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CENTRAL ILLINOIS PATHOLOGY, SC
NPI 1114970761
Pathology - Anatomic Pathology & Clinical Pathology in Peoria, IL

Active since May 17, 2006
530 NE GLEN OAK AVE, PEORIA, IL 61637(309) 624-9011(309) 624-9152 Get Directions Write a Review

NPPES record last updated: October 30, 2007. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Central Illinois Pathology, Sc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CENTRAL ILLINOIS PATHOLOGY, SC (NPI 1114970761) is a healthcare organization registered as an anatomic pathology & clinical pathology in Peoria, Illinois and active in the NPI registry since May 2006. The organization lists Michael P Hayes, Administrator, as its authorized official.

NPPES Registry Identity

NPI1114970761
Entity TypeOrganization
Primary Taxonomy207ZP0102X
Legal Business NameCENTRAL ILLINOIS PATHOLOGY, SC
Location Address530 NE GLEN OAK AVEPeoria, IL 61637-0001
Mailing Address10335 N Port Washington Rd, Suite 250Mequon, WI 53092-5763 · (262) 240-9870 · Fax (262) 240-9869
Phone(309) 624-9011
Fax(309) 624-9152
Organization SubpartNo
Authorized OfficialMichael P HayesAdministrator · (309) 624-9011
Enumeration DateMay 17, 2006
Last NPPES UpdateOctober 30, 2007
✔ NPI 1114970761 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPathology · Anatomic Pathology & Clinical PathologyAllopathic & Osteopathic Physicians
Taxonomy Code207ZP0102X
Definition
A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease.
530 NE GLEN OAK AVE, Peoria, IL 61637
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Other Identifiers 1

Medicare PIN351250IL

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Central Illinois Pathology, Sc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

14

Medicare enrollment records show 14 clinicians reassign Medicare billing to Central Illinois Pathology, Sc, which bills Medicare for the services they deliver. Of these, 5 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (14)

Janeen Buonaccorsi, M.D.
Pathology
NPI 1174765721
530 NE GLEN OAK AVE
Peoria, IL 61637
(309) 624-9052
✔ PECOS✔ Accepts Medicare0.2 mi
Manuel Doria, MD
Pathology
NPI 1306879010
530 NE GLEN OAK AVE
Peoria, IL 61637
(309) 624-9011
✔ PECOS✔ Accepts Medicare0.2 mi
Hamid Zia, M.D
Pathology
NPI 1003121310
530 NE GLEN OAK AVE CENTRAL ILLINOIS PATHOLOGY SC
Peoria, IL 61637
(309) 624-9011
✔ PECOS✔ Accepts Medicare0.3 mi
John Farrell, MD
Pathology
NPI 1043284649
DEPARTMENT OF INTERNAL MEDICINE 530 NE GLEN OAK DRIVE
Peoria, IL 61637
(309) 655-7734
✔ PECOS✔ Accepts Medicare7.4 mi
Purvi Patel, MD
Pathology
NPI 1609437094
2321 W KENFIELD CT
Peoria, IL 61615
(669) 264-9750
✔ PECOS✔ Accepts Medicare7.8 mi
Jerome Anderson, D.O.
Pathology
NPI 1619955986
525 E GRANT ST
Macomb, IL 61455
(309) 837-2368
✔ PECOS✔ Accepts Medicare59 mi
Rakesh Mandal, M.D.
Pathology
NPI 1629336524
600 HIGHLAND AVE
Madison, WI 53792
(608) 263-8443
✔ PECOS✔ Accepts Medicare164 mi
Vidhu Kaushik, MBBS, MD
Pathology
NPI 1972767044
200 1ST ST SW
Rochester, MN 55905
(507) 284-2511
✔ PECOS✔ Accepts Medicare272 mi
Dionnee James, MD
Pathology
NPI 1871016717
1133 COLLEGE AVE STE B131
Manhattan, KS 66502
(785) 539-5363
✔ PECOS✔ Accepts Medicare387 mi
Nibha Saxena, MD
Pathology
NPI 1841270113
7730 FIRST PL
Oakwood Village, OH 44146
(800) 331-7546
✔ PECOS✔ Accepts Medicare424 mi
Michael Lunt, MD
Pathology
NPI 1154647055
601 ELMWOOD AVE BOX 626
Rochester, NY 14642
(585) 273-4580
✔ PECOS✔ Accepts Medicare638 mi
Tian Li
Pathology
NPI 1447661392
600 MOYE BLVD
Greenville, NC 27834
(252) 744-2803
✔ PECOS✔ Accepts Medicare750 mi
Viren Patel, M.D
Pathology
NPI 1891137980
3401 N BROAD ST
Philadelphia, PA 19140
(215) 707-8995
✔ PECOS✔ Accepts Medicare763 mi
Sean Fitzgerald, MD
Pathology
NPI 1912107186
3433 COVE VIEW BLVD APT 1511
Galveston, TX 77554
(216) 385-7461
✔ PECOS✔ Accepts Medicare844 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Central Illinois Pathology, Sc's NPI number?

The NPI number for Central Illinois Pathology, Sc is 1114970761. It was assigned to this organization in the NPPES registry on May 17, 2006.

Where is Central Illinois Pathology, Sc located?

Central Illinois Pathology, Sc is located at 530 NE Glen Oak Ave, Peoria, IL 61637. The listed phone number is (309) 624-9011.

What is Central Illinois Pathology, Sc's specialty?

The primary specialty registered for this NPI is Pathology, specializing in Anatomic Pathology & Clinical Pathology, with taxonomy code 207ZP0102X.

Is Central Illinois Pathology, Sc enrolled in Medicare?

Yes. Central Illinois Pathology, Sc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Central Illinois Pathology, Sc?

According to the CMS Revalidation Reassignment List (October 2026 release), 14 clinicians, all in Pathology, reassign their Medicare billing to Central Illinois Pathology, Sc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 5 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Central Illinois Pathology, Sc was last updated on October 30, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.