ROGER B TRAYCOFF (NPI# 1528078540) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1528078540 |
Entity Type | Individual |
Full Name | ROGER B TRAYCOFF |
Credential | M.D. |
Practice Address |
2901 Old Jacksonville Rd Springfield IL 62704-7437 |
Mailing Address |
Po Box 500 Chatham IL 62629-0500 |
Practice Telephone | 2176989722 |
Practice Fax Number | 2173910392 |
Mailing Telephone | 2176702424 |
Mailing Fax Number | 2176702809 |
Enumeration Date | 2006-08-09 |
Last Update Date | 2011-12-16 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207R00000X | Internal Medicine | 036051951 | IL | Allopathic & Osteopathic Physicians |
Y | 207RR0500X |
Internal Medicine Specialization: Rheumatology |
036051951 | IL | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IL | HEALTH ALLIANCE | 029224 | 01 |
IL | BLACK LUNG | 020057300 | 01 |
IL | 6394P | CATERPILLAR | 01 |
IL | BC/BS | 08421024 | 01 |
IL | ACS-OWCP | 133586700 | 01 |
IL | PERSONAL CARE | 194883 | 01 |
IL | HEALTHLINK | 206164 | 01 |
IL | CLIA | 14D0949277 | 01 |
IL | IL STATE LICENSE | 036051951 | 01 |
IL | RR MEDICARE GROUP | CD7143 | 01 |
IL | 036051951 | 05 | |
IL | RR MEDICARE PIN | P00144541 | 01 |
Street Address |
2901 OLD JACKSONVILLE RD |
City | SPRINGFIELD |
State | IL |
Zip Code | 62704-7437 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1467441550 | Julio Cesar Vijil Sr. | Surgery | 2901 Old Jacksonville Rd, Suite B3, Springfield, IL 62704-7439 | 2005-10-20 |
1316591761 | Shelby Kern | Nurse Practitioner | 2901 Old Jacksonville Rd, Springfield, IL 62704-7437 | 2019-07-24 |
1609392091 | Tamara Hardwick | Nurse Practitioner | 2901 Old Jacksonville Rd, Springfield, IL 62704-7437 | 2017-08-17 |
1598217978 | Amy J Welch | Registered Nurse | 2901 Old Jacksonville Rd, Springfield, IL 62704-7437 | 2016-11-01 |
1316399140 | Neesha Settipalle | Internal Medicine | 2901 Old Jacksonville Rd, Springfield, IL 62704 | 2016-07-05 |
1508245028 | Carly Ellison | Nurse Practitioner | 2901 Old Jacksonville Rd, Springfield, IL 62704-7437 | 2015-05-29 |
1013395250 | Gopinathan Gangadharan Nambiar | Pediatrics | 2901 Old Jacksonville Rd, Springfield, IL 62704-7437 | 2015-05-07 |
1467849257 | Hshs Medical Group Inc | Durable Medical Equipment & Medical Supplies | 2901 Old Jacksonville Rd, Springfield, IL 62704-7437 | 2015-04-20 |
1225443484 | Erin Blackburn | Pediatrics | 2901 Old Jacksonville Rd, Springfield, IL 62704-7437 | 2014-06-26 |
1801209291 | Jieun Heo | Family Medicine | 2901 Old Jacksonville Rd, Springfield, IL 62704-7437 | 2014-06-03 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1902394901 | Hillary Haaker | Occupational Therapist | 2035 W Iles, Suite C, Springfield, ID 62704 | 2018-04-25 |
1871095364 | Edward Doyle Slifer Sr. | Pathology | 2117 Greenside Drive, Spring Field, IL 62704 | 2018-03-01 |
1598263345 | Santarelli & Feller Dental Group | Dentist | 1140 Rickard Road, Suite B, Springfield, IL 62704 | 2018-01-26 |
1447774757 | Lisa Ann Rogers | Developmental Therapist | 2101 Lexington Dr, Apt 3, Springfield, IL 62704 | 2017-07-28 |
1730611286 | Mindi Rowe | Occupational Therapist | 2508 County Rd 4 1/2 E, Springfield, IL 62704 | 2017-04-03 |
1366992208 | Jayme Jordan | Contractor | 2409 Westchester Blvd, Springfield, IL 62704 | 2016-10-04 |
1154793974 | Dina Payne | Social Worker | 917 Clocktower Drive, Suite 600, Springfield, IL 62704 | 2015-10-21 |
1770959819 | James R Reynolds | Hearing Instrument Specialist | 2347 W Monroe St, Springfield, IL 62704 | 2015-08-12 |
1336576495 | Emily Jane Dungey | Counselor | 920 S Spring St Ste 1300, Springfield, IL 62704 | 2013-10-03 |
1942552161 | Jeannie Marie Hundley | Specialist/Technologist, Other | 2921 Monvale Drive, Springfield, IL 62704 | 2012-10-11 |
Find all providers in zip 62704 |
Taxonomy Code | 207RR0500X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Rheumatology |
An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and "collagen" diseases. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1487096996 | Dilpreet Kaur Singh | Internal Medicine | 3377 Main Street, Springfield, MA 01107-1111 | 2013-07-25 |
1215296215 | Beenish Nazir Hafiz | Internal Medicine | 751 N Rutledge St Ste 2300, Springfield, IL 62702-4968 | 2012-05-10 |
1548325723 | Mujeeb Ranginwala, Md | Internal Medicine | 2029 E High St, Springfield, OH 45505-1315 | 2006-12-27 |
1205840345 | Mujeeb A Ranginwala | Internal Medicine | 1929 E High St, Springfield, OH 45505-1227 | 2006-07-27 |
1972546786 | Stephen D Armstrong | Internal Medicine | 3555 S National, Springfield, MO 65807 | 2006-06-13 |
1609854769 | David Gregory True | Internal Medicine | 4350 S National Ave Ste C100, Springfield, MO 65810-2658 | 2006-01-08 |
1942297254 | Robert G Gray | Internal Medicine | 3377 Main St, Springfield, MA 01107-1111 | 2005-10-03 |
1902448426 | 417 Rheumatology LLC | Internal Medicine | 4350 S National Ave Ste C100, Springfield, MO 65810-2658 | 2019-10-16 |
1407218571 | Anthony John Nicolas | Internal Medicine | Baystate Medical Center 759 Chestnut St, Springfield, MA 01199-0001 | 2016-03-28 |
1518251370 | Dane H Dougherty | Internal Medicine | 1007 Harlow Rd, Springfield, OR 97477-7124 | 2011-06-08 |
Find all providers in SPRINGFIELD |
City | SPRINGFIELD |
Zip Code | 62704 |
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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.