Provider Demographics
NPI:1730050675
Name:METHODIST MEDICAL CENTER OF ILLINOIS
Entity type:Organization
Organization Name:METHODIST MEDICAL CENTER OF ILLINOIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:ARON
Authorized Official - Middle Name:
Authorized Official - Last Name:KLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-268-2410
Mailing Address - Street 1:221 NE GLEN OAK AVE
Mailing Address - Street 2:GOMP100
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61636-0001
Mailing Address - Country:US
Mailing Address - Phone:309-672-4874
Mailing Address - Fax:309-671-8253
Practice Address - Street 1:525 S SWEETBRIAR DR
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:IL
Practice Address - Zip Code:61523-2264
Practice Address - Country:US
Practice Address - Phone:309-274-2102
Practice Address - Fax:309-274-3555
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE CARLE FOUNDATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-09-15
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty