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

Peoria Integrative Medical Center Ltd

Organization Family Medicine Physician · NPI 1699839985

Peoria Integrative Medical Center Ltd provides Family Medicine Physician services in Peoria, Illinois. Licensed in Illinois. Registered with an NPI since 2006.

Licensed in
IL
In the registry since
2006
What do these letters mean?
Ltd — Limited
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4930 N Executive Dr Ste B
Peoria, IL 61614-4894 Not confirmed with CMS for 17 years — call before visiting
Phone: (309) 683-6002
Fax: (309) 683-6007
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 036114042 (IL)

Record details

NPI number1699839985
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Yang Xie — Owner · (309) 636-7302
NPI enumeratedDecember 20, 2006
Last updated in NPPESApril 20, 2009
Mailing address4930 N Executive Dr, Suite B, Peoria, IL 61614-4894

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