Revathi Swaminathan, MD | |
221 Ne Glen Oak Ave, Peoria, IL 61636-0001 | |
(309) 672-5700 | |
(309) 671-2774 |
Full Name | Revathi Swaminathan |
---|---|
Gender | Female |
Speciality | Radiology - Radiation Oncology |
Location | 221 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 |
---|---|---|---|
1841234929 | NPI | - | NPPES |
RAILROAD MED PIN | Other | P00310337 | |
036062991 | Medicaid | IL | |
254642 | Other | HEALTHLINK | |
CM5868 | Other | RAILROAD MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2085R0001X | Radiology - Radiation Oncology | 036062991 (Illinois) | Primary |
Entity Name | Methodist Medical Center Of Illinois |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1982656575 PECOS PAC ID: 1355259714 Enrollment ID: O20031126000494 |
Entity Name | Proctor Health Systems |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1134173917 PECOS PAC ID: 3476440173 Enrollment ID: O20040227000906 |
Entity Name | Central Illinois Radiation Oncology Physicians, Ltd |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1003857061 PECOS PAC ID: 2062426281 Enrollment ID: O20060126000809 |
Mailing Address | Practice Location Address |
---|---|
Revathi Swaminathan, MD 450 Mayo Dr, Galesburg, IL 61401-1211 Ph: (309) 344-2831 | Revathi Swaminathan, MD 221 Ne Glen Oak Ave, Peoria, IL 61636-0001 Ph: (309) 672-5700 |
Dr. Lawrence C Wang, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 401 Sw Water St, 1824, Peoria, IL 61602 Phone: 309-494-9320 | |
Dr. Matthew Trent Carpenter, MD Radiology Medicare: May Accept Medicare Assignments Practice Location: 221 Ne Glen Oak Ave, Department Of Radiation Oncology, Peoria, IL 61636 Phone: 309-672-5700 Fax: 309-671-2774 | |
Dr. Cameron Wailynn Taylor, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637 Phone: 309-655-2000 | |
Robert T Bockel, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 401 Sw Water St, Suite 507, Peoria, IL 61602 Phone: 309-494-9320 | |
Dr. Steven J Ullenius, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637 Phone: 309-655-2000 | |
Dr. Amanda Catherine Cross, M.D. Radiology Medicare: Medicare Enrolled Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61603 Phone: 309-655-2000 | |
Dr. Derek Beatty, D.O. Radiology Medicare: Accepting Medicare Assignments Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637 Phone: 309-655-7768 |