CENTRAL ILLINOIS RADIOLOGICAL ASSOCIATES, LTD. (NPI# 1538192828) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538192828 |
| Entity Type | Organization |
| Organization Name | CENTRAL ILLINOIS RADIOLOGICAL ASSOCIATES, LTD. |
| Other Organization Name | CENTRAL ILLINOIS RADIOLOGICAL ASSOCIATES |
| Practice Address |
530 Ne Glen Oak Avenue Peoria IL 61637 |
| Mailing Address |
111 Oakwood Rd East Peoria IL 61611-1853 |
| Practice Telephone | 3097404272 |
| Practice Fax Number | 3097407479 |
| Mailing Telephone | 3097404272 |
| Mailing Fax Number | 3097407479 |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2020-07-09 |
| Authorized Official Name | DR. KEVIN FAHEY (PRESIDENT) |
| Authorized Official Telephone | 3097404272 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Central Illinois Radiological Associates | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386659241 | Central Illinois Radiological Associates, Ltd. | Radiology | Osf St Francis Medical Ctr, 530 N.e. Glen Oak, Peoria, IL 61636-0001 | 2006-07-29 |
| Street Address |
530 NE GLEN OAK AVENUE |
| City | PEORIA |
| State | IL |
| Zip Code | 61637 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831712389 | Amandeep Sehra | Pediatrics | 530 Ne Glen Oak Avenue, Peoria, IL 61637 | 2020-05-19 |
| 1932761194 | Haig Hagop Manougian | Pediatrics | 530 Ne Glen Oak Avenue, Peoria, IL 61637 | 2019-07-08 |
| 1043871486 | Rose Chisenga | Student in an Organized Health Care Education/Training Program | 530 Ne Glen Oak Avenue, Peoria, IL 61637 | 2019-06-26 |
| 1285120725 | Sujitha Sree Ketineni | Student in an Organized Health Care Education/Training Program | 530 Ne Glen Oak Avenue, Peoria, IL 61637 | 2018-07-09 |
| 1528504727 | Christina Marie Ropp | Physical Therapist | 530 Ne Glen Oak Avenue, Peoria, IL 61637 | 2017-01-11 |
| 1942649710 | Ramanan Rom Satchi | Pediatrics | 530 Ne Glen Oak Avenue, Choi - Peds Dept Osf Saint Francis Med, Peoria, IL 61637 | 2013-06-14 |
| 1366799256 | Michael Sullivan O'keefe | Emergency Medicine | 530 Ne Glen Oak Avenue, Osf St Francis Medical Center, Peoria, IL 61637 | 2012-08-09 |
| 1689920530 | Tara Mcgovern | Speech-Language Pathologist | 530 Ne Glen Oak Avenue, Peoria, IL 61637-0001 | 2012-07-30 |
| 1619262474 | Megan M Daghfal | Radiology | 530 Ne Glen Oak Avenue, Peoria, IL 61637-2991 | 2011-06-09 |
| 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 | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| 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 Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992054829 | Justin S Ferragut | Radiology | 530 Northeast Glen Oak Avenue, Peoria, IL 61603 | 2012-09-06 |
| 1932490075 | Christine Ann Wigginton | Radiology | 221 Ne Glen Oak Ave Dept Of, Peoria, IL 61636 | 2011-04-24 |
| 1932421591 | Smi Imaging, LLC | Radiology | 9125 W Thunderbird Rd, Suite 105, Peoria, AZ 85381-4920 | 2010-02-24 |
| 1972736163 | Smi Imaging, LLC | Radiology | 9403 W Thunderbird Rd, Peoria, AZ 85381-4825 | 2009-09-03 |
| 1184828360 | Jane Ho Maksimovic | Radiology | 2612 W Newman Pkwy, Peoria, IL 61604-2208 | 2007-06-12 |
| 1124030705 | Terry M Brady | Radiology | 411 Hamilton Blvd, 1824, Peoria, IL 61602-1144 | 2006-08-12 |
| 1275543456 | Kim V. Arellano-villarreal | Radiology | 401 Sw Water St, Peoria, IL 61602-1571 | 2006-08-09 |
| 1386659241 | Central Illinois Radiological Associates, Ltd. | Radiology | Osf St Francis Medical Ctr, 530 N.e. Glen Oak, Peoria, IL 61636-0001 | 2006-07-29 |
| 1265469399 | Brian A Holtan | Radiology | 31003 N 118th Ln, Peoria, AZ 85383-8240 | 2006-06-26 |
| 1992755870 | Jan Namyslowski | Radiology | 114 W Stratford Dr Ste E, Peoria, IL 61614-7300 | 2006-05-11 |
| 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.