Mr Glyn E Jones, MD | |
1001 Main Street, 3rd Floor, Peoria, IL 61606-2037 | |
(309) 495-0200 | |
(309) 676-6545 |
Full Name | Mr Glyn E Jones |
---|---|
Gender | Male |
Speciality | Plastic Surgery |
Location | 1001 Main Street, 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 |
---|---|---|---|
1366462475 | NPI | - | NPPES |
7215166 | Other | BCBS OF ILLINOIS | |
036118115-1 | Medicaid | IL | |
K37419 | Other | IL | MEDICARE ID TYPE UNSPECI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208200000X | Plastic Surgery | 036118115 (Illinois) | Primary |
Entity Name | Peoria Surgical Group, Ltd. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1275542045 PECOS PAC ID: 9335039882 Enrollment ID: O20040405001013 |
Entity Name | Illinois Surgical Specialists, Ltd |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1215170246 PECOS PAC ID: 6103256334 Enrollment ID: O20200430000988 |
Mailing Address | Practice Location Address |
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Mr Glyn E Jones, MD 1001 Main Street, 3rd Floor, Peoria, IL 61606-2037 Ph: (309) 495-0200 | Mr Glyn E Jones, MD 1001 Main Street, 3rd Floor, Peoria, IL 61606-2037 Ph: (309) 495-0200 |
Dr. John E Lomax, M.D. Plastic Surgery Medicare: Not Enrolled in Medicare Practice Location: 4909 N Glen Park Place Rd, Peoria, IL 61614 Phone: 309-674-7546 | |
Todd Gerlach, MD Plastic Surgery Medicare: Accepting Medicare Assignments Practice Location: 4909 N Glen Park Place Rd, Peoria, IL 61614 Phone: 309-674-7546 Fax: 309-282-0500 | |
Dr. Tyler Andrew Evans, M.D. Plastic Surgery Medicare: Accepting Medicare Assignments Practice Location: 1001 Main St Ste 300, Peoria, IL 61606 Phone: 217-528-7541 | |
Dr. Richard D Corley, MD Plastic Surgery Medicare: Not Enrolled in Medicare Practice Location: 808 W Trailcreek Dr, Peoria, IL 61614 Phone: 309-693-3122 Fax: 309-693-4250 |