Dr Johnnatan Marin, MD | |
530 Ne Glen Oak Ave, Peoria, IL 61637-1005 | |
(309) 655-2553 | |
(309) 655-2602 |
Full Name | Dr Johnnatan Marin |
---|---|
Gender | Male |
Speciality | Emergency Medicine |
Location | 530 Ne Glen Oak Ave, Peoria, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1164059259 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207P00000X | Emergency Medicine | ME156427 (Florida) | Secondary |
207P00000X | Emergency Medicine | U3937 (Texas) | Secondary |
207P00000X | Emergency Medicine | 036165712 (Illinois) | Primary |
Entity Name | Edinburg Emergency Medicine Associates Pa |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1942467113 PECOS PAC ID: 9638246408 Enrollment ID: O20080919000177 |
Entity Name | Municipal Emergency Medicine Associates, Pa |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1396250650 PECOS PAC ID: 2365701323 Enrollment ID: O20180119000723 |
Entity Name | Shavano Emergency Medicine Associates, Pa |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1255820775 PECOS PAC ID: 2062777634 Enrollment ID: O20180531002487 |
Entity Name | Oak Creek Emergency Medicine Associates Pa |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1629576632 PECOS PAC ID: 4385988385 Enrollment ID: O20181203000555 |
Entity Name | Canyon Springs Emergency Medicine Associates Pa |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1154825412 PECOS PAC ID: 2769728641 Enrollment ID: O20190114002723 |
Mailing Address | Practice Location Address |
---|---|
Dr Johnnatan Marin, MD 130 Nw 199th St, Miami, FL 33169-2919 Ph: (704) 302-4621 | Dr Johnnatan Marin, MD 530 Ne Glen Oak Ave, Peoria, IL 61637-1005 Ph: (309) 655-2553 |
Dr. Austin Lamb, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 530 N.e. Glen Oak Avenue, Osf St. Francis, Emergency Medicine Residency Program, Peoria, IL 61637 Phone: 309-655-7257 | |
Philip A Fifield, M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637 Phone: 309-655-2553 Fax: 309-655-2602 | |
Dr. Anthony J Buecker, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 221 Ne Glen Oak Ave, Peoria, IL 61636 Phone: 309-672-5500 | |
Dr. Mark Phillip Gaudio, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637 Phone: 309-655-6710 | |
Michael M Raso, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1115 N Bourland Ave, Peoria, IL 61606 Phone: 309-264-0730 | |
Ryan Newberger, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637 Phone: 248-207-2018 | |
Craig D Koch, M.D Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637 Phone: 309-655-7257 |