista 207R00000X Internal medicine 6830 Villagreen View Rockford IL 61107 8152821339 1316918923 David S. Bayley 207L00000X Anesthesiology 1100 E Norris Drive Ottawa IL 61350 8154333100 1194006635 Sarah B. Beam 363LA2100X Nurse practitioner 719 N William Kumpf Blvd Suite 100 Peoria IL 61605 3096760766 1538241591 Shad D. Beaty 208000000X Pediatric medicine 435 Maxine Drive Suites 3 & 4 Morton IL 61550 3092632424 1922215920 Jason E. Becker 208000000X Pediatric medicine 2900 N Knoxville Avenue Peoria IL 61603 3096883616 1962660076 Michele K. Beekman 208000000X Pediatric medicine 530 N E Glen Oak Avenue Peoria IL 61637 3092632424

Upload: doancong

Post on 19-Mar-2018

234 views

Category:

Documents


9 download

TRANSCRIPT

Page 1: NPI First Name MI Last Name Taxonomy Code Specialty ... · PDF fileNPI First Name MI Last Name Taxonomy Code Specialty Address 1 Address 2 City State ZIP Code Phone ... Bradley 363LF0000X;

NPI First Name MI Last Name Taxonomy Code Specialty Address 1 Address 2 City State ZIP Code Phone1598926818 Susan Abraham 207R00000X Internal medicine 2500 W Reynolds Street Pontiac IL 61764 81584228281871567495 Waleed A. Abraham 207R00000X Internal medicine 1505 Eastland Drive Suite 320 Bloomington IL 61701 30966233111275613689 James K. Adams 207R00000X Internal medicine 8600 North Route 91 Suite 130 Peoria IL 61615 30968350501548377559 Patience O. Adesida 207V00000X Obstetrics/gynecology 2500 W Reynolds Street Pontiac IL 61764 81584235671134173875 Subhashish Agarwal 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30965525531538134960 Naresh K. Agarwal 207R00000X Internal medicine 8600 North Route 91 Suite 130 Peoria IL 61615 30968350501649293226 Anita Agarwal 207R00000X Internal medicine 5114 N Glen Park Place Peoria IL 61614 30968381001336142017 Yogesh K. Agarwal 207RC0000X Cardiology 1505 Eastland Drive Suite 330 Bloomington IL 61701 30966558001164641791 Iftekhar U. Ahmad 2085R0001X Radiation oncology 5666 E State Street Rockford IL 61108 81522722731720243025 Sameen Ahmad 2084P0800X Psychiatry 1207 Starfire Drive Mental Health Dept Ottawa IL 61350 81543154631639335078 Saroosh Ahmed 207P00000X Emergency medicine 5666 E State Street Rockford IL 61108 81539552611841468394 Khan I. Ahmed 207R00000X Internal medicine 530 N E Glen Oak Avenue Peoria IL 61637 30962488181972595296 Amy L. Ailes DiNello 363A00000X Physician assistant 698 Featherstone Road Suite 250 Rockford IL 61107 81539944041497879290 Cecilia A. Albaro 2080P0202X Cardiology 420 N E Glen Oak Avenue Suite 301 Peoria IL 61603 30965534531144256017 John Alexander 207R00000X Internal medicine 5666 E State Street Rockford IL 61108 81522620001700804028 Azra M. Ali 208M00000X Critical care (intensivists) 5666 E State Street Rockford IL 61108 81522620001497716823 Julie A. Alms DuBois 363L00000X Nurse practitioner 8800 North Route 91 Peoria IL 61615 30968350001679665020 Lynessa A. Alonso 208000000X Pediatric medicine 10 Saint Claire Court Suite 100 Washington IL 61571 30988640001588653935 Renee M. Alwan Percell 363A00000X Physician assistant 1701 E College Avenue Bloomington IL 61704 30966430001780604900 Anil Amin 208M00000X Critical care (intensivists) 5666 E State Street Rockford IL 61108 81522620001558500579 Cynthia A. Anagnos 363A00000X Physician assistant 1701 E College Avenue Bloomington IL 61704 30966430001194757831 Jeremiah S. Anders 208M00000X Critical care (intensivists) 530 N E Glen Oak Avenue Peoria IL 61637 30962488181942485735 Sameer Ansar 207R00000X Internal medicine 5668 E State Street Suite 2000 Rockford IL 61108 81522620001386736023 Jerry M. Antonini 207R00000X Internal medicine 1505 Eastland Drive Suite 320 Bloomington IL 61701 30966233111033323902 Charles J. Aprahamian 208600000X General surgery 420 N E Glen Oak Avenue Suite 201 Peoria IL 61603 30965523431568629822 Rosalyn M. Aranas 2084N0400X Neurology 535 Roxbury Rd. Rockford IL 61107 81538717171437249760 Kenneth L. Arnett 207KA0200X Allergy / immunology 200 E Pennsylvania Avenue Suite 101 Peoria IL 61603 30965541841639464985 Garner A. Arnold 207L00000X Anesthesiology 1100 E Norris Drive Ottawa IL 61350 81543331001821439647 Suzanne M. Artale-Fritz 363LF0000X Nurse practitioner 444 Roxbury Road Rockford IL 61107 81539830001487851184 Teresa F. Asam-Jensen 208000000X Pediatric medicine 5101 N Executive Drive Peoria IL 61614 30967707001114051455 Julie E. Ashbacher 363LF0000X Nurse practitioner 5114 N Glen Park Place Peoria IL 61614 30968366001639166374 Tara Atta 207RC0000X Cardiology 444 Roxbury Road Rockford IL 61107 81539830001114038072 Linda M. Auer 207W00000X Ophthalmology 3315 N Seminary Street Galesburg IL 61401 30934410001750420758 Bhagat S. Aulakh 207R00000X Internal medicine 1001 N Main Street Peoria IL 61606 30967256821780669309 Sharon R. Austin 363LF0000X Nurse practitioner 104 E Bridge Street Streator IL 61364 81567324411952346231 Basem Awadh 207RR0500X Rheumatology 200 E Pennsylvania Avenue Suite 101 Peoria IL 61603 30965579001104813997 Sharon E. Aycock 363A00000X Physician assistant 200 E Pennsylvania Avenue Suite 105 Peoria IL 61603 30965578881013238609 Asfiya T. Azizuddin 390200000X Unknown supplier/provider specialty 9951 Rock Cut Crossing Loves Park IL 61111 81563984501124303730 Malinda M. Babcock 363L00000X Nurse practitioner 435 Maxine Drive Suites 3 & 4 Morton IL 61550 30926324241962431585 Mari B. Baker 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30965525531902134208 Isabel Bales 363L00000X Nurse practitioner 530 N E Glen Oak Avenue Peoria IL 61637 30962488181467783290 Imran L. Balouch 207RG0100X Gastroenterology 2805 N Knoxville Avenue Peoria IL 61603 30962494001831230812 Timir S. Baman 207RC0001X Internal medicine 5405 N Knoxville Avenue Peoria IL 61614 30969144101831207174 Pia A. Bangcaya-Ong 208M00000X Critical care (intensivists) 5666 E State Street Rockford IL 61108 81522620001477580116 Lisa T. Barker 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30965525531477587921 H. Trent Barnhart 207Q00000X Family practice 5666 E State Street Rockford IL 61108 81539944041316971823 Marco A. Barzallo 207RC0000X Cardiology 5405 N Knoxville Avenue Peoria IL 61614 30969144101417041666 Stephen E. Bash 2080P0202X Cardiology 420 N E Glen Oak Avenue Suite 301 Peoria IL 61603 30965534531538480603 Leopoldo M Basilico 207R00000X Internal medicine 1000 W Harlem Avenue Monmouth IL 61462 30973431411538480603 Leopoldo M Basilico 207R00000X Internal medicine 1000 W Harlem Avenue Monmouth IL 61462 30973431411538480603 Leopoldo M Basilico 207R00000X Internal medicine 1000 W Harlem Avenue Monmouth IL 61462 30973431411851387443 James R Battenburg 207Q00000X Family practice 1000 W Harlem Avenue Monmouth IL 61462 30973431411851387443 James R Battenburg 207Q00000X Family practice 1000 W Harlem Avenue Monmouth IL 61462 30973431411851387443 James R Battenburg 207Q00000X Family practice 1000 W Harlem Avenue Monmouth IL 61462 30973431411437465986 Paula S. Bauman 363LF0000X Nurse practitioner 4423 Manchester Drive Rockford IL 61109 81592189001780669804 Eleanor V. Bautista 207R00000X Internal medicine 6830 Villagreen View Rockford IL 61107 81528213391316918923 David S. Bayley 207L00000X Anesthesiology 1100 E Norris Drive Ottawa IL 61350 81543331001194006635 Sarah B. Beam 363LA2100X Nurse practitioner 719 N William Kumpf Blvd Suite 100 Peoria IL 61605 30967607661538241591 Shad D. Beaty 208000000X Pediatric medicine 435 Maxine Drive Suites 3 & 4 Morton IL 61550 30926324241922215920 Jason E. Becker 208000000X Pediatric medicine 2900 N Knoxville Avenue Peoria IL 61603 30968836161962660076 Michele K. Beekman 208000000X Pediatric medicine 530 N E Glen Oak Avenue Peoria IL 61637 3092632424

Page 2: NPI First Name MI Last Name Taxonomy Code Specialty ... · PDF fileNPI First Name MI Last Name Taxonomy Code Specialty Address 1 Address 2 City State ZIP Code Phone ... Bradley 363LF0000X;

NPI First Name MI Last Name Taxonomy Code Specialty Address 1 Address 2 City State ZIP Code Phone1336412337 Timothy E. Beeman 367500000X Crna, anesthesia assistant 3333 N Seminary Street Galesburg IL 61401 30934431611114271905 Danielle E. Beer 363A00000X Physician assistant 1505 Eastland Drive Suite 1100 Bloomington IL 61701 30966321001114951357 Stephen J. Belgrave 207Q00000X Family practice 1701 E College Avenue Bloomington IL 61704 30966430001548363765 Ralph S. Benejam 208800000X Urology 3315 N Seminary Street Galesburg IL 61401 30934410001720002637 Kimberly Benko 363L00000X Nurse practitioner 5114 N Glen Park Place Peoria IL 61614 30968366001619396157 Cinthia A. Bennett 363L00000X Nurse practitioner 5666 E State Street Rockford IL 61108 81522620001679653083 Mary L. Benson 363A00000X Physician assistant 100 N Monroe Abingdon IL 61410 30946223431295716330 George B. Beranek 207P00000X Emergency medicine 600 S 13th Street Pekin Hospital Pekin IL 61554 30935311011629200753 Catherine R. Beratio 207Q00000X Family practice 435 Maxine Drive Suites 3 & 4 Morton IL 61550 30926324241710922182 Michelle L. Bertke 363LF0000X Nurse practitioner 5114 N Glen Park Place Peoria IL 61614 30968366001447284989 David G. Best 207RC0000X Cardiology 5405 N Knoxville Avenue Peoria IL 61614 30969144101821046186 Jasmine N. Bhurgri 207Q00000X Family practice 1614 E Norris Drive Ottawa IL 61350 81543310101700034113 Julia Biernot 390200000X Unknown supplier/provider specialty 100 N E Randolph Street Peoria IL 61606 30962485001417982703 Ghassan Bitar 2084P0800X Psychiatry 7317 Willow Lake Court Peoria IL 61614 30968373731326105024 Pamela Bloomfield 363L00000X Nurse practitioner 220 SW 5th Street Woodhull IL 61490 30933428951326146994 Gregory M. Blume 2084N0400X Neurology 100 N E Randolph Street Peoria IL 61606 30962485001417267832 Heather L. Blythe 363LF0000X Nurse practitioner 9951 Rock Cut Crossing Loves Park IL 61111 81563985001750310553 Ismail A. Bobat 207RP1001X Pulmonary disease 1505 Eastland Drive Suite 320 Bloomington IL 61701 30966123681598734980 Lorenzo Boccuzzi 207R00000X Internal medicine 5114 N Glen Park Place Peoria IL 61614 30968350001811190556 Elizabeth G. Bockewitz 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30965525531225340805 Kyle W. Boerke 103TC0700X Clinical psychologist 7317 Willow Lake Court Peoria IL 61614 30968373731245279181 David Bogolub 207P00000X Emergency medicine 3333 N Seminary Street Galesburg IL 61401 30934431611912126640 Charles K. Boley 207R00000X Internal medicine 10 Saint Claire Court Suite 100 Washington IL 61571 30988640001053568667 Ahmed A Bolkhir 207R00000X Internal medicine 5666 E State Street Rockford IL 61108 81522620001891768636 Brian L Bostwick 207R00000X Internal medicine 320 E Armstrong Avenue Peoria IL 61603 30962496901316040553 John S. Boydstun 207RG0100X Gastroenterology 3315 N Seminary Street Galesburg IL 61401 30934410001407888712 Tracy Boykin 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30965525531205080405 Laura K. Bradley 363LF0000X Nurse practitioner 220 SW 5th Street Woodhull IL 61490 30948255711043236573 Patresa R. Brager 103TC0700X Clinical psychologist 7317 Willow Lake Court Peoria IL 61614 30968373731164689428 Matthew T. Bramlet 2080P0202X Cardiology 420 N E Glen Oak Avenue Suite 301 Peoria IL 61603 30965534531568422806 David A. Braun 207Q00000X Family practice 1505 Eastland Drive Suite 1100 Bloomington IL 61701 30966321001851612139 Jermaine D. Bridges 390200000X Unknown supplier/provider specialty 5666 E State Street Rockford IL 61108 81539552611881609261 Susan A. Broquard 363A00000X Physician assistant 1701 E College Avenue Bloomington IL 61704 30966430001386646826 Heidi L. Brown 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30965525531003865031 Allen F. Browne 2086S0120X General surgery 420 N E Glen Oak Avenue Suite 201 Peoria IL 61603 30965523431063675445 Kari N. Bruening 363LF0000X Nurse practitioner 5114 N Glen Park Place Peoria IL 61614 30968366001447287495 George T. Bryan 2085R0001X Radiation oncology 5666 E State Street Rockford IL 61108 81522722731902906571 Christine J. Buehler 208000000X Pediatric medicine 8600 North Route 91 Suite 200 Peoria IL 61615 30969210301497784797 Gregory Bullis 207PE0004X Emergency medicine 5666 E State Street Rockford IL 61108 81539552611962674820 Lisa J Burckhartzmeyer 390200000X Unknown supplier/provider specialty 7317 Willow Lake Court Peoria IL 61614 30968373731073785101 Coleen R Burkart 363LF0000X Nurse practitioner 7219 Walton Street Rockford IL 61107 81592189001487661948 Karen M. Bussone 363L00000X Nurse practitioner 5405 N Knoxville Avenue Peoria IL 61614 30969144101861419327 Daniel Butterbach 207P00000X Emergency medicine 5666 E State Street Rockford IL 61108 81539552611497708382 Cynthia A. Cabalfin 207R00000X Internal medicine 1614 E Norris Drive Ottawa IL 61350 81543310101003936766 Karen Cadet-Saintilus 207Q00000X Family practice 5111 N Glen Park Place Peoria IL 61614 30968357001295825594 Dennis R. Caffery 207Q00000X Family practice 143 Ford Aveue Hopedale IL 61747 30944933361942561618 Genev J. Calek 367500000X Crna, anesthesia assistant 3333 N Seminary Street Galesburg IL 61401 30934431611306938675 Nels E. Calvert 207PE0004X Emergency medicine 600 S 13th Street Pekin Hospital Pekin IL 61554 30935311011487898524 Anthony B. Cameron 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30965525531962573626 Mark D Canty 207Q00000X Family practice 2500 W Reynolds Street Pontiac IL 61764 81584451151306123757 Katherine I. Carlson 363A00000X Physician assistant 9951 Rock Cut Crossing Loves Park IL 61111 81563984501275557498 Wade D. Carlson 207Q00000X Family practice 5114 N Glen Park Place Peoria IL 61614 30968366001386726255 Scott D. Carlson 208000000X Pediatric medicine 10 Saint Claire Court Suite 100 Washington IL 61571 30988640001073760716 Leslie M. Carmack 363L00000X Nurse practitioner 1701 E College Avenue Bloomington IL 61704 30966430001851640825 Cheryl A. Carmack 363LF0000X Nurse practitioner 1231 Kleemann Drive Clinton IL 61727 21793550221841390481 Susan J. Carmody 207Q00000X Family practice 1505 Eastland Drive Suite 1100 Bloomington IL 61701 30966321001437434982 Abbi D Carr 363L00000X Nurse practitioner 302 Saint Joseph Drive Bloomington IL 61701 30966253611083747356 Cheri J. Carroll 1041C0700X Licensed clinical social worker 405 Kays Drive Suite C Normal IL 61761 30966431301356606594 Jennifer L. Carroll 367500000X Crna, anesthesia assistant 8600 North Route 91 Suite 240 Peoria IL 61615 30968354571063593382 Jason W. Cash 207Q00000X Family practice 1001 N. Mitsubishi Motorway Center for Health at Nord Farms Bloomington IL 61705 30982964071881635605 Michael D. Cashman 207RG0100X Gastroenterology 2805 N Knoxville Avenue Peoria IL 61603 3096249400

Page 3: NPI First Name MI Last Name Taxonomy Code Specialty ... · PDF fileNPI First Name MI Last Name Taxonomy Code Specialty Address 1 Address 2 City State ZIP Code Phone ... Bradley 363LF0000X;

