DALE M GEISS (NPI# 1912970617) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912970617 |
| Entity Type | Individual |
| Full Name | DALE M GEISS |
| Credential | MD |
| Practice Address |
515 Ne Glen Oak Suite 105 Peoria IL 61603-3167 |
| Practice Telephone | 3096742002 |
| Practice Fax Number | 3096249898 |
| Mailing Telephone | 3096742002 |
| Mailing Fax Number | 3096249898 |
| Enumeration Date | 2006-02-12 |
| Last Update Date | 2014-05-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
036060685 | IL | Allopathic & Osteopathic Physicians |
| N | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 036060685 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | JOHN DEERE | IL0101 | 01 |
| IL | BLUE SHIELD PROVIDER NUMB | 07215075 | 01 |
| IL | 036060685 | 05 | |
| IL | RAILROAD MEDICARE | 780000428/CM1779 | 01 |
| Street Address |
515 NE GLEN OAK SUITE 105 |
| City | PEORIA |
| State | IL |
| Zip Code | 61603-3167 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144479981 | Diane Marie Cass | Social Worker | 515 Ne Glen Oak, Peoria, IL 61637-0001 | 2008-09-17 |
| 1447430616 | Angela D Brown | Nurse Practitioner | 515 Ne Glen Oak, Suite 105, Peoria, IL 61603-3167 | 2007-11-06 |
| 1003990839 | Sheri K Buskirk | Registered Nurse | 515 Ne Glen Oak, Suite 105, Peoria, IL 61603-3167 | 2006-10-25 |
| 1114018439 | Illinois Cardiac Surgery Associates Sc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 515 Ne Glen Oak, Suite 105, Peoria, IL 61603-3167 | 2006-09-28 |
| 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 | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| 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 Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790049617 | Sonoran Vein and Endovascular LLC | Surgery | 9200 W Union Hills Dr, Ste A-103, Peoria, AZ 85382-8210 | 2012-06-25 |
| 1306043211 | Sean Benedict D'souza | Surgery | 9192 W Union Hills Dr, Peoria, AZ 85382-8208 | 2007-07-03 |
| 1265433882 | James Bertram Williams | Surgery | 2420 W Nebraska Ave, Peoria, IL 61604-3112 | 2005-08-04 |
| 1487281770 | Titan Medical Services, LLC | Surgery | 13660 N 94th Dr # D-1, Peoria, AZ 85381-4836 | 2020-03-25 |
| 1164700183 | Jessica L Secor | Surgery | 7725 N Knoxville Ave, Peoria, IL 61614-2079 | 2011-07-25 |
| 1982929121 | Sammy Zakhary Md PC | Surgery | 15396 N 83rd Ave, Suite E, Peoria, AZ 85381-5622 | 2010-03-31 |
| 1699783886 | James R Debord | Surgery | 5409 N Knoxville Ave, Peoria, IL 61614-5016 | 2006-08-03 |
| 1962417485 | Cardiac Thoracic & Endovascular Therapies, S.c. | Surgery | 2420 W Nebraska Ave, Peoria, IL 61604-3112 | 2006-07-31 |
| 1063454197 | Andy C. Chiou | Surgery | 1001 Main Street, 3rd Floor, Peoria, IL 61606-2037 | 2006-06-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396267324 | Congress Vascular Center LLC | Surgery | 41 W Congress Pkwy Fl 1, Chicago, IL 60605-1531 | 2017-07-11 |
| 1043731300 | Elmwood Park Vascular Center LLC | Surgery | 7230 W North Ave Ste 108, Elmwood Park, IL 60707-4261 | 2017-06-27 |
| 1588105811 | Mickey Graphia | Surgery | 701 N 1st St # D346, Springfield, IL 62702 | 2017-03-20 |
| 1992126668 | Vascular Specialists LLC | Surgery | 20060 Governors Dr Ste 102, Olympia Fields, IL 60461-1099 | 2013-12-26 |
| 1588959548 | Patrick Michael Sullivan Neville | Surgery | 4600 Memorial Dr Ste 120, Belleville, IL 62226-5359 | 2011-06-17 |
| 1235454968 | Margaret Claire Rigamer | Surgery | 1901 W Harrison St Dept Of, Chicago, IL 60612-3714 | 2010-04-06 |
| 1215251541 | John V. White, Md, LLC | Surgery | 8816 W Dempster St, Niles, IL 60714-5109 | 2010-03-15 |
| 1710212733 | Vascular Surgery and Interpretation S.c. | Surgery | 3330 W 177th St Ste 2c1, Hazel Crest, IL 60429-2184 | 2009-10-08 |
| 1538391792 | Usa Vein Clinics of Chicago LLC | Surgery | 4141 Dundee Rd, Northbrook, IL 60062-2129 | 2009-08-20 |
| 1306010731 | Tanq, Inc. | Surgery | 18510 S Marilynn Ct, Mokena, IL 60448-9517 | 2008-04-16 |
| 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.