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Peoria Obstetrics & Gynecology, S.C.

Obstetrics & Gynecology Physician in Peoria, IL · enumerated 2007 · authorized official Paula Clark, Practice Administrator.

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

National Provider Identifier

1477672020

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Registry record

Entity type Organization (Type 2)
Legal business name Peoria Obstetrics & Gynecology, S.C.
Practice address 900 Main St Ste 660, Peoria, IL, 61602
Phone (309) 687-4230
Fax (309) 272-7704
Enumeration date Mar 28, 2007
Last updated in NPPES Jan 26, 2009

Taxonomy & classification

207V00000X Obstetrics & Gynecology Physician Allopathic & Osteopathic Physicians · License 036084069 (IL) Primary

Authorized official

Name Paula Clark
Title Practice Administrator
Phone (309) 687-4242

Other identifiers

Identifier Type State Issuer
036065639 Medicaid IL -
036108543 Medicaid IL -
036084069 Medicaid IL -
036098292 Medicaid IL -
036111906 Medicaid IL -
036044919 Medicaid IL -
036062138 Medicaid IL -

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

Where is Peoria Obstetrics & Gynecology, S.C. located?
The practice location on file with NPPES is in Peoria, IL.
How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2009-01-26. Verify at npiregistry.cms.hhs.gov.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2009-01-26.