PATRICK TERENCE TRACY (NPI# 1750336889) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750336889 |
| Entity Type | Individual |
| Full Name | PATRICK TERENCE TRACY |
| Credential | MD |
| Practice Address |
200 E Pennsylvania Ave Peoria IL 61603-3089 |
| Practice Telephone | 3096244000 |
| Practice Fax Number | 3096244010 |
| Mailing Telephone | 3096244000 |
| Mailing Fax Number | 3096244010 |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2016-03-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207T00000X | Neurological Surgery | 036069397 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036069397 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164576245 | Patrick Harlan Tracy | Hospitalist | 1111 6th Ave, Des Moines, IA 50314-2613 | 2007-01-23 |
| 1073541587 | Patrick Lloyd Tracy | Family Medicine | 19245 7th Ave Ne, Poulsbo, WA 98370-7504 | 2006-06-30 |
| Street Address |
200 E PENNSYLVANIA AVE |
| City | PEORIA |
| State | IL |
| Zip Code | 61603-3089 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912901711 | James W Bauer | Internal Medicine | 200 E Pennsylvania Ave, Ste 105, Peoria, IL 61603-3045 | 2005-06-09 |
| 1205473154 | Gargi Dnyanesh Gupte | Physician Assistant | 200 E Pennsylvania Ave, Peoria, IL 61603-3089 | 2019-12-10 |
| 1487127734 | Stephanie S Beckstrom | Nurse Practitioner | 200 E Pennsylvania Ave, Peoria, IL 61603-3089 | 2019-01-09 |
| 1174093009 | Katelyn M Johnson | Nurse Practitioner | 200 E Pennsylvania Ave, Peoria, IL 61603-3089 | 2018-12-04 |
| 1093298127 | Loan T Nguyen | Nurse Practitioner | 200 E Pennsylvania Ave, Peoria, IL 61603-3089 | 2018-09-14 |
| 1922580695 | Anna K Boyce | Audiologist | 200 E Pennsylvania Ave, Peoria, IL 61603-3089 | 2018-08-30 |
| 1033604855 | Caroline Marie Boczar | Audiologist | 200 E Pennsylvania Ave, Peoria, IL 61603-3089 | 2018-06-25 |
| 1831608991 | Laurel K Donaldson | Audiologist | 200 E Pennsylvania Ave, Peoria, IL 61603-3089 | 2017-09-21 |
| 1851818835 | Cynthia I Guede | Nurse Practitioner | 200 E Pennsylvania Ave, Peoria, IL 61603-3089 | 2017-08-29 |
| 1275986051 | Travis E. Towne | Social Worker | 200 E Pennsylvania Ave, Peoria, IL 61603-3089 | 2016-07-18 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598362980 | Courtney Klein | Nurse Practitioner | 1306 N. Berkley Ave, Peoria, IL 61603 | 2020-10-08 |
| 1114588217 | Kong Xing Wang | Dentist | 320 East Armstrong Ave, Peoria, IL 61603 | 2019-06-28 |
| 1073015319 | Sara Kristine Rosenbery | Nurse Practitioner | 515 Ne Glen Oak Ave Ste 202, Peoria, IL 61603 | 2018-03-02 |
| 1861860058 | Jennifer Michelle Kelsey | Clinical Nurse Specialist | 420 Ne Glen Oak Avenue, Suite 401, Peoria, IL 61603 | 2015-09-04 |
| 1467859793 | Bonnie Lansing | Counselor | 617 N Gendale Avenue, Behavioral Health Adult Program, Peoria, IL 61603 | 2014-12-02 |
| 1639597172 | Jael K. Mahasi | Counselor | 1800 Ne Perry Avenue, Peoria, IL 61603 | 2014-04-02 |
| 1992054829 | Justin S Ferragut | Radiology | 530 Northeast Glen Oak Avenue, Peoria, IL 61603 | 2012-09-06 |
| 1780952994 | Syed Muhammad Tayyab | Internal Medicine | 828 Ne Glen Oak Ave Apt No208a, Peoria, IL 61603 | 2011-12-02 |
| 1528389079 | St. Francis Medical Center | General Acute Care Hospital | 530 N E Glen Oak Ave, Peoria, IL 61603 | 2010-06-18 |
| 1780810648 | Children's Home Association of Illinois | Voluntary or Charitable | 400 E. Frye, Peoria, IL 61603 | 2009-06-05 |
| Find all providers in zip 61603 | ||||
| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003861634 | Patrick William Elwood | Neurological Surgery | 719 N William Kumpf Blvd, Suite 100, Peoria, IL 61605 | 2006-05-23 |
| 1295185056 | Thomas Morison Russell | Neurological Surgery | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2016-06-13 |
| 1700235280 | Nolan Winslow | Neurological Surgery | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2016-06-06 |
| 1790167559 | Daniel Vollhaber | Neurological Surgery | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2015-06-29 |
| 1053793315 | Max Kahn | Neurological Surgery | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2015-06-23 |
| 1720493000 | Sujit Bhimireddy | Neurological Surgery | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2014-06-25 |
| 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 |
| 1326485921 | Illinois Neuroscience Institute | Neurological Surgery | 100 Ne Randolph Ave, Peoria, IL 61606-1919 | 2013-05-23 |
| 1043506942 | Derek Martinez | Neurological Surgery | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2011-06-20 |
| 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.