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THITAPA PETLERKWONG DO
NPI 1285372193
Internal Medicine in Peoria, IL

Active since May 22, 2022PECOS EnrolledAccepts Medicare Assignment
530 NE GLEN OAK AVE, PEORIA, IL 61637(309) 655-6384(309) 655-7732 Get Directions Write a Review

NPPES record last updated: June 6, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 6, 2025, May 22, 2022 (2 updates tracked since 2022).

About Thitapa Petlerkwong Do NPPES

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

THITAPA PETLERKWONG DO (NPI 1285372193) is an individual internal medicine provider in Peoria, Illinois, licensed in Illinois (036174075) and active in the NPI registry since May 2022. She is enrolled in Medicare PECOS, is affiliated with St Mary Medical Center, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1285372193
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameTHITAPA PETLERKWONGCredential: DO
Location Address530 NE GLEN OAK AVEPeoria, IL 61637-0001
Mailing Address530 Ne Glen Oak AvePeoria, IL 61637-0001 · (309) 655-2730 · Fax (309) 655-3297
Phone(309) 655-6384
Fax(309) 655-7732
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateMay 22, 2022
Last NPPES UpdateJune 6, 20252 updates tracked since enumeration
NPPES CertifiedJune 6, 2025
✔ NPI 1285372193 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in IL · 036174075
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
530 NE GLEN OAK AVE, Peoria, IL 61637
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Thitapa Petlerkwong Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6305357849
PECOS Enrollment IDI20250612003199
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Mary Medical Center

Acute Care Hospitals · Galesburg, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140064
Location3333 North SeminaryGalesburg, IL 61401 · Knox County
Emergency services Birthing friendly

Saint Francis Medical Center

Acute Care Hospitals · Peoria, IL
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140067
Location530 NE Glen Oak AvePeoria, IL 61637 · Peoria County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61637 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$127.46 typical visit price
range $54.80 – $168.44
Typical copayment $31.86 (range $13.70 – $42.11)
Most-billed visit code 99204
Established Patient
$97.25 typical visit price
range $17.16 – $136.56
Typical copayment $24.31 (range $4.29 – $34.14)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

DR. DEEPAK S NAIR M.D.
Psychiatry & Neurology (Neurology)
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2000
DR. HAMID MAHMOOD ZIA M.D
Pathology (Anatomic Pathology & Clinical Pathology)
530 NE GLEN OAK AVE, CENTRAL ILLINOIS PATHOLOGY SC
PEORIA, IL 61637
Peoria County (309) 624-9011
THOMAS JAMES MCMORROW MD
Pediatrics
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2553
ALEXANDRA ROPER MD
Surgery
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2000
JAPMEHR KAUR SANDHU M.B.B.S.
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 624-9351
THOMAS BLACKWELL JR. MD
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2000
LUKE KLOFT
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2109
ABIGAIL V. WELU DO
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-6710

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 Thitapa Petlerkwong's NPI number?

The NPI number for Thitapa Petlerkwong is 1285372193. It was assigned to this individual provider in the NPPES registry on May 22, 2022.

Where is Thitapa Petlerkwong located?

Thitapa Petlerkwong practices at 530 NE Glen Oak Ave, Peoria, IL 61637. The listed phone number is (309) 655-6384.

What is Thitapa Petlerkwong's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Thitapa Petlerkwong enrolled in Medicare?

Yes. Thitapa Petlerkwong is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Thitapa Petlerkwong affiliated with any hospitals?

According to CMS data, Thitapa Petlerkwong is affiliated with St Mary Medical Center and Saint Francis Medical Center.

When was this NPI record last updated?

The NPPES record for Thitapa Petlerkwong was last updated on June 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months 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.