| Dr Javier E Fajardo, MD | |
|
2419 W Cornerstone Ct, Peoria, IL 61614-2529 | |
| (309) 692-2025 | |
| Not Available |
| Full Name | Dr Javier E Fajardo |
|---|---|
| Gender | Male |
| Speciality | Obstetrics & Gynecology |
| Location | 2419 W Cornerstone Ct, Peoria, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902943780 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207V00000X | Obstetrics & Gynecology | 036117247 (Illinois) | Secondary |
| 207V00000X | Obstetrics & Gynecology | 036-117247 (Illinois) | Primary |
| Entity Name | Rockford Health Physicians |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043242886 PECOS PAC ID: 2567374036 Enrollment ID: O20031103000584 |
| Entity Name | Saint Anthony Health Affiliates |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1881086064 PECOS PAC ID: 1254321474 Enrollment ID: O20040518000419 |
| Entity Name | Christina L Midkiff Md Sc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1518031558 PECOS PAC ID: 1951301126 Enrollment ID: O20070111000512 |
| Entity Name | Obhg Illinois Sc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1700107216 PECOS PAC ID: 7810179702 Enrollment ID: O20110314001065 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Javier E Fajardo, MD 2023 Vadalabene Dr, Ste 200, Maryville, IL 62062-5636 Ph: (618) 288-7408 | Dr Javier E Fajardo, MD 2419 W Cornerstone Ct, Peoria, IL 61614-2529 Ph: (309) 692-2025 |
Dr. Michael Leonardi, M.D. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 4911 N Executive Dr, Suite 200, Peoria, IL 61614 Phone: 309-683-6700 Fax: 309-683-6722 | |
Charles Egley, MD Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: 221 Ne Glen Oak Ave, Peoria, IL 61636 Phone: 309-672-4144 | |
Dr. Pilar Mckay Rainey, D.O. Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: 530 Ne Glen Oak, Peoria, IL 61634 Phone: 309-655-4163 | |
Gary A Johnson, MD Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: 8940 N Wood Sage Rd, Peoria, IL 61615 Phone: 309-243-3000 Fax: 309-243-3000 | |
Mrs. Tamara L. Olt, M.D. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 6915 N Knoxville Ave, Peoria, IL 61614 Phone: 309-692-2805 Fax: 309-692-1913 | |
Dr. Rebecca Jane Byler Dann, M.D., M.P.H. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 1 Illini Dr # 1649, Peoria, IL 61605 Phone: 309-655-3024 Fax: 309-655-3739 | |
Rida W Boulos, MD Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: Dept Of Ob / Gyn, 530 Ne Glen Oak, Peoria, IL 61637 Phone: 309-655-3024 |