# METHODIST MEDICAL CENTER OF ILLINOIS

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** THE CARLE FOUNDATION
- **Other names:** CARLE HEALTH LACON
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1073484929
- **Legal business name:** THE CARLE FOUNDATION
- **Authorized official:** ARON KLEIN (VP FINANCE)
- **Authorized official phone:** (309) 268-2410

## Contact information

- **Practice address:** 1112 5TH ST, LACON, IL 61540-1353
- **Practice address phone:** (309) 246-2416
- **Practice address fax:** (309) 246-3574
- **Mailing address:** 221 NE GLEN OAK AVE, GOMP100, PEORIA, IL 61636-0001
- **Mailing address phone:** (309) 672-4874

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/15/2025
- **Last updated:** 09/15/2025