MICHAEL D. TARANTINO, M.D. S.C. (NPI# 1740430784) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740430784 |
| Entity Type | Organization |
| Organization Name | MICHAEL D. TARANTINO, M.D. S.C. |
| Practice Address |
6811 N Knoxville Ave Suite A Peoria IL 61614-2861 |
| Mailing Address |
2 Old Farm Ln Washington IL 61571-9733 |
| Practice Telephone | 3096925337 |
| Practice Fax Number | 3096933913 |
| Mailing Telephone | 3093706124 |
| Mailing Fax Number | 3096933913 |
| Enumeration Date | 2008-09-26 |
| Last Update Date | 2010-07-06 |
| Authorized Official Name | MR. MICHAEL D. TARANTINO (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 3093706124 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0207X |
Pediatrics Specialization: Pediatric Hematology-Oncology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 398680716 | 05 | |
| IL | BCBS OF IL | 7225372 | 01 |
| RAILROAD MEDICARE | P00096725 | 01 |
| Street Address |
6811 N KNOXVILLE AVE SUITE A |
| City | PEORIA |
| State | IL |
| Zip Code | 61614-2861 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104938729 | Carin A Purtle | Chiropractor | 6811 N Knoxville Ave, Suite A, Peoria, IL 61614-2861 | 2006-08-31 |
| 1689079238 | Inspirit Health PC | Chiropractor | 6811 N Knoxville Ave, Ste A, Peoria, IL 61614-2861 | 2014-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548818511 | Christine Svoboda | Social Worker | 6919 N Knoxville Ave Ste 100 and 202, Peoria, IL 61614 | 2019-09-03 |
| 1639649007 | Kathy Karouzos Counseling, LLC | Clinic/Center | 330 W. Ivy Ln., Peoria, IL 61614 | 2018-11-28 |
| 1205312790 | Kathleen Marie Hendricks | Nurse Practitioner | 2809 W Willow Knolls Dr, Peoria, IL 61614 | 2018-07-17 |
| 1629563937 | Mary Elizabeth Cunningham | Counselor | 6219 N. Eldorado Dr., Peoria, IL 61614 | 2018-06-28 |
| 1861937955 | Angela Gilles | Social Worker | 6919 N Knoxville Ave Ste 100, Peoria, IL 61614 | 2016-12-27 |
| 1467994897 | Melissa Saxsma | Specialist | 5009 N Executive Dr, Peoria, IL 61614 | 2016-11-16 |
| 1902258874 | Rashid Plastic Surgery, LLC | Plastic Surgery | 804 W Trailcreek Drive, Peoria, IL 61614 | 2016-07-05 |
| 1215313143 | Melissa Lynn Phelan | Nurse Practitioner | 122 E Morningside Dr, Peoria, IL 61614 | 2015-08-03 |
| 1811380165 | All Ways Caring Services, Inc. | In Home Supportive Care | 6919 N Knoxville Ave, Suite 102, Peoria, IL 61614 | 2015-03-11 |
| 1568875920 | Schuler & Arkwell Orthodontic Partnership | Dentist | 2425 Cornerstone Ct. Ste. A, Peoria, IL 61614 | 2014-06-03 |
| Find all providers in zip 61614 | ||||
| Taxonomy Code | 2080P0207X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Hematology-Oncology |
| A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases. |
| 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 Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265720510 | Reuben Antony | Pediatrics | 530 Ne Glen Oak Ave., C/o Ms Suzy Lewellen, Peoria, IL 61637 | 2011-07-20 |
| 1568433050 | University of Illinois | Pediatrics | St Jude Midwest Affiliate, 530 Ne Glen Oak, Peoria, IL 61637-0001 | 2006-02-01 |
| 1396731063 | Michael D Tarantino | Pediatrics | 9128 N Lindbergh Dr, Peoria, IL 61615-1422 | 2005-09-27 |
| 1841293032 | Pedro A De Alarcon | Pediatrics | Children's Hospital of Illinois 530 Ne Glen Oak Ave, Peoria, IL 61637 | 2005-05-23 |
| 1205195849 | Brinda Mukesh Mehta | Pediatrics | 530 Ne Glen Oak Ave, Uicomp/dept. of Pediatrics Osf North Bldg. Room 5642, Peoria, IL 61637 | 2012-05-15 |
| 1558339978 | Kay Saving | Pediatrics | St Jude Midwest Affiliate, 530 Ne Glen Oak, Peoria, IL 61637-0001 | 2006-03-10 |
| 1841287588 | Mary Elizabeth Ross | Pediatrics | 530 Ne Glen Oak Ave, Peoria, IL 61637 | 2005-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780829911 | Richard Moldwin | Pediatrics | 9017 Ewing Ave, Evanston, IL 60203-1908 | 2008-12-02 |
| 1801005848 | Marie-ellen Tubal Sarvida | Pediatrics | 4440 West 95th Street, Oak Lawn, IL 60453 | 2007-05-22 |
| 1639395304 | Lenore Evans Gonzalez | Pediatrics | 236 S 5th St, Apt C, Springfield, IL 62701-1431 | 2007-04-18 |
| 1700948643 | Astrid K. Mack | Pediatrics | 2300 N Childrens Plz # 30, Chicago, IL 60614-3363 | 2006-12-15 |
| 1659449163 | Pediatric Cancer Institute | Pediatrics | 4440 W.95th Street, Oak Lawn, IL 60453 | 2006-12-01 |
| 1699724385 | Joanna Lynn Weinstein | Pediatrics | 2300 Childrens Plaza Box 30, Childrens Memorial Hospital Hem Onc, Chicago, IL 60614 | 2006-05-09 |
| 1427051622 | John M Cunningham | Pediatrics | 5841 South Maryland Ave, University of Chicago Rm N-112 Mc 4060, Chicago, IL 60637 | 2005-05-23 |
| 1053958173 | Anna Kathryn Person | Pediatrics | 225 E Chicago Ave, Chicago, IL 60611-2991 | 2019-12-09 |
| 1891189221 | Lindsay Schwartz | Pediatrics | 5841 S Maryland Ave # Mc4060, Chicago, IL 60637-1443 | 2015-03-24 |
| 1639599475 | Katherine Marie Harris | Pediatrics | 5841 S Maryland Ave # Mc4060, Chicago, IL 60637-1443 | 2014-04-20 |
| Find all providers with the same taxonomy | ||||
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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.