| NPI | LastName | FirstName | MidName | Organization | Mailing Address | City | State | Zip |
| 1275587420 | JAK ENTERPRISES INC | 8309 N KNOXVILLE AVE | PEORIA | IL | 616152170 | |||
| 1396753059 | EDWARDS | ROBERT | P | 8309 N KNOXVILLE AVE | PEORIA | IL | 616152170 | |
| 1023480316 | GUITHUES | MOLLY | 8309 N KNOXVILLE AVE | PEORIA | IL | 616152170 | ||
| 1942462486 | LEAVITT | ERIC | JOHN | 8309 N KNOXVILLE AVE | PEORIA | IL | 616152170 | |
| 1932116449 | SARMIENTO | MARC | CHRISTOPHER | 8309 N KNOXVILLE AVE | PEORIA | IL | 616152170 | |
| 1255479358 | ZAJICEK | RICHARD | MARK | 720 WELLINGTON AVE | ELK GROVE VILLAGE | IL | 600073366 |