NPI First Name MI Last Name Taxonomy Code Specialty Address 1 Address 2 City State ZIP Code Phone1972693059 Jason A. Castator 207R00000X Internal medicine 530 N E Glen Oak Avenue Peoria IL 61637 30962488181447485693 Kristen A. Chambers-Damm 207R00000X Internal medicine 8600 North Route 91 Suite 130 Peoria IL 61615 30968350501427057595 David P. Chan 2080P0202X Cardiology 420 N E Glen Oak Avenue Suite 301 Peoria IL 61603 30965534531104843101 Suk-Yin Chan 207R00000X Internal medicine 698 Featherstone Road Rockford IL 61107 81539832771982928404 Jerry Chan 363L00000X Nurse practitioner 5666 E State Street Rockford IL 61108 81539552611942596192 Victor Wai Yuen Chan 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30965525531649299967 Nisha Chandran 208000000X Pediatric medicine 621 Roxbury Road Rockford IL 61107 81539733501962485037 Dongwoo J. Chang 207T00000X Neurosurgery 535 Roxbury Rd. Rockford IL 61107 81538717171841499902 David R. Charles 207RC0000X Cardiology 5405 N Knoxville Avenue Peoria IL 61614 30969144101245311778 Malini Chavali 207R00000X Internal medicine 5114 N Glen Park Place Peoria IL 61614 30968381001982925756 Amy H Chelin 207P00000X Emergency medicine 600 S 13th Street Pekin Hospital Pekin IL 61554 30935311011861687584 Nipun Chhabra 207Y00000X Otolaryngology 698 Featherstone Road Rockford IL 61107 81539832771881785178 Rita C. Chism 208000000X Pediatric medicine 3315 N Seminary Street Galesburg IL 61401 30934410001932195880 Subramanyam Chittivelu 207RP1001X Pulmonary disease 1001 N Main Street Peoria IL 61606 30967256821366467813 Paul M. Christensen 207RC0000X Cardiology 444 Roxbury Road Rockford IL 61107 81539830001902891237 Steve Christos 207P00000X Emergency medicine 2500 W Reynolds Street Pontiac IL 61764 81584228281235310756 Gordon K.T. Chu 207T00000X Neurosurgery 535 Roxbury Rd. Rockford IL 61107 81538717171295946580 Guoxiang Chu 207R00000X Internal medicine 1505 Eastland Drive Suite 210 Bloomington IL 61701 30966255061205154796 Sulin Chung 390200000X Unknown supplier/provider specialty 5666 E State Street Rockford IL 61108 81539552611942313804 Joseph W. Chuprevich 2084P0800X Psychiatry 1207 Starfire Drive Mental Health Dept Ottawa IL 61350 81543154631710002910 Daniel G. Ciaburri 208G00000X Thoracic surgery 5405 N Knoxville Avenue Peoria IL 61614 30969144101649370271 Robert P. Cipolla 207Q00000X Family practice 1505 Eastland Drive Suite 1100 Bloomington IL 61701 30966321001871600247 Elizabeth K. Cleveland 363L00000X Nurse practitioner 801 Fox Run Heyworth IL 61745 30947320691295750669 Adele J. Cobbs 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30965525531760463327 Larry L Coble 208000000X Pediatric medicine 2500 W Reynolds Street Pontiac IL 61764 81584465511154453454 Timothy Coggin 207P00000X Emergency medicine 5666 E State Street Rockford IL 61108 81539552611114959970 Cheryl M. Colbenson 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30965525531821000217 Deborah Collins 363AM0700X Physician assistant 435 Maxine Drive Suites 3 & 4 Morton IL 61550 30968366001699855007 Janet L. Collopy 363L00000X Nurse practitioner 120 E Gale Street Williamsfield IL 61489 30963922331275760456 Daniel P Congreve 208600000X General surgery 1051 West South Street Kewanee IL 61443 30985275001275760456 Daniel P Congreve 208600000X General surgery 1051 West South Street P.O. Box 747 Kewanee IL 61443 30985275001275760456 Daniel P Congreve 208600000X General surgery 1051 West South Street P.O. Box 747 Kewanee IL 61443 30985275001053540237 Annevay D. Conlee 390200000X Unknown supplier/provider specialty 3375 N Seminary Street Galesburg IL 61401 30934351141952353518 Jeffrey R. Cook 207RC0000X Cardiology 444 Roxbury Road Rockford IL 61107 81539830001205106341 Erica S. Cook 363LF0000X Nurse practitioner 9951 Rock Cut Crossing Loves Park IL 61111 81563984501619057031 Melinda B. Cooling 363L00000X Nurse practitioner 401 N Main Street Roanoke IL 61561 30992326611336371269 Terrah L Cornell 363L00000X Nurse practitioner 530 N E Glen Oak Avenue Suite 1200 Peoria IL 61637 30962478111932122595 Gene G. Couri 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30965525531710099841 Danny M. Cox 363AM0700X Physician assistant 5114 N Glen Park Place Peoria IL 61614 30968366001821275074 Eric M. Cox 208600000X General surgery 3315 N Seminary Street Galesburg IL 61401 30934410001073509824 Jeremiah E. Crabb 207RP1001X Pulmonary disease 1001 N Main Street Peoria IL 61606 30967256821336179449 Robert D. Crawford 207RI0011X Internal medicine 5405 N Knoxville Avenue Peoria IL 61614 30969144101003821448 Emily C Crebo 363LF0000X Nurse practitioner 5405 N Knoxville Avenue Peoria IL 61614 30969144101467423111 Barbara A Cree 363A00000X Physician assistant 1000 W Harlem Avenue Monmouth IL 61462 30973431411467423111 Barbara A Cree 363A00000X Physician assistant 1000 W Harlem Avenue Monmouth IL 61462 30973431411467423111 Barbara A Cree 363A00000X Physician assistant 1000 W Harlem Avenue Monmouth IL 61462 30973431411629398169 Sara E. Creighton 208000000X Pediatric medicine 530 N E Glen Oak Avenue Peoria IL 61637 30962488181831164409 Dennis J. Crnkovich 207R00000X Internal medicine 200 E Pennsylvania Avenue Suite 105 Peoria IL 61603 30965578881205936879 Trina D. Croland 208000000X Pediatric medicine 530 N E Glen Oak Avenue Peoria IL 61637 30926324241831301282 David T. Cross 208000000X Pediatric medicine 435 Maxine Drive Suites 3 & 4 Morton IL 61550 30926324241295763787 Michael A. Cruz 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30965525531023156734 Jeffrey A. Culp 207KA0200X Allergy / immunology 1701 E College Avenue Bloomington IL 61704 30966430001730272964 Brian S. Curtis 207R00000X Internal medicine 530 N E Glen Oak Avenue Peoria IL 61637 30937030541669422333 Anthony J. Cutinello 207Q00000X Family practice 10 Saint Claire Court Suite 100 Washington IL 61571 30988640001336255611 Antoine G. Daccache 207R00000X Internal medicine 530 N E Glen Oak Avenue Peoria IL 61637 30937030541073532511 Nancy G. Dagefoerde 363L00000X Nurse practitioner 444 Roxbury Road Rockford IL 61107 81539830001326109992 Nicole M. Dalton 363A00000X Physician assistant 1231 Kleemann Drive Clinton IL 61727 21793550221326109992 Nicole M. Dalton 363A00000X Physician assistant 1231 Kleemann Drive Clinton IL 61727 21793550221164676896 Angela B. Danielson 363A00000X Physician assistant 2500 W Reynolds Street Pontiac IL 61764 81584465511669818415 Ashley E. Darin-Messmer 363L00000X Nurse practitioner 5114 N Glen Park Place Peoria IL 61614 30965524311982639621 Jason S. Davis 2085U0001X Diagnostic radiology 1701 E College Avenue Bloomington IL 61704 3096643000

Page 4: NPI First Name MI Last Name Taxonomy Code Specialty ... · PDF fileNPI First Name MI Last Name Taxonomy Code Specialty Address 1 Address 2 City State ZIP Code Phone ... Bradley 363LF0000X;

NPI First Name MI Last Name Taxonomy Code Specialty Address 1 Address 2 City State ZIP Code Phone1780629485 Donald F. Davison 208000000X Pediatric medicine 302 Saint Joseph Drive Bloomington IL 61701 30966430001669565800 Vicki S. Day 363L00000X Nurse practitioner 106 S First Street Fairbury IL 61739 81594522611669565800 Vicki S. Day 363L00000X Nurse practitioner 106 S First Street Fairbury IL 61739 81594522611902834229 Pedro B. de Guzman 207R00000X Internal medicine 9951 Rock Cut Crossing Loves Park IL 61111 81563985001083697171 Joy B. De Leoz 207Q00000X Family practice 698 Featherstone Road Rockford IL 61107 81539832771902864796 Alan B. DeBord 174400000X Unknown supplier/provider specialty 200 E Pennsylvania Avenue Peoria IL 61603 30965520451043303399 Patricia A. Decker 363L00000X Nurse practitioner 120 E 7th Street Minonk IL 61760 30943225151326373457 Suzanne M. Decker 363L00000X Nurse practitioner 3375 N Seminary Street Galesburg IL 61401 30934351141306020334 Erica M. DeFord 363AM0700X Physician assistant 2805 N Knoxville Avenue Peoria IL 61603 30962494001447267919 Nancy L. DeHaan 363LA2100X Nurse practitioner 5405 N Knoxville Avenue Peoria IL 61614 30969144101437301637 Jennifer A. Delucia 363A00000X Physician assistant 5114 N Glen Park Place Peoria IL 61614 30968366001851326508 Charles A. Dennis 207R00000X Internal medicine 1701 E College Avenue Bloomington IL 61704 30966430001609073030 Neesha Desai 207P00000X Emergency medicine 5666 E State Street Rockford IL 61108 81539552611063488187 Satyajit Deshmukh 207P00000X Emergency medicine 5666 E State Street Rockford IL 61108 81539552611578645537 Dana J. DeShon 363L00000X Nurse practitioner 435 Maxine Drive Suites 3 & 4 Morton IL 61550 30926324241841489929 Benali G. Deshpande 208000000X Pediatric medicine 2900 N Knoxville Avenue Peoria IL 61603 30968836161972539575 Patricia Deters 207PE0004X Emergency medicine 600 S 13th Street Pekin Hospital Pekin IL 61554 30935311011275559270 Jodie A. Dewey 208000000X Pediatric medicine 302 Saint Joseph Drive Bloomington IL 61701 30966430001477811792 Phillis A. Dewitt 363L00000X Nurse practitioner 530 N E Glen Oak Avenue Peoria IL 61637 30937030541801826938 Leela S. Dhanekula 207RC0000X Cardiology 444 Roxbury Road Rockford IL 61107 81539830001679643902 Ravinder S. Dhillon 207P00000X Emergency medicine 5666 E State Street Rockford IL 61108 81539552611871615096 Rajbir K. Dhillon 207R00000X Internal medicine 5666 E State Street Rockford IL 61108 81522620001225017593 Sonu Dhillon 207RI0008X Internal medicine 2805 N Knoxville Avenue Peoria IL 61603 30962494001952491284 Cynthia K Dickinson 363AM0700X Physician assistant 200 E Pennsylvania Avenue Suite 101 Peoria IL 61603 30965579001386734689 Bonita G. Dietrich 363L00000X Nurse practitioner 2900 N Knoxville Avenue Peoria IL 61603 30968836161649691064 Tiffany Dillow 363A00000X Physician assistant 5666 E State Street Rockford IL 61108 81539552611679513642 Dzung H. Dinh 207T00000X Neurosurgery 719 N William Kumpf Blvd Suite 100 Peoria IL 61605 30967607661679733760 Hulbert Do 207R00000X Internal medicine 1050 E Norris Drive Suite 2C Ottawa IL 61350 81543402761013194042 Venkata R. Dodda 207R00000X Internal medicine 1505 Eastland Drive Suite 320 Bloomington IL 61701 30966123681861563397 Pamela R. Doloszycki 363LP0200X Nurse practitioner 1001 N Main Street Peoria IL 61606 30967256821376559161 Preethi Donakonda 207R00000X Internal medicine 5666 E State Street Rockford IL 61108 81522620001942304456 Katerina C. Doronila-Hughes 207Q00000X Family practice 4682 E Rockton Road Suite 102 Roscoe IL 61073 81554474001548429509 Ami M. Dose 363LF0000X Nurse practitioner 1614 E Norris Drive Ottawa IL 61350 81543310101740380385 Lawrence M. Dowden 207Q00000X Family practice 1505 Eastland Drive Suite 1100 Bloomington IL 61701 30966321001669491239 Patrick J. Dowling 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30965525531730289224 Mary Draeger-Schultz 208000000X Pediatric medicine 320 E Armstrong Avenue Peoria IL 61603 30962496901134104755 Patricia A. Duffield 363LF0000X Nurse practitioner 104 E Bridge Street Streator IL 61364 81567324411841495785 Henry Lawrence A. Dumbab 390200000X Unknown supplier/provider specialty 530 N E Glen Oak Avenue Peoria IL 61637 30962488181376591933 Adriana P. Dumitrescu 207Q00000X Family practice 1614 E Norris Drive Ottawa IL 61350 81543310101841219763 Eric D. Duncan 207R00000X Internal medicine 1701 E College Avenue Bloomington IL 61704 30966430001629161856 William G. Edwards 208000000X Pediatric medicine 530 N E Glen Oak Avenue Peoria IL 61637 30926324241053421248 John N. Edwards 207L00000X Anesthesiology 3333 N Seminary Street Galesburg IL 61401 30934431611235457631 Jennifer D Effler 363L00000X Nurse practitioner 308 Saint Joseph Drive Bloomington IL 61701 30966350501548361959 Gilbert N. Egekeze 207R00000X Internal medicine 5666 E State Street Rockford IL 61108 81522620001861658668 Jennifer K. Ehlers 363LF0000X Nurse practitioner 5405 N Knoxville Avenue Peoria IL 61614 30969144101528345642 Jennifer M. Eide 363LA2200X Nurse practitioner 444 Roxbury Road Rockford IL 61107 81539830001881759678 Clyde D Elswick 367500000X Crna, anesthesia assistant 1000 W Harlem Avenue Monmouth IL 61462 30973431411881759678 Clyde D Elswick 367500000X Crna, anesthesia assistant 1000 W Harlem Avenue Monmouth IL 61462 30973431411881759678 Clyde D Elswick 367500000X Crna, anesthesia assistant 1000 W Harlem Avenue Monmouth IL 61462 30973431411003861634 Patrick W. Elwood 207T00000X Neurosurgery 719 N William Kumpf Blvd Suite 100 Peoria IL 61605 30967607661407872591 Karen J. Englund 207Q00000X Family practice 4423 Manchester Drive Rockford IL 61109 81539413911376558734 Katy I Enloe 225100000X Physical therapist (independently practicing) 719 N William Kumpf Blvd Suite 100 Peoria IL 61605 30967607661649378241 Erhan Ergene 2084N0400X Neurology 530 N E Glen Oak Avenue 6th Floor SFMC Peoria IL 61637 30962489811558346544 Freddy A. Escorcia 207P00000X Emergency medicine 600 S 13th Street Pekin Hospital Pekin IL 61554 30935311011861623100 Osman R Espinoza 207R00000X Internal medicine 1000 W Harlem Avenue Monmouth IL 61462 30973431411861623100 Osman R Espinoza 207R00000X Internal medicine 1000 W Harlem Avenue Monmouth IL 61462 30973431411861623100 Osman R Espinoza 207R00000X Internal medicine 1000 W Harlem Avenue Monmouth IL 61462 30973431411568731321 Francis R. Evangelista 390200000X Unknown supplier/provider specialty 5666 E State Street Rockford IL 61108 81522620001326303983 Diane L. Ewers 367500000X Crna, anesthesia assistant 8600 North Route 91 Suite 240 Peoria IL 61615 30968354571366649279 Chigolum C. Eze 390200000X Unknown supplier/provider specialty 530 N E Glen Oak Avenue 6th Floor SFMC Peoria IL 61637 30962489811639153216 Farhad Farokhi 207RC0001X Internal medicine 444 Roxbury Road Rockford IL 61107 8153983000

Page 5: NPI First Name MI Last Name Taxonomy Code Specialty ... · PDF fileNPI First Name MI Last Name Taxonomy Code Specialty Address 1 Address 2 City State ZIP Code Phone ... Bradley 363LF0000X;

