RAJ PATEL (NPI# 1104245406) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104245406 |
| Entity Type | Individual |
| Full Name | RAJ PATEL |
| Credential | M.D. |
| Practice Address |
530 Ne Glen Oak Ave Peoria IL 61637-4501 |
| Mailing Address |
1918 Glenbridge Rd Bloomington IL 61704-8708 |
| Practice Telephone | 3096552000 |
| Mailing Telephone | (337) 842-8492 |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
XX01248494 | IL | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2359 Shelley Ct, Shelby Township, MI 483174501 | 3378428492 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508396409 | Raj Patel | Student in an Organized Health Care Education/Training Program | 1099 Pomona St, Crockett, CA 94525-1427 | 2017-06-14 |
| 1912352014 | Raj Patel | Student in an Organized Health Care Education/Training Program | 102 Joni Ave, Hamilton, NJ 08690-3641 | 2016-04-27 |
| 1750793477 | Raj Patel | Dentist | 2757 Jefferson Davis Hwy Ste 119, Stafford, VA 22554-8328 | 2014-05-29 |
| 1366888711 | Raj Patel | Surgery | 4100 Outpatient Cirlce, 616, Little Rock, AR 72205 | 2013-05-13 |
| 1780995845 | Raj P Patel | Dentist | 301 Oxford Valley Rd Ste 1801, Yardley, PA 19067-7725 | 2010-06-23 |
| 1508930736 | Raj Patel | Internal Medicine | 385 Bartlett Plz, Bartlett, IL 60103-4234 | 2006-11-20 |
| 1447270848 | Raj M Patel | Dentist | 10130 S Memorial Dr, Tulsa, OK 74133 | 2006-07-20 |
| 1952383721 | Raj S Patel | Pediatrics | 750 N Estrella Pkwy, Suite 20, Goodyear, AZ 85338-9272 | 2005-11-17 |
| 1063403004 | Raj Patel | Genetic Counselor, MS | 10999 Windjammer Trce, Indianapolis, IN 46256-9676 | 2005-10-31 |
| 1053934570 | Raj Patel | Student in an Organized Health Care Education/Training Program | 1200 Childrens Ave, Oklahoma City, OK 73104-4637 | 2020-05-19 |
| Street Address |
530 NE GLEN OAK AVE |
| City | PEORIA |
| State | IL |
| Zip Code | 61637-4501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346235777 | Jack Michael Gibson | Obstetrics & Gynecology | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2005-09-12 |
| 1053912188 | Janie Clary | Nurse Practitioner | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-11-04 |
| 1265030548 | Christina David | Nurse Practitioner | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-10-09 |
| 1033726831 | Corry Lynn Rediger | Occupational Therapist | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-09-25 |
| 1720694094 | Katelynn M Madden | Clinical Nurse Specialist | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-09-21 |
| 1568074474 | Amanda Diane Beoletto | Pharmacist | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-08-21 |
| 1881212892 | Mohammad Mousbah Al-tabbaa | Student in an Organized Health Care Education/Training Program | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-07-07 |
| 1750909693 | Mohammad Gareeb | Student in an Organized Health Care Education/Training Program | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-07-07 |
| 1376160846 | Bassel Elia Abouzeid | Student in an Organized Health Care Education/Training Program | 530 Ne Glen Oak Ave, Peoria, IL 61637 | 2020-07-01 |
| 1700403516 | Christina Marie Spurgeon | Nurse Practitioner | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-06-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780200865 | Kuang Chuen Liu | Pediatrics | 530 Ne Glen Oak Ave, Peoria, Peoria, IL 61637 | 2020-06-24 |
| 1174184527 | Manisha Tharoor | Student in an Organized Health Care Education/Training Program | 530 N.e Glen Oak Ave, Peoria, IL 61637 | 2019-06-26 |
| 1609436724 | Sriviji Senthil Kumaran | Student in an Organized Health Care Education/Training Program | 530. N.e Glen Oak Ave., Peoria, IL 61637 | 2019-06-20 |
| 1780240929 | Abuzar Ali Asif | Student in an Organized Health Care Education/Training Program | 530 N. E. Glen Oak Ave., Peoria, IL 61637 | 2019-05-14 |
| 1518328665 | Jenna Bishop | Dietitian, Registered | 600 Ne Water Street, Peoria, IL 61637 | 2016-03-17 |
| 1194133850 | Ashish Kumar Roy | Internal Medicine | 530 N.e. Glen Oak Ave, Peoria, IL 61637 | 2014-07-25 |
| 1265720510 | Reuben Antony | Pediatrics | 530 Ne Glen Oak Ave., C/o Ms Suzy Lewellen, Peoria, IL 61637 | 2011-07-20 |
| 1366673436 | Joseph William Hauter | Emergency Medicine | 830 Ne Glen Oak Ave, Peoria, IL 61637 | 2009-08-06 |
| 1437380748 | Jeremy R Monroe | Emergency Medicine | 530 Glen Oak, Osf St Francis Medical Center, Peoria, IL 61637 | 2009-08-04 |
| 1326244682 | Maria S. Parr | Psychiatry & Neurology | Osf Saint Francis Medical Center, 530 N.e.glen Oak Ave., Peoria, FL 61637 | 2007-06-25 |
| Find all providers in zip 61637 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558553016 | Ashim Aggarwal | Internal Medicine | 13634 N 93rd Ave Ste 300, Peoria, AZ 85381 | 2007-08-17 |
| 1174672331 | Thanad S Shay | Internal Medicine | 1201 N North St, Peoria, IL 61606-1533 | 2007-01-09 |
| 1568558492 | Barry Rosen | Internal Medicine | 28685 N. 129th Ave, Peoria, AZ 85383 | 2006-10-05 |
| 1265535116 | Frank Gold | Internal Medicine | 112 Crescent Avenue, Peoria, IL 61603 | 2006-09-06 |
| 1912929118 | Alexander Adler | Internal Medicine | 112 Ne Crescent, 2nd Floor, Peoria, IL 61603 | 2006-07-24 |
| 1588691877 | Joseph J Sarmiento IIi | Internal Medicine | 5405 North Knoxville Avenue, Peoria, IL 61614 | 2006-06-26 |
| 1265407399 | Cardiac Consultants Sc | Internal Medicine | 900 Main Street, Suite 320, Peoria, IL 61602 | 2006-02-22 |
| 1649268723 | Gabor S Jilly | Internal Medicine | 13128 N 94th Dr, No 100, Peoria, AZ 85381-4252 | 2005-10-12 |
| 1003804170 | Manoj Rawal | Internal Medicine | 13460 N 94th Drive, Ste J-1, Peoria, AZ 85381-4246 | 2005-10-12 |
| 1134121825 | Marc A Petein | Internal Medicine | 13634 N 93rd Ave, Suite 300, Peoria, AZ 85381-4915 | 2005-08-11 |
| Find all providers in PEORIA | ||||
Please comment or provide details below to improve the information on RAJ PATEL.
| 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.