Peoria Site 014030 – Foster Care Agency, NPI 1104154277

Peoria Site 014030 is a healthcare provider. based in Peoria, Illinois. specializing in Foster Care Agency. The NPI Number for Peoria Site 014030 is 1104154277

Main info

Organization
Name
Peoria Site 014030
NPI
1104154277
Phone
(309) 676-6131
Address
4507 N STERLING AVE
Authorized Official
VIVIANE NGWA EXECUTIVE DIRECTOR MSW
Enumeration Date
30 November 2009
Last Update Date
3 December 2010
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience47
Completeness80
Years active:16State licenses:0Digital endpointsUpdated within 12 months

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Provider Addresses for Peoria Site 014030

  • 4507, North Sterling Avenue, Peoria, Peoria County, Illinois, 61615, United States

    PEORIA, IL 616153824

    Phone: (309) 676-6131

    Fax: (309) 676-5655

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 61615)

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Reviews

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Frequently asked questions

How do I look up Peoria Site 014030 by NPI?
Use NPI 1104154277 when you need to reference Peoria Site 014030 in forms, claims, or directories.
Is Peoria Site 014030's enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Can you summarize Peoria Site 014030's specialty in plain language?
Clinically, the directory lists Peoria Site 014030 with Foster Care Agency. Clinical services aligned with this taxonomy classification.
Does Peoria Site 014030 practice in Illinois?
You will see Peoria, Illinois on file for Peoria Site 014030 alongside any extra practice locations.
What if Peoria, Illinois seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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