| NPI | LastName | FirstName | MidName | Organization | Mailing Address | City | State | Zip |
| 1932153186 | JAK ENTERPRISES INC | 8309 N KNOXVILLE AVE | PEORIA | IL | 616152170 | |||
| 1629004767 | MAHAFFEY | LINDA | L | 8309 N KNOXVILLE AVE | PEORIA | IL | 616152170 | |
| 1184611766 | RICHMOND | RONALD | L | 8309 N KNOXVILLE AVE | PEORIA | IL | 616152170 |