Unknown Individual – Nephrology Physician, NPI 1235455619
Nephrology Physician
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Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Unknown Individual
420 NE GLEN OAK AVE STE 401
PEORIA, IL 616033112
Phone: (309) 676-8123
Fax: (309) 676-8455
Type: Mailing
765 N KELLOGG ST STE 203
GALESBURG, IL 614012859
Phone: (309) 676-8123
Fax: (309) 676-8455
Type: Location
420 NE Glen Oak Ave Ste 401
Peoria, IL 616033112
Phone: (309) 676-8123
Fax: (309) 676-8455
Type: Location
527 E Grant St
Macomb, IL 614553351
Phone: (309) 676-8123
Fax: (309) 676-8455
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 708 | 398 | $0 |
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 254 | 100 | $0 |
| 90960 | Dialysis services, 4 or more physician visits per month (20 years or older) | 182 | 27 | $0 |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | 95 | 84 | $0 |
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | 94 | 37 | $0 |
Insurance plans in this area (ZIP 61603)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | IL | |
| N E P H R O L O G Y | IL | |
| N E P H R O L O G Y | IL | |
| Internal Medicine, Nephrology | IL | |
| N E P H R O L O G Y | IL | |
| Nephrology, Internal Medicine | IL | |
| Nurse Practitioner | IL | |
| Nurse Practitioner | IL | |
| Nurse Practitioner | IA | |
| Nurse Practitioner | IL |
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