MR. GLYN E. JONES (NPI# 1366462475) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366462475 |
| Entity Type | Individual |
| Full Name | MR. GLYN E. JONES |
| Credential | MD |
| Practice Address |
1001 Main Street 3rd Floor Peoria IL 61606-2037 |
| Practice Telephone | 3094950200 |
| Practice Fax Number | 3096766545 |
| Mailing Telephone | 3094950200 |
| Mailing Fax Number | 3096766545 |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2008-10-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208200000X | Plastic Surgery | 036118115 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BCBS OF ILLINOIS | 7215166 | 01 | |
| IL | MEDICARE ID TYPE UNSPECI | K37419 | 01 |
| IL | 036118115-1 | 05 |
| Street Address |
1001 MAIN STREET 3RD FLOOR |
| City | PEORIA |
| State | IL |
| Zip Code | 61606-2037 |
| 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 |
| 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 |
| 1649206533 | James R Debord | Surgery | 1001 Main Street, 3rd Floor, Peoria, IL 61606-2037 | 2006-06-23 |
| Find all providers in the same location | ||||
| 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 | 208200000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Plastic Surgery |
| A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Plastic Surgery, 2007. http://www.abplsurg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Plastic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902258874 | Rashid Plastic Surgery, LLC | Plastic Surgery | 804 W Trailcreek Drive, Peoria, IL 61614 | 2016-07-05 |
| 1538498209 | Dr. Richard D. Corley, S.c. | Plastic Surgery | 416 St. Mark Ct., #106, Peoria, IL 61603-1928 | 2009-12-09 |
| 1801914882 | Richard D Corley | Plastic Surgery | 808 W Trailcreek Dr, Peoria, IL 61614-1862 | 2007-03-27 |
| 1780709394 | Jason D Johnson | Plastic Surgery | 15396 N 83rd Ave Ste B100, Peoria, AZ 85381-5626 | 2007-03-20 |
| 1356344626 | Brian B Bruggeman | Plastic Surgery | 14155 N. 83rd Ave, Suite 147, Peoria, AZ 85381 | 2005-05-31 |
| 1538162201 | Martin Lloyd Johnson | Plastic Surgery | 13090 N 94th Dr, Suite 101, Peoria, AZ 85381-4256 | 2005-05-24 |
| 1629416920 | Tyler Andrew Evans | Plastic Surgery | 1001 Main St Ste 300, Peoria, IL 61606-2036 | 2013-06-07 |
| 1154512127 | Kunvarji Gangji Shah | Plastic Surgery | 802 W Trailcreek Dr, Peoria, IL 61614-1862 | 2007-08-06 |
| 1417923517 | John E Lomax | Plastic Surgery | 4909 N Glen Park Place Rd, Peoria, IL 61614-4676 | 2006-02-27 |
| 1356336317 | Michael N Desvigne | Plastic Surgery | 9165 W Thunderbird Rd, Suite 100, Peoria, AZ 85381-4847 | 2005-09-15 |
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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.