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General NPI Number Information
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NPI Number | 1013829936
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Entity Type | Organization
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Legal Business Name | METHODIST MEDICAL CENTER OF ILLINOIS
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Dates
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Enumeration Date | 09/17/2026
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Last Update Date | 09/17/2026
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Provider Practice Location Address
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Address Line | 5401 N KNOXVILLE AVE STE 300
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City | PEORIA
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State | IL
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Zip | 61614-5021
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Country | US
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Telephone | 309-643-6104
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Fax | 309-683-6106
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Provider Business Mailing Address
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Address Line | 5401 N KNOXVILLE AVE STE 300
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City | PEORIA
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State | IL
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Zip | 61614-5021
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Country | US
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Telephone | 309-671-2197
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Fax | 309-671-8253
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Authorized Official
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Title or Position | VP FINANCIAL SERVICES
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Name | ARON KLEIN
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Credential |
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Telephone | 217-902-5814
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0700X
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Taxonomy Name | End-Stage Renal Disease (ESRD) Treatment Clinic/Center
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License Number |
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License Number State |
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