Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Central Illinois Pathology, SC

Organization Anatomic Pathology & Clinical Pathology Physician · NPI 1114970761

Central Illinois Pathology, SC is an Anatomic Pathology & Clinical Pathology Physician in Peoria, Illinois. Registered with an NPI since 2006.

In the registry since
2006

Practice location Address checks out

530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone: (309) 624-9011
Fax: (309) 624-9152
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anatomic Pathology & Clinical Pathology Physician (primary) Taxonomy 207ZP0102X

Record details

NPI number1114970761
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michael Hayes — Administrator · (309) 624-9011
NPI enumeratedMay 17, 2006
Last updated in NPPESOctober 30, 2007
Mailing address10335 N Port Washington Rd, Suite 250, Mequon, WI 53092-5763

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