Healthcare Provider Details

I. General information

NPI: 1881434868
Provider Name (Legal Business Name): BAYVIEW MEDICAL CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2024
Last Update Date: 01/16/2026
Certification Date: 01/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 BURWASH AVE
SAVOY IL
61874-9510
US

IV. Provider business mailing address

206 BURWASH AVE
SAVOY IL
61874-9510
US

V. Phone/Fax

Practice location:
  • Phone: 217-356-3400
  • Fax: 217-866-0122
Mailing address:
  • Phone: 217-356-3400
  • Fax: 217-866-0122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BAMIDELE EKUNSANMI
Title or Position: CEO
Credential: MD
Phone: 217-356-3400