OrganizationActive
Mid Illini Surgical Associates Sc
NPI 1093854002 · Surgery Physician · Peoria, IL
Provider details
- NPI number
- 1093854002
- Entity type
- Organization
- Primary specialty
- Surgery PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Greg Totten, Office Manager(309) 672-5975
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
900 Main St
Suite 530
Peoria, IL 61602-1074
Phone: (309) 672-5975
Fax: (309) 655-1678
Street-level locationGet directions
Mailing address
900 Main Street
Peoria, IL 61602-1074
Registry dates
- Enumerated
- 2007-02-06
- Last updated
- 2022-07-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.