NPI First Name MI Last Name Taxonomy Code Specialty Address 1 Address 2 City State ZIP Code Phone1043284649 John J. Farrell 207RI0200X Infectious disease 723 N E Glen Oak Avenue Peoria IL 61603 30962487491205902442 Daniel R. Fassett 207T00000X Neurosurgery 719 N William Kumpf Blvd Suite 100 Peoria IL 61605 30967607661972739548 Sheila R Feaster 213E00000X Podiatry 1000 W Harlem Avenue Monmouth IL 61462 30973431411972739548 Sheila R Feaster 213E00000X Podiatry 1000 W Harlem Avenue Monmouth IL 61462 30973431411972739548 Sheila R Feaster 213E00000X Podiatry 1000 W Harlem Avenue Monmouth IL 61462 30973431411144224429 Peter J. Fecht 367500000X Crna, anesthesia assistant 3333 N Seminary Street Galesburg IL 61401 30934431611982633202 Lucille A. Fendrick 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30965525531710145453 Dian Feng 207ZP0102X Pathology 5666 E State Street OSF Saint Anthony Medical Center Laboratory Rockford IL 61108 81539551051669452934 Jonathan L. Ferguson 207YX0007X Otolaryngology 698 Featherstone Road Rockford IL 61107 81539832771588976237 Amy M. Ferguson 208000000X Pediatric medicine 530 N E Glen Oak Avenue Peoria IL 61637 30962488181700966116 Angelito J. Fernandez 207Q00000X Family practice 2500 W Reynolds Street Pontiac IL 61764 81584461231669576179 Richard E. Field 174400000X Unknown supplier/provider specialty 6030 Garrett Lane Rockford IL 61107 81522611721952647273 Amy L. Fielder 363A00000X Physician assistant 5666 E State Street Rockford IL 61108 81539552611023042157 Philip A. Fifield 207P00000X Emergency medicine 5114 N Glen Park Place Peoria IL 61614 30926654051477579563 David C. Finnegan 363A00000X Physician assistant 9951 Rock Cut Crossing Loves Park IL 61111 81563985001083899710 Holly L. Fisk 363A00000X Physician assistant 530 N E Glen Oak Avenue 6th Floor SFMC Peoria IL 61637 30962499601891708491 Gary J. Fisk 363AS0400X Physician assistant 5405 N Knoxville Avenue Peoria IL 61614 30969144101255430120 Valerie A. Flacco 207Q00000X Family practice 3375 N Seminary Street Galesburg IL 61401 30934351141407955362 Richard M. Flacco 207Q00000X Family practice 3375 N Seminary Street Galesburg IL 61401 30934351141619185303 Benjamin T. Flagel 207P00000X Emergency medicine 2500 W Reynolds Street Pontiac IL 61764 81584228281477985547 Laura E. Flinn 363LF0000X Nurse practitioner 5111 N Glen Park Place Peoria IL 61614 30968357001235126632 Cynthia A. Floore 207Q00000X Family practice 621 Roxbury Road Rockford IL 61107 81539733501710980396 Ronald B. Foran 174400000X Unknown supplier/provider specialty 5701 Strathmoor Drive Suite 1 Rockford IL 61107 81522756001285607986 Randall S. Fortuna 2086S0129X Vascular surgery 420 N E Glen Oak Avenue Suite 301 Peoria IL 61603 30965534531194724104 Anthony O. Foulen 207L00000X Anesthesiology 1100 E Norris Drive Ottawa IL 61350 81543331001881891240 Samuel D. Fox 207V00000X Obstetrics/gynecology 3315 N Seminary Street Galesburg IL 61401 30934410001093928566 Maria Teresa C. Fraser 2084N0400X Neurology 100 N E Randolph Street Peoria IL 61606 30962485001740211002 Richard C. Frederick 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30965525531417967993 Christine L. Fredrickson 367500000X Crna, anesthesia assistant 3333 N Seminary Street Galesburg IL 61401 30934431611962757799 Kimberly L. French 363LA2100X Nurse practitioner 420 N E Glen Oak Avenue Suite 301 Peoria IL 61603 30965534531861584542 Abraham R. Frenkel 2084P0800X Psychiatry 7317 Willow Lake Court Peoria IL 61614 30968373731356321244 Charles Frey 207K00000X Allergy / immunology 698 Featherstone Road Rockford IL 61107 81539832771144657503 Elaine M. Frink 363L00000X Nurse practitioner 3375 N Seminary Street Galesburg IL 61401 30934351141982738597 Patricia A. Furnace 363L00000X Nurse practitioner 1701 E College Avenue Bloomington IL 61704 30966430001316948987 Douglas H. Gaither 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30965525531417055989 Sonia Gajula 207RE0101X Endocrinology 5105 N Glen Park Place Peoria IL 61614 30968383831285724583 John P. Galbreath 208000000X Pediatric medicine 2900 N Knoxville Avenue Peoria IL 61603 30968836161295903359 Gustavo A. Galue 207Q00000X Family practice 1701 E College Avenue Bloomington IL 61704 30966430001255379863 Kevin J. Gander 207Q00000X Family practice 6830 Villagreen View Rockford IL 61107 81528213391194161992 Jessica E. Garceau 363LG0600X Nurse practitioner 10 Saint Claire Court Suite 100 Washington IL 61571 30988640001104852631 Joanna C. Gardner 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30965525531306028212 Pamela J. Garner 363L00000X Nurse practitioner 530 N E Glen Oak Avenue Peoria IL 61637 30962488181417055922 Dennis J. Garwacki 2084N0400X Neurology 100 N E Randolph Street Peoria IL 61606 30962485001053514414 Mark P Gaudio 207P00000X Emergency medicine 8800 North Route 91 Peoria IL 61615 30968350001346330339 Jessica A. Gedraitis 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30965525531477643708 Mark A. Getz 207RR0500X Rheumatology 200 E Pennsylvania Avenue Suite 101 Peoria IL 61603 30965579001154567964 Leesa E. Gillooley 363A00000X Physician assistant 698 Featherstone Road Rockford IL 61107 81539832771336231836 Richard A. Ginnetti 207Q00000X Family practice 308 Saint Joseph Drive Bloomington IL 61701 30966350501225062573 Metyl A. Ginoli 363L00000X Nurse practitioner 530 N E Glen Oak Avenue 6th Floor SFMC Peoria IL 61637 30962489811669614392 Adam Glassman 207P00000X Emergency medicine 5666 E State Street Rockford IL 61108 81539552611417187659 Alan R. Glatz 363L00000X Nurse practitioner 1701 E College Avenue Bloomington IL 61704 30966199991376629741 Michael L. Glavin 2084P0800X Psychiatry 1207 Starfire Drive Mental Health Dept Ottawa IL 61350 81543154631932288289 Robert C. Glazeski 103T00000X Psychologist (billing independently) 7317 Willow Lake Court Peoria IL 61614 30968373731659428464 Bradley H. Gleason 2084N0400X Neurology 530 N E Glen Oak Avenue 6th Floor SFMC Peoria IL 61637 30962489811003996125 Mukund P Godbole 208600000X General surgery 1000 W Harlem Avenue Monmouth IL 61462 30973431411003996125 Mukund P Godbole 208600000X General surgery 1000 W Harlem Avenue Monmouth IL 61462 30973431411003996125 Mukund P Godbole 208600000X General surgery 1000 W Harlem Avenue Monmouth IL 61462 30973431411366524233 Gail L. Goeppinger 363L00000X Nurse practitioner 10 Saint Claire Court Suite 100 Washington IL 61571 30988640001871740506 Amy Golden 363L00000X Nurse practitioner 1701 E College Avenue Bloomington IL 61704 30966430001255376471 Jocelyn R. Go-Lim 207Q00000X Family practice 1572 S Bell School Road Cherry Valley IL 61016 81533230151871523258 George S. Gorchynsky 207PE0004X Emergency medicine 5666 E State Street Rockford IL 61108 8153955261

Page 6: NPI First Name MI Last Name Taxonomy Code Specialty ... · PDF fileNPI First Name MI Last Name Taxonomy Code Specialty Address 1 Address 2 City State ZIP Code Phone ... Bradley 363LF0000X;

NPI First Name MI Last Name Taxonomy Code Specialty Address 1 Address 2 City State ZIP Code Phone1548295322 Stanley R Gordon 367500000X Crna, anesthesia assistant 1000 W Harlem Avenue Monmouth IL 61462 30973431411548295322 Stanley R Gordon 367500000X Crna, anesthesia assistant 1000 W Harlem Avenue Monmouth IL 61462 30973431411548295322 Stanley R Gordon 367500000X Crna, anesthesia assistant 1000 W Harlem Avenue Monmouth IL 61462 30973431411427130392 Matthew J. Gorman 207R00000X Internal medicine 10 Saint Claire Court Suite 100 Washington IL 61571 30988640001447498878 Emelinda V. Gorostiza-Tolod 2084P0800X Psychiatry 1100 E Norris Drive Ottawa IL 61350 81543331001578534889 Susan Gould 207P00000X Emergency medicine 5666 E State Street Rockford IL 61108 81539552611871645622 Lynn M. Grabher 207R00000X Internal medicine 1701 E College Avenue Bloomington IL 61704 30966430001851484075 Clyde M. Grady 207Q00000X Family practice 104 E Bridge Street Knoxville IL 61448 30928923351386733293 Stephen J. Graham 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30965525531386618833 Samuel A. Grampsas 208800000X Urology 200 E Pennsylvania Avenue Peoria IL 61603 30965520451053315861 Dean A. Gravlin 207R00000X Internal medicine 200 E Pennsylvania Avenue Suite 105 Peoria IL 61603 30965578881275636425 Lynn L. Greeley 208000000X Pediatric medicine 3315 N Seminary Street Galesburg IL 61401 30934410001588890214 Troy M. Green 390200000X Unknown supplier/provider specialty 3333 N Seminary Street Galesburg IL 61401 30934431611629157987 Shelley Falkin Gregg 103T00000X Psychologist (billing independently) 7317 Willow Lake Court Peoria IL 61614 30968373731134350994 Erin N Grinhaug 207P00000X Emergency medicine 600 S 13th Street Pekin Hospital Pekin IL 61554 30935311011568412724 Kelli E. Groomer 363AM0700X Physician assistant 5666 E State Street Rockford IL 61108 81522722731023190337 Henry R. Gross 207Q00000X Family practice 5111 N Glen Park Place Peoria IL 61614 30968357001912083601 Thomas L. Gross 207VM0101X Obstetrics/gynecology 530 N E Glen Oak Avenue Suite 1200 Peoria IL 61637 30962478111982642740 Kristin M. Gruber 207Q00000X Family practice 435 Maxine Drive Morton IL 61550 30926654051336172006 Gudmundur S. Gudmundsson 207RC0000X Cardiology 444 Roxbury Road Rockford IL 61107 81539830001356336952 Gueorgui S. Gueorguiev 207Q00000X Family practice 1614 E Norris Drive Ottawa IL 61350 81543310101053307660 Raul V. Guerrero 207R00000X Internal medicine 1614 E Norris Drive Ottawa IL 61350 81543310101316028855 R. M. Gulley 207R00000X Internal medicine 5114 N Glen Park Place Peoria IL 61614 30968381001669406054 Darrel C. Gumm 207RC0000X Cardiology 5405 N Knoxville Avenue Peoria IL 61614 30969144101215030481 Madan L. Gupta 207RC0000X Cardiology 3315 N Seminary Street Galesburg IL 61401 30934410001518158914 Jody K. Gurtler 363L00000X Nurse practitioner 302 Saint Joseph Drive Bloomington IL 61701 30966430001821177973 Thomas S. Haas 207ZP0102X Pathology 5666 E State Street OSF Saint Anthony Medical Center Laboratory Rockford IL 61108 81539551051033366968 Connie S. Haase 363LF0000X Nurse practitioner 530 N E Glen Oak Avenue Peoria IL 61637 30962485501912101684 Hani Habal 390200000X Unknown supplier/provider specialty 200 E Pennsylvania Avenue Suite 101 Peoria IL 61603 30965579001255360715 John W. Hafner 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30965525531790894897 Sarah E. Hagarty 208200000X Plastic and reconstructive surgery 698 Featherstone Road Rockford IL 61107 81539832771487642419 Rose M. Haisler 207PE0004X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30965525531003164617 Melissa A. Hajostek 363L00000X Nurse practitioner 3315 N Seminary Street Galesburg IL 61401 30934410001578645347 David M. Hall 207R00000X Internal medicine 10 Saint Claire Court Suite 100 Washington IL 61571 30988640001548352107 Ira L Halperin 207R00000X Internal medicine 302 Saint Joseph Drive Bloomington IL 61701 30966253611164431904 Robert S. Hamilton 2084P0800X Psychiatry 405 Kays Drive Suite C Normal IL 61761 30966431301952525222 Jessica R. Hanks 207R00000X Internal medicine 530 N E Glen Oak Avenue Peoria IL 61637 30962488181346299849 Tami L Harker 363L00000X Nurse practitioner 1051 West South Street Kewanee IL 61443 30985275001649410994 Mary J. Harker 363L00000X Nurse practitioner 9951 Rock Cut Crossing Loves Park IL 61111 81592188001346299849 Tami L Harker 363L00000X Nurse practitioner 1051 West South Street P.O. Box 747 Kewanee IL 61443 30985275001346299849 Tami L Harker 363L00000X Nurse practitioner 1051 West South Street P.O. Box 747 Kewanee IL 61443 30985275001447222146 Andrew T. Harris 207P00000X Emergency medicine 1614 E Norris Drive Ottawa IL 61350 81543310101295825586 Jeanne A. Harris 208000000X Pediatric medicine 8600 North Route 91 Suite 200 Peoria IL 61615 30969210301013226794 Carey L Harris 363L00000X Nurse practitioner 302 Saint Joseph Drive Bloomington IL 61701 30966253611699858068 Ravishankar Hasanadka 2086S0129X Vascular surgery 5405 N Knoxville Avenue Peoria IL 61614 30969144101063637544 Syed O. Hassan 207Q00000X Family practice 1954 Gateway Center Drive Belvidere IL 61008 81554474001861438434 Ty E. Hasselman 2080P0202X Cardiology 420 N E Glen Oak Avenue Suite 301 Peoria IL 61603 30965534531366673436 Joseph W. Hauter 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30965525531902895048 William Hauter 207L00000X Anesthesiology 530 N E Glen Oak Avenue Peoria IL 61637 30965525531053688275 Angeline Heaver 363L00000X Nurse practitioner 444 Roxbury Road Rockford IL 61107 81539830001164439659 Gerri A. Hellhake-Hall 363LF0000X Nurse practitioner 5405 N Knoxville Avenue Peoria IL 61614 30969144101316039977 Justin W. Hering 207P00000X Emergency medicine 3333 N Seminary Street Galesburg IL 61401 30934431611588801278 Fabiene R. Herman 207P00000X Emergency medicine 5666 E State Street Rockford IL 61108 81539552611922101104 Jeffrey D. Hershkowitz 207R00000X Internal medicine 3315 N Seminary Street Galesburg IL 61401 30934410001881654937 George Z. Hevesy 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30965525531104916485 Robert G. Hickerson 207Q00000X Family practice 3375 N Seminary Street Galesburg IL 61401 30934351141982933974 Jennifer L. Hicks 363LA2200X Nurse practitioner 200 E Pennsylvania Avenue Peoria IL 61603 30965520451649488925 Craig L. Higgs 208000000X Pediatric medicine 5114 N Glen Park Place Peoria IL 61614 30968356001831269224 Alicia R. High 363A00000X Physician assistant 1701 E College Avenue Bloomington IL 61704 30966430001982898417 Steven R. Hilligoss 367500000X Crna, anesthesia assistant 3333 N Seminary Street Galesburg IL 61401 30934431611104847458 Kerry L. Hincks 207Q00000X Family practice 5111 N Glen Park Place Peoria IL 61614 3096835700

Page 7: NPI First Name MI Last Name Taxonomy Code Specialty ... · PDF fileNPI First Name MI Last Name Taxonomy Code Specialty Address 1 Address 2 City State ZIP Code Phone ... Bradley 363LF0000X;

NPI First Name MI Last Name Taxonomy Code Specialty Address 1 Address 2 City State ZIP Code Phone1225273915 Mustafa Hindi 208M00000X Critical care (intensivists) 1000 W Harlem Avenue Monmouth IL 61462 30973431411225273915 Mustafa Hindi 208M00000X Critical care (intensivists) 1000 W Harlem Avenue Monmouth IL 61462 30973431411578750212 Anne E. Hinz 207R00000X Internal medicine 200 E Pennsylvania Avenue Suite 105 Peoria IL 61603 30965578881659451060 Stephen E. Hippler 207R00000X Internal medicine 8600 North Route 91 Suite 130 Peoria IL 61615 30968350501538184924 Mark W. Hiser 207RC0000X Cardiology 444 Roxbury Road Rockford IL 61107 81539830001841230752 Jennifer S. Hoffman 363LF0000X Nurse practitioner 10 Saint Claire Court Suite 100 Washington IL 61571 30988640001881727287 Linda J. Hokanson 1041C0700X Licensed clinical social worker 405 Kays Drive Suite C Normal IL 61761 30966431301235325994 Stephen R. Holley 207R00000X Internal medicine 530 N E Glen Oak Avenue Peoria IL 61637 30962488181902908932 Charles B. Hollman 174400000X Unknown supplier/provider specialty 6030 Garrett Lane Rockford IL 61107 81522611721053623330 Justin J. Holschbach 207Q00000X Family practice 308 Saint Joseph Drive Bloomington IL 61701 30966350501932320819 Travis A. Holt 208600000X General surgery 1505 Eastland Drive Bloomington IL 61701 30966290221518127950 Nathan P Holt 207Q00000X Family practice 2500 W Reynolds Street Pontiac IL 61764 81584465511033168273 Mark J. Holterman 2086S0120X General surgery 420 N E Glen Oak Avenue Suite 201 Peoria IL 61603 30965523431649228032 Ai-Xuan L. Holterman 2086S0120X General surgery 420 N E Glen Oak Avenue Suite 201 Peoria IL 61603 30965523431255363529 Kent F. Hoskins 207RX0202X Medical oncology 5666 E State Street Rockford IL 61108 81522722731417038852 John W. Houser 207R00000X Internal medicine 319 N Fourth Street Chillicothe IL 61523 30968381001396977278 Aubrey J. Hoye 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30965525531376573428 Mark J. Hsu 207RC0000X Cardiology 5405 N Knoxville Avenue Peoria IL 61614 30969144101831364025 Alisha Hudson 2084P0800X Psychiatry 7317 Willow Lake Court Peoria IL 61614 30968373731740366178 Melissa E. Huggins 207VG0400X Obstetrics/gynecology 5401 N Knoxville Avenue Suite 418 Peoria IL 61614 30968365551437252335 Theresa M. Hughes 213E00000X Podiatry 1707 N Henderson Street Galesburg IL 61401 30934310171659536639 Terry L. Hunt 207L00000X Anesthesiology 2200 Fort Jesse Road Suite 210 Normal IL 61761 30966162501306849989 Alfred R. HuYoung 174400000X Unknown supplier/provider specialty 5701 Strathmoor Drive Suite 1 Rockford IL 61107 81522756001063448652 Elvira M. Iancu 207Q00000X Family practice 9951 Rock Cut Crossing Loves Park IL 61111 81563985001457487597 Lela Iduna 207P00000X Emergency medicine 5666 E State Street Rockford IL 61108 81539552611629282546 Riffat Iftekhar 208000000X Pediatric medicine 420 N E Glen Oak Avenue Suite 201 Peoria IL 61603 88862756731720308687 Esther Ihezie 207P00000X Emergency medicine 5666 E State Street Rockford IL 61108 81539552611316991193 Ossama I. Ikladios 207RP1001X Pulmonary disease 1001 N Main Street Peoria IL 61606 30967256821679630156 Patricio B. Ilada 207Q00000X Family practice 5114 N Glen Park Place Peoria IL 61614 30968366001124046214 Sharon T Ingram 207V00000X Obstetrics/gynecology 2500 W Reynolds Street Pontiac IL 61764 81584235671053403626 Kenneth H. Inoue 207R00000X Internal medicine 1505 Eastland Drive Suite 320 Bloomington IL 61701 30966233111629035829 Tayyaba Irshad 208M00000X Critical care (intensivists) 719 N William Kumpf Blvd Suite 100 Peoria IL 61605 30967607661104884311 Thomas C. Isaacson 207RC0000X Cardiology 444 Roxbury Road Rockford IL 61107 81539830001063640563 Sandra N. Jackson 207R00000X Internal medicine 9951 Rock Cut Crossing Loves Park IL 61111 81563984501538199187 Matthew N. Jackson 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30968366001952331019 Mark D. Jackson 207RC0000X Cardiology 610 Park Avenue Pekin IL 61554 30969144101356544472 Matthew D. Jager 207R00000X Internal medicine 5101 N Executive Drive Peoria IL 61614 30967707001841529625 Shivi Jain 207R00000X Internal medicine 5666 E State Street Rockford IL 61108 81522620001013950476 Asad Jamal 207Q00000X Family practice 9951 Rock Cut Crossing Loves Park IL 61111 81563984501669575460 Brij Jamnadas 207R00000X Internal medicine 3315 N Seminary Street Galesburg IL 61401 30934410001154361566 Harshal H. Jani 363A00000X Physician assistant 1701 E College Avenue Bloomington IL 61704 30966430001790877835 Jyotir H. Jani 207Q00000X Family practice 2200 Fort Jesse Road Suite 110 Normal IL 61761 30966162901851559942 Jaydev Y Jani 207R00000X Internal medicine 302 Saint Joseph Drive Bloomington IL 61701 30966253611306030648 Kamran Javaid 207R00000X Internal medicine 1505 Eastland Drive Suite 320 Bloomington IL 61701 30966123681831165034 Timothy E. Jessen 207K00000X Allergy / immunology 698 Featherstone Road Rockford IL 61107 81539832771861411027 Won H. Jhee 208100000X Physical medicine and rehabilitation 2200 Fort Jesse Road Suite 200 Normal IL 61761 30966162401013128925 Nayantara Jnananand 207Q00000X Family practice 1000 W Harlem Avenue Monmouth IL 61462 30973431411013128925 Nayantara Jnananand 207Q00000X Family practice 1000 W Harlem Avenue Monmouth IL 61462 30973431411013128925 Nayantara Jnananand 207Q00000X Family practice 1000 W Harlem Avenue Monmouth IL 61462 30973431411083962500 Jessica L. Johann 363L00000X Nurse practitioner 2200 Fort Jesse Road Suite 110 Normal IL 61761 30966162901407039167 Michele D. Johnson 363LA2200X Nurse practitioner 698 Featherstone Road Suite 250 Rockford IL 61107 81539944041043445869 Christopher R. Johnson 207Q00000X Family practice 435 Maxine Drive Suites 3 & 4 Morton IL 61550 30926324241235133935 David M. Johnson 207R00000X Internal medicine 200 E Pennsylvania Avenue Suite 105 Peoria IL 61603 30965578881689926784 Samantha R. Johnson 363L00000X Nurse practitioner 2200 E Washington Street Bloomington IL 61701 30966123681033425145 Timothy W. Johnson 363A00000X Physician assistant 3315 N Seminary Street Galesburg IL 61401 30934410001841236254 Jeffrey A. Jones 367500000X Crna, anesthesia assistant 8600 North Route 91 Suite 240 Peoria IL 61615 30968354571952302101 Matthew T. Jordan 207P00000X Emergency medicine 2500 W Reynolds Street Pontiac IL 61764 81584228281881974541 Sarah A. Joseph 208000000X Pediatric medicine 10 Saint Claire Court Suite 100 Washington IL 61571 30988640001275794992 Andy C. Jou 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30965525531437119450 Mohammed Kaleemuddin 207Q00000X Family practice 9951 Rock Cut Crossing Loves Park IL 61111 81563984501205876166 Jane A. Kalmes 363AM0700X Physician assistant 5114 N Glen Park Place Peoria IL 61614 3096836600

