ILLINOIS GASTROENTEROLOGY INSTITUTE, PLLC
NPI 1275575706
Internal Medicine - Gastroenterology in Peoria, IL

NPI Status: Active since June 11, 2006

Contact Information

1001 MAIN ST
SUITE 500A
PEORIA, IL
ZIP 61606
Phone: (309) 672-4980
Fax: (309) 671-2944

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  • Organization
  • Internal Medicine
  • Gastroenterology
  • CLIA Number: 14D0708999
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 08-31-2026

About ILLINOIS GASTROENTEROLOGY INSTITUTE, PLLC

This page provides the complete NPI Profile along with additional information for Illinois Gastroenterology Institute, Pllc, an internist established in Peoria, Illinois operating as a Internal Medicine, focusing in gastroenterology . The healthcare provider is registered in the NPI registry with number 1275575706 assigned on June 2006. The practitioner's primary taxonomy code is 207RG0100X with license number 042006270 (IL). The provider is registered as an organization and their NPI record was last updated 6 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The provider's former legal business name is Gastroenterology, Ltd. The authorized official of this NPI record is Mike Shadley (Administrator)

NPI
1275575706
Provider Legal Name
ILLINOIS GASTROENTEROLOGY INSTITUTE, PLLC
Other Organization Name
GASTROENTEROLOGY, LTD
Other Name Type
Former Legal Business Name (4)
Entity Type
Organization
Location Address
1001 MAIN ST SUITE 500A PEORIA, IL 61606
Location Phone
(309) 672-4980
Location Fax
(309) 671-2944
Mailing Address
PO BOX 365 MORTON, IL 61550
Mailing Phone
(309) 672-4980
Mailing Fax
(309) 671-2944
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
06-11-2006
Last Update Date
08-17-2020
Code Navigator

An internist like Illinois Gastroenterology Institute, Pllc is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Internal Medicine Gastroenterology

Taxonomy Code
207RG0100X
Type
Allopathic & Osteopathic Physicians
License No.
042006270
License State
IL
Taxonomy Description
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MIKE SHADLEY

Authorized Official Title
ADMINISTRATOR
Authorized Official Phone
(309) 672-4980

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
07215152OTHER (01)ILBLUE CROSS
CE0700OTHER (01)ILRAILROAD MEDICARE

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
14D0708999
Facility Type
Physician Office
Certificate Effective Date
September 01, 2024
Certificate Expiration Date
August 31, 2026
Laboratory Director
MICHAEL R. TREANOR
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Illinois Gastroenterology Institute, Pllc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Reviews for ILLINOIS GASTROENTEROLOGY INSTITUTE, PLLC

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1275575706, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 54. The final step is to find the difference between that total and the next multiple of ten (60 - 54 = 6).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
2
Unchanged
Pos 3
7
Doubled → 14 → 1 + 4
Pos 4
5
Unchanged
Pos 5
5
Doubled → 10 → 1 + 0
Pos 6
7
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
7
Unchanged
Pos 9
0
Doubled → 0
Check
6
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 7 → 14 → 5 5 → 10 → 1 5 → 10 → 1 0 → 0

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 1 + 4 + 5 + 1 + 0 + 7 + 1 + 0 + 7 + 0 + 24 = 54

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 54 is 60. The difference is the calculated check digit.

60 - 54 = 6
This NPI is valid
The calculated check digit is 6, which matches the last digit of 1275575706.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Internal Medicine (Pulmonary Disease)
1001 MAIN ST, SUITE 200
PEORIA, IL 61606
Internal Medicine (Pulmonary Disease)
1001 MAIN ST, SUITE 200
PEORIA, IL 61606
Internal Medicine (Pulmonary Disease)
1001 MAIN ST, SUITE 200
PEORIA, IL 61606
Internal Medicine (Pulmonary Disease)
1001 MAIN ST, SUITE 200
PEORIA, IL 61606
Pathology (Anatomic Pathology & Clinical Pathology)
1001 MAIN ST, SUITE 500A
PEORIA, IL 61606
Internal Medicine (Gastroenterology)
1001 MAIN ST, SUITE 500A
PEORIA, IL 61606
Internal Medicine (Gastroenterology)
1001 MAIN ST, SUITE 500A
PEORIA, IL 61606
Internal Medicine (Pulmonary Disease)
1001 MAIN ST, ILLINOIS LUNG AND CRITICAL CARE SUITE 200
PEORIA, IL 61606
Internal Medicine (Pulmonary Disease)
1001 MAIN ST, SUITE 200
PEORIA, IL 61606
Nurse Practitioner (Pediatrics)
1001 MAIN ST, SUITE 200
PEORIA, IL 61606
Clinic/Center (Endoscopy)
1001 MAIN ST, STE 530
PEORIA, IL 61606
Nurse Practitioner
1001 MAIN ST, SUITE 500A
PEORIA, IL 61606
Internal Medicine (Pulmonary Disease)
1001 MAIN ST, STE 200
PEORIA, IL 61606
Urology
1001 MAIN ST, SUITE 201
PEORIA, IL 61606
Clinical Nurse Specialist
1001 MAIN ST, 3RD FLOOR
PEORIA, IL 61606
Clinical Nurse Specialist
1001 MAIN ST, 3RD FLOOR
PEORIA, IL 61606
Hospitalist
1001 MAIN ST, SUITE 200
PEORIA, IL 61606
Physician Assistant
1001 MAIN ST, SUITE 500A
PEORIA, IL 61606
Nurse Practitioner
1001 MAIN ST, SUITE 300
PEORIA, IL 61606
Thoracic Surgery (Cardiothoracic Vascular Surgery)
1001 MAIN ST, SUITE 300
PEORIA, IL 61606

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1275575706, enumerated as an "organization" on June 11, 2006.

The provider is located at 1001 MAIN ST SUITE 500A PEORIA, IL 61606 and the phone number is (309) 672-4980.

Internal Medicine with taxonomy code 207RG0100X and a focus in Gastroenterology.

The provider might be accepting Accepts: Blue Cross Blue Shield, Medicare, Medicaid and. Please consult your insurance carrier or call the provider to verify.