1. Home
  2. Directory
  3. Illinois
  4. Peoria
  5. Nursing Facility Intermediate Care Facility
  6. NPI Profile

PHILLIP A. IMMESOETE MD, LTD
NPI 1245544543
Nursing Facility/Intermediate Care Facility in Peoria, IL

Active since July 29, 2010
5401 N KNOXVILLE AVE, SUITE 406, PEORIA, IL 61614(309) 691-0030(309) 691-9262 Get Directions Write a Review

NPPES record last updated: July 29, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Phillip A. Immesoete Md, Ltd NPPES

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

PHILLIP A. IMMESOETE MD, LTD (NPI 1245544543) is a healthcare organization registered as a nursing facility/intermediate care facility in Peoria, Illinois and active in the NPI registry since July 2010. The organization lists Phillip Arthur Immesoete, Physician, as its authorized official.

NPPES Registry Identity

NPI1245544543
Entity TypeOrganization
Primary Taxonomy313M00000X
Legal Business NamePHILLIP A. IMMESOETE MD, LTD
Location Address5401 N KNOXVILLE AVE, SUITE 406Peoria, IL 61614-5098
Mailing Address5401 N Knoxville Ave, Suite 406Peoria, IL 61614-5098 · (309) 691-0030 · Fax (309) 691-9262
Phone(309) 691-0030
Fax(309) 691-9262
Organization SubpartNo
Authorized OfficialPhillip Arthur ImmesoetePhysician · (309) 691-0030
Enumeration DateJuly 29, 2010
✔ NPI 1245544543 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNursing Facility/Intermediate Care FacilityNursing & Custodial Care Facilities
Taxonomy Code313M00000X
License✔ Licensed in IL · 036042568
Definition
An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals.
5401 N KNOXVILLE AVE, Peoria, IL 61614
Open in Google Maps ↗

Other Identifiers 2

Medicaid036042568IL
Medicare PIN215690IL

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

YIBING LI MD
Physical Medicine & Rehabilitation
5401 N KNOXVILLE AVE, STE 117
PEORIA, IL 61614
Peoria County (309) 689-8888
PATTI L ALLY
Audiologist-Hearing Aid Fitter
5401 N KNOXVILLE AVE, SUITE 116
PEORIA, IL 61614
Peoria County (309) 282-0887
PROCTOR HEALTH SYSTEMS
Clinic/Center (Medical Specialty)
5401 N KNOXVILLE AVE, SUITE 103
PEORIA, IL 61614
Peoria County (309) 691-7800
MS. BARBARA J NALL APN
Nurse Practitioner (Women's Health)
5401 N KNOXVILLE AVE, SUITE 308
PEORIA, IL 61614
Peoria County (309) 692-5100
SUSAN GWILLIM PT
Physical Therapist
5401 N KNOXVILLE AVE, SUITE 218
PEORIA, IL 61614
Peoria County (309) 693-2244
MR. KEVIN M HENRY MD
Anesthesiology (Pain Medicine)
5401 N KNOXVILLE AVE, SUITE 416
PEORIA, IL 61614
Peoria County (309) 692-7246
MS. COLLEEN SUSANNE CUSHING RAGON APN, CNS
Nurse Practitioner (Family)
5401 N KNOXVILLE AVE
PEORIA, IL 61614
Peoria County (309) 691-1069
SUSAN J COLE, MD & ASSOCIATES
Clinic/Center (Medical Specialty)
5401 N KNOXVILLE AVE, SUITE 107
PEORIA, IL 61614
Peoria County (309) 691-2311

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 Phillip A. Immesoete MD, Ltd's NPI number?

The NPI number for Phillip A. Immesoete MD, Ltd is 1245544543. It was assigned to this organization in the NPPES registry on July 29, 2010.

Where is Phillip A. Immesoete MD, Ltd located?

Phillip A. Immesoete MD, Ltd is located at 5401 N Knoxville Ave Suite 406, Peoria, IL 61614. The listed phone number is (309) 691-0030.

What is Phillip A. Immesoete MD, Ltd's specialty?

The primary specialty registered for this NPI is Nursing Facility/Intermediate Care Facility with taxonomy code 313M00000X.

When was this NPI record last updated?

The NPPES record for Phillip A. Immesoete MD, Ltd was last updated on July 29, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.