PEORIA EAR NOSE AND THROAT GROUP SC
NPI 1952380628
Otolaryngology in Peoria, IL
NPI Status: Active since January 11, 2006
Contact Information
7301 N KNOXVILLE AVE
PEORIA, IL
ZIP 61614
Phone: (309) 589-5900
Fax: (309) 689-0312
Some details in this NPI profile have been updated in the NPI registry within the last 30 days.
- Organization
- Otolaryngology
- Accepts Insurance
About PEORIA EAR NOSE AND THROAT GROUP SC
This page provides the complete NPI Profile along with additional information for Peoria Ear Nose And Throat Group Sc, a provider established in Peoria, Illinois operating as a Otolaryngology. The healthcare provider is registered in the NPI registry with number 1952380628 assigned on January 2006. The practitioner's primary taxonomy code is 207Y00000X with license number 042000742 (IL). The provider is registered as an organization and their NPI record was last updated July 2025. Peoria Ear Nose And Throat Group Sc operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The authorized official of this NPI record is Tyler Robertson (Ceo)
- NPI
- 1952380628
- Provider Name
- PEORIA EAR NOSE AND THROAT GROUP SC
- Entity Type
- Organization
- Location Address
- 7301 N KNOXVILLE AVE PEORIA, IL 61614
- Location Phone
- (309) 589-5900
- Location Fax
- (309) 689-0312
- Mailing Address
- 7301 N KNOXVILLE AVE PEORIA, IL 61614
- Mailing Phone
- (309) 589-5900
- Mailing Fax
- (309) 689-0312
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 01-11-2006
- Last Update Date
- 07-22-2025
- 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
Otolaryngology
- Taxonomy Code
- 207Y00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 042000742
- License State
- IL
- Taxonomy Description
- An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Bronze 1 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Rx Copay - HMO
- Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
- Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
- Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Rx Copay - HMO
- Gold 3 Advanced: Aetna network + $0 MinuteClinic + Adult Dental + Vision + Rx Copay - HMO
- Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Rx Copay - HMO
- Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
- Silver 5 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Rx Copay - HMO
- Silver 5 Advanced: Aetna network + $0 MinuteClinic + Adult Dental + Vision + Rx Copay - HMO
- Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- WellFirst by Medica Bronze $0 Copay PCP Visits - EPO
- WellFirst by Medica Bronze Share - EPO
- WellFirst by Medica Catastrophic - EPO
- WellFirst by Medica Expanded Bronze Standard - EPO
- WellFirst by Medica Gold $0 Copay PCP Visits - EPO
- WellFirst by Medica Gold Copay Plus - EPO
- WellFirst by Medica Gold Standard - EPO
- WellFirst by Medica Silver $0 Copay PCP Visits - EPO
- WellFirst by Medica Silver Copay Plus - EPO
- WellFirst by Medica Silver Standard - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
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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 | 9 | 5 | 2 | 3 | 8 | 0 | 6 | 2 | 8 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 9 | 10 | 2 | 6 | 8 | 0 | 6 | 4 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 9 + 1 + 0 + 2 + 6 + 8 + 0 + 6 + 4 + 24 = 62 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 62 = 8 | 8 | ||||||||
The NPI number 1952380628 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 19 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1114997558 | SHEILA DELK MS Individual | Audiologist | 7301 N KNOXVILLE AVE PEORIA, IL 61614 (309) 589-5900 |
| 1477524171 | HARRISON C PUTMAN III MD Individual | Otolaryngology (Otolaryngology/Facial Plastic Surgery) | 7301 N KNOXVILLE AVE PEORIA, IL 61614 (309) 589-3233 |
| 1013988427 | MRS. HOLLY J DEMICHELIS MA Individual | Audiologist-Hearing Aid Fitter | 7301 N KNOXVILLE AVE PEORIA, IL 61614 (309) 589-5900 |
| 1316911589 | JULIE A SIDAK MS Individual | Audiologist-Hearing Aid Fitter | 7301 N KNOXVILLE AVE PEORIA, IL 61614 (309) 589-5900 |
| 1467576660 | KATHERINE D WYMAN AUDIOLOGIST Individual | Audiologist | 7301 N KNOXVILLE AVE PEORIA, IL 61614 (309) 589-5900 |
| 1700431160 | SAWYER T MILAM AUD Individual | Audiologist | 7301 N KNOXVILLE AVE PEORIA, IL 61614 (309) 589-5900 |
| 1417557703 | JESSICA SALIM PT, DPT Individual | Physical Medicine & Rehabilitation | 7301 N KNOXVILLE AVE PEORIA, IL 61614 (309) 589-5900 |
| 1376214601 | MICHAEL ROONEY HIS Individual | Hearing Instrument Specialist | 7301 N KNOXVILLE AVE PEORIA, IL 61614 (309) 589-5900 |
| 1578176418 | DR. JENNIFER ANNE MEYER AUD Individual | Audiologist | 7301 N KNOXVILLE AVE PEORIA, IL 61614 (406) 351-2317 |
| 1194888677 | FACIAL PLASTIC & LASER SURGERY Organization | Clinic/Center | 7301 N KNOXVILLE AVE PEORIA, IL 61614 (309) 589-3233 |
| 1114703022 | TINA MARIE LEMAN MS Individual | Audiologist | 7301 N KNOXVILLE AVE PEORIA, IL 61614 (309) 589-5900 |
| 1881702769 | BECKY L BRAUN AUD Individual | Audiologist | 7301 N KNOXVILLE AVE PEORIA, IL 61614 (309) 589-8051 |
| 1134739931 | DR. JACEY GAIL HOEKSTRA AUD Individual | Audiologist | 7301 N KNOXVILLE AVE PEORIA, IL 61614 (309) 589-5900 |
| 1366456527 | JILL ANNE PRUVOST M.S., CCC-A Individual | Audiologist | 7301 N KNOXVILLE AVE PEORIA, IL 61614 (309) 589-5900 |
| 1417928128 | JAMES A GERAGHTY MD Individual | Otolaryngology | 7301 N KNOXVILLE AVE PEORIA, IL 61614 (309) 589-5900 |
| 1508065558 | DR. JAMES J KLEMENS M.D. Individual | Otolaryngology | 7301 N KNOXVILLE AVE PEORIA, IL 61614 (309) 589-5900 |
| 1508998105 | MR. RICHARD ANDREW MILLER PA-C Individual | Physician Assistant (Medical) | 7301 N KNOXVILLE AVE PEORIA, IL 61614 (309) 589-5900 |
| 1598288060 | DR. SAMANTHA CHARLOTTE FISHER AU.D. Individual | Audiologist | 7301 N KNOXVILLE AVE PEORIA, IL 61614 (309) 589-8051 |
| 1871263475 | DR. MONA MARIE DWORSACK AU.D., CCC-A, FAAA Individual | Audiologist | 7301 N KNOXVILLE AVE PEORIA, IL 61614 (309) 589-8051 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1952380628, enumerated in the NPI registry as an "organization" on January 11, 2006
The provider is located at 7301 N Knoxville Ave Peoria, Il 61614 and the phone number is (309) 589-5900
This medical organization specializes in Otolaryngology with taxonomy code 207Y00000X
The provider might be accepting Accepts: Aetna CVS Health and Medica. 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 January 11, 2006. 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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