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MIDWEST PAIN & SPINE CENTER, LLC
NPI 1679944334
Specialist in Peoria, IL

Active since October 07, 2015
5401 N KNOXVILLE AVE, SUITE 416, PEORIA, IL 61614(309) 692-7246(309) 692-7226 Get Directions Write a Review

NPPES record last updated: October 23, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Midwest Pain & Spine Center, Llc NPPES

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

MIDWEST PAIN & SPINE CENTER, LLC (NPI 1679944334) is a healthcare organization registered as a specialist in Peoria, Illinois and active in the NPI registry since October 2015. The organization lists Gayle Mucciante, Practice Administrator, as its authorized official.

NPPES Registry Identity

NPI1679944334
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameMIDWEST PAIN & SPINE CENTER, LLC
Location Address5401 N KNOXVILLE AVE, SUITE 416Peoria, IL 61614-5098
Mailing Address5401 N Knoxville Ave, Suite 416Peoria, IL 61614-5098 · (309) 692-7246 · Fax (309) 692-7226
Phone(309) 692-7246
Fax(309) 692-7226
Organization SubpartNo
Authorized OfficialGayle MucciantePractice Administrator · (309) 692-7246
Enumeration DateOctober 7, 2015
Last NPPES UpdateOctober 23, 2015
✔ NPI 1679944334 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
5401 N KNOXVILLE AVE, Peoria, IL 61614
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

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

YIBING LI MD
Physical Medicine & Rehabilitation
5401 N KNOXVILLE AVE, STE 117
PEORIA, IL 61614
Peoria County (309) 689-8888
PATTI L ALLY
Audiologist-Hearing Aid Fitter
5401 N KNOXVILLE AVE, SUITE 116
PEORIA, IL 61614
Peoria County (309) 282-0887
PROCTOR HEALTH SYSTEMS
Clinic/Center (Medical Specialty)
5401 N KNOXVILLE AVE, SUITE 103
PEORIA, IL 61614
Peoria County (309) 691-7800
MS. BARBARA J NALL APN
Nurse Practitioner (Women's Health)
5401 N KNOXVILLE AVE, SUITE 308
PEORIA, IL 61614
Peoria County (309) 692-5100
SUSAN GWILLIM PT
Physical Therapist
5401 N KNOXVILLE AVE, SUITE 218
PEORIA, IL 61614
Peoria County (309) 693-2244
MR. KEVIN M HENRY MD
Anesthesiology (Pain Medicine)
5401 N KNOXVILLE AVE, SUITE 416
PEORIA, IL 61614
Peoria County (309) 692-7246
MS. COLLEEN SUSANNE CUSHING RAGON APN, CNS
Nurse Practitioner (Family)
5401 N KNOXVILLE AVE
PEORIA, IL 61614
Peoria County (309) 691-1069
SUSAN J COLE, MD & ASSOCIATES
Clinic/Center (Medical Specialty)
5401 N KNOXVILLE AVE, SUITE 107
PEORIA, IL 61614
Peoria County (309) 691-2311

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 Midwest Pain & Spine Center, LLC's NPI number?

The NPI number for Midwest Pain & Spine Center, LLC is 1679944334. It was assigned to this organization in the NPPES registry on October 7, 2015.

Where is Midwest Pain & Spine Center, LLC located?

Midwest Pain & Spine Center, LLC is located at 5401 N Knoxville Ave Suite 416, Peoria, IL 61614. The listed phone number is (309) 692-7246.

What is Midwest Pain & Spine Center, LLC's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Midwest Pain & Spine Center, LLC was last updated on October 23, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.