MR. JULIUS P. BONELLO (NPI# 1093751257) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093751257 |
| Entity Type | Individual |
| Full Name | MR. JULIUS P. BONELLO |
| Credential | M.D. |
| Practice Address |
1001 Main Street Suite 300 Peoria IL 61606 |
| Practice Telephone | 3094950200 |
| Practice Fax Number | 3096766545 |
| Mailing Telephone | 3094950200 |
| Mailing Fax Number | 3096766545 |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2013-02-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 036058876-1 | IL | Allopathic & Osteopathic Physicians |
| N | 208C00000X | Colon & Rectal Surgery | 036058876 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036058876-1 | 05 | |
| IL | BCBS | 7215166 | 01 |
| Street Address |
1001 MAIN STREET SUITE 300 |
| City | PEORIA |
| State | IL |
| Zip Code | 61606 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033151162 | Eric T Elwood | Surgery | 1001 Main Street, 3rd Floor, Peoria, IL 61606-2037 | 2006-06-12 |
| 1972604221 | Denise M. Mammolito | Surgery | 1001 Main Street, 3rd Floor, Peoria, IL 61606-2037 | 2006-09-26 |
| 1275542045 | Peoria Surgical Group, Ltd. | Surgery | 1001 Main Street, Suite 300, Peoria, IL 61606-2037 | 2006-08-07 |
| 1366462475 | Glyn E. Jones | Plastic Surgery | 1001 Main Street, 3rd Floor, Peoria, IL 61606-2037 | 2006-07-20 |
| 1366471997 | John S Marshall | Surgery | 1001 Main Street, 3rd Floor, Peoria, IL 61606-2037 | 2006-07-03 |
| 1073542585 | Samir K. Gupta | Surgery | 1001 Main Street, 3rd Floor, Peoria, IL 61606-2037 | 2006-06-30 |
| 1851320238 | Thomas R. Rossi | Surgery | 1001 Main Street, 3rd Floor, Peoria, IL 61606-2037 | 2006-06-30 |
| 1306874128 | David L Crawford | Surgery | 1001 Main Street, Suite 300, Peoria, IL 61606 | 2006-06-29 |
| 1205864170 | Norman C Estes | Surgery | 1001 Main Street, Suite 300, Peoria, IL 61606 | 2006-06-29 |
| 1699703892 | Richard Anderson | Surgery | 1001 Main Street, 3rd Floor, Peoria, IL 61606-2037 | 2006-06-28 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194292334 | Kelley Stork | Speech-Language Pathologist | 807 W Columbia Terrace, Peoria, IL 61606 | 2018-10-25 |
| 1689140519 | Emma Cristine Tully | Speech-Language Pathologist | 1619 W. Fredonia Ave, Peoria, IL 61606 | 2018-10-18 |
| 1316492432 | Jennifer Greenwood | Nurse Practitioner | 1001 Main St Ste 500a, Peoria, IL 61606 | 2016-08-18 |
| 1104944974 | Robert I Martin | Preventive Medicine | 1127 N North Street, Peoria, IL 61606 | 2007-03-27 |
| 1023062312 | Saint Francis Medical Center | Physical Medicine & Rehabilitation | 100 Ne Randoph Street, Peoria, IL 61606 | 2006-05-20 |
| 1174573307 | Cpo Services, Inc | Prosthetic/Orthotic Supplier | 741 West Main Street, Peoria, IL 61606 | 2006-05-10 |
| 1174025357 | Amy M Durst | Nurse Practitioner | 1001 Main St Ste 500a, Peoria, IL 61606 | 2018-03-05 |
| 1538471099 | Jacob Royle Hopping | Surgery | 1001 Main St Ste 300, Peoria, IL 61606 | 2010-07-12 |
| 1881906410 | Heather Jefford | Clinical Nurse Specialist | 1001 Main St, 3rd Floor, Peoria, IL 61606 | 2010-07-12 |
| 1780628388 | Donald E Penn Jr. | Internal Medicine | 1001 Main St, Suite 500a, Peoria, IL 61606 | 2006-06-15 |
| Find all providers in zip 61606 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235760406 | Star Surgery Center, LLC | Surgery | 14155 N 83rd Ave Ste 140, Peoria, AZ 85381-5652 | 2020-01-28 |
| 1093008237 | Jordan J Glenn | Surgery | 6750 W Thunderbird Rd Ste B-108, Peoria, AZ 85381-5026 | 2011-05-20 |
| 1023207131 | Comprehensive Breast Center of Arizona Plc | Surgery | 9179 W Thunderbird Rd # 103, Peoria, AZ 85381-4875 | 2007-10-15 |
| 1659589653 | Matthew Lawrence Lynch | Surgery | 26900 N Lake Pleasant Pkwy, Peoria, AZ 85383-1558 | 2007-05-21 |
| 1457480063 | Lorin Dixon Whittaker Jr. | Surgery | 624 Ne Glen Oak Ave, 2686, Peoria, IL 61603-3135 | 2007-03-02 |
| 1639132087 | Brian Edward Prebil | Surgery | 14155 N. 83rd Ave., Ste. A-105, Peoria, AZ 85381 | 2006-04-07 |
| 1073584470 | Eric L Thomas | Surgery | 14155 N 83rd Ave Ste A105, Peoria, AZ 85381-5640 | 2006-02-01 |
| 1801874565 | Maqbool B Ali | Surgery | 4930 N Executive Dr, Peoria, IL 61614-4894 | 2006-01-04 |
| 1518956465 | Leann Cari Allgood | Surgery | 9159 W Thunderbird Rd, Peoria, AZ 85381-4910 | 2005-10-13 |
| 1225037310 | John J Brothwell | Surgery | 9856 W Villa Lindo Dr, Peoria, AZ 85383-1339 | 2005-07-20 |
| Find all providers in PEORIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.