MEDICARE: ASCLEPIUS ILLINOIS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2083B0002X	Obesity Medicine (Preventive Medicine) Physician

General Provider Information

NPI Number	:	1114884210
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASCLEPIUS ILLINOIS LLC

Provider Business Mailing Address
First Line	:	4440 N PROSPECT RD
Second Line	:
City	:	PEORIA HEIGHTS
State	:	IL
Zip	:	61616-6556
Country	:	US
Telephone Number	:	309-248-6399
Fax Number	:

Provider Business Practice Location Address
First Line	:	4440 N PROSPECT RD
Second Line	:
City	:	PEORIA HEIGHTS
State	:	IL
Zip	:	61616-6556
Country	:	US
Telephone Number	:	309-248-6399
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JAMES RAYMOND HUBLER
Credential	:	MD
Telephone Number	:	309-712-1766

Provider Enumeration Date	:	01/08/2026
Last Update Date	:	01/08/2026

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