PHILLIP A. IMMESOETE MD, LTD
NPI 1245544543
Nursing Facility/Intermediate Care Facility in Peoria, IL
NPI Status: Active since July 29, 2010
Contact Information
5401 N KNOXVILLE AVE
SUITE 406
PEORIA, IL
ZIP 61614
Phone: (309) 691-0030
Fax: (309) 691-9262
- Organization
- Nursing Facility/Intermediate Care Facil...
About PHILLIP A. IMMESOETE MD, LTD
This page provides the complete NPI Profile along with additional information for Phillip A. Immesoete Md, Ltd, a provider established in Peoria, Illinois operating as a Nursing Facility/intermediate Care Facility. The healthcare provider is registered in the NPI registry with number 1245544543 assigned on July 2010. The practitioner's primary taxonomy code is 313M00000X with license number 036042568 (IL). The provider is registered as an organization and their NPI record was last updated 15 years ago. The authorized official of this NPI record is Phillip Arthur Immesoete M.d. (Physician)
- NPI
- 1245544543
- Provider Name
- PHILLIP A. IMMESOETE MD, LTD
- Entity Type
- Organization
- Location Address
- 5401 N KNOXVILLE AVE SUITE 406 PEORIA, IL 61614
- Location Phone
- (309) 691-0030
- Location Fax
- (309) 691-9262
- Mailing Address
- 5401 N KNOXVILLE AVE SUITE 406 PEORIA, IL 61614
- Mailing Phone
- (309) 691-0030
- Mailing Fax
- (309) 691-9262
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 07-29-2010
- Last Update Date
- 07-29-2010
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Nursing Facility/Intermediate Care Facility
- Taxonomy Code
- 313M00000X
- Type
- Nursing & Custodial Care Facilities
- License No.
- 036042568
- License State
- IL
- Taxonomy Description
- An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 036042568 | MEDICAID (05) | IL | |
| 215690 | MEDICARE PIN (08) | IL |
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 2 | 4 | 5 | 5 | 4 | 4 | 5 | 4 | 3 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 2 | 8 | 5 | 10 | 4 | 8 | 5 | 8 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 2 + 8 + 5 + 1 + 0 + 4 + 8 + 5 + 8 + 24 = 67 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 67 = 3 | 3 | ||||||||
The NPI number 1245544543 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1871597450 | DR. EDWARD A RUFUS JR MD Individual | Internal Medicine | 5401 N KNOXVILLE AVE SUITE 306 PEORIA, IL 61614 (309) 691-7890 |
| 1972509743 | BRUCE BING CHIEN MD Individual | Anesthesiology (Pain Medicine) | 5401 N KNOXVILLE AVE STE 212 PEORIA, IL 61614 (309) 691-8973 |
| 1184624280 | DR. ROBERT ALLAN LIZER D.O. Individual | Family Medicine | 5401 N KNOXVILLE AVE SUITE 412 PEORIA, IL 61614 (309) 692-4375 |
| 1831181726 | DIETRA DUFFALA TEICHMANN PH.D. Individual | Clinical Neuropsychologist | 5401 N KNOXVILLE AVE SUITE 217 PEORIA, IL 61614 (309) 282-1864 |
| 1245223130 | DR. TIMOTHY M LAHOOD M.D. Individual | Family Medicine | 5401 N KNOXVILLE AVE SUITE 400 PEORIA, IL 61614 (309) 689-0909 |
| 1144291055 | DR. ANTOINETTE T LEVASSEUR M.D. Individual | Obstetrics & Gynecology | 5401 N KNOXVILLE AVE SUITE 208 PEORIA, IL 61614 (309) 692-7400 |
| 1053383471 | MS. BARBARA J NALL APN Individual | Nurse Practitioner (Women's Health) | 5401 N KNOXVILLE AVE SUITE 308 PEORIA, IL 61614 (309) 692-5100 |
| 1417920232 | DR. GENE C CHENG M.D. Individual | Psychiatry & Neurology (Neurology) | 5401 N KNOXVILLE AVE SUITE 414 PEORIA, IL 61614 (309) 629-9516 |
| 1508839176 | DR. JAMES J MCCABE MD Individual | Internal Medicine (Pulmonary Disease) | 5401 N KNOXVILLE AVE SUITE 203 PEORIA, IL 61614 (309) 692-0422 |
| 1033163761 | PROCTOR HEALTH SYSTEMS Organization | Clinic/Center (Medical Specialty) | 5401 N KNOXVILLE AVE SUITE 103 PEORIA, IL 61614 (309) 691-7800 |
| 1518910363 | PROCTOR HEALTH SYSTEMS Organization | Clinic/Center (Rehabilitation) | 5401 N KNOXVILLE AVE SUITE 218 PEORIA, IL 61614 (309) 693-2244 |
| 1306890108 | PROCTOR HEALTH SYSTEMS Organization | Clinic/Center (Primary Care) | 5401 N KNOXVILLE AVE SUITE 300 PEORIA, IL 61614 (309) 683-1200 |
| 1134173917 | PROCTOR HEALTH SYSTEMS Organization | Family Medicine | 5401 N KNOXVILLE AVE SUITE 209 PEORIA, IL 61614 (309) 689-6049 |
| 1205883741 | JEROME P KRAFT MD Individual | Orthopaedic Surgery | 5401 N KNOXVILLE AVE SUITE 400 PEORIA, IL 61614 (309) 692-6644 |
| 1740227032 | GEORGE W LANE SR. MD Individual | Orthopaedic Surgery | 5401 N KNOXVILLE AVE SUITE 400 PEORIA, IL 61614 (309) 692-6644 |
| 1396789509 | MARY L BRENNAN NP Individual | Nurse Practitioner | 5401 N KNOXVILLE AVE SUITE 119 PEORIA, IL 61614 (309) 692-1700 |
| 1609892728 | DR. CHANG KI SONG MD Individual | Surgery | 5401 N KNOXVILLE AVE SUITE 217 PEORIA, IL 61614 (309) 691-1092 |
| 1013923929 | YIBING LI MD Individual | Physical Medicine & Rehabilitation | 5401 N KNOXVILLE AVE STE 117 PEORIA, IL 61614 (309) 689-8888 |
| 1336255009 | MS. TRACY ANN BOCHANTIN M.D. Individual | Obstetrics & Gynecology | 5401 N KNOXVILLE AVE SUITE 308 PEORIA, IL 61614 (309) 692-5100 |
| 1336251958 | JENECSIS CASTRO-SKOGLUND Individual | Internal Medicine | 5401 N KNOXVILLE AVE SUITE 114 PEORIA, IL 61614 (309) 689-8370 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1245544543, enumerated in the NPI registry as an "organization" on July 29, 2010
The provider is located at 5401 N Knoxville Ave Suite 406 Peoria, Il 61614 and the phone number is (309) 691-0030
This medical organization specializes in Nursing Facility/Intermediate Care Facility with taxonomy code 313M00000X
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
This NPI record was last updated on July 29, 2010. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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