DR. TIMOTHY EAMON FAHEY (NPI# 1861756652) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861756652 |
| Entity Type | Individual |
| Full Name | DR. TIMOTHY EAMON FAHEY |
| Credential | M.D. |
| Practice Address |
530 Ne Glen Oak Ave Peoria IL 61637 |
| Mailing Address |
111 Oakwood Rd East Peoria IL 61611-1853 |
| Practice Telephone | 3097404272 |
| Mailing Telephone | 3097404272 |
| Enumeration Date | 2012-06-27 |
| Last Update Date | 2018-08-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207U00000X | Nuclear Medicine | 036.145291 | IL | Allopathic & Osteopathic Physicians |
| N | 207U00000X | Nuclear Medicine | 2018008046 | MO | Allopathic & Osteopathic Physicians |
| N | 2085N0904X |
Radiology Specialization: Nuclear Radiology |
2018008046 | MO | Allopathic & Osteopathic Physicians |
| Y | 2085N0904X |
Radiology Specialization: Nuclear Radiology |
036.145291 | IL | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
036.145291 | IL | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
2018008046 | MO | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568621720 | Timothy Fahey | Military Health Care Provider | 4 Newfield St, Leicester, MA 01524-1416 | 2008-06-03 |
| 1972678126 | Timothy John Fahey | Chiropractor | 13523 Sleepy Oaks Ln, San Antonio, TX 78253-5363 | 2006-11-22 |
| Street Address |
530 NE GLEN OAK AVE |
| City | PEORIA |
| State | IL |
| Zip Code | 61637 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346235777 | Jack Michael Gibson | Obstetrics & Gynecology | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2005-09-12 |
| 1053912188 | Janie Clary | Nurse Practitioner | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-11-04 |
| 1265030548 | Christina David | Nurse Practitioner | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-10-09 |
| 1033726831 | Corry Lynn Rediger | Occupational Therapist | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-09-25 |
| 1720694094 | Katelynn M Madden | Clinical Nurse Specialist | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-09-21 |
| 1568074474 | Amanda Diane Beoletto | Pharmacist | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-08-21 |
| 1881212892 | Mohammad Mousbah Al-tabbaa | Student in an Organized Health Care Education/Training Program | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-07-07 |
| 1750909693 | Mohammad Gareeb | Student in an Organized Health Care Education/Training Program | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-07-07 |
| 1376160846 | Bassel Elia Abouzeid | Student in an Organized Health Care Education/Training Program | 530 Ne Glen Oak Ave, Peoria, IL 61637 | 2020-07-01 |
| 1700403516 | Christina Marie Spurgeon | Nurse Practitioner | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-06-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780200865 | Kuang Chuen Liu | Pediatrics | 530 Ne Glen Oak Ave, Peoria, Peoria, IL 61637 | 2020-06-24 |
| 1174184527 | Manisha Tharoor | Student in an Organized Health Care Education/Training Program | 530 N.e Glen Oak Ave, Peoria, IL 61637 | 2019-06-26 |
| 1609436724 | Sriviji Senthil Kumaran | Student in an Organized Health Care Education/Training Program | 530. N.e Glen Oak Ave., Peoria, IL 61637 | 2019-06-20 |
| 1780240929 | Abuzar Ali Asif | Student in an Organized Health Care Education/Training Program | 530 N. E. Glen Oak Ave., Peoria, IL 61637 | 2019-05-14 |
| 1518328665 | Jenna Bishop | Dietitian, Registered | 600 Ne Water Street, Peoria, IL 61637 | 2016-03-17 |
| 1194133850 | Ashish Kumar Roy | Internal Medicine | 530 N.e. Glen Oak Ave, Peoria, IL 61637 | 2014-07-25 |
| 1265720510 | Reuben Antony | Pediatrics | 530 Ne Glen Oak Ave., C/o Ms Suzy Lewellen, Peoria, IL 61637 | 2011-07-20 |
| 1366673436 | Joseph William Hauter | Emergency Medicine | 830 Ne Glen Oak Ave, Peoria, IL 61637 | 2009-08-06 |
| 1437380748 | Jeremy R Monroe | Emergency Medicine | 530 Glen Oak, Osf St Francis Medical Center, Peoria, IL 61637 | 2009-08-04 |
| 1326244682 | Maria S. Parr | Psychiatry & Neurology | Osf Saint Francis Medical Center, 530 N.e.glen Oak Ave., Peoria, FL 61637 | 2007-06-25 |
| Find all providers in zip 61637 | ||||
| Taxonomy Code | 2085N0904X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Nuclear Radiology |
| A radiologist who is involved in the analysis and imaging of radionuclides and radiolabeled substances in vitro and in vivo for diagnosis and the administration of radionuclides and radiolabeled substances for the treatment of 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 |
|---|---|---|---|---|
| 1346228848 | Tri County Radiology | Radiology | 5409 N Knoxville Ave, Peoria, IL 61615 | 2006-01-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114420304 | Khushboo Gupta | Radiology | Rumc, 1653 W Congress Pkwy, Jelke 181, Department of Radiology and Nuclear Medicine, Chicao, IL 60612 | 2018-03-14 |
| 1427272418 | Highland Nuclear Imaging LLP | Radiology | 330 W Army Trail Rd, Suite 405, Bloomingdale, IL 60108-2681 | 2007-04-12 |
| 1437231560 | Future Diagnostics Group LLC | Radiology | 254 Republic Ave, Joliet, IL 60435-6518 | 2006-10-19 |
| 1356310163 | Northwest Suburban Imaging Associates, S.c. | Radiology | 1425 N Randall Rd, Elgin, IL 60123-2300 | 2006-03-15 |
| 1093716722 | Hinsdale Regional Pet Scan, LLC | Radiology | 812 E Ogden Ave, Westmont, IL 60559-1246 | 2005-08-03 |
| 1710988423 | Northshore Regional Pet Scan, LLC | Radiology | 1464 Waukegan Rd, Glenview, IL 60025-2121 | 2005-08-03 |
| 1396744751 | Northern Illinois Diagnostic Medical Imaging | Radiology | 200 Berteau Ave, Elmhurst, IL 60126-2966 | 2005-07-19 |
| 1306131719 | Cardiac Imaging Sc | Radiology | 1440 W North Ave, Suite 101, Melrose Park, IL 60160-1422 | 2011-06-14 |
| 1023240470 | John C Tricou Md LLC | Radiology | 200 E Fairman Ave, Watseka, IL 60970-1644 | 2009-08-19 |
| 1902030661 | Joliet Oncology Hematology Associates Ltd | Radiology | 3825 Highland Ave, # 2l,tower 1, Downers Grove, IL 60515-1552 | 2009-05-11 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DR. TIMOTHY EAMON FAHEY.
| 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.