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

Phillip A. Immesoete MD, Ltd

Organization Nursing Facility/Intermediate Care Facility · NPI 1245544543

Phillip A. Immesoete MD, Ltd is a Nursing Facility/Intermediate Care Facility in Peoria, Illinois. Licensed in Illinois. Registered with an NPI since 2010.

Licensed in
IL
In the registry since
2010
What do these letters mean?
Ltd — Limited
A form of business registration, not a clinical qualification.

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Practice location Address checks out

5401 N Knoxville Ave Ste 406
Peoria, IL 61614-5098
Phone: (309) 691-0030
Fax: (309) 691-9262
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nursing Facility/Intermediate Care Facility (primary) Taxonomy 313M00000X · Licence 036042568 (IL)

Record details

NPI number1245544543
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Phillip Immesoete — Physician · (309) 691-0030
NPI enumeratedJuly 29, 2010
Last updated in NPPESJuly 29, 2010
Mailing address5401 N Knoxville Ave, Suite 406, Peoria, IL 61614-5098

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