JACOB TONY (NPI# 1881815488) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881815488 |
| Entity Type | Individual |
| Full Name | JACOB TONY |
| Credential | M.D. |
| Practice Address |
900 Main St Ste 250 Peoria IL 61602-5006 |
| Practice Telephone | 3096724522 |
| Mailing Telephone | 3096724522 |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2017-11-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
125-046927 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | LICENSE | 036119046 | 01 |
| Street Address |
900 MAIN ST STE 250 |
| City | PEORIA |
| State | IL |
| Zip Code | 61602-5006 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720574676 | Critical Care Rx, LLC | Pharmacy | 126 Oak St, Peoria, IL 61602 | 2018-07-03 |
| 1235675836 | Cheryl Beckman | Registered Nurse | 211 Fulton Street, Suite 207, One Technology Plaza, Peoria, IL 61602 | 2017-01-06 |
| 1063957942 | Rosemary Ince | Registered Nurse | 211 Fulton St. Suite 207, One Technology Plaza, Peoria, IL 61602 | 2016-12-30 |
| 1962674820 | Lisa Jean Burckhartzmeyer | Psychiatry & Neurology | 228 Ne Jefferson St, Peoria, IL 61602 | 2008-03-31 |
| 1669503587 | Jill Larson | Counselor | 330 Sw Washington Street, Peoria, IL 61602 | 2007-03-09 |
| 1265407399 | Cardiac Consultants Sc | Internal Medicine | 900 Main Street, Suite 320, Peoria, IL 61602 | 2006-02-22 |
| 1013364470 | Rafal Szymczuk | Student in an Organized Health Care Education/Training Program | 900 Main Street, Suite 720, Peoria, IL 61602 | 2016-05-16 |
| 1043693831 | Kari Beth Watts | Family Medicine | 815 Main St, Peoria, IL 61602 | 2015-06-30 |
| 1881072791 | Kristen Dent | Family Medicine | 815 Main St, Peoria, IL 61602 | 2015-05-12 |
| 1023422797 | Andrew Wang | Psychiatry & Neurology | 900 Main St Ste 580, Peoria, IL 61602 | 2014-06-20 |
| Find all providers in zip 61602 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326244682 | Maria S. Parr | Psychiatry & Neurology | Osf Saint Francis Medical Center, 530 N.e.glen Oak Ave., Peoria, FL 61637 | 2007-06-25 |
| 1861473076 | Dennis Q Mcmanus | Psychiatry & Neurology | 8600 N Il-91, Suite 110, Peoria, IL 61615 | 2005-11-07 |
| 1073503819 | Robert I(sa) Pfeffer | Psychiatry & Neurology | 3323 W Gloucester Ct, Peoria, IL 61615-2601 | 2005-10-24 |
| 1558366856 | Asad Ehtisham | Psychiatry & Neurology | 15396 N 83rd Ave Ste E, Peoria, AZ 85381-5627 | 2005-06-15 |
| 1700375854 | Maxwell Quincy Nyce | Psychiatry & Neurology | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2018-05-03 |
| 1396145264 | Envi Pllc | Psychiatry & Neurology | 15396 N 83rd Ave Ste E, Peoria, AZ 85381-5627 | 2014-08-28 |
| 1134535693 | Elias Samaha | Psychiatry & Neurology | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2014-07-05 |
| 1831504844 | Javad Alam | Psychiatry & Neurology | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2014-06-27 |
| 1285047977 | Deepak Reddy | Psychiatry & Neurology | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2014-06-10 |
| 1023436995 | Douglas Juvinall | Psychiatry & Neurology | 200 E Pennsylvania Ave, Peoria, IL 61603-3089 | 2014-03-28 |
| 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.