THE BLEEDING AND CLOTTING DISORDERS INSTITUTE


Address: 9128 N Lindbergh Dr, Peoria, IL 61615-1422
Phone: 3096925337

THE BLEEDING AND CLOTTING DISORDERS INSTITUTE (NPI# 1134424633) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1134424633
Entity Type Organization
Organization Name THE BLEEDING AND CLOTTING DISORDERS INSTITUTE
Practice Address 9128 N Lindbergh Dr
Peoria
IL 61615-1422
Practice Telephone 3096925337
Practice Fax Number 3096933913
Mailing Telephone 3093978431
Mailing Fax Number 3096933913
Enumeration Date 2011-01-14
Last Update Date 2015-09-03
Authorized Official Name MR. MICHAEL D TARANTINO (MEDICAL DIRECTOR)
Authorized Official Telephone 3096925337
Authorized Official Credential M.D.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261Q00000X Clinic/Center 036101239 IL Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
RAILROAD MEDICARE P00096725 01
BCBS OF IL 7225372 01
IL 398680716 05

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1639508567 The Bleeding and Clotting Disorders Institute Pharmacy 9128 N Lindbergh Dr, Peoria, IL 61615-1422 2013-11-01
1962783431 The Bleeding and Clotting Disorders Institute Pharmacy 9128 N Lindbergh Dr, Peoria, IL 61615-1422 2011-08-29

Office Location

Street Address 9128 N LINDBERGH DR
City PEORIA
State IL
Zip Code 61615-1422

Providers in the same location

NPI Name Taxonomy Address Enumeration
1396731063 Michael D Tarantino Pediatrics 9128 N Lindbergh Dr, Peoria, IL 61615-1422 2005-09-27
1396396024 Kristin T Ansteatt Registered Nurse 9128 N Lindbergh Dr, Peoria, IL 61615-1422 2019-09-24
1225571219 Jackie Marie Helms Nurse Practitioner 9128 N Lindbergh Dr, Peoria, IL 61615-1422 2016-11-23
1720450026 Elizabeth Ann Lepper Nurse Practitioner 9128 N Lindbergh Dr, Peoria, IL 61615-1422 2015-10-26
1639508567 The Bleeding and Clotting Disorders Institute Pharmacy 9128 N Lindbergh Dr, Peoria, IL 61615-1422 2013-11-01
1639434871 Stephanie Lynn Arnold Pharmacist 9128 N Lindbergh Dr, Peoria, IL 61615-1422 2012-07-12
1962783431 The Bleeding and Clotting Disorders Institute Pharmacy 9128 N Lindbergh Dr, Peoria, IL 61615-1422 2011-08-29
1538469481 Rohith Jesudas Pediatrics 9128 N Lindbergh Dr, Peoria, IL 61615-1422 2010-10-26
1871757070 Jonathan Charles Roberts Pediatrics 9128 N Lindbergh Dr, Peoria, IL 61615-1422 2008-07-16
1366461139 Amanda Kilgore Physical Therapist 9128 N Lindbergh Dr, Peoria, IL 61615 2006-07-19
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1124627906 Lance Jay Bucher Occupational Therapist 8600 Il-91, Peoria, IL 61615 2020-10-22
1093327496 Angela Mitchell Speech-Language Pathologist 3903 W Ridgeview Dr, Peoria, IL 61615 2020-08-18
1578110680 Emily E Buenting Audiologist 8600 Il Route 91, Suite 300, Peoria, IL 61615 2019-08-22
1730655572 Sylwia M. Budzik Physician Assistant 8600 Illinois Rt. 91, Suite 300, Peoria, IL 61615 2018-10-19
1487169207 Heather Hart Registered Nurse 9016 N. Scrimshaw Dr. Apt 104, Peoria, IL 61615 2017-12-04
1528586849 Leanne Runyon Speech-Language Pathologist 10723 Collett Dr., Peoria, IL 61615 2017-09-07
1467974196 Elizabeth A Mcleod Nurse Practitioner 8600 Illinois Route 91, Suite 130, Peoria, IL 61615 2017-07-14
1790223022 Janet Warner Counselor 8914 North Prarie Court, Peoria, IL 61615 2017-02-07
1437524022 Brooke Bisping Dietitian, Registered 7610 North Orange Prairie Road, Peoria, IL 61615 2015-12-08
1003292111 Crystal Ann Casper Dietitian, Registered 7610 N Orange Prarie Road, Peoria, IL 61615 2015-07-31
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Taxonomy Information

Taxonomy Code 261Q00000X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center

Taxonomy Definition

A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1326608126 E3 Fitology, LLC Clinic/Center 22431 N 81st Ave, Peoria, AZ 85383-2106 2019-06-14
1548781990 A Plus Pulmonary Center PC Clinic/Center 13352 N 83rd Ave Ste A100, Peoria, AZ 85381-4158 2017-07-06
1265977078 Unitypoint Health Junction Medical, LLC Clinic/Center 5901 N Prospect Rd Ste 101b, Peoria, IL 61614-1395 2017-01-03
1083020911 Planned Parenthood of Illinois Clinic/Center 705 Ne Jefferson St., Peoria, IL 61603-3843 2014-07-11
1972811404 Sunshine Medical Care Corp Clinic/Center 15943 N 77th Ave, Peoria, AZ 85382-3867 2010-09-17
1730417676 Cigna Healthcare of Arizona, Inc. Clinic/Center 21731 N 77th Ave, Suite 1300, Peoria, AZ 85382-2109 2009-12-04
1396923702 Proctor Health Systems Clinic/Center 5401 N Knoxville Ave Ste 306, Peoria, IL 61614-5021 2008-02-07
1750493805 Belcrest Services, Ltd Clinic/Center 3915 Barring Trce, Peoria, IL 61615-2500 2006-08-31
1922110089 Belcrest Services, Ltd Clinic/Center 9118 N Lindbergh Dr, Peoria, IL 61615-1422 2006-08-31
1063021269 Valley Direct Primary Care, Pllc Clinic/Center 9240 W Union Hills Dr Ste 100, Peoria, AZ 85382-8213 2020-07-24
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Competitor

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City PEORIA
Zip Code 61615

Improve Information

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Dataset Information

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.

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