SAINT FRANCIS MEDICAL CENTER (NPI# 1295785632) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1295785632 |
Entity Type | Organization |
Organization Name | SAINT FRANCIS MEDICAL CENTER |
Other Organization Name | SAINT FRANCIS MEDICAL CENTER RADIATION ONCOLOGY |
Practice Address |
530 Ne Glen Oak Ave Peoria IL 61637-0001 |
Practice Telephone | 3096552000 |
Practice Fax Number | 3096557869 |
Mailing Telephone | 3096552000 |
Mailing Fax Number | 3096557869 |
Enumeration Date | 2006-05-10 |
Last Update Date | 2020-10-01 |
Authorized Official Name | DIANE L MCGREW (PRESIDENT, OSF HEALTHCARE SYSTEM) |
Authorized Official Telephone | 3096552850 |
Is Organization Subpart | Y |
Parent Organization Name | OSF HEALTHCARE SYSTEM |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
0002394 | IL | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IL | RAILROAD MEDICARE | CA3486 | 01 |
Other Name | Type Code |
---|---|
OSF Saint Francis Medical Center | Doing Business As Name - Organization |
Saint Francis Medical Center Radiation Oncology | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023574365 | Saint Francis Medical Center | Pediatrics | 2210 Barron Rd Ste 120, Poplar Bluff, MO 63901-1908 | 2019-02-12 |
1053844282 | Saint Francis Medical Center | Obstetrics & Gynecology | Rr 4 #4515, Piedmont, MO 63957-9417 | 2017-04-05 |
1023541265 | Saint Francis Medical Center | Family Medicine | 1212 Saint Francis Dr, Dexter, MO 63841-2769 | 2017-04-05 |
1366831943 | Saint Francis Medical Center | Family Medicine | 1212 Saint Francis Drive, Dexter, MO 63841-1212 | 2015-01-20 |
1457757767 | Saint Francis Medical Center | Family Medicine | 420 Piedmont Ave, Piedmont, MO 63957-1024 | 2014-11-13 |
1518372481 | Saint Francis Medical Center | Advanced Practice Midwife | 1702 N Kings Highway St, Cape Girardeau, MO 63701-2122 | 2014-06-30 |
1831523695 | Saint Francis Medical Center | General Acute Care Hospital | 150 South Mount Auburn Road, Suite 342, Cape Girardeau, MO 63703 | 2013-08-29 |
1932454956 | Saint Francis Medical Center | Family Medicine | 545 Broad Ridge, Jackson, MO 63755-3001 | 2012-07-16 |
1861711640 | Saint Francis Medical Center | Licensed Practical Nurse | 1300 W Commerce Dr, Ste 200, Peoria, IL 61615-1405 | 2010-05-19 |
1528198942 | Saint Francis Medical Center | Emergency Medicine | 211 St Francid Dr, Cape Girardeau, MO 63703 | 2007-03-06 |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | SAINT FRANCIS MEDICAL CENTER | 2620 W Faidley Ave, Grand Island, NE 68803-4205 |
Street Address |
530 NE GLEN OAK AVE |
City | PEORIA |
State | IL |
Zip Code | 61637-0001 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346235777 | Jack Michael Gibson | Obstetrics & Gynecology | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2005-09-12 |
1053912188 | Janie Clary | Nurse Practitioner | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-11-04 |
1265030548 | Christina David | Nurse Practitioner | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-10-09 |
1033726831 | Corry Lynn Rediger | Occupational Therapist | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-09-25 |
1720694094 | Katelynn M Madden | Clinical Nurse Specialist | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-09-21 |
1568074474 | Amanda Diane Beoletto | Pharmacist | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-08-21 |
1881212892 | Mohammad Mousbah Al-tabbaa | Student in an Organized Health Care Education/Training Program | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-07-07 |
1750909693 | Mohammad Gareeb | Student in an Organized Health Care Education/Training Program | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-07-07 |
1376160846 | Bassel Elia Abouzeid | Student in an Organized Health Care Education/Training Program | 530 Ne Glen Oak Ave, Peoria, IL 61637 | 2020-07-01 |
1700403516 | Christina Marie Spurgeon | Nurse Practitioner | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-06-26 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780200865 | Kuang Chuen Liu | Pediatrics | 530 Ne Glen Oak Ave, Peoria, Peoria, IL 61637 | 2020-06-24 |
1174184527 | Manisha Tharoor | Student in an Organized Health Care Education/Training Program | 530 N.e Glen Oak Ave, Peoria, IL 61637 | 2019-06-26 |
1609436724 | Sriviji Senthil Kumaran | Student in an Organized Health Care Education/Training Program | 530. N.e Glen Oak Ave., Peoria, IL 61637 | 2019-06-20 |
1780240929 | Abuzar Ali Asif | Student in an Organized Health Care Education/Training Program | 530 N. E. Glen Oak Ave., Peoria, IL 61637 | 2019-05-14 |
1518328665 | Jenna Bishop | Dietitian, Registered | 600 Ne Water Street, Peoria, IL 61637 | 2016-03-17 |
1194133850 | Ashish Kumar Roy | Internal Medicine | 530 N.e. Glen Oak Ave, Peoria, IL 61637 | 2014-07-25 |
1265720510 | Reuben Antony | Pediatrics | 530 Ne Glen Oak Ave., C/o Ms Suzy Lewellen, Peoria, IL 61637 | 2011-07-20 |
1366673436 | Joseph William Hauter | Emergency Medicine | 830 Ne Glen Oak Ave, Peoria, IL 61637 | 2009-08-06 |
1437380748 | Jeremy R Monroe | Emergency Medicine | 530 Glen Oak, Osf St Francis Medical Center, Peoria, IL 61637 | 2009-08-04 |
1326244682 | Maria S. Parr | Psychiatry & Neurology | Osf Saint Francis Medical Center, 530 N.e.glen Oak Ave., Peoria, FL 61637 | 2007-06-25 |
Find all providers in zip 61637 |
Taxonomy Code | 2085R0001X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Radiology |
Specialization | Radiation Oncology |
A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
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 Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346668514 | Ashley Ann Albert | Radiology | 14155 N 83rd Ave Ste 127, Peoria, AZ 85381-5652 | 2014-04-03 |
1952420671 | Candace Correa | Radiology | 221 Ne Glen Oak Ave, Peoria, IL 61636-3813 | 2007-03-28 |
1205844602 | Anthony C. Zalduendo | Radiology | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2006-08-03 |
1245244862 | James L. Mcgee | Radiology | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2006-07-28 |
1841234929 | Revathi Swaminathan | Radiology | 221 Ne Glen Oak Ave, Peoria, IL 61636-0001 | 2006-06-16 |
1003857061 | Central Illinois Radiation Oncology Physicians, Ltd | Radiology | 221 Ne Glen Oak Ave, Peoria, IL 61636-0001 | 2006-06-09 |
1255395463 | Terry T Lee | Radiology | 14155 N 83rd Ave, Suite 127, Peoria, AZ 85381-5639 | 2006-04-14 |
1669447504 | William H Dunn | Radiology | 530 Ne Glen Oak Ave, Peoria, IL 61637-6163 | 2006-02-22 |
1043298334 | Matthew Trent Carpenter | Radiology | 221 Ne Glen Oak Ave, Department of Radiation Oncology, Peoria, IL 61636-0001 | 2006-01-06 |
1811983489 | Roby Adhinayak Lal | Radiology | 221 Ne Glen Oak Ave, Peoria, IL 61636-0002 | 2005-09-20 |
Find all providers in PEORIA |
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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.