| Timothy Grant Raines, MD | |
|
530 Ne Glen Oak Ave, Peoria, IL 61603-3133 | |
| (309) 655-2268 | |
| Not Available |
| Full Name | Timothy Grant Raines |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | 530 Ne Glen Oak Ave, 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 |
|---|---|---|---|
| 1932305182 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 01064696A (Indiana) | Secondary |
| 207P00000X | Emergency Medicine | 125-049400 (Illinois) | Primary |
| Entity Name | St. Vincent Emergency Physicians, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1306891700 PECOS PAC ID: 1759363450 Enrollment ID: O20040720000734 |
| Entity Name | Cep America Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1285103671 PECOS PAC ID: 6608056171 Enrollment ID: O20190214000611 |
| Mailing Address | Practice Location Address |
|---|---|
| Timothy Grant Raines, MD 4207 W Hollow Creek Dr, Peoria, IL 61615-5635 Ph: (765) 278-1323 | Timothy Grant Raines, MD 530 Ne Glen Oak Ave, Peoria, IL 61603-3133 Ph: (309) 655-2268 |
Austin J Lamb, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 530 N.e. Glen Oak Avenue, Osf St. Francis, Emergency Medicine Residency Program, Peoria, IL 61637 Phone: 309-655-7257 | |
Philip A Fifield, M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637 Phone: 309-655-2553 Fax: 309-655-2602 | |
Brittain Utah Ladd, DO Emergency Medicine Medicare: Medicare Enrolled Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637 Phone: 309-655-2553 Fax: 309-655-2602 | |
Dr. Anthony J Buecker, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 221 Ne Glen Oak Ave, Peoria, IL 61636 Phone: 309-672-5500 | |
Dr. Mark Phillip Gaudio, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637 Phone: 309-655-6710 | |
Michael M Raso, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1115 N Bourland Ave, Peoria, IL 61606 Phone: 309-264-0730 | |
Joseph Devito, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 530 Ne Glen Oak Ave Bldg Room2620, Peoria, IL 61637 Phone: 309-655-6710 |