THE BLEEDING AND CLOTTING DISORDERS INSTITUTE (NPI# 1962783431) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962783431 |
| Entity Type | Organization |
| Organization Name | THE BLEEDING AND CLOTTING DISORDERS INSTITUTE |
| Practice Address |
9128 N Lindbergh Dr Peoria IL 61615-1422 |
| Practice Telephone | 3096925337 |
| Practice Fax Number | 3096933913 |
| Mailing Telephone | 3096925337 |
| Mailing Fax Number | 3096933913 |
| Enumeration Date | 2011-08-29 |
| Last Update Date | 2015-08-31 |
| Authorized Official Name | MICHAEL TARANTINO (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 3096925337 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 333600000X | Pharmacy | 054-017718 | IL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RAILROAD MEDICARE | P00096725 | 01 | |
| IL | 398680716 | 05 | |
| BCBS OF IL | 7225372 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639508567 | The Bleeding and Clotting Disorders Institute | Pharmacy | 9128 N Lindbergh Dr, Peoria, IL 61615-1422 | 2013-11-01 |
| 1134424633 | The Bleeding and Clotting Disorders Institute | Clinic/Center | 9128 N Lindbergh Dr, Peoria, IL 61615-1422 | 2011-01-14 |
| Street Address |
9128 N LINDBERGH DR |
| City | PEORIA |
| State | IL |
| Zip Code | 61615-1422 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396731063 | Michael D Tarantino | Pediatrics | 9128 N Lindbergh Dr, Peoria, IL 61615-1422 | 2005-09-27 |
| 1396396024 | Kristin T Ansteatt | Registered Nurse | 9128 N Lindbergh Dr, Peoria, IL 61615-1422 | 2019-09-24 |
| 1225571219 | Jackie Marie Helms | Nurse Practitioner | 9128 N Lindbergh Dr, Peoria, IL 61615-1422 | 2016-11-23 |
| 1720450026 | Elizabeth Ann Lepper | Nurse Practitioner | 9128 N Lindbergh Dr, Peoria, IL 61615-1422 | 2015-10-26 |
| 1639508567 | The Bleeding and Clotting Disorders Institute | Pharmacy | 9128 N Lindbergh Dr, Peoria, IL 61615-1422 | 2013-11-01 |
| 1639434871 | Stephanie Lynn Arnold | Pharmacist | 9128 N Lindbergh Dr, Peoria, IL 61615-1422 | 2012-07-12 |
| 1134424633 | The Bleeding and Clotting Disorders Institute | Clinic/Center | 9128 N Lindbergh Dr, Peoria, IL 61615-1422 | 2011-01-14 |
| 1538469481 | Rohith Jesudas | Pediatrics | 9128 N Lindbergh Dr, Peoria, IL 61615-1422 | 2010-10-26 |
| 1871757070 | Jonathan Charles Roberts | Pediatrics | 9128 N Lindbergh Dr, Peoria, IL 61615-1422 | 2008-07-16 |
| 1366461139 | Amanda Kilgore | Physical Therapist | 9128 N Lindbergh Dr, Peoria, IL 61615 | 2006-07-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124627906 | Lance Jay Bucher | Occupational Therapist | 8600 Il-91, Peoria, IL 61615 | 2020-10-22 |
| 1093327496 | Angela Mitchell | Speech-Language Pathologist | 3903 W Ridgeview Dr, Peoria, IL 61615 | 2020-08-18 |
| 1578110680 | Emily E Buenting | Audiologist | 8600 Il Route 91, Suite 300, Peoria, IL 61615 | 2019-08-22 |
| 1730655572 | Sylwia M. Budzik | Physician Assistant | 8600 Illinois Rt. 91, Suite 300, Peoria, IL 61615 | 2018-10-19 |
| 1487169207 | Heather Hart | Registered Nurse | 9016 N. Scrimshaw Dr. Apt 104, Peoria, IL 61615 | 2017-12-04 |
| 1528586849 | Leanne Runyon | Speech-Language Pathologist | 10723 Collett Dr., Peoria, IL 61615 | 2017-09-07 |
| 1467974196 | Elizabeth A Mcleod | Nurse Practitioner | 8600 Illinois Route 91, Suite 130, Peoria, IL 61615 | 2017-07-14 |
| 1790223022 | Janet Warner | Counselor | 8914 North Prarie Court, Peoria, IL 61615 | 2017-02-07 |
| 1437524022 | Brooke Bisping | Dietitian, Registered | 7610 North Orange Prairie Road, Peoria, IL 61615 | 2015-12-08 |
| 1003292111 | Crystal Ann Casper | Dietitian, Registered | 7610 N Orange Prarie Road, Peoria, IL 61615 | 2015-07-31 |
| Find all providers in zip 61615 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568083301 | Pointcore, Inc. | Pharmacy | 1800 N Knoxville Ave Ste G, Peoria, IL 61603-3028 | 2020-05-04 |
| 1215575824 | Maricopa County Special Health Care District | Pharmacy | 8088 W Whitney Dr, Peoria, AZ 85345 | 2019-12-13 |
| 1467958611 | Arizona Community Pharmacy | Pharmacy | 14100 N 83rd Ave Ste 160, Peoria, AZ 85381 | 2018-04-04 |
| 1942756812 | Smiths Food & Drug Centers Inc | Pharmacy | 25401 N Lake Pleasant Pkwy, Peoria, AZ 85383-1351 | 2016-08-30 |
| 1003235144 | Pharmatek Pharmacy Inc | Pharmacy | 10995 N 99th Ave, Suite 112, Peoria, AZ 85345-5405 | 2014-04-15 |
| 1700014446 | Extended Pharmacy LLC | Pharmacy | 121 State St Ste 1a, Peoria, IL 61602-1547 | 2009-07-01 |
| 1922249127 | Potters House Apothecary Inc | Pharmacy | 21585 N 77th Ave, Ste 1500, Peoria, AZ 85382 | 2009-03-18 |
| 1508004144 | Desert Sky Pharmacy, LLC | Pharmacy | 6750 W Thunderbird Rd Ste 103, Peoria, AZ 85381-5046 | 2009-02-03 |
| 1093883290 | Dolan Central Illinois Compounding LLC | Pharmacy | 5832 N Knoxville Ave Ste E, Peoria, IL 61614-4304 | 2006-12-04 |
| 1598853194 | Bashas Inc | Pharmacy | 7586 W Thunderbird Rd, Peoria, AZ 85381-6077 | 2006-10-10 |
| 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.