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KWABENA A BOATENG MD
NPI 1639215312
Obstetrics & Gynecology in Peoria, IL

Active since January 29, 2007PECOS Enrolled
2321 N WISCONSIN AVE, PEORIA, IL 61603(309) 680-7600(309) 681-4681 Get Directions Write a Review

NPPES record last updated: August 28, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kwabena A Boateng Md NPPES

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

KWABENA A BOATENG MD (NPI 1639215312) is an individual obstetrics & gynecology provider in Peoria, Illinois, licensed in Illinois (036084514) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS and maintains a secondary practice location in Joliet.

NPPES Registry Identity

NPI1639215312
Entity TypeIndividualMale
Primary Taxonomy207V00000X
Provider Legal NameKWABENA A BOATENGCredential: MD
Location Address2321 N WISCONSIN AVEPeoria, IL 61603-5613
Mailing Address2214 N University StPeoria, IL 61604-3221 · (309) 680-7669 · Fax (309) 681-8443
Phone(309) 680-7600
Fax(309) 681-4681
Sole ProprietorNo
Enumeration DateJanuary 29, 2007
Last NPPES UpdateAugust 28, 2020
NPPES CertifiedAugust 28, 2020
✔ NPI 1639215312 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
License✔ Licensed in IL · 036084514
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
2321 N WISCONSIN AVE, Peoria, IL 61603
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Secondary Practice Location 1

Location 12000 Glenwood Avenue, LLE Lower Level EastJoliet, IL 60435 · Phone (815) 553-0500 · Fax (815) 553-0505

Other Identifiers 1

Medicaid036084514IL

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kwabena A Boateng 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61603 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
$68.64 typical visit price
range $17.16 – $136.56
Typical copayment $17.16 (range $4.29 – $34.14)
Most-billed visit code 99213
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 17

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

KROGER LIMITED PARTNERSHIP I
Pharmacy (Community/Retail Pharmacy)
2321 N WISCONSIN AVE
PEORIA, IL 61603
Peoria County (309) 688-9456
TERRYL A. POLANIN FNP
Nurse Practitioner (Family)
2321 N WISCONSIN AVE
PEORIA, IL 61603
Peoria County (309) 680-7600
BETHANY JOY WINFREY FERGUSON FNP-BC
Nurse Practitioner
2321 N WISCONSIN AVE
PEORIA, IL 61603
Peoria County (309) 680-7600
MACKENZIE LYNN SMALLEY LCSW
Social Worker (Clinical)
2321 N WISCONSIN AVE
PEORIA, IL 61603
Peoria County (309) 680-7600
KRISTINA LYNN MCCUE APRN
Nurse Practitioner (Psychiatric/Mental Health)
2321 N WISCONSIN AVE
PEORIA, IL 61603
Peoria County (309) 680-7600
MS. LAURA MARIE FULLERTON APN
Nurse Practitioner (Family)
2321 N WISCONSIN AVE
PEORIA, IL 61603
Peoria County (309) 680-7600
CIARA JUNE WHITE APN
Nurse Practitioner (Family)
2321 N WISCONSIN AVE
PEORIA, IL 61603
Peoria County (309) 680-7600
HEARTLAND COMMUNITY HEALTH CLINIC
Clinic/Center (Federally Qualified Health Center (FQHC))
2321 N WISCONSIN AVE
PEORIA, IL 61603
Peoria County (309) 680-7600

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 Kwabena Boateng's NPI number?

The NPI number for Kwabena Boateng is 1639215312. It was assigned to this individual provider in the NPPES registry on January 29, 2007.

Where is Kwabena Boateng located?

Kwabena Boateng practices at 2321 N Wisconsin Ave, Peoria, IL 61603. The listed phone number is (309) 680-7600.

What is Kwabena Boateng's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Is Kwabena Boateng enrolled in Medicare?

Yes. Kwabena Boateng is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kwabena Boateng was last updated on August 28, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.