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Regency Park Medical Group LLC

General Practice Physician in O Fallon, IL · enumerated 2020 · authorized official Ellie Descalzo, Credentialing Officer.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1063034783

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Registry record

Entity type Organization (Type 2)
Legal business name Regency Park Medical Group LLC
Practice address 124 Regency Park Ste 7, O Fallon, IL, 62269
Phone (480) 926-7800
Enumeration date May 15, 2020
Last updated in NPPES Aug 19, 2021

Taxonomy & classification

111N00000X Chiropractor Chiropractic Providers Secondary
207R00000X Internal Medicine Physician Allopathic & Osteopathic Physicians Secondary
208D00000X General Practice Physician Allopathic & Osteopathic Physicians Primary
225100000X Physical Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers Secondary
363A00000X Physician Assistant Physician Assistants & Advanced Practice Nursing Providers Secondary
363LF0000X Family Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Secondary

Authorized official

Name Ellie Descalzo
Title Credentialing Officer
Phone (480) 926-7800

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

Who is the authorized official for Regency Park Medical Group LLC?
NPPES lists Ellie Descalzo (Credentialing Officer) as the authorized official for this organization.
What is the NPI number for Regency Park Medical Group LLC?
The NPI for Regency Park Medical Group LLC is 1063034783, a Type 2 (organization) record in the CMS NPPES registry.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2021-08-19.