Bradley Reatherford, | |
221 Northeast Ave, Peoria, IL 61636-0001 | |
(309) 672