Page 8: NPI First Name MI Last Name Taxonomy Code Specialty ... · PDF fileNPI First Name MI Last Name Taxonomy Code Specialty Address 1 Address 2 City State ZIP Code Phone ... Bradley 363LF0000X;

NPI First Name MI Last Name Taxonomy Code Specialty Address 1 Address 2 City State ZIP Code Phone1780811513 Kavitha Kalvakuri 207R00000X Internal medicine 530 N E Glen Oak Avenue Peoria IL 61637 30937030541295805174 Binoy Kamal 208M00000X Critical care (intensivists) 5666 E State Street Rockford IL 61108 81522620001447452180 Bhavana S. Kandikattu 208000000X Pediatric medicine 530 N E Glen Oak Avenue Peoria IL 61637 30926324241174772552 Kristin Kang 363LP0200X Nurse practitioner 420 N E Glen Oak Avenue Suite 201 Peoria IL 61603 30965523431447283015 Anuradha Kantamneni 207R00000X Internal medicine 1701 E College Avenue Bloomington IL 61704 30966430001184722647 Maria M. Karbowska-Jankowska 2084N0400X Neurology 100 N E Randolph Street Peoria IL 61606 30962485001750489050 Jorge C. Kattah 2084N0400X Neurology 530 N E Glen Oak Avenue 6th Floor SFMC Peoria IL 61637 30962489811942279252 Martha A. Kelley 207P00000X Emergency medicine 3333 N Seminary Street Galesburg IL 61401 30934431611689802282 JaCara Kelley-Muhammad 207Q00000X Family practice 3315 N Seminary Street Galesburg IL 61401 30934410001639209679 Calista R Kelly 225100000X Physical therapist (independently practicing) 719 N William Kumpf Blvd Suite 100 Peoria IL 61605 30967607661114187705 Molly M. Kelly 207L00000X Anesthesiology 1100 E Norris Drive Ottawa IL 61350 81543331001699095067 Benjamin O. Kemp 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30965525531265629760 Harleena K. Kendhari 208000000X Pediatric medicine 420 N E Glen Oak Avenue Suite 201 Peoria IL 61603 88862756731437499803 Kristin M. Kendrick 363L00000X Nurse practitioner 2200 Fort Jesse Road Suite 110 Normal IL 61761 30966162901457376725 Gail L. Kennedy 208000000X Pediatric medicine 302 Saint Joseph Drive Bloomington IL 61701 30966430001578656716 Mary H. Kennedy 363L00000X Nurse practitioner 105 W Hack Street Cullom IL 60929 81568921261578656716 Mary H. Kennedy 363L00000X Nurse practitioner 105 W Hack Street Cullom IL 60929 81568921261710070057 Tom J. Kenney 207Q00000X Family practice 1405 Eastland Drive Bloomington IL 61701 30966124001063424836 Nancy K. Kertz 363LF0000X Nurse practitioner 5666 E State Street Rockford IL 61108 81522620001558641662 Megan M. Kesler 363LF0000X Nurse practitioner 5114 N Glen Park Place Peoria IL 61614 30968356001346448388 Bonnie May-Hung Keung 207R00000X Internal medicine 530 N E Glen Oak Avenue 6th Floor SFMC Peoria IL 61637 30962489811881783793 Niko I. Keys 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30965525531023018322 Asra F. Khan 207Q00000X Family practice 9951 Rock Cut Crossing Loves Park IL 61111 81563984501043484736 Ajaz M. Khan 207RH0003X Hematology/oncology 5666 E State Street Rockford IL 61108 81522722731003822941 Masood Khan 208000000X Pediatric medicine 3315 N Seminary Street Galesburg IL 61401 30934410001386865244 Omar S. Khokhar 207R00000X Internal medicine 1701 E College Avenue Bloomington IL 61704 30966430001477572154 John F. Kincinas 363A00000X Physician assistant 2500 W Reynolds Street Pontiac IL 61764 81584440621295838001 James H. King 207R00000X Internal medicine 3315 N Seminary Street Galesburg IL 61401 30934410001306861463 Katherine M Kinsella 363LF0000X Nurse practitioner 1051 West South Street P.O. Box 747 Kewanee IL 61443 30985275001609197565 Amy Kiraly 207P00000X Emergency medicine 2500 W Reynolds Street Pontiac IL 61764 81584228281972552529 Lance A, Kirby 363A00000X Physician assistant 5114 N Glen Park Place Peoria IL 61614 30968366001558336214 Tinoy J. Kizhakekuttu 207R00000X Internal medicine 3375 N Seminary Street Galesburg IL 61401 30934377751578508354 Jeffrey B. Klopfenstein 174400000X Unknown supplier/provider specialty 719 N William Kumpf Blvd Suite 100 Peoria IL 61605 30967607661760824114 Kaitlin L. Knackstedt 363A00000X Physician assistant 5666 E State Street Rockford IL 61108 81522620001336174580 Lawrence D. Kneezel 207R00000X Internal medicine 1701 E College Avenue Bloomington IL 61704 30966430001568686277 Marc D. Knepp 208000000X Pediatric medicine 420 N E Glen Oak Avenue Suite 301 Peoria IL 61603 30965534531346322310 Matthew E. Knight 208000000X Pediatric medicine 435 Maxine Drive Suites 3 & 4 Morton IL 61550 30926324241588693626 William E. Kobler 207Q00000X Family practice 6830 Villagreen View Rockford IL 61107 81528213391679535728 Micheal D Koeppen 207Q00000X Family practice 3333 N Seminary Street Galesburg IL 61401 30934431611992917009 Ushasri Koganti 207QH0002X Family practice 1207 Starfire Drive Suite 3 Ottawa IL 61350 81543420481740575976 Stephanie Kok 207P00000X Emergency medicine 600 S 13th Street Pekin Hospital Pekin IL 61554 30935311011073741021 Spandana Kolakaleti 207R00000X Internal medicine 1701 E College Avenue Bloomington IL 61704 30966430001336172121 Ramaprasad Konanur 208M00000X Critical care (intensivists) 530 N E Glen Oak Avenue Peoria IL 61637 30962488181326028507 Edward Koo 207Q00000X Family practice 1614 E Norris Drive Ottawa IL 61350 81543310101902833999 Mete Korkmaz 207RX0202X Medical oncology 5666 E State Street Rockford IL 61108 81522722731124037429 Kathryn B. Kott 363L00000X Nurse practitioner 1701 E College Avenue Bloomington IL 61704 30966430001033373907 Michael D. Kouimelis 207Q00000X Family practice 9951 Rock Cut Crossing Loves Park IL 61111 81563985001275626525 Mary J. Krall 363L00000X Nurse practitioner 106 S First Street Fairbury IL 61739 81569223081720188204 Elizabeth S. Kramer 208000000X Pediatric medicine 530 N E Glen Oak Avenue Peoria IL 61637 30926324241801886890 Christine I. Krause 363L00000X Nurse practitioner 4682 E Rockton Road Suite 102 Roscoe IL 61073 81562413001124126909 John F. Kreckman 207Q00000X Family practice 1505 Eastland Drive Suite 1100 Bloomington IL 61701 30966321001215029582 Jean M. Kriz 207PE0004X Emergency medicine 5666 E State Street Rockford IL 61108 81539552611821082751 Kelley A. Krug 363A00000X Physician assistant 3375 N Seminary Street Galesburg IL 61401 30934351141669588869 Joseph J Krug 207PE0004X Emergency medicine 1000 W Harlem Avenue Monmouth IL 61462 30973431411669588869 Joseph J Krug 207PE0004X Emergency medicine 1000 W Harlem Avenue Monmouth IL 61462 30973431411669588869 Joseph J Krug 207PE0004X Emergency medicine 1000 W Harlem Avenue Monmouth IL 61462 30973431411477729796 Sara M. Krzyzaniak 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30965525531992858617 Vijay Kumar 207RE0101X Endocrinology 1701 E College Avenue Bloomington IL 61704 30966430001285608976 Shaun Kurien 207R00000X Internal medicine 444 Roxbury Road Rockford IL 61107 81539830001366476772 Stephen Craig Kurtz 207RC0000X Cardiology 5405 N Knoxville Avenue Peoria IL 61614 30969144101881674299 David S. Laib 207ZP0102X Pathology 5666 E State Street OSF Saint Anthony Medical Center Laboratory Rockford IL 61108 8153955105

Page 9: NPI First Name MI Last Name Taxonomy Code Specialty ... · PDF fileNPI First Name MI Last Name Taxonomy Code Specialty Address 1 Address 2 City State ZIP Code Phone ... Bradley 363LF0000X;

NPI First Name MI Last Name Taxonomy Code Specialty Address 1 Address 2 City State ZIP Code Phone1285842666 Catherine Lamb 207R00000X Internal medicine 530 N E Glen Oak Avenue Peoria IL 61637 30962488181013202530 Austin J. Lamb 207P00000X Emergency medicine 600 S 13th Street Pekin Hospital Pekin IL 61554 30935311011972522720 Daniel P. Lange 208800000X Urology 1701 E College Avenue Bloomington IL 61704 30966430001457634693 Meropi I. Langley 363L00000X Nurse practitioner 5114 N Glen Park Place Peoria IL 61614 30968381081285668723 Christine E. Larson 363A00000X Physician assistant 6830 Villagreen View Rockford IL 61107 81528213391538116975 Frank T Lasala 207Q00000X Family practice 1000 W Harlem Avenue Monmouth IL 61462 30973431411538116975 Frank T Lasala 207Q00000X Family practice 1000 W Harlem Avenue Monmouth IL 61462 30973431411538116975 Frank T Lasala 207Q00000X Family practice 1000 W Harlem Avenue Monmouth IL 61462 30973431411720398480 Daniel S. Lau 207Q00000X Family practice 918 E Lincoln Street Chenoa IL 61726 81594522611720398480 Daniel S. Lau 207Q00000X Family practice 918 E Lincoln Street Chenoa IL 61726 81594522611437443777 Vivian Lau 207P00000X Emergency medicine 600 S 13th Street Pekin Hospital Pekin IL 61554 30935311011932148145 William B. Lauth 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30965525531831134436 Victor Lawrinenko 207RG0100X Gastroenterology 2805 N Knoxville Avenue Peoria IL 61603 30962494001366435158 Richard H. Lee 174400000X Unknown supplier/provider specialty 719 N William Kumpf Blvd Suite 100 Peoria IL 61605 30967607661225108855 Shao-Tseng Lee 207R00000X Internal medicine 5114 N Glen Park Place Peoria IL 61614 30968381081649216789 Kristen M. Lee 363AM0700X Physician assistant 3333 N Seminary Street Galesburg IL 61401 30934431611427331404 Brittany S. Lees 363LA2200X Nurse practitioner 530 N E Glen Oak Avenue Peoria IL 61637 30962488181891888145 Dawn R. Lemmert 207Q00000X Family practice 435 Maxine Drive Suites 3 & 4 Morton IL 61550 30926324241730132333 Cheryl A. LeNeve 363A00000X Physician assistant 5111 N Glen Park Place Peoria IL 61614 30968357001760562177 Ronald K. Leonard 207Q00000X Family practice 235 E Penn Avenue P.O. Box 110 Roseville IL 61473 30942621281033295738 Michael R. Leonardi 207VM0101X Obstetrics/gynecology 530 N E Glen Oak Avenue Suite 1200 Peoria IL 61637 30962478111427328798 Megan C. Lesley Glenn 363A00000X Physician assistant 530 N E Glen Oak Avenue Peoria IL 61637 30962488181750466710 Deidra K. Lewandowski 363L00000X Nurse practitioner 530 N E Glen Oak Avenue 6th Floor SFMC Peoria IL 61637 30962489811669456729 Berry E. Lewis 207PE0004X Emergency medicine 2500 W Reynolds Street Pontiac IL 61764 81584228281215966858 Edison U. Lim 207Q00000X Family practice 1572 S Bell School Road Cherry Valley IL 61016 81533230151437104593 Julian J. Lin 207T00000X Neurosurgery 719 N William Kumpf Blvd Suite 100 Peoria IL 61605 30967607661770681629 Larry S. Lindahl 207RG0300X Geriatric medicine 8600 North Route 91 Suite 130 Peoria IL 61615 30968350581740205954 James S Lindbom 207R00000X Internal medicine 1051 West South Street Kewanee IL 61443 30985275001740205954 James S Lindbom 207R00000X Internal medicine 1051 West South Street Kewanee IL 61443 30985275001740205954 James S Lindbom 207R00000X Internal medicine 1051 West South Street Kewanee IL 61443 30985275001871692798 Greg A. Link 207Q00000X Family practice 435 Maxine Drive Suites 3 & 4 Morton IL 61550 30926324241669564738 Joseph H. Liu 207Q00000X Family practice 2200 Fort Jesse Road Suite 110 Normal IL 61761 30966162901366540684 Yan Liu 207R00000X Internal medicine 3315 N Seminary Street Galesburg IL 61401 30934410001023100781 Shannon K. Lizer 363LF0000X Nurse practitioner 5666 E State Street Rockford IL 61108 81522620001003942491 Steven M. Lome 207RC0000X Cardiology 1050 E Norris Drive Suite 2C Ottawa IL 61350 81543402761366485906 Layne T. Lovell 207Q00000X Family practice 5114 N Glen Park Place Peoria IL 61614 30968366001134368129 Jeffrey A. Lowe 207X00000X Orthopedic surgery 2500 W Reynolds Street Pontiac IL 61764 81584440621124349089 Molly K. Lundy 208000000X Pediatric medicine 435 Maxine Drive Suites 3 & 4 Morton IL 61550 30926324241649469826 Katherine V. Lutyens 363AM0700X Physician assistant 435 Maxine Drive Morton IL 61550 30926654051104894906 Teresa J. Lynch 207R00000X Internal medicine 530 N E Glen Oak Avenue Peoria IL 61637 30962496901205262508 Ashley I. Lynn 363L00000X Nurse practitioner 100 N E Randolph Street Peoria IL 61606 30962485001215963798 Justin Macariola-Coad 207P00000X Emergency medicine 5666 E State Street Rockford IL 61108 81539552611942308291 Nancy A. Machens 363L00000X Nurse practitioner 530 N E Glen Oak Avenue 6th Floor SFMC Peoria IL 61637 30962489811952510729 Rachid Ryan Macwar 207RC0000X Cardiology 5405 N Knoxville Avenue Peoria IL 61614 30969144101033543822 Elizabeth A. Madlem 363L00000X Nurse practitioner 1505 Eastland Drive Suite 1100 Bloomington IL 61701 30966321001144266065 Madhavi Madugula 207Q00000X Family practice 2200 Fort Jesse Road Suite 110 Normal IL 61761 30966162901174571673 Robert B. Maguire 207R00000X Internal medicine 1614 E Norris Drive Ottawa IL 61350 81543310101346479458 Rajat Maheshwari 207R00000X Internal medicine 530 N E Glen Oak Avenue Peoria IL 61637 30962488181891992269 Dejan Maksimovic 207Q00000X Family practice 8800 North Route 91 Peoria IL 61615 30968350001407965585 Shaista A. Malik 207L00000X Anesthesiology 1100 E Norris Drive Ottawa IL 61350 81543331001447284864 Muhammad F. Malik 207RC0000X Cardiology 5405 N Knoxville Avenue Peoria IL 61614 30969144101740296953 Mark J. Malone 207RP1001X Pulmonary disease 1505 Eastland Drive Suite 320 Bloomington IL 61701 30966123681164452611 Michael B. Maloney 207R00000X Internal medicine 698 Featherstone Road Suite 250 Rockford IL 61107 81539944041568620276 Salman Mamdani 207P00000X Emergency medicine 5666 E State Street Rockford IL 61108 81539552611457580680 Ashvarya Mangla 207R00000X Internal medicine 530 N E Glen Oak Avenue Peoria IL 61637 30962488181346299641 David O. Manigold 207R00000X Internal medicine 1614 E Norris Drive Ottawa IL 61350 81543310101508977133 Robin L. Maniurski 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30965525531477701639 Zlatina G. Manov 207Q00000X Family practice 5666 E State Street Rockford IL 61108 81522620001811078207 Haytham Mansour 213ES0103X Podiatry 1000 W Harlem Avenue Monmouth IL 61462 30973431411811078207 Haytham Mansour 213ES0103X Podiatry 1000 W Harlem Avenue Monmouth IL 61462 30973431411558422931 Rabia Manzoor 2080A0000X Pediatric medicine 9951 Rock Cut Crossing Loves Park IL 61111 8156398470

