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PROCTOR MEDICAL GROUP RENALDO JACQUES MD
NPI 1396923702
Clinic/Center in Peoria, IL

Active since February 07, 2008
5401 N KNOXVILLE AVE STE 306, PEORIA, IL 61614(309) 691-0027 Get Directions Write a Review

NPPES record last updated: February 7, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Proctor Medical Group Renaldo Jacques Md NPPES

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

PROCTOR MEDICAL GROUP RENALDO JACQUES MD (NPI 1396923702) is a healthcare organization registered as a clinic/center in Peoria, Illinois and active in the NPI registry since February 2008. The organization lists Carrie Chiaravalle, Director Operations, as its authorized official.

NPPES Registry Identity

NPI1396923702
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NamePROCTOR HEALTH SYSTEMS
Location Address5401 N KNOXVILLE AVE STE 306Peoria, IL 61614-5021
Mailing Address5401 N Knoxville Ave Ste 306Peoria, IL 61614-5021
Phone(309) 691-0027
Organization SubpartNo
Authorized OfficialCarrie ChiaravalleDirector Operations · (309) 689-6043
Enumeration DateFebruary 7, 2008
✔ NPI 1396923702 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
5401 N KNOXVILLE AVE STE 306, Peoria, IL 61614
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Other Names 1

Doing Business AsProctor Medical Group Renaldo Jacques Md

Other Identifiers 2

Other07232122IL · Bcbsil
Medicare PIN242904IL

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 Proctor Health Systems's NPI number?

The NPI number for Proctor Health Systems is 1396923702. It was assigned to this organization in the NPPES registry on February 7, 2008. The provider is doing business as Proctor Medical Group Renaldo Jacques MD.

Where is Proctor Health Systems located?

Proctor Health Systems is located at 5401 N Knoxville Ave Ste 306, Peoria, IL 61614. The listed phone number is (309) 691-0027.

What is Proctor Health Systems's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

When was this NPI record last updated?

The NPPES record for Proctor Health Systems was last updated on February 7, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.