The Antioch Group, Inc.
NPI 1801993142ActiveOrganization· Psychologist· Peoria, IL
Psychologist in Peoria, Illinois, registered in NPPES in September 2006. The authorized official on file is Shelley Wilson, Credentialing/Billing Specialist. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1801993142 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 20, 2006 |
| Last updated in NPPES | Oct 3, 2024 |
| Certified by provider | Oct 3, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist Primary | 103T00000X | 071-004483 | IL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (IL) |
|---|
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