Page 10: NPI First Name MI Last Name Taxonomy Code Specialty ... · PDF fileNPI First Name MI Last Name Taxonomy Code Specialty Address 1 Address 2 City State ZIP Code Phone ... Bradley 363LF0000X;

NPI First Name MI Last Name Taxonomy Code Specialty Address 1 Address 2 City State ZIP Code Phone1720018161 Michael A. Marck 207PE0004X Emergency medicine 9951 Rock Cut Crossing Loves Park IL 61111 81563985001255678751 Gail M Marich 363LA2100X Nurse practitioner 5666 E State Street Rockford IL 61108 81539552611154348969 Daniel S. Marley 207Q00000X Family practice 1701 E College Avenue Bloomington IL 61704 30966430001124189865 Dorcas S. Maroon 363AS0400X Physician assistant 5405 N Knoxville Avenue Peoria IL 61614 30969144101144219171 John D. Marshall 207L00000X Anesthesiology 719 N William Kumpf Blvd Suite 100 Peoria IL 61605 30967607661710142740 Monica A. Martens 207Q00000X Family practice 9951 Rock Cut Crossing Loves Park IL 61111 81563985001043285315 Christopher J. Martin 207R00000X Internal medicine 530 N E Glen Oak Avenue Peoria IL 61637 30962488181578874293 Daniel K. Martin 207R00000X Internal medicine 2805 N Knoxville Avenue Peoria IL 61603 30962494001457441743 Henry Martin-del-Campo 207Q00000X Family practice 5114 N Glen Park Place Peoria IL 61614 30926324241194830695 Michele E. Masching-Wright 363A00000X Physician assistant 2500 W Reynolds Street Pontiac IL 61764 81584228281508045626 Sterlon A. Matheny 367500000X Crna, anesthesia assistant 3333 N Seminary Street Galesburg IL 61401 30934431611457451957 Maureen L. Mathews 363L00000X Nurse practitioner 530 N E Glen Oak Avenue 6th Floor SFMC Peoria IL 61637 30962485251063702116 Kristy Matschullat 363A00000X Physician assistant 5666 E State Street Rockford IL 61108 81539552611609974096 Shanta D. Mattai 2084N0400X Neurology 100 N E Randolph Street Peoria IL 61606 30962485001619906146 Paul M. Matthews 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30965525531033365291 Mathew J. Maupin 367500000X Crna, anesthesia assistant 3333 N Seminary Street Galesburg IL 61401 30934431611508054297 Todd D. McCall 207T00000X Neurosurgery 719 N William Kumpf Blvd Suite 100 Peoria IL 61605 30967607661033327069 John M. McCarthy 207R00000X Internal medicine 530 N E Glen Oak Avenue Peoria IL 61637 30937030541033248208 Neil Mcclymont 207P00000X Emergency medicine 5666 E State Street Rockford IL 61108 81539552611891885182 Randolph L. McCrea 207R00000X Internal medicine 5114 N Glen Park Place Peoria IL 61614 30968356001104879071 Rachel D. McDowell 207PE0004X Emergency medicine 5666 E State Street Rockford IL 61108 81539552611598799926 Donald B. McElroy 207RC0000X Cardiology 5405 N Knoxville Avenue Peoria IL 61614 30969144101245244862 James L. McGee 2085R0001X Radiation oncology 530 N E Glen Oak Avenue Peoria IL 61637 30965568101407010333 Mackenzie C. McGee 2085R0203X Interventional Radiology 530 N E Glen Oak Avenue Peoria IL 61637 30965568101568452555 Cynthia A. McGrath 363LF0000X Nurse practitioner 9951 Rock Cut Crossing Loves Park IL 61111 81563985001184723934 Mary K. McKinley 363L00000X Nurse practitioner 3375 N Seminary Street Galesburg IL 61401 30934351141669463436 Scott W McLain 207R00000X Internal medicine 302 Saint Joseph Drive Bloomington IL 61701 30966253611861473076 Dennis Q. McManus 2084N0400X Neurology 8600 North Route 91 Suite 130 Peoria IL 61615 30968350581669553012 Gerald J. McShane 207R00000X Internal medicine 5114 N Glen Park Place Peoria IL 61614 30968381001073714176 Bryan P. McVay 207R00000X Internal medicine 1001 N Main Street Peoria IL 61606 30967256821447223789 Kathleen M. Meade 207Q00000X Family practice 9951 Rock Cut Crossing Loves Park IL 61111 81563985001073509683 Ruben Medrano 207R00000X Internal medicine 1000 W Harlem Avenue Monmouth IL 61462 30973431411073509683 Ruben Medrano 207R00000X Internal medicine 1000 W Harlem Avenue Monmouth IL 61462 30973431411073509683 Ruben Medrano 207R00000X Internal medicine 1000 W Harlem Avenue Monmouth IL 61462 30973431411225139058 Mark A. Meeker 207R00000X Internal medicine 3315 N Seminary Street Galesburg IL 61401 30934410001174616411 Shilpa I. Mehta 207Q00000X Family practice 1505 Eastland Drive Suite 1100 Bloomington IL 61701 30966124001518118140 Teresa D. Mejorado 363A00000X Physician assistant 2200 Fort Jesse Road Suite 220 Normal IL 61761 30966162301790727410 Susan M. Mettille 363A00000X Physician assistant 2805 N Knoxville Avenue Peoria IL 61603 30962494001598062689 Stephanie C. Meuser 363L00000X Nurse practitioner 435 Maxine Drive Morton IL 61550 30926654051437244555 Jon C. Michel 207RP1001X Pulmonary disease 1001 N Main Street Peoria IL 61606 30967256821790927309 James B. Mikeworth 207R00000X Internal medicine 2500 W Reynolds Street Pontiac IL 61764 81584420011871675645 Rhett L. Miller 207R00000X Internal medicine 10 Saint Claire Court Suite 100 Washington IL 61571 30988640001891885190 Barry L. Miller 207R00000X Internal medicine 5114 N Glen Park Place Peoria IL 61614 30968356001942238613 Richard F Miller 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30965525531902131014 David E. Milligan 208000000X Pediatric medicine 302 Saint Joseph Drive Bloomington IL 61701 30966430001740209261 Robert L. Minor 207RC0000X Cardiology 444 Roxbury Road Rockford IL 61107 81539830001174747885 Matthew J. Mischler 208000000X Pediatric medicine 530 N E Glen Oak Avenue Peoria IL 61637 30962488181174739205 Jessica M. Mitchell 363L00000X Nurse practitioner 530 N E Glen Oak Avenue Peoria IL 61637 30937030541770714776 Todd R. Mitchell 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30965525531679674402 Jerry E. Mitchell 208600000X General surgery 3315 N Seminary Street Galesburg IL 61401 30934410001093726226 James N Mock 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30965525531144216243 Syed M. Mohiuddin 207Q00000X Family practice 4423 Manchester Drive Rockford IL 61109 81539413911053645580 Noel C. Molina 207R00000X Internal medicine 530 N E Glen Oak Avenue Peoria IL 61637 30962488181437380748 Jeremy R. Monroe 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30965525531922394121 Daniel P. Montemayor 207P00000X Emergency medicine 600 S 13th Street Pekin Hospital Pekin IL 61554 30935311011902096142 Sergio E. Morales 207P00000X Emergency medicine 600 S 13th Street Pekin Hospital Pekin IL 61554 30935311011073776134 Aimee C. Morell-Watton 207R00000X Internal medicine 5666 E State Street Rockford IL 61108 81522620001679547947 Scott C. Morgan 208800000X Urology 1701 E College Avenue Bloomington IL 61704 30966199991720178007 David D. Morland 363A00000X Physician assistant 120 E Division Steet Galva IL 61434 30993238001336104884 Teresa J. Morrell-Riech 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30965525531548281082 Charles T. Morton 2080P0006X Pediatric medicine 302 Saint Joseph Drive Bloomington IL 61701 3096643000

Page 11: NPI First Name MI Last Name Taxonomy Code Specialty ... · PDF fileNPI First Name MI Last Name Taxonomy Code Specialty Address 1 Address 2 City State ZIP Code Phone ... Bradley 363LF0000X;

NPI First Name MI Last Name Taxonomy Code Specialty Address 1 Address 2 City State ZIP Code Phone1033161054 Gregory T. Moskop 207Q00000X Family practice 5111 N Glen Park Place Peoria IL 61614 30968357001013144021 Lacey D. Moy 207Q00000X Family practice 1506 W Reynolds Street Pontiac IL 61764 81584461231154558732 Calvin Moy 207Q00000X Family practice 1506 W Reynolds Street Pontiac IL 61764 81584461231952335333 John H. Mueller 207Q00000X Family practice 9951 Rock Cut Crossing Loves Park IL 61111 81563985001598799942 Dale K. Mueller 208G00000X Thoracic surgery 5405 N Knoxville Avenue Peoria IL 61614 30969144101568542975 Kathryn A. Mulcahey 207R00000X Internal medicine 8600 North Route 91 Suite 130 Peoria IL 61615 30968350501558791459 Brian Mulder 363L00000X Nurse practitioner 5666 E State Street Rockford IL 61108 81539552611013953546 Laxmi V. Mullapudi 207R00000X Internal medicine 5666 E State Street Rockford IL 61108 81522620001437165966 Anna M. Mullens 363L00000X Nurse practitioner 5114 N Glen Park Place Peoria IL 61614 30968381001700836509 Melisa S Mundwiler 363L00000X Nurse practitioner 1051 West South Street Kewanee IL 61443 30985275001700836509 Melisa S Mundwiler 363L00000X Nurse practitioner 1051 West South Street P.O. Box 747 Kewanee IL 61443 30985275001700836509 Melisa S Mundwiler 363L00000X Nurse practitioner 1051 West South Street P.O. Box 747 Kewanee IL 61443 30985275001760670913 Megha Mungee 207Q00000X Family practice 5111 N Glen Park Place Peoria IL 61614 30968357001023113743 Sudhir Mungee 207RI0011X Internal medicine 5405 N Knoxville Avenue Peoria IL 61614 30969144101154576221 Tanya J. Munger 363L00000X Nurse practitioner 621 Roxbury Road Rockford IL 61107 81539733501992735922 James R. Munns 208G00000X Thoracic surgery 5405 N Knoxville Avenue Peoria IL 61614 30969144101962832394 Leann M. Murphy 363A00000X Physician assistant 5114 N Glen Park Place Peoria IL 61614 30965524311104087394 Thomas C. Murphy 207Q00000X Family practice 1506 W Reynolds Street Pontiac IL 61764 81584461231235324450 Lyle A. Murphy 363AM0700X Physician assistant 1707 N Henderson Street Galesburg IL 61401 30934410001013149889 Rachel N. Myers 207Q00000X Family practice 109 N Franklin Street Byron IL 61010 81539545421265695498 Nur-Ain Nadir 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30965525531881609675 Kakan K Naha 207R00000X Internal medicine 1051 West South Street Kewanee IL 61443 30985275001881609675 Kakan K Naha 207R00000X Internal medicine 1051 West South Street Kewanee IL 61443 30985275001881609675 Kakan K Naha 207R00000X Internal medicine 1051 West South Street Kewanee IL 61443 30985275001003019209 Deepak S. Nair 2084N0400X Neurology 530 N E Glen Oak Avenue 6th Floor SFMC Peoria IL 61637 30962489811144206178 Paul R. Naour 207LP2900X Anesthesiology 2200 Fort Jesse Road Suite 210 Normal IL 61761 30966162501821261892 Jibran Naseer 207Q00000X Family practice 2200 Fort Jesse Road Suite 110 Normal IL 61761 30966162901104023092 Christopher W. Nau 207R00000X Internal medicine 319 N Fourth Street Chillicothe IL 61523 30967364641639286131 William L. Neil 207Q00000X Family practice 1701 E College Avenue Bloomington IL 61704 30966430001497957468 Hrachya Nersesyan 2084N0400X Neurology 100 N E Randolph Street Peoria IL 61606 30962485001164521928 James M. Nesselroad 207Q00000X Family practice 3375 N Seminary Street Galesburg IL 61401 30934351141457540379 Michelle M. Nice 363LF0000X Nurse practitioner 535 Roxbury Rd. Rockford IL 61107 81538717171124276811 Deborah L. Nielsen 363LA2100X Nurse practitioner 2500 W Reynolds Street Pontiac IL 61764 81584453431588765317 Borislav M. Nikolov 2084N0400X Neurology 3315 N Seminary Street Galesburg IL 61401 30934410001588765317 Borislav M. Nikolov 2084N0400X Neurology 3315 N Seminary Street Galesburg IL 61401 30934410001821382052 Nicole M. Noel 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30965525531902890932 Sheri L. Noonan 363A00000X Physician assistant 1505 Eastland Drive Suite 210 Bloomington IL 61701 30966255061376570846 Richard E. Nora 207RX0202X Medical oncology 5666 E State Street Rockford IL 61108 81522722731346333689 Paul F. Nord 207Q00000X Family practice 308 Saint Joseph Drive Bloomington IL 61701 30966350501396789210 Kimberly S. Nord 363L00000X Nurse practitioner 1405 Eastland Drive Bloomington IL 61701 30966124001316988934 Steven S. Norris 207Q00000X Family practice 530 N E Glen Oak Avenue Peoria IL 61637 30962488181275625865 Pamela J Norris 363L00000X Nurse practitioner 302 Saint Joseph Drive Bloomington IL 61701 30966253611134172943 Abdel H. Noureldin 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30965525531740367895 William V. Novak 207RC0000X Cardiology 1505 Eastland Drive Suite 330 Bloomington IL 61701 30966558001114142643 Christina B. Nulty 207RA0000X Internal medicine 5101 N Executive Drive Peoria IL 61614 30967707001639148356 William G. Nulty 2080A0000X Pediatric medicine 5101 N Executive Drive Peoria IL 61614 30967707001073606323 Shai J. Nyi 207V00000X Obstetrics/gynecology 2500 W Reynolds Street Pontiac IL 61764 81584235671124110499 Jon G Oakley 207PE0004X Emergency medicine 600 S 13th Street Pekin Hospital Pekin IL 61554 30935311011790922599 Elizabeth A Objartel 363L00000X Nurse practitioner 5114 N Glen Park Place Peoria IL 61614 30968381081275741829 Daniel E. O'Brien 207R00000X Internal medicine 928 W Mount Vernon Metamora IL 615481184836561 Christy A. Oliphant 208000000X Pediatric medicine 8600 North Route 91 Suite 200 Peoria IL 61615 30969210301881724508 Phillip J. Olsson 207RN0300X Nephrology 2265 W Altorfer Drive Peoria IL 61615 30968394711164451456 Bernard E. O'Malley 207Q00000X Family practice 13539 IL Route 76 Poplar Grove IL 61065 81576501471760411367 Allan L. Ong 208M00000X Critical care (intensivists) 5666 E State Street Rockford IL 61108 81522620001366422438 Ron M. Oren 207RC0000X Cardiology 5405 N Knoxville Avenue Peoria IL 61614 30969144101235249921 Chad S. Osborne 207Q00000X Family practice 1701 E College Avenue Bloomington IL 61704 30966430001952331993 Pasupathy Padmanabhan 207RC0000X Cardiology 3375 N Seminary Street Galesburg IL 61401 30934377751720242605 Alexandra A. Paprocki 207R00000X Internal medicine 5114 N Glen Park Place Peoria IL 61614 30968356001689992885 Ruchi Parikh 207Q00000X Family practice 1954 Gateway Center Drive Belvidere IL 61008 81554474001396907317 Edward Park 207R00000X Internal medicine 1505 Eastland Drive Suite 320 Bloomington IL 61701 30966233111699937888 Sarah E. Parker 390200000X Unknown supplier/provider specialty 530 N E Glen Oak Avenue 6th Floor SFMC Peoria IL 61637 3096248981

Page 12: NPI First Name MI Last Name Taxonomy Code Specialty ... · PDF fileNPI First Name MI Last Name Taxonomy Code Specialty Address 1 Address 2 City State ZIP Code Phone ... Bradley 363LF0000X;

