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

Mid Illini Surgical Associates SC

Organization Surgery Physician · NPI 1093854002

Mid Illini Surgical Associates SC is a Surgery Physician in Peoria, Illinois. Licensed in Illinois. Registered with an NPI since 2007.

Licensed in
IL
In the registry since
2007

Practice location Address checks out

900 Main St Ste 530
Peoria, IL 61602-1074
Phone: (309) 672-5975
Fax: (309) 655-1678
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X (IL)

Record details

NPI number1093854002
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Greg Totten — Office Manager · (309) 672-5975
NPI enumeratedFebruary 6, 2007
Last updated in NPPESJuly 21, 2022
Mailing address900 Main Street, Suite 530, Peoria, IL 61602-1074

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