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

University of Illinois

Organization Pediatric Neurodevelopmental Disabilities Physician · NPI 1174596225

University of Illinois is a Pediatric Neurodevelopmental Disabilities Physician in Peoria, Illinois. Licensed in Illinois. Registered with an NPI since 2006.

Licensed in
IL
In the registry since
2006

Practice location Address checks out

515 NE Glen Oak Ave Pediatric Neurology
Peoria, IL 61603-3165
Phone: (309) 624-9844
Show map & directions

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

Specialties & licences

Pediatric Neurodevelopmental Disabilities Physician (primary) Taxonomy 2080P0008X (IL)

Record details

NPI number1174596225
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official William Nicholas — Executive Director Of Msp · (312) 413-0573
Other names Medical Service Plan At Peoria
NPI enumeratedFebruary 9, 2006
Last updated in NPPESAugust 22, 2020
Mailing address1 Illini Dr, Peoria, IL 61605-2576

Other providers in Peoria