Jonathan C Roberts (NPI# 1871757070, PAC ID# 5193994424) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PEDIATRIC MEDICINE.
| Nation Provider ID (NPI) | 1871757070 |
| PAC ID by PECOS | 5193994424 |
| Professional Enrollment ID | I20140730000552 |
| Full Name | Jonathan C Roberts |
| Organization Legal Name | MICHAEL D. TARANTINO, M.D. S.C. |
| Address |
9128 N Lindbergh Dr Peoria IL 61615-1422 |
| Phone Number | 3096925337 |
| Gender | M |
| Medical School | SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 2008 |
| Primary Specialty | PEDIATRIC MEDICINE |
| Secondary Specialties | HEMATOLOGY/ONCOLOGY |
| Group Practice PAC ID | 6800950833 |
| Number of Group Practice Members | 5 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 140067 | OSF SAINT FRANCIS MEDICAL CENTER |
| 140209 | METHODIST MEDICAL CENTER OF ILLINOIS |
| Address | Phone | Organization |
|---|---|---|
| 9128 N Lindbergh Dr, Peoria, IL 61615-1422 | 3096925337 | MICHAEL D. TARANTINO, M.D. S.C. |
| Organization Legal Name | MICHAEL D. TARANTINO, M.D. S.C. |
| Physicians | 5 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Amanda Miriam Kilgore | Physical Therapy | Michael D. Tarantino, M.d. S.c. | 9128 N Lindbergh Dr, Peoria, IL 61615-1422 |
| Rohith Jesudas | Pediatric Medicine | Michael D. Tarantino, M.d. S.c. | 9128 N Lindbergh Dr, Peoria, IL 61615-1422 |
| Elizabeth A Lepper | Nurse Practitioner | Michael D. Tarantino, M.d. S.c. | 9128 N Lindbergh Dr, Peoria, IL 61615-1422 |
| Jackie M El-darazi | Nurse Practitioner | Michael D. Tarantino, M.d. S.c. | 9128 N Lindbergh Dr, Peoria, IL 61615-1422 |
| Street Address |
9128 N LINDBERGH DR |
| City | PEORIA |
| State | IL |
| Zip | 61615-1422 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Amanda Miriam Kilgore | Physical Therapy | Michael D. Tarantino, M.d. S.c. | 9128 N Lindbergh Dr, Peoria, IL 61615-1422 |
| Michael Dominic Tarantino | Hematology/oncology | 9128 N Lindbergh Dr, Peoria, IL 61615-1422 | |
| Rohith Jesudas | Pediatric Medicine | Michael D. Tarantino, M.d. S.c. | 9128 N Lindbergh Dr, Peoria, IL 61615-1422 |
| Elizabeth A Lepper | Nurse Practitioner | Michael D. Tarantino, M.d. S.c. | 9128 N Lindbergh Dr, Peoria, IL 61615-1422 |
| Jackie M El-darazi | Nurse Practitioner | Michael D. Tarantino, M.d. S.c. | 9128 N Lindbergh Dr, Peoria, IL 61615-1422 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jennifer N Thompson | Ophthalmology | Gailey Eye Clinic, Ltd | 8800 N Orange Prairie, Peoria, IL 61615 |
| Jeffrey Y Liang | Internal Medicine | Iowa Physicians Clinic Medical Foundation | 10322 N Juliet Ct, Peoria, IL 61615-1199 |
| Matthew Carr | Nurse Practitioner | Iowa Physicians Clinic Medical Foundation | 8914 N Knoxville Ave, Peoria, IL 61615-1410 |
| Abby G Freckleton | Nurse Practitioner | Iowa Physicians Clinic Medical Foundation | 8914 N Knoxville Ave, Peoria, IL 61615-1410 |
| Susannah Dintzis | Nurse Practitioner | Iowa Physicians Clinic Medical Foundation | 8914 N Knoxville Ave, Peoria, IL 61615-1410 |
| Michael J Pace | Family Practice | Methodist Medical Center of Illinois | 8914 N Knoxville Ave, Peoria, IL 61615-1410 |
| Whitney Hanlon | Physical Therapy | Rock Valley Physical Therapy Center | 9901 N Knoxville Ave, Suite D, Peoria, IL 61615-1433 |
| Jonathan L Acklie | Physical Therapy | Rock Valley Physical Therapy Center | 9901 N Knoxville Ave, Suite D, Peoria, IL 61615-1433 |
| Lacey Neal | Physical Therapy | Rock Valley Physical Therapy Center | 9901 N Knoxville Ave, Suite D, Peoria, IL 61615-1433 |
| Clara C Tostovarsnik | Physical Therapy | Rock Valley Physical Therapy Center | 9901 N Knoxville Ave, Suite D, Peoria, IL 61615-1433 |
| Find all physicians in zip 61615 | |||
| City | PEORIA |
| Zip Code | 61615 |
| Specialty | PEDIATRIC MEDICINE |
| City + Specialty | PEORIA + PEDIATRIC MEDICINE |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.