| NPI | LastName | FirstName | MidName | Organization | Mailing Address | City | State | Zip |
| 1528013471 | JAK ENTERPRISES INC | 8309 N KNOXVILLE AVE | PEORIA | IL | 616152170 | |||
| 1043373871 | JONES | DEBORAH | S | 8309 N KNOXVILLE AVE | PEORIA | IL | 616152170 | |
| 1922109172 | MORGRET | DAVID | R | 8309 N KNOXVILLE AVE | PEORIA | IL | 616152170 |