NPI First Name MI Last Name Taxonomy Code Specialty Address 1 Address 2 City State ZIP Code Phone1528375706 Marisa L. Parker 363L00000X Nurse practitioner 3375 N Seminary Street Galesburg IL 61401 30934351141003015447 Ryan E. Parnham 363LF0000X Nurse practitioner 530 N E Glen Oak Avenue Peoria IL 61637 30962488181184631418 Marian Parr 363LF0000X Nurse practitioner 8800 North Route 91 Peoria IL 61615 30968350001912099060 Zeenat Parveen 207R00000X Internal medicine 5668 E State Street Suite 2000 Rockford IL 61108 81533230151942445234 Kristina B. Passarelli 363LF0000X Nurse practitioner 698 Featherstone Road Suite 250 Rockford IL 61107 81539944041740483627 Priti M. Patel 2080P0202X Cardiology 420 N E Glen Oak Avenue Suite 301 Peoria IL 61603 30965534531356543375 Alpa M. Patel 207RG0300X Geriatric medicine 5666 E State Street Rockford IL 61108 81522620001215233192 Mitul N Patel 207R00000X Internal medicine 530 N E Glen Oak Avenue Peoria IL 61637 30937030541720049786 Marlynn P. Patel 207R00000X Internal medicine 723 N E Glen Oak Avenue Peoria IL 61603 30962487491780602946 Mukesh V. Patel 207R00000X Internal medicine 2500 W Reynolds Street Pontiac IL 61764 81584451151780602946 Mukesh V. Patel 207R00000X Internal medicine 2500 W Reynolds Street Pontiac IL 61764 81584451151396846853 Kishorbhai K. Patel 207RP1001X Pulmonary disease 3315 N Seminary Street Galesburg IL 61401 30934410001689995086 Bandana Pathak 390200000X Unknown supplier/provider specialty 530 N E Glen Oak Avenue Peoria IL 61637 30962488181942260427 Hari P. Pathi 207R00000X Internal medicine 1505 Eastland Drive Suite 320 Bloomington IL 61701 30966233111588972087 Jacob L. Patty 363A00000X Physician assistant 3375 N Seminary Street Galesburg IL 61401 30934351141730489261 Ann M Patty 363A00000X Physician assistant 1000 W Harlem Avenue Monmouth IL 61462 30973431411730489261 Ann M Patty 363A00000X Physician assistant 1000 W Harlem Avenue Monmouth IL 61462 30973431411730489261 Ann M Patty 363A00000X Physician assistant 1000 W Harlem Avenue Monmouth IL 61462 30973431411033318555 Bhanu T. Paturi 207R00000X Internal medicine 5105 N Glen Park Place Peoria IL 61614 30968383831457389272 Richard H. Pearl 2086S0120X General surgery 420 N E Glen Oak Avenue Suite 201 Peoria IL 61603 30965523431659390714 Jane E. Pearson 207PE0004X Emergency medicine 5666 E State Street Rockford IL 61108 81539552611669418380 Pamela S. Pecenka 363L00000X Nurse practitioner 3315 N Seminary Street Galesburg IL 61401 30934410001053403675 Paul E Pedersen 207R00000X Internal medicine 302 Saint Joseph Drive Bloomington IL 61701 30966253611215947171 Lori L. Pegram 207R00000X Internal medicine 302 Saint Joseph Drive Bloomington IL 61701 30966430001821084567 Michael L. Peil 207RP1001X Pulmonary disease 1001 N Main Street Peoria IL 61606 30967256821184714487 Troy E. Pequette 208000000X Pediatric medicine 10 Saint Claire Court Suite 100 Washington IL 61571 30988640001972697605 Kristine S. Percy 207Q00000X Family practice 5114 N Glen Park Place Peoria IL 61614 30968366001306845789 Carol M. Perenchio 363L00000X Nurse practitioner 1954 Gateway Center Drive Belvidere IL 61008 81554474001740292564 Anitha M. Perinchery 207RC0000X Cardiology 1505 Eastland Drive Suite 330 Bloomington IL 61701 30966558001033383070 Christine C. Perks 207RC0000X Cardiology 5405 N Knoxville Avenue Peoria IL 61614 30969144101972829687 Priya D. Perumalsamy 390200000X Unknown supplier/provider specialty 530 N E Glen Oak Avenue Peoria IL 61637 30965525531639108129 Joseph Peters 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30965525531750580718 Christina M. Pica 208000000X Pediatric medicine 3315 N Seminary Street Galesburg IL 61401 30934410001912334467 Sonny R. Pickowitz 1041C0700X Licensed clinical social worker 8600 North Route 91 Suite 130 Peoria IL 61615 30968350501720160500 Shawn E. Piers 207Q00000X Family practice 10 Saint Claire Court Suite 100 Washington IL 61571 30988640001750522272 David V. Pinto 207P00000X Emergency medicine 2500 W Reynolds Street Pontiac IL 61764 81584228281750447157 Shailesh C Pinto 207RP1001X Pulmonary disease 1001 N Main Street Peoria IL 61606 30967256821265478770 Sam Pittmon 207P00000X Emergency medicine 1000 W Harlem Avenue Monmouth IL 61462 30973431411265478770 Sam Pittmon 207P00000X Emergency medicine 1000 W Harlem Avenue Monmouth IL 61462 30973431411265478770 Sam Pittmon 207P00000X Emergency medicine 1000 W Harlem Avenue Monmouth IL 61462 30973431411225013840 John E. Podzamsky 207Q00000X Family practice 104 E Bridge Street Streator IL 61364 81567324411396846127 Steven G. Potaczek 207X00000X Orthopedic surgery 3315 N Seminary Street Galesburg IL 61401 30934410001477514958 Orie R Potter 363A00000X Physician assistant 1000 W Harlem Avenue Monmouth IL 61462 30973431411477514958 Orie R Potter 363A00000X Physician assistant 1000 W Harlem Avenue Monmouth IL 61462 30973431411871618900 Darrell C. Powe 207P00000X Emergency medicine 5666 E State Street Rockford IL 61108 81539552611154596732 Dyveke P. Pratt 2084N0400X Neurology 100 N E Randolph Street Peoria IL 61606 30962485001144313404 Trent D. Proehl 208600000X General surgery 2500 W Reynolds Street Pontiac IL 61764 81584453431427141787 Rebecca A. Proehl 208000000X Pediatric medicine 2500 W Reynolds Street Pontiac IL 61764 81584465511326069824 Srinivas R. Puli 207RG0100X Gastroenterology 2805 N Knoxville Avenue Peoria IL 61603 30962494001194901686 B. Susan Pulkowski 363L00000X Nurse practitioner 9951 Rock Cut Crossing Loves Park IL 61111 81592188001326367236 Robin A. Punsalan 208000000X Pediatric medicine 109 N Franklin Street Byron IL 61010 81523439001417058256 Elizabeth J. Puthenveetil 207Q00000X Family practice 1707 N Henderson Street Galesburg IL 61401 30934310171972815033 Muneeb Qadri 207Q00000X Family practice 9951 Rock Cut Crossing Loves Park IL 61111 81563984501447527882 Julie A. Quam 363A00000X Physician assistant 530 N E Glen Oak Avenue 6th Floor SFMC Peoria IL 61637 30962489811972533925 Ronald R. Rabjohns 207RC0000X Cardiology 5405 N Knoxville Avenue Peoria IL 61614 30969144101710917422 Genene P. Radden 207RR0500X Rheumatology 1701 E College Avenue Bloomington IL 61704 30966547291942498159 Susan Maria Rahimi 207Q00000X Family practice 9951 Rock Cut Crossing Loves Park IL 61111 81563984501508865239 Khawaja Y. Rahman 207R00000X Internal medicine 1505 Eastland Drive Suite 320 Bloomington IL 61701 30966123681386738375 William H. Raino 2084N0400X Neurology 2200 Fort Jesse Road Normal IL 61761 30966123681053512814 Venkedesh Raju 208000000X Pediatric medicine 530 N E Glen Oak Avenue Peoria IL 61637 30926324241801873328 Alan C. Rakoff 207P00000X Emergency medicine 5114 N Glen Park Place Peoria IL 61614 3096836600

Page 13: NPI First Name MI Last Name Taxonomy Code Specialty ... · PDF fileNPI First Name MI Last Name Taxonomy Code Specialty Address 1 Address 2 City State ZIP Code Phone ... Bradley 363LF0000X;

NPI First Name MI Last Name Taxonomy Code Specialty Address 1 Address 2 City State ZIP Code Phone1720281447 Sreemdevi Ramakrishnan 208000000X Pediatric medicine 9951 Rock Cut Crossing Loves Park IL 61111 81563984701952300907 Sumathi M Rangineni 207R00000X Internal medicine 530 N E Glen Oak Avenue Peoria IL 61637 30962488181225020076 Sean M Rardin 207Q00000X Family practice 1051 West South Street Kewanee IL 61443 30985275001225020076 Sean M Rardin 207Q00000X Family practice 1051 West South Street Kewanee IL 61443 30985275001225020076 Sean M Rardin 207Q00000X Family practice 1051 West South Street Kewanee IL 61443 30985275001992762892 Thomas M. Rashid 208800000X Urology 200 E Pennsylvania Avenue Peoria IL 61603 30965520451386674349 John F. Rashid 207RC0000X Cardiology 5405 N Knoxville Avenue Peoria IL 61614 30969144101821202524 Sajjad A. Rattansi 207R00000X Internal medicine 530 N E Glen Oak Avenue Peoria IL 61637 30962488181174544407 Daren J. Rauch 207Q00000X Family practice 1231 Kleemann Drive Clinton IL 61727 21793550221174544407 Daren J. Rauch 207Q00000X Family practice 1231 Kleemann Drive Clinton IL 61727 21793550221841208568 Savitha S. Reddy 208100000X Physical medicine and rehabilitation 530 N E Glen Oak Avenue Peoria IL 61637 30962485501487829057 Veena Reddy 207R00000X Internal medicine 1505 Eastland Drive Suite 320 Bloomington IL 61701 30966233111659446805 Jana L. Reed 363L00000X Nurse practitioner 719 N William Kumpf Blvd Suite 100 Peoria IL 61605 30967607661255593919 Adrian D. Reed 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30965525531548297252 Churphena A. Reid 208800000X Urology 420 N E Glen Oak Avenue Suite 201 Peoria IL 61603 30949502821942525878 Nicholas R. Reinhart 390200000X Unknown supplier/provider specialty 2500 W Reynolds Street Pontiac IL 61764 81584228281518043280 Yolanda R. Renfroe 207VM0101X Obstetrics/gynecology 530 N E Glen Oak Avenue Suite 1200 Peoria IL 61637 30962478111922041938 Benjamin K. Rhee 208800000X Urology 420 N E Glen Oak Avenue Suite 201 Peoria IL 61603 30949502821437225935 R. Ryan Riech 207R00000X Internal medicine 319 N Fourth Street Chillicothe IL 61523 30967364641679889026 Benjamin D Riegle 363A00000X Physician assistant 1506 W Reynolds Street Pontiac IL 61764 81584461231942429055 Jami J. Riggenbach-Hays 363LF0000X Nurse practitioner 530 N E Glen Oak Avenue Peoria IL 61637 30962488181609848282 Kevin Riggs 363AM0700X Physician assistant 5666 E State Street Rockford IL 61108 81539552611578848925 Alyse C. Ringenberg 363L00000X Nurse practitioner 10 Saint Claire Court Suite 100 Washington IL 61571 30988640001063521169 Christopher J. Rink 2081P2900X Physical medicine and rehabilitation 2200 Fort Jesse Road Suite 210 Normal IL 61761 30966162501316173636 John M. Rinker 207R00000X Internal medicine 2500 W Reynolds Street Pontiac IL 61764 81584451151871754309 Anne C. Risk 207R00000X Internal medicine 5114 N Glen Park Place Peoria IL 61614 30968356001154335792 Santos M. Rivera 363AS0400X Physician assistant 698 Featherstone Road Rockford IL 61107 81539832771235403296 Jennifer M. Robb 363L00000X Nurse practitioner 2805 N Knoxville Avenue Peoria IL 61603 30962494001982936969 Marlene C. Robertson 363L00000X Nurse practitioner 2200 Fort Jesse Road Suite 110 Normal IL 61761 30966162901417038860 David A. Rodenberg 207R00000X Internal medicine 5114 N Glen Park Place Peoria IL 61614 30968381001881889194 Pedro Rodriguez 2086S0122X General surgery 698 Featherstone Road Rockford IL 61107 81539832771104153550 Leslie E. Romersberger 363A00000X Physician assistant 2500 W Reynolds Street Pontiac IL 61764 81584453431992804793 Maria R. Rosa 208000000X Pediatric medicine 302 Saint Joseph Drive Bloomington IL 61701 30966430001881643948 Brian S. Rosborough 207Q00000X Family practice 1614 E Norris Drive Ottawa IL 61350 81543310101245559210 David J Ross 207P00000X Emergency medicine 600 S 13th Street Pekin Hospital Pekin IL 61554 30935311011679609630 Carolyn K. Roth 363L00000X Nurse practitioner 1701 E College Avenue Bloomington IL 61704 30966430001821227976 Abdul W Royeen 207Q00000X Family practice 1000 W Harlem Avenue Monmouth IL 61462 30973431411821227976 Abdul W Royeen 207Q00000X Family practice 1000 W Harlem Avenue Monmouth IL 61462 30973431411821227976 Abdul W Royeen 207Q00000X Family practice 1000 W Harlem Avenue Monmouth IL 61462 30973431411811121361 Neal D. Rushforth 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30965525531114978574 John L Ruskusky 213EP1101X Podiatry 5105 N Glen Park Place Peoria IL 61614 30968383831811960933 Darrell D. Rust 207P00000X Emergency medicine 2500 W Reynolds Street Pontiac IL 61764 81584228281801053830 Erin E Ruud 363L00000X Nurse practitioner 1505 Eastland Drive Suite 320 Bloomington IL 61701 30966123681962831511 Amanda L. Ryan 363L00000X Nurse practitioner 3315 N Seminary Street Galesburg IL 61401 30934410001447599071 Monique M. Rynties 363A00000X Physician assistant 1505 Eastland Drive Suite 1100 Bloomington IL 61701 30966321001497862817 David G. Rzepczynski 207RG0100X Gastroenterology 1701 E College Avenue Bloomington IL 61704 30966430001992918577 Mohammad H. Sabit 208000000X Pediatric medicine 5666 E State Street Rockford IL 61108 81539552611093761363 Erica Salaman 207PE0004X Emergency medicine 5666 E State Street Rockford IL 61108 81539552611184704595 Vivian W. Salazar 207R00000X Internal medicine 8600 North Route 91 Suite 130 Peoria IL 61615 30968350501194700567 Qamar U. Saleheen 207R00000X Internal medicine 698 Featherstone Road Rockford IL 61107 81539832771871785923 Ashima Salwan 207R00000X Internal medicine 5666 E State Street Rockford IL 61108 81522620001477575306 Scott R. Samlan 207P00000X Emergency medicine 5666 E State Street Rockford IL 61108 81539552611790937092 Rahul R. Sampat 207Q00000X Family practice 1614 E Norris Drive Ottawa IL 61350 81543310101407807589 Edward Felipe A. Santos 207ZP0102X Pathology 5666 E State Street OSF Saint Anthony Medical Center Laboratory Rockford IL 61108 81539551051780878736 Tammy C. Sarmiento 363L00000X Nurse practitioner 530 N E Glen Oak Avenue Peoria IL 61637 30962488181588691877 Joseph J. Sarmiento 207RC0001X Internal medicine 5405 N Knoxville Avenue Peoria IL 61614 30969144101649260076 W. Anthony Sauder 207RP1001X Pulmonary disease 1001 N Main Street Peoria IL 61606 30967256821528114956 Christine D. Savage 363L00000X Nurse practitioner 6030 Garrett Lane Rockford IL 61107 81522611721184638009 Robert Sawicki 207Q00000X Family practice 2265 W Altorfer Drive Peoria IL 61615 30968377001902883648 Samir Saxena 207R00000X Internal medicine 530 N E Glen Oak Avenue Peoria IL 61637 30962488181124071865 Kamil N. Sayegh 207R00000X Internal medicine 5114 N Glen Park Place Peoria IL 61614 3096835600

Page 14: NPI First Name MI Last Name Taxonomy Code Specialty ... · PDF fileNPI First Name MI Last Name Taxonomy Code Specialty Address 1 Address 2 City State ZIP Code Phone ... Bradley 363LF0000X;

