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

John Lidvall, MD

Individual provider Family Medicine Physician · NPI 1376856559

John Lidvall, MD is a Family Practice in Peoria, Illinois. Qualified in 2010, 16 years ago. Practices with Methodist Medical Center of Illinois, a 393-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
16
Licensed in
IL
In the registry since
2010
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

815 Main St
Peoria, IL 61602-1076
Phone: (309) 672-4977
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 036132696 (IL)

Record details

NPI number1376856559
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 16, 2010
Last updated in NPPESSeptember 15, 2020
Certification dateSeptember 15, 2020
Mailing address5100 Reliable Pkwy, Chicago, IL 60686-0001

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Group practice Methodist Medical Center Of Illinois — 393 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations10 on file with Medicare

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