Methodist Medical Group – Family Medicine Physician, NPI 1184670663
Family Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Methodist Medical Group
A-Reliable Glass & Door Corp., 4128, West Belmont Avenue, Hermosa, Chicago, Jefferson Township, Cook County, Illinois, 60641, United States
CHICAGO, IL 606860051
Phone:
Type: Mailing
Glen Oak Medical Plaza, 120, Northeast Glen Oak Avenue, Peoria, Peoria County, Illinois, 61636, United States
SUITE 101
PEORIA, IL 61603
Phone: (309) 671-8230
Fax: (309) 671-5118
Type: Location
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.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2026-01-26
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2026-03-31 (67 days ago).
Enrollment records
15
Earliest due date
2026-03-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20210315002818 | O | Clinic/Group Practice | PA | 2026-03-31 |
| O20210325002199 | O | Clinic/Group Practice | NV | 2026-05-31 |
| O20210721002240 | O | Clinic/Group Practice | KS | 2026-07-31 |
| O20220830000270 | O | Clinic/Group Practice | MI | TBD |
| O20220909001561 | O | Clinic/Group Practice | MO | TBD |
| O20221007002813 | O | Clinic/Group Practice | CO | TBD |
| O20221012002902 | O | Clinic/Group Practice | DC | TBD |
| O20221129000067 | O | Clinic/Group Practice | WI | TBD |
| O20250723003530 | O | Clinic/Group Practice | CA | TBD |
| O20250919002129 | O | Clinic/Group Practice | VA | TBD |
| O20251216004408 | O | Clinic/Group Practice | MD | TBD |
| O20251223000344 | O | Clinic/Group Practice | KY | TBD |
| O20260102000889 | O | Clinic/Group Practice | WV | TBD |
| O20260126001402 | O | Clinic/Group Practice | OH | TBD |
| O20260223003360 | O | Clinic/Group Practice | SC | TBD |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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 60686)
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