NPI First Name MI Last Name Taxonomy Code Specialty Address 1 Address 2 City State ZIP Code Phone1316030679 Richard I. Saylor 363A00000X Physician assistant 2500 W Reynolds Street Pontiac IL 61764 81584440621508894098 Timothy J. Schaefer 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30965525531558380246 Tina M. Schaffer 363LF0000X Nurse practitioner 5114 N Glen Park Place Peoria IL 61614 30968366001699096644 Conor D. Schaye 207P00000X Emergency medicine 2500 W Reynolds Street Pontiac IL 61764 81584228281578553251 Steven K. Schell 207L00000X Anesthesiology 3333 N Seminary Street Galesburg IL 61401 30934431611881966455 Megan R. Schmidt 363L00000X Nurse practitioner 5114 N Glen Park Place Peoria IL 61614 30968366001023048089 Paul J. Schmidt 207RI0011X Internal medicine 5405 N Knoxville Avenue Peoria IL 61614 30969144101992734446 John J. Schoenwald 207Q00000X Family practice 621 Roxbury Road Rockford IL 61107 81539733501003029224 Ellissa A. Schwartz 363A00000X Physician assistant 6830 Villagreen View Rockford IL 61107 81528213391578656831 Heather D. Schweizer 207Q00000X Family practice 106 S First Street Fairbury IL 61739 81569223081225247760 Sarah B. Scott 207V00000X Obstetrics/gynecology 6030 Garrett Lane Rockford IL 61107 81522611721043227846 Richard S. Seaboch 363A00000X Physician assistant 5405 N Knoxville Avenue Peoria IL 61614 30969144101689994162 Samuel A. Sears 2084P0800X Psychiatry 7317 Willow Lake Court Peoria IL 61614 30968373731518288547 Brian Sellers 207P00000X Emergency medicine 2500 W Reynolds Street Pontiac IL 61764 81584228281588700256 Murali Senapathi 207RC0000X Cardiology 1505 Eastland Drive Suite 330 Bloomington IL 61701 30966558001952491243 Hady E. Sfeir 207RE0101X Endocrinology 5105 N Glen Park Place Peoria IL 61614 30968383831619061827 Jitendra J. Shah 2080P0202X Cardiology 420 N E Glen Oak Avenue Suite 301 Peoria IL 61603 30965534531396914065 Saif U Shah 207Q00000X Family practice 1051 West South Street Kewanee IL 61443 30985275001578754354 Prakriti Shah 207P00000X Emergency medicine 5666 E State Street Rockford IL 61108 81539552611619284189 Rajnil G. Shah 208000000X Pediatric medicine 420 N E Glen Oak Avenue Suite 201 Peoria IL 61603 88862756731396914065 Saif U Shah 207Q00000X Family practice 1051 West South Street Kewanee IL 61443 30985275001396914065 Saif U Shah 207Q00000X Family practice 1051 West South Street Kewanee IL 61443 30985275001114214145 Lylla Shahab 207R00000X Internal medicine 530 N E Glen Oak Avenue Peoria IL 61637 30962488181942381306 John S. Shallat 207R00000X Internal medicine 5114 N Glen Park Place Peoria IL 61614 30968381001841502549 Aimee N Shane 367500000X Crna, anesthesia assistant 1051 West South Street Kewanee IL 61443 30985275001447332424 Stephan W. Shane 207R00000X Internal medicine 200 E Pennsylvania Avenue Suite 105 Peoria IL 61603 30965578881841502549 Aimee N Shane 367500000X Crna, anesthesia assistant 1051 West South Street Kewanee IL 61443 30985275001841502549 Aimee N Shane 367500000X Crna, anesthesia assistant 1051 West South Street Kewanee IL 61443 30985275001881709566 Mary J. Shane-Cox 363LF0000X Nurse practitioner 5114 N Glen Park Place Peoria IL 61614 30968366001619189859 Lacie R. Shanks 207Q00000X Family practice 1505 Eastland Drive Suite 1100 Bloomington IL 61701 30966321001992827299 Anuradha Shanmugham 207R00000X Internal medicine 1701 E College Avenue Bloomington IL 61704 30966430001407956758 Timothy D. Shannon 103T00000X Psychologist (billing independently) 405 Kays Drive Suite C Normal IL 61761 30966431301780814863 Ismael Shaukat 207R00000X Internal medicine 5666 E State Street Rockford IL 61108 81522722731326149162 Kathleen M Shaw 207V00000X Obstetrics/gynecology 3315 N Seminary Street Galesburg IL 61401 30934410001508050832 Cathy A. Shehorn 103T00000X Psychologist (billing independently) 7317 Willow Lake Court Peoria IL 61614 30968373731588759815 Asad Sheikh 390200000X Unknown supplier/provider specialty 444 Roxbury Road Rockford IL 61107 81539830001912097205 Michael F. Shekleton 207RG0100X Gastroenterology 2805 N Knoxville Avenue Peoria IL 61603 30962494001598857278 Susan J. Sheppard 207Q00000X Family practice 2200 Fort Jesse Road Suite 110 Normal IL 61761 30966162901841480274 Kianoush Sheykholeslami 207YX0905X Otolaryngology 698 Featherstone Road Rockford IL 61107 81539832771285718874 Suzanne M. Shimaitis 363A00000X Physician assistant 9951 Rock Cut Crossing Loves Park IL 61111 81563984501891021416 Melinda S Shimmin 363LF0000X Nurse practitioner 1051 West South Street Kewanee IL 61443 30985275001891021416 Melinda S Shimmin 363LF0000X Nurse practitioner 1051 West South Street P.O. Box 747 Kewanee IL 61443 30985275001932265956 Leah R Shimmin 363L00000X Nurse practitioner 1000 W Harlem Avenue Monmouth IL 61462 30973431411891021416 Melinda S Shimmin 363LF0000X Nurse practitioner 1051 West South Street P.O. Box 747 Kewanee IL 61443 30985275001932265956 Leah R Shimmin 363L00000X Nurse practitioner 1000 W Harlem Avenue Monmouth IL 61462 30973431411932265956 Leah R Shimmin 363L00000X Nurse practitioner 1000 W Harlem Avenue Monmouth IL 61462 30973431411760486245 Thomas J. Shula 174400000X Unknown supplier/provider specialty 5701 Strathmoor Drive Suite 1 Rockford IL 61107 81522756001972612836 Terri N. Shumway 363L00000X Nurse practitioner 8600 North Route 91 Suite 130 Peoria IL 61615 30968350501073644035 Cecilia Siberon-Sone 363L00000X Nurse practitioner 1701 E College Avenue Bloomington IL 61704 30966547291417186420 Rebecca A. Sierra 208000000X Pediatric medicine 435 Maxine Drive Suites 3 & 4 Morton IL 61550 30926324241235154659 Eugene A. Silva 207RC0000X Cardiology 444 Roxbury Road Rockford IL 61107 81539830001184776403 Monica I. Simionescu 2084N0400X Neurology 535 Roxbury Rd. Rockford IL 61107 81538717171659620342 Kayla A. Simons 363LF0000X Nurse practitioner 1614 E Norris Drive Ottawa IL 61350 81543310101538108238 Michael Sims 207P00000X Emergency medicine 5666 E State Street Rockford IL 61108 81539552611285621219 Thomas J Singel 207P00000X Emergency medicine 5666 E State Street Rockford IL 61108 81539552611386737641 Brian D. Sipe 208600000X General surgery 2500 W Reynolds Street Pontiac IL 61764 81584440621760497416 Yaser Siraj 207RC0000X Cardiology 444 Roxbury Road Rockford IL 61107 81539830001790710283 Jan P. Skowronski 207RC0000X Cardiology 444 Roxbury Road Rockford IL 61107 81539830001891763082 David C. Slagle 207RI0200X Infectious disease 723 N E Glen Oak Avenue Peoria IL 61603 30962487491992938625 Mark A. Sloan 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30965525531932207859 Roger D. Sloan 207Q00000X Family practice 3375 N Seminary Street Galesburg IL 61401 3093435114

Page 15: NPI First Name MI Last Name Taxonomy Code Specialty ... · PDF fileNPI First Name MI Last Name Taxonomy Code Specialty Address 1 Address 2 City State ZIP Code Phone ... Bradley 363LF0000X;

NPI First Name MI Last Name Taxonomy Code Specialty Address 1 Address 2 City State ZIP Code Phone1356375638 James R. Smalley 207RC0000X Cardiology 610 Park Avenue Pekin IL 61554 30934677761083779698 Sharon C. Smith 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30965525531275729139 Jeanne F. Smith 207R00000X Internal medicine 5101 N Executive Drive Peoria IL 61614 30968381561861582165 Terry E. Smith 207R00000X Internal medicine 5114 N Glen Park Place Peoria IL 61614 30968356001326031105 G. Bradley Smith 208G00000X Thoracic surgery 1505 Eastland Drive Suite 210 Bloomington IL 61701 30966255061811097033 Todd C. Snoeyink 213E00000X Podiatry 1701 E College Avenue Bloomington IL 61704 30966430001033187216 Vijaya Somaraju 207RI0200X Infectious disease 723 N E Glen Oak Avenue Peoria IL 61603 30962487491598067654 Angela P. Sommers Cormier 363A00000X Physician assistant 5101 N Executive Drive Peoria IL 61614 30967707001750317327 Joseph A Sottile 207P00000X Emergency medicine 1000 W Harlem Avenue Monmouth IL 61462 30973431411750317327 Joseph A Sottile 207P00000X Emergency medicine 1000 W Harlem Avenue Monmouth IL 61462 30973431411750317327 Joseph A Sottile 207P00000X Emergency medicine 1000 W Harlem Avenue Monmouth IL 61462 30973431411366871956 Erica M. Spangler 363L00000X Nurse practitioner 530 N E Glen Oak Avenue 6th Floor SFMC Peoria IL 61637 30962489811356379184 Jack Phillip Spaniol 207Q00000X Family practice 308 Saint Joseph Drive Bloomington IL 61701 30966350501922436682 Jackie M. Spence 363A00000X Physician assistant 3315 N Seminary Street Galesburg IL 61401 30934410001770511289 Robin L. Spencer 207Q00000X Family practice 435 Maxine Drive Suites 3 & 4 Morton IL 61550 30926324241477599272 Marc D. Squillante 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30965525531972706604 Shylendra B. Sreenivasappa 207RH0003X Hematology/oncology 5666 E State Street Rockford IL 61108 81522722731972932317 Meghan J. Sreniawski 363A00000X Physician assistant 3375 N Seminary Street Galesburg IL 61401 30934351141982914834 Carrie N. Stalter 363LF0000X Nurse practitioner 5114 N Glen Park Place Peoria IL 61614 30968366001992898258 Larry P. Stalter 207Q00000X Family practice 103 W South Street Flanagan IL 61740 81579645911689877136 Mihaela M. Stancu 207RC0000X Cardiology 1505 Eastland Drive Suite 330 Bloomington IL 61701 30966558001891922571 Mary E. Stapel 207R00000X Internal medicine 5114 N Glen Park Place Peoria IL 61614 30968356001346340973 Timothy A. Stead 363L00000X Nurse practitioner 1707 N Henderson Street Galesburg IL 61401 30934310171497775373 Jeffery E. Stedwill 208100000X Physical medicine and rehabilitation 530 N E Glen Oak Avenue Peoria IL 61637 30962485501700998622 Jenny H. Steffen 363A00000X Physician assistant 416 E Locust Chatsworth IL 60921 81563531771700998622 Jenny H. Steffen 363A00000X Physician assistant 416 E Locust Chatsworth IL 60921 81563531771568699254 Carrie L. Stephen 363A00000X Physician assistant 420 N E Glen Oak Avenue Suite 201 Peoria IL 61603 30965523431043412893 Jennifer E. Stevens 207Q00000X Family practice 416 E Locust Chatsworth IL 60921 81563531771043412893 Jennifer E. Stevens 207Q00000X Family practice 416 E Locust Chatsworth IL 60921 81563531771932204484 Joseph M. Stewart 174400000X Unknown supplier/provider specialty 6030 Garrett Lane Rockford IL 61107 81522611721831204262 Carl Stilson 207P00000X Emergency medicine 5666 E State Street Rockford IL 61108 81539552611508887860 Brad A. Stoecker 207Q00000X Family practice 401 N Main Street Roanoke IL 61561 30992326611083758403 Erin I. Stoneking 207Q00000X Family practice 3375 N Seminary Street Galesburg IL 61401 30934351141659473692 Ericka Stoor-Burning 363A00000X Physician assistant 5666 E State Street Rockford IL 61108 81539552611982851283 Heidi R Streeter 225100000X Physical therapist (independently practicing) 719 N William Kumpf Blvd Suite 100 Peoria IL 61605 30967607661053652545 Kevin J Strohl 363LF0000X Nurse practitioner 1051 West South Street Kewanee IL 61443 30985275001053652545 Kevin J Strohl 363LF0000X Nurse practitioner 1051 West South Street P.O. Box 747 Kewanee IL 61443 30985275001104002690 Vladimir Strunin 207V00000X Obstetrics/gynecology 3315 N Seminary Street Galesburg IL 61401 30934410001891817441 Kavitha Subramanian 207RI0200X Infectious disease 698 Featherstone Road Rockford IL 61107 81539832771174712673 Bhuvaneswari Subramanian 207R00000X Internal medicine 530 N E Glen Oak Avenue Peoria IL 61637 30937030541386951085 Jessica M. Sullivan 363L00000X Nurse practitioner 1405 Eastland Drive Bloomington IL 61701 30966124001881952646 Chrissa M. Summers 163W00000X Nurse, Non Practitioner 8600 North Route 91 Suite 240 Peoria IL 61615 30968354571518165406 Randall S. Sutter 207R00000X Internal medicine 530 N E Glen Oak Avenue Peoria IL 61637 30937030541619060977 Travis W. Swink 207Q00000X Family practice 105 S John Street Dwight IL 60420 81558433431306997911 Chin W. Swong 207Y00000X Otolaryngology 1614 E Norris Drive Ottawa IL 61350 81543310101659358703 Esther A. Sy 207Q00000X Family practice 4423 Manchester Drive Rockford IL 61109 81539413911518072867 James G. Szudera 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30965525531215249164 Mia S Tanaka 207P00000X Emergency medicine 600 S 13th Street Pekin Hospital Pekin IL 61554 30935311011841492394 Deepak Taneja 208M00000X Critical care (intensivists) 1001 N Main Street Peoria IL 61606 30967256821508895780 Mahtab Tashakori 207Q00000X Family practice 6830 Villagreen View Rockford IL 61107 81528213391629007067 Atef S. Tawfik 207Q00000X Family practice 621 Roxbury Road Rockford IL 61107 81539733501265412084 Shannon V. Taylor 363AM0700X Physician assistant 698 Featherstone Road Rockford IL 61107 81539832771700805249 Edward A. Telfer 207RC0000X Cardiology 444 Roxbury Road Rockford IL 61107 81539830001144421694 Aimee J. Terhark 363L00000X Nurse practitioner 2265 W Altorfer Drive Peoria IL 61615 30968377001992044317 Neal P Tex 367500000X Crna, anesthesia assistant 1051 West South Street Kewanee IL 61443 30985275001992044317 Neal P Tex 367500000X Crna, anesthesia assistant 1051 West South Street Kewanee IL 61443 30985275001992044317 Neal P Tex 367500000X Crna, anesthesia assistant 1051 West South Street Kewanee IL 61443 30985275001831441641 Hardik D. Thakkar 363A00000X Physician assistant 2500 W Reynolds Street Pontiac IL 61764 81584228281063673515 David G. Thompson 207R00000X Internal medicine 1050 E Norris Drive Suite 2C Ottawa IL 61350 81543402761689602211 Jeffry M. Tillery 207Q00000X Family practice 9951 Rock Cut Crossing Loves Park IL 61111 81563985001487993390 Jennifer M. Tillery 363A00000X Physician assistant 1505 Eastland Drive Suite 1100 Bloomington IL 61701 3096632100

Page 16: NPI First Name MI Last Name Taxonomy Code Specialty ... · PDF fileNPI First Name MI Last Name Taxonomy Code Specialty Address 1 Address 2 City State ZIP Code Phone ... Bradley 363LF0000X;

