OSF Medical Group-Mendota – Family Medicine Physician, NPI 1407872997
Family Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for OSF Medical Group-Mendota
124 SW ADAMS ST
PEORIA, IL 616021320
Phone: (093) 655-2850
Fax: (309) 655-4878
Type: Mailing
OSF Saint Paul Medical Center, 1401, East 12th Street, Mendota, Mendota Township, LaSalle County, Illinois, 61342, United States
MENDOTA, IL 613429216
Phone: (815) 539-7461
Fax: (815) 539-1461
Type: Mailing
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
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PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-01-31
PECOS data refreshed: 2026-05-27
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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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 61602)
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