CENTRAL ILLINOIS FRIENDS OF PWA, INC.
NPI 1376492306
Nurse Practitioner - Community Health in Peoria, IL
About Central Illinois Friends Of Pwa, Inc. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CENTRAL ILLINOIS FRIENDS OF PWA, INC. (NPI 1376492306) is a healthcare organization registered as a community health in Peoria, Illinois and active in the NPI registry since January 2026. The organization holds a CLIA Microscopy certificate valid through May 14, 2028 and lists Deric Kimler, Executive Director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
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 for Provider-Performed Microscopy Procedures (PPMP) 14D2344034
Central Illinois Friends Of P W A, Inc · Galesburg, ILFrequently 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 Friends Of Pwa, Inc.'s NPI number?
The NPI number for Central Illinois Friends Of Pwa, Inc. is 1376492306. It was assigned to this organization in the NPPES registry on January 23, 2026.
Where is Central Illinois Friends Of Pwa, Inc. located?
Central Illinois Friends Of Pwa, Inc. is located at 120 NE Glen Oak Ave Ste 201, Peoria, IL 61603. The listed phone number is (309) 431-5880.
What is Central Illinois Friends Of Pwa, Inc.'s specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Community Health, with taxonomy code 363LC1500X.
Does Central Illinois Friends Of Pwa, Inc. hold a CLIA laboratory certificate?
Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 14D2344034) is associated with this NPI, valid through May 14, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Central Illinois Friends Of Pwa, Inc. was last updated on January 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# Central Illinois Friends Of Pwa, Inc. · NPI 1376492306
Community Health organization in Peoria, Illinois. Organization record, active in the CMS NPPES registry since January 23, 2026.
## Identity
- **NPI:** 1376492306 (Entity type: Organization)
- **Enumerated:** January 23, 2026
- **Primary specialty:** Nurse Practitioner - Community Health · taxonomy 363LC1500X
- **Organization subpart:** No
- **Authorized official:** Deric Kimler, EXECUTIVE DIRECTOR
## Practice location
- **Address:** 120 NE GLEN OAK AVE STE 201, Peoria, IL 61603-4315
- **Phone:** (309) 431-5880
## Record status
- **NPPES last updated:** January 23, 2026
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1376492306) · Data from the CMS NPPES public registry.