NPI First Name MI Last Name Taxonomy Code Specialty Address 1 Address 2 City State ZIP Code Phone1669468377 William P. Tillis 207RP1001X Pulmonary disease 1001 N Main Street Peoria IL 61606 30967256821649213141 Derek J. Timmermann 207P00000X Emergency medicine 5666 E State Street Rockford IL 61108 81539552611083924724 Tanvi Tiwari 390200000X Unknown supplier/provider specialty 530 N E Glen Oak Avenue Peoria IL 61637 30962488181306899182 Rebecca A. Todd 363LF0000X Nurse practitioner 515 N E Glen Oak Avenue Suite 202 Peoria IL 61603 30965534531336565134 Angela M. Todd 363LF0000X Nurse practitioner 1614 E Norris Drive Ottawa IL 61350 81543310101356315626 Mariano V. Tolentino 208800000X Urology 1701 E College Avenue Bloomington IL 61704 30966199991144414921 Moses S. Tomacruz 207Q00000X Family practice 9951 Rock Cut Crossing Loves Park IL 61111 81563985001750336889 Patrick T. Tracy 207T00000X Neurosurgery 719 N William Kumpf Blvd Suite 100 Peoria IL 61605 30967607661144331828 Stephen P. Trainor 208000000X Pediatric medicine 302 Saint Joseph Drive Bloomington IL 61701 30966430001184856155 Monica T. Tran 207Q00000X Family practice 9951 Rock Cut Crossing Loves Park IL 61111 81563984501760685390 Andrew J. Tsung 207T00000X Neurosurgery 719 N William Kumpf Blvd Suite 100 Peoria IL 61605 30967607661356377626 Gregory J. Tudor 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30965525531639105034 Nenita C. Tudtud 208100000X Physical medicine and rehabilitation 2200 Fort Jesse Road Suite 200 Normal IL 61761 30966162401134442213 Bryan P. Tully 207R00000X Internal medicine 5666 E State Street Rockford IL 61108 81522620001639195514 James E. Tuschen 207PE0004X Emergency medicine 4423 Manchester Drive Rockford IL 61109 81563984501992930119 Renee Tweneboah-Koduah 163W00000X Nurse, Non Practitioner 100 N E Randolph Street Peoria IL 61606 30962485001679673222 Lamont A. Tyler 207Q00000X Family practice 1505 Eastland Drive Suite 1100 Bloomington IL 61701 30966321001467766253 Shital R. Ughreja 207R00000X Internal medicine 2500 W Reynolds Street Pontiac IL 61764 81584228281982857926 Raj H. Ughreja 207R00000X Internal medicine 2500 W Reynolds Street Pontiac IL 61764 81584228281639492655 Amy K. Ulrich 367500000X Crna, anesthesia assistant 3333 N Seminary Street Galesburg IL 61401 30934431611588756134 Blair O. Valentine 207R00000X Internal medicine 1505 Eastland Drive Suite 320 Bloomington IL 61701 30966233111598938540 Nirupama Vallala 207RC0000X Cardiology 1050 E Norris Drive Suite 2C Ottawa IL 61350 81543402761215235007 Danielle J. VanderVeen 363A00000X Physician assistant 2500 W Reynolds Street Pontiac IL 61764 81584465511396837662 Charles S. VanDyke 207P00000X Emergency medicine 600 S 13th Street Pekin Hospital Pekin IL 61554 30935311011366435224 Jesse L. VanLe 208G00000X Thoracic surgery 1505 Eastland Drive Suite 210 Bloomington IL 61701 30966255061073525770 Rajeev Varma 207RP1001X Pulmonary disease 1505 Eastland Drive Suite 320 Bloomington IL 61701 30966123681356542864 Elsa L Vazquez-Melendez 207R00000X Internal medicine 320 E Armstrong Avenue Peoria IL 61603 30962496901508956897 Tim J. Vega 207Q00000X Family practice 100 N E Randolph Street Peoria IL 61606 30962485251609952670 Virginia L. Velazquez 363L00000X Nurse practitioner 698 Featherstone Road Suite 250 Rockford IL 61107 81539944041508889908 Kenneth A Velez 207P00000X Emergency medicine 1000 W Harlem Avenue Monmouth IL 61462 30973431411508889908 Kenneth A Velez 207P00000X Emergency medicine 1000 W Harlem Avenue Monmouth IL 61462 30973431411508889908 Kenneth A Velez 207P00000X Emergency medicine 1000 W Harlem Avenue Monmouth IL 61462 30973431411811077357 Suneetha Venkatapuram 207RC0000X Cardiology 5405 N Knoxville Avenue Peoria IL 61614 30969144101770522500 Anupam Verma 207R00000X Internal medicine 1505 Eastland Drive Suite 320 Bloomington IL 61701 30966123681265503429 Kaninika Verma 207RP1001X Pulmonary disease 1001 N Main Street Peoria IL 61606 30967256821376751735 Dawn M. Vernon 363L00000X Nurse practitioner 444 Roxbury Road Rockford IL 61107 81539830001699786806 Lori S.G. Verseman 363A00000X Physician assistant 5114 N Glen Park Place Peoria IL 61614 30968381081417039736 Alain W. Vilatte 207Q00000X Family practice 5111 N Glen Park Place Peoria IL 61614 30968357001487974424 Andrew L. Vincent 207P00000X Emergency medicine 600 S 13th Street Pekin Hospital Pekin IL 61554 30935311011700962867 Kathleen L. Voelker 363L00000X Nurse practitioner 200 E Pennsylvania Avenue Suite 101 Peoria IL 61603 30965579001447351077 Fritz-Henry Volmar 207RG0100X Gastroenterology 2805 N Knoxville Avenue Peoria IL 61603 30962494001265659007 Kurt E Volz 104100000X Licensed clinical social worker 1000 W Harlem Avenue Monmouth IL 61462 30973431411265659007 Kurt E Volz 104100000X Licensed clinical social worker 1000 W Harlem Avenue Monmouth IL 61462 30973431411265659007 Kurt E Volz 104100000X Licensed clinical social worker 1000 W Harlem Avenue Monmouth IL 61462 30973431411508178609 Samreen Vora 207P00000X Emergency medicine 600 S 13th Street Pekin Hospital Pekin IL 61554 30935311011831160779 Judith A Wakeland 363A00000X Physician assistant 1000 W Harlem Avenue Monmouth IL 61462 30973431411831160779 Judith A Wakeland 363A00000X Physician assistant 1000 W Harlem Avenue Monmouth IL 61462 30973431411831160779 Judith A Wakeland 363A00000X Physician assistant 1000 W Harlem Avenue Monmouth IL 61462 30973431411417019084 Lizabeth J. Wallace 363L00000X Nurse practitioner 420 N E Glen Oak Avenue Suite 201 Peoria IL 61603 30965523431700899788 Donald R. Wallace 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30968366001558577460 Xu Wang 207RC0000X Cardiology 444 Roxbury Road Rockford IL 61107 81539830001194799684 Mu Wang 208000000X Pediatric medicine 302 Saint Joseph Drive Bloomington IL 61701 30966430001023247699 Peggy J Wang 207Q00000X Family practice 13539 IL Route 76 Poplar Grove IL 61065 81576501471831297274 David Z. Wang 2084N0400X Neurology 530 N E Glen Oak Avenue 6th Floor SFMC Peoria IL 61637 30962489811477661627 Mary C. Ward 207P00000X Emergency medicine 5114 N Glen Park Place Peoria IL 61614 30968366001710066980 Eric M. Ward 103T00000X Psychologist (billing independently) 7317 Willow Lake Court Peoria IL 61614 30968373731124058599 Charles Washington 207PE0004X Emergency medicine 5666 E State Street Rockford IL 61108 81539552611982797254 Lisa M. Watson 363L00000X Nurse practitioner 1506 W Reynolds Street Pontiac IL 61764 81584461231407821077 Keattiyoat Wattanakit 207R00000X Internal medicine 5405 N Knoxville Avenue Peoria IL 61614 30969144101255676409 Lauren M. Weber 363L00000X Nurse practitioner 5666 E State Street Rockford IL 61108 81539552611376656827 Joey A. Wegmann 363AS0400X Physician assistant 1707 N Henderson Street Galesburg IL 61401 3093431017

Page 17: NPI First Name MI Last Name Taxonomy Code Specialty ... · PDF fileNPI First Name MI Last Name Taxonomy Code Specialty Address 1 Address 2 City State ZIP Code Phone ... Bradley 363LF0000X;

NPI First Name MI Last Name Taxonomy Code Specialty Address 1 Address 2 City State ZIP Code Phone1720227143 Yongzhong Wei 363A00000X Physician assistant 100 N E Randolph Street Peoria IL 61606 30962485001134226145 Matthew J Weidman 208000000X Pediatric medicine 1000 W Harlem Avenue Monmouth IL 61462 30973431411134226145 Matthew J Weidman 208000000X Pediatric medicine 1000 W Harlem Avenue Monmouth IL 61462 30973431411134226145 Matthew J Weidman 208000000X Pediatric medicine 1000 W Harlem Avenue Monmouth IL 61462 30973431411922206929 Elaine R.F. Welch 207Q00000X Family practice 2200 Fort Jesse Road Suite 110 Normal IL 61761 30966162901285649780 Karl F. Welke 208G00000X Thoracic surgery 420 N E Glen Oak Avenue Suite 301 Peoria IL 61603 30965534531922054873 Michelle M. Wessels 367500000X Crna, anesthesia assistant 1100 E Norris Drive Ottawa IL 61350 81543331001790714285 David S. West 207RP1001X Pulmonary disease 1505 Eastland Drive Suite 320 Bloomington IL 617011477598241 Sarah A. Whelan 207Q00000X Family practice 698 Featherstone Road Suite 250 Rockford IL 61107 81539944041629320445 Elizabeth J. Whelan 363L00000X Nurse practitioner 530 N E Glen Oak Avenue Suite 1200 Peoria IL 61637 30962478111851333819 Tina V. White 363LP2300X Nurse practitioner 200 E Pennsylvania Avenue Suite 101 Peoria IL 61603 30965579001255424511 Nancy S. White 363L00000X Nurse practitioner 2500 W Reynolds Street Pontiac IL 61764 81584451151902048986 Jessica L. White 207R00000X Internal medicine 120 E 7th Street Minonk IL 61760 30943225151952537797 Jennifer A. Whitfill 363L00000X Nurse practitioner 2500 W Reynolds Street Pontiac IL 61764 81584465511073883203 Clyde T Whiting 207QS0010X Family practice 1000 W Harlem Avenue Monmouth IL 61462 30973431411073883203 Clyde T Whiting 207QS0010X Family practice 1000 W Harlem Avenue Monmouth IL 61462 30973431411366438087 Patrick E. Whitten 207RP1001X Pulmonary disease 1001 N Main Street Peoria IL 61606 30967256821154422988 Thomas J. Whittle 208600000X General surgery 3315 N Seminary Street Galesburg IL 61401 30934410001811939234 Ronald J. Wiechert 207P00000X Emergency medicine 3333 N Seminary Street Galesburg IL 61401 30934431611063513893 Mark A. Wiechert 207P00000X Emergency medicine 1707 N Henderson Street Galesburg IL 61401 30934310171528318128 Rebecca R. Wigant 363LA2100X Nurse practitioner 5405 N Knoxville Avenue Peoria IL 61614 30969144101851363022 Randall L. Wilcoxen 363A00000X Physician assistant 5114 N Glen Park Place Peoria IL 61614 30968366001811274756 Tamara D. Wilkins 363L00000X Nurse practitioner 530 N E Glen Oak Avenue Peoria IL 61637 30962488181447589650 Tiffani L. WIlliams 363A00000X Physician assistant 435 Maxine Drive Suites 3 & 4 Morton IL 61550 30926324241639287766 Carrie C. Wilson 207P00000X Emergency medicine 5666 E State Street Rockford IL 61108 81539552611568471241 Kathryn C. Wilson 207R00000X Internal medicine 1505 Eastland Drive Suite 320 Bloomington IL 61701 30966233111073816013 Susan C. Winterbauer 363LF0000X Nurse practitioner 9951 Rock Cut Crossing Loves Park IL 61111 81563984501639284995 Earl J. Wipfler 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30965525531700823556 Sharon R. Wissler 363L00000X Nurse practitioner 1506 W Reynolds Street Pontiac IL 61764 81584461231427266279 Mark J. Wolfmeyer 207R00000X Internal medicine 530 N E Glen Oak Avenue Peoria IL 61637 30937030541043230709 Robert W. Wolford 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30965525531871698761 Michael J. Woods 207Q00000X Family practice 1701 E College Avenue Bloomington IL 61704 30966430001669400974 Michael Y. Xu 2084N0400X Neurology 530 N E Glen Oak Avenue 6th Floor SFMC Peoria IL 61637 30962489811083840698 Hongmei Yang 390200000X Unknown supplier/provider specialty 200 E Pennsylvania Avenue Suite 105 Peoria IL 61603 30965578881629165741 Edmund Y. Yang 2086S0120X General surgery 420 N E Glen Oak Avenue Suite 201 Peoria IL 61603 30965523431871516781 Joseph R. Yates 207P00000X Emergency medicine 5666 E State Street Rockford IL 61108 81539552611487649596 Leon A. Yeh 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30965525531033214994 Micheal S. Young 208600000X General surgery 1701 E College Avenue Bloomington IL 61704 30966430001104835768 LeAnn B. Young 363AM0700X Physician assistant 8600 North Route 91 Suite 130 Peoria IL 61615 30968350501235392358 Sara Zafar 208000000X Pediatric medicine 530 N E Glen Oak Avenue Peoria IL 61637 30926324241417996729 Kashif M. Zaheer 207Q00000X Family practice 556 E Grant Highway Marengo IL 60152 81556865571285949800 Syed R. Zaidi 207Q00000X Family practice 698 Featherstone Road Suite 250 Rockford IL 61107 81539944041205844602 Anthony C. Zalduendo 2085R0001X Radiation oncology 530 N E Glen Oak Avenue Peoria IL 61637 30965568101467543942 Sarah N. Zallek 2084N0400X Neurology 530 N E Glen Oak Avenue 6th Floor SFMC Peoria IL 61637 30962489811548368822 Christopher M. Zallek 2084N0400X Neurology 100 N E Randolph Street Peoria IL 61606 30962485001295798742 George A. Zaverdas 207RC0000X Cardiology 444 Roxbury Road Rockford IL 61107 81539830001437479151 Joshua M. Zavitz 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30965525531952560500 Jianxun Zhou 208100000X Physical medicine and rehabilitation 719 N William Kumpf Blvd Suite 100 Peoria IL 61605 30967607661609090208 Matthew Zopel 207P00000X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 30965525531578596227 Diane H. Zug 207Q00000X Family practice 6830 Villagreen View Rockford IL 61107 8152821339

3416L0300X Ambulance service supplier 318 Roxbury Road Rockford IL 61107 81539546952080P0202X Cardiology 420 N E Glen Oak Avenue Suite 301 Peoria IL 61603 3096553453207T00000X Neurosurgery 719 N William Kumpf Blvd Suite 100 Peoria IL 61605 3096760766207RC0000X Cardiology 444 Roxbury Road Rockford IL 61107 8153983000207R00000X Internal medicine 1701 E College Avenue Bloomington IL 61704 3096643000261QM2500X Multispecialty clinic or group practice 1051 West South Street Kewanee IL 61443 3098527500282NC0060X Hospital 1051 West South Street Kewanee IL 61443 3098527500207Q00000X Family practice 556 E Grant Highway P.O. Box 75 Marengo IL 60152 8155686557251E00000X Home Health Agency 9951 Rock Cut Crossing Loves Park IL 61111 8159218700207Q00000X Family practice 143 Kishwaukee Street Belvidere IL 61008 8155447400251G00000X Hospice 9951 Rock Cut Crossing Loves Park IL 61111 8159218700

Page 18: NPI First Name MI Last Name Taxonomy Code Specialty ... · PDF fileNPI First Name MI Last Name Taxonomy Code Specialty Address 1 Address 2 City State ZIP Code Phone ... Bradley 363LF0000X;

NPI First Name MI Last Name Taxonomy Code Specialty Address 1 Address 2 City State ZIP Code Phone207Q00000X Family practice 4423 Manchester Drive Rockford IL 61109 8153941391207K00000X Allergy / immunology 698 Featherstone Road Suite 250 Rockford IL 61107 8153983277282N00000X Hospital 5666 E State Street Rockford IL 61108 8152262000207Q00000X Family practice 698 Featherstone Road Suite 250 Rockford IL 61107 8153994404207Q00000X Family practice 621 Roxbury Road Rockford IL 61107 8153973350207Q00000X Family practice 6830 Villagreen View Rockford IL 61107 8152821339208000000X Pediatric medicine 9951 Rock Cut Crossing Loves Park IL 61111 8156398500273R00000X Hospital 1100 E Norris Drive Ottawa IL 61350 1543313100251E00000X Home Health Agency 1601 Mercury Circle Ottawa IL 61350 1543606090332B00000X Medical supply company for DMERC 5668 E State Street Suite 1100 Rockford IL 61108 8664161562332B00000X Medical supply company for DMERC 1800 N Knoxville Avenue Suite 104 Peoria IL 61604 87779504163336H0001X Pharmacy 2265 W Altorfer Drive Peoria IL 61615 30968377003336H0001X Pharmacy 9951 Rock Cut Crossing Loves Park IL 61111 8159218700251G00000X Hospice 2265 W Altorfer Drive Peoria IL 61615 3096837795208100000X Physical medicine and rehabilitation 530 N E Glen Oak Avenue Peoria IL 61637 3096552000282N00000X Hospital 530 N E Glen Oak Avenue Peoria IL 61637 30965520002084N0400X Neurology 530 N E Glen Oak Avenue Peoria IL 61637 30965520002085R0001X Radiation oncology 530 N E Glen Oak Avenue Peoria IL 61637 3096552000207Q00000X Family practice P O Box 1712 Peoria IL 61656 3096835969251E00000X Home Health Agency 2265 W Altorfer Drive Peoria IL 61615 3096837700273Y00000X Hospital 530 N E Glen Oak Avenue Peoria IL 61637 3096552000207PE0004X Emergency medicine 530 N E Glen Oak Avenue Peoria IL 61637 3096552000363L00000X Nurse practitioner 530 N E Glen Oak Avenue Peoria IL 61637 3096552000275N00000X Hospital 2500 W Reynolds Street Pontiac IL 61764 8158422828282N00000X Hospital 2500 W Reynolds Street Pontiac IL 61764 8158422828261QR1300X Rehabilitation Agency 2500 W Reynolds Street Pontiac IL 61764 8158422828261QR1300X Rehabilitation Agency 2500 W Reynolds Street Pontiac IL 61764 8158422828207Q00000X Family practice 2500 W Reynolds Street Suite 212 Pontiac IL 61764 8158423567261QR1300X Rehabilitation Agency 2500 W Reynolds Street Pontiac IL 61764 8158422828207L00000X Anesthesiology 2500 W Reynolds Street Pontiac IL 61764 8158422828251G00000X Hospice 2265 W Altorfer Drive Peoria IL 61615 30968377002085R0001X Radiation oncology 2200 E Washington Street Bloomington IL 61701 3096623311261QR1300X Rehabilitation Agency 1231 Kleemann Drive Clinton IL 61727 2179355022282N00000X Hospital 2200 E Washington Street Bloomington IL 61701 3096623311207P00000X Emergency medicine 2200 E Washington Street Bloomington IL 61701 3096623311251E00000X Home Health Agency 2265 W Altorfer Drive Peoria IL 61615 3096837700207Q00000X Family practice P O Box 1712 Peoria IL 61656 3096835969207RI0011X Internal medicine 2200 E Washington Street Bloomington IL 61701 3096623311314000000X Skilled Nursing Facility 2200 E Washington Street Bloomington IL 61701 3096623311282N00000X Hospital 3333 N Seminary Street Galesburg IL 61401 3093443161251E00000X Home Health Agency 2265 W Altorfer Drive Peoria IL 61615 3096837700207Q00000X Family practice P O Box 1712 Peoria IL 61656 3096835969207PE0004X Emergency medicine 3333 N Seminary Street Galesburg IL 61401 3093443161367500000X Crna, anesthesia assistant 3333 N Seminary Street Galesburg IL 61401 3093443161261QR1300X Rehabilitation Agency 1051 West South Street Kewanee IL 61443 3098527500282NC0060X Hospital 1000 W Harlem Avenue Monmouth IL 61462 3097343141261QR1300X Rehabilitation Agency 1000 W Harlem Avenue Monmouth IL 61462 3097343141275N00000X Hospital 1000 W Harlem Avenue Monmouth IL 61462 3097343141261Q00000X Multispecialty clinic or group practice 1051 West South Street Kewanee IL 61443 3098527500275N00000X Hospital 1051 West South Street Kewanee IL 61443 3098527500282NC0060X Hospital 1051 West South Street Kewanee IL 61443 3098527500207RC0000X Cardiology 5405 N Knoxville Avenue Peoria IL 61614 3096914410207ZP0105X Pathology 530 N E Glen Oak Avenue Peoria IL 61637 3096552000207RP1001X Pulmonary disease 1001 N Main Street Suite 200 Peoria IL 61606 3096725682207VM0101X Obstetrics/gynecology 4911 Executive Drive 2nd Floor Peoria IL 61614 3096836700207R00000X Internal medicine 3315 N Seminary Street Galesburg IL 61401 30934410002080P0202X Cardiology 5701 Strathmoor Drive Suite 1 Rockford IL 61107 8152275600207P00000X Emergency medicine 600 S 13th Street Pekin IL 61554 3093531101