Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Greater Peoria Obstetrics & Gynecology Corp SC

Organization Specialist · NPI 1912129271

Greater Peoria Obstetrics & Gynecology Corp SC provides Specialist services in Peoria, Illinois. Licensed in Illinois. Registered with an NPI since 2007.

Licensed in
IL
In the registry since
2007
What do these letters mean?
Corp — Corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4930 N Executive Dr
Peoria, IL 61614-4894 Not confirmed with CMS for 11 years — call before visiting
Phone: (309) 671-8749
Fax: (309) 671-8749
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence 03658850 (IL)

Record details

NPI number1912129271
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Judy Mueller — Manager · (309) 692-7575
NPI enumeratedMay 3, 2007
Last updated in NPPESMay 1, 2015
Mailing address4930 N Executive Dr, Peoria, IL 61614-4894

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