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MEDICAL GROUP OF MACOMB, LLC
NPI 1356430664
Internal Medicine in Macomb, IL

Active since October 12, 2006CLIA 14D1010481 · Waiver
505 E GRANT ST STE 103, MACOMB, IL 61455(309) 833-3536(309) 836-5729 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Medical Group Of Macomb, Llc NPPES

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

MEDICAL GROUP OF MACOMB, LLC (NPI 1356430664) is a healthcare organization registered as an internal medicine in Macomb, Illinois and active in the NPI registry since October 2006. The organization holds a CLIA Waiver certificate valid through March 13, 2027 and lists David Miller, President, as its authorized official.

NPPES Registry Identity

NPI1356430664
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameMEDICAL GROUP OF MACOMB, LLC
Location Address505 E GRANT ST STE 103Macomb, IL 61455-3308
Mailing AddressPo Box 556Macomb, IL 61455-0556 · (309) 833-3536 · Fax (309) 836-5729
Phone(309) 833-3536
Fax(309) 836-5729
Organization SubpartNo
Authorized OfficialDavid MillerPresident · (309) 833-3536
Enumeration DateOctober 12, 2006
Last NPPES UpdateJuly 21, 2022
✔ NPI 1356430664 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
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.
Also ListedPediatricsTaxonomy 208000000X
505 E GRANT ST STE 103, Macomb, IL 61455
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Other Identifiers 7

Medicaid036111319IL
Other5532005IL · Blue Cross/blue Shield Il
OtherDG6820IL · Railroad Medicare
Medicaid036104354IL
Other095260IL · Health Alliance
Other067033IL · Health Alliance
Other110247080IL · Railroad Medicare

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D1010481

Medical Group Of Macomb LLC · Macomb, IL
Active · expires Mar 13, 2027
CLIA Number14D1010481
Laboratory TypePhysician Office
Certificate Effective DateMarch 14, 2025
Certificate Expiration DateMarch 13, 2027
Laboratory DirectorDavid L. Miller Dd
Laboratory Phone(309) 833-3536
Laboratory LocationMedical Group Of Macomb LLC505 E Grant Street - Suite 103 P O Box 556, Macomb, IL 61455
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

MRS. KYMBERLY DANIELLE LOCKARD APRN
Pediatrics
505 E GRANT ST STE 103
MACOMB, IL 61455
McDonough County (309) 833-1303

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 Medical Group Of Macomb, LLC's NPI number?

The NPI number for Medical Group Of Macomb, LLC is 1356430664. It was assigned to this organization in the NPPES registry on October 12, 2006.

Where is Medical Group Of Macomb, LLC located?

Medical Group Of Macomb, LLC is located at 505 E Grant St Ste 103, Macomb, IL 61455. The listed phone number is (309) 833-3536.

What is Medical Group Of Macomb, LLC's specialty?

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

Does Medical Group Of Macomb, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D1010481) is associated with this NPI, valid through March 13, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Medical Group Of Macomb, LLC was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.