Timothy Grant Raines, MD | |
530 Ne Glen Oak Ave, Peoria, IL 61603-3133 | |
(309) 655-2268 | |
Not Available |
Full Name | Timothy Grant Raines |
---|---|
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 |
---|---|---|---|
1932305182 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207P00000X | Emergency Medicine | 01064696A (Indiana) | Secondary |
207P00000X | Emergency Medicine | 125-049400 (Illinois) | Primary |
Entity Name | Indiana Physician Management, Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1629019138 PECOS PAC ID: 4486636180 Enrollment ID: O20040605000304 |
Entity Name | St. Vincent Emergency Physicians, Inc. |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1306891700 PECOS PAC ID: 1759363450 Enrollment ID: O20040720000734 |
Entity Name | Indiana Physician Management-northeast, Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1740431576 PECOS PAC ID: 0941363071 Enrollment ID: O20090115000124 |
Entity Name | Indiana Physician Management - Mercy Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1225309073 PECOS PAC ID: 6800051319 Enrollment ID: O20120709000441 |
Entity Name | Cep America Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1285103671 PECOS PAC ID: 6608056171 Enrollment ID: O20190214000611 |
Mailing Address | Practice Location Address |
---|---|
Timothy Grant Raines, MD 4207 W Hollow Creek Dr, Peoria, IL 61615-5635 Ph: (765) 278-1323 | Timothy Grant Raines, MD 530 Ne Glen Oak Ave, Peoria, IL 61603-3133 Ph: (309) 655-2268 |
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 |