CENTRAL ILLINOIS RADIOLOGICAL ASSOCIATES, LTD. (NPI# 1386659241) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386659241 |
| Entity Type | Organization |
| Organization Name | CENTRAL ILLINOIS RADIOLOGICAL ASSOCIATES, LTD. |
| Practice Address |
Osf St Francis Medical Ctr 530 N.e. Glen Oak Peoria IL 61636-0001 |
| Mailing Address |
411 Hamilton Blvd Suite 1824 Peoria IL 61602-1144 |
| Practice Telephone | 3096554934 |
| Mailing Telephone | 3094949320 |
| Mailing Fax Number | 3094949321 |
| Enumeration Date | 2006-07-29 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | KENNETH FRASER (PRESIDENT) |
| Authorized Official Telephone | 3094949320 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538192828 | Central Illinois Radiological Associates, Ltd. | Radiology | 530 Ne Glen Oak Avenue, Peoria, IL 61637 | 2006-07-09 |
| Street Address |
OSF ST FRANCIS MEDICAL CTR 530 N.E. GLEN OAK |
| City | PEORIA |
| State | IL |
| Zip Code | 61636-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336526524 | Ammar Ahmed | Student in an Organized Health Care Education/Training Program | Osf St Francis Medical Ctr, 530 Ne Glen Oak Ave, Sfnb 2624, Peoria, IL 61637-0001 | 2015-04-27 |
| 1528477015 | Dianne Maria Endress | Nurse Practitioner | Osf St Francis Medical Ctr, 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2014-08-08 |
| 1295173789 | Paul Miles Macmahon | Neurological Surgery | Osf St Francis Medical Ctr, 530 N.e. Glen Oak Ave, Peoria, IL 61637-0001 | 2013-06-06 |
| 1790122141 | Kendrick Dewayne Johnson | Neurological Surgery | Osf St Francis Medical Ctr, 530 N.e. Glen Oak Ave, Peoria, IL 61637-0001 | 2013-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962767376 | Aman Deep Singh | Psychiatry & Neurology | 221 Ne Glen Oak Ave. 7 West, Dept. of Psych. and Behavior Health., Peoria, IL 61636 | 2012-07-11 |
| 1932490075 | Christine Ann Wigginton | Radiology | 221 Ne Glen Oak Ave Dept Of, Peoria, IL 61636 | 2011-04-24 |
| 1154856607 | Shubhada Reddy | Psychiatry & Neurology | 221 Ne Glen Oak Ave, Peoria, IL 61636 | 2017-04-21 |
| 1649657685 | Nicholas Grieco | Internal Medicine | 221 Ne Glen Oak Ave, Peoria, IL 61636 | 2015-04-29 |
| 1659703759 | Dhaval Save | Internal Medicine | 221 Ne Glen Oak Ave, Peoria, IL 61636 | 2013-07-31 |
| 1164474755 | Methodist Medical Center of Illinois | General Acute Care Hospital | 221 Ne Glen Oak Ave, Peoria, IL 61636 | 2006-05-16 |
| 1871560623 | Minna Jinn O'leary | Psychiatry & Neurology | 221 Ne Glen Oak Ave, Peoria, IL 61636 | 2006-03-01 |
| 1568901544 | Stephanie Ann Sullivan | Nurse Anesthetist, Certified Registered | Unity Point Health Methodist, 221 Ne Glen Oak Avenue, Peoria, IL 61636-0001 | 2017-02-23 |
| 1073066155 | Caroline Vanaman | Counselor | 221 Ne Glen Oak Ave # 7w, Peoria, IL 61636-0001 | 2016-07-26 |
| 1497141758 | Amber Hemminger | Registered Nurse | 200 Ne Glen Oak Ave, Peoria, IL 61636-0001 | 2015-04-13 |
| Find all providers in zip 61636 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| 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 Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992054829 | Justin S Ferragut | Radiology | 530 Northeast Glen Oak Avenue, Peoria, IL 61603 | 2012-09-06 |
| 1932490075 | Christine Ann Wigginton | Radiology | 221 Ne Glen Oak Ave Dept Of, Peoria, IL 61636 | 2011-04-24 |
| 1932421591 | Smi Imaging, LLC | Radiology | 9125 W Thunderbird Rd, Suite 105, Peoria, AZ 85381-4920 | 2010-02-24 |
| 1972736163 | Smi Imaging, LLC | Radiology | 9403 W Thunderbird Rd, Peoria, AZ 85381-4825 | 2009-09-03 |
| 1184828360 | Jane Ho Maksimovic | Radiology | 2612 W Newman Pkwy, Peoria, IL 61604-2208 | 2007-06-12 |
| 1124030705 | Terry M Brady | Radiology | 411 Hamilton Blvd, 1824, Peoria, IL 61602-1144 | 2006-08-12 |
| 1275543456 | Kim V. Arellano-villarreal | Radiology | 401 Sw Water St, Peoria, IL 61602-1571 | 2006-08-09 |
| 1538192828 | Central Illinois Radiological Associates, Ltd. | Radiology | 530 Ne Glen Oak Avenue, Peoria, IL 61637 | 2006-07-09 |
| 1265469399 | Brian A Holtan | Radiology | 31003 N 118th Ln, Peoria, AZ 85383-8240 | 2006-06-26 |
| 1992755870 | Jan Namyslowski | Radiology | 114 W Stratford Dr Ste E, Peoria, IL 61614-7300 | 2006-05-11 |
| Find all providers in PEORIA | ||||
Please comment or provide details below to improve the information on CENTRAL ILLINOIS RADIOLOGICAL ASSOCIATES, LTD..
| 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.