OrganizationActive
University of Illinois
NPI 1619948411 · Developmental - Behavioral Pediatrics Physician · Peoria, IL
Provider details
- NPI number
- 1619948411
- Entity type
- Organization
- Primary specialty
- Developmental - Behavioral Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- William Nichaolas, Executive Director of Msp(312) 413-0573
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 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
Regional Development Center
507 E Armstrong
Peoria, IL 61603
Phone: (309) 681-6960
Approximate (ZIP-level) locationGet directions
Mailing address
1 Illini Dr
Peoria, IL 61605-2576
Other names (DBA / former)
- Doing business as
- Medical Service Plan at Peoria
Registry dates
- Enumerated
- 2006-01-30
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.