Jackie M El-darazi (NPI# 1225571219, PAC ID# 0648553008) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1225571219 |
| PAC ID by PECOS | 0648553008 |
| Professional Enrollment ID | I20170208002365 |
| Full Name | Jackie M El-darazi |
| Organization Legal Name | MICHAEL D. TARANTINO, M.D. S.C. |
| Address |
9128 N Lindbergh Dr Peoria IL 61615-1422 |
| Phone Number | 3096925337 |
| Gender | F |
| Graduation Year | 2016 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 6800950833 |
| Number of Group Practice Members | 4 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 140067 | OSF SAINT FRANCIS MEDICAL CENTER |
| 140209 | METHODIST MEDICAL CENTER OF ILLINOIS |
| Address | Phone | Organization |
|---|---|---|
| 9128 N Lindbergh Dr, Peoria, IL 61615-1422 | 3096925337 | MICHAEL D. TARANTINO, M.D. S.C. |
| Organization Legal Name | MICHAEL D. TARANTINO, M.D. S.C. |
| Physicians | 5 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Amanda Miriam Kilgore | Physical Therapy | Michael D. Tarantino, M.d. S.c. | 9128 N Lindbergh Dr, Peoria, IL 61615-1422 |
| Rohith Jesudas | Pediatric Medicine | Michael D. Tarantino, M.d. S.c. | 9128 N Lindbergh Dr, Peoria, IL 61615-1422 |
| Elizabeth A Lepper | Nurse Practitioner | Michael D. Tarantino, M.d. S.c. | 9128 N Lindbergh Dr, Peoria, IL 61615-1422 |
| Jonathan C Roberts | Pediatric Medicine | Michael D. Tarantino, M.d. S.c. | 9128 N Lindbergh Dr, Peoria, IL 61615-1422 |
| Street Address |
9128 N LINDBERGH DR |
| City | PEORIA |
| State | IL |
| Zip | 61615-1422 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Amanda Miriam Kilgore | Physical Therapy | Michael D. Tarantino, M.d. S.c. | 9128 N Lindbergh Dr, Peoria, IL 61615-1422 |
| Michael Dominic Tarantino | Hematology/oncology | 9128 N Lindbergh Dr, Peoria, IL 61615-1422 | |
| Rohith Jesudas | Pediatric Medicine | Michael D. Tarantino, M.d. S.c. | 9128 N Lindbergh Dr, Peoria, IL 61615-1422 |
| Elizabeth A Lepper | Nurse Practitioner | Michael D. Tarantino, M.d. S.c. | 9128 N Lindbergh Dr, Peoria, IL 61615-1422 |
| Jonathan C Roberts | Pediatric Medicine | Michael D. Tarantino, M.d. S.c. | 9128 N Lindbergh Dr, Peoria, IL 61615-1422 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jennifer N Thompson | Ophthalmology | Gailey Eye Clinic, Ltd | 8800 N Orange Prairie, Peoria, IL 61615 |
| Jeffrey Y Liang | Internal Medicine | Iowa Physicians Clinic Medical Foundation | 10322 N Juliet Ct, Peoria, IL 61615-1199 |
| Matthew Carr | Nurse Practitioner | Iowa Physicians Clinic Medical Foundation | 8914 N Knoxville Ave, Peoria, IL 61615-1410 |
| Abby G Freckleton | Nurse Practitioner | Iowa Physicians Clinic Medical Foundation | 8914 N Knoxville Ave, Peoria, IL 61615-1410 |
| Susannah Dintzis | Nurse Practitioner | Iowa Physicians Clinic Medical Foundation | 8914 N Knoxville Ave, Peoria, IL 61615-1410 |
| Michael J Pace | Family Practice | Methodist Medical Center of Illinois | 8914 N Knoxville Ave, Peoria, IL 61615-1410 |
| Whitney Hanlon | Physical Therapy | Rock Valley Physical Therapy Center | 9901 N Knoxville Ave, Suite D, Peoria, IL 61615-1433 |
| Jonathan L Acklie | Physical Therapy | Rock Valley Physical Therapy Center | 9901 N Knoxville Ave, Suite D, Peoria, IL 61615-1433 |
| Lacey Neal | Physical Therapy | Rock Valley Physical Therapy Center | 9901 N Knoxville Ave, Suite D, Peoria, IL 61615-1433 |
| Clara C Tostovarsnik | Physical Therapy | Rock Valley Physical Therapy Center | 9901 N Knoxville Ave, Suite D, Peoria, IL 61615-1433 |
| Find all physicians in zip 61615 | |||
| City | PEORIA |
| Zip Code | 61615 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | PEORIA + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Jackie M El-darazi.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.