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WILLIAM G NULTY MD
NPI 1639148356
Pediatrics - Adolescent Medicine in Peoria, IL

Active since March 15, 2006PECOS Enrolled
ONE ILLINI DR, MEDICAL SERVICE PLAN, PEORIA, IL 61605(309) 671-8503 Get Directions Write a Review

NPPES record last updated: July 9, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About William G Nulty Md NPPES

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

WILLIAM G NULTY MD (NPI 1639148356) is an individual adolescent medicine provider in Peoria, Illinois and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1639148356
Entity TypeIndividualMale
Primary Taxonomy2080A0000X
Provider Legal NameWILLIAM G NULTYCredential: MD
Location AddressONE ILLINI DR, MEDICAL SERVICE PLANPeoria, IL 61605
Mailing Address1 Illini DrPeoria, IL 61605-2576 · (309) 671-8503
Phone(309) 671-8503
Sole ProprietorNo
Enumeration DateMarch 15, 2006
Last NPPES UpdateJuly 9, 2007
✔ NPI 1639148356 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Adolescent MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080A0000X
Definition
A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
ONE ILLINI DR, Peoria, IL 61605
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Other Identifiers 4

OtherIL01DCIL · John Deere
Other07215036IL · Bcbs
Medicare UPINF83738IL
Medicare ID-Type Unspecified639810IL · Medicare

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

William G Nulty Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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 William Nulty's NPI number?

The NPI number for William Nulty is 1639148356. It was assigned to this individual provider in the NPPES registry on March 15, 2006.

Where is William Nulty located?

William Nulty practices at One Illini Dr Medical Service Plan, Peoria, IL 61605. The listed phone number is (309) 671-8503.

What is William Nulty's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Adolescent Medicine, with taxonomy code 2080A0000X.

Is William Nulty enrolled in Medicare?

Yes. William Nulty is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for William Nulty was last updated on July 9, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.