| Dr Michael D Tarantino, MD | |
|
427 W Northmoor Rd, Peoria, IL 61614-3542 | |
| (309) 692-5337 | |
| (309) 693-3913 |
| Full Name | Dr Michael D Tarantino |
|---|---|
| Gender | Male |
| Speciality | Hematology/oncology |
| Experience | 38 Years |
| Location | 427 W Northmoor Rd, Peoria, Illinois |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396731063 | NPI | - | NPPES |
| P00096725 | Other | RAILROAD MEDICARE | |
| 64299787 | Other | KY | KENTUCKY MEDICAID |
| 7225372 | Other | IL | BCBS OF IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2080P0207X | Pediatrics - Pediatric Hematology-oncology | 29978 (Kentucky) | Secondary |
| 2080P0207X | Pediatrics - Pediatric Hematology-oncology | 036-101239 (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Saint Francis Medical Center | Peoria, IL | Hospital |
| Graham Hospital Association | Canton, IL | Hospital |
| Methodist Medical Center Of Illinois | Peoria, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| The Bleeding And Clotting Disorders Institute | 6608051230 | 2 |
| Michael D. Tarantino, M.d. S.c. | 6800950833 | 4 |
| Entity Name | Michael D. Tarantino, M.d. S.c. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1740430784 PECOS PAC ID: 6800950833 Enrollment ID: O20090205000359 |
| Entity Name | The Bleeding And Clotting Disorders Institute |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1134424633 PECOS PAC ID: 6608051230 Enrollment ID: O20110426000500 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Michael D Tarantino, MD 427 W Northmoor Rd, Peoria, IL 61614-3542 Ph: (309) 692-5337 | Dr Michael D Tarantino, MD 427 W Northmoor Rd, Peoria, IL 61614-3542 Ph: (309) 692-5337 |
Thomas James Mcmorrow, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637 Phone: 309-655-2553 Fax: 309-655-2602 | |
Jessica Ford-davis, D.O. Pediatrics Medicare: Medicare Enrolled Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637 Phone: 309-655-2274 | |
Kelsey Elizabeth Grimes, DO Pediatrics Medicare: May Accept Medicare Assignments Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637 Phone: 309-655-2000 | |
Jessica N Mistretta, DO Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 8600 State Route 91 Ste 200, Peoria, IL 61615 Phone: 309-692-1030 Fax: 309-691-3241 | |
Mrs. Valeria Claudia Benavides Lopez, M.D., M.P.H. Pediatrics Medicare: Medicare Enrolled Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637 Phone: 309-624-3313 | |
Dr. Gretchen L Kopec, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637 Phone: 309-624-0615 | |
Dr. Patrick Joseph Rizzuto Iii, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637 Phone: 309-671-3000 |