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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261Q00000X | Clinic/Center | 036101239 | IL | Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
RAILROAD MEDICARE | P00096725 | 01 | |
BCBS OF IL | 7225372 | 01 | |
IL | 398680716 | 05 |
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 |
Street Address |
9128 N LINDBERGH DR |
City | PEORIA |
State | IL |
Zip Code | 61615-1422 |
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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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 |
Find all providers in zip 61615 |
Taxonomy Code | 261Q00000X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
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). |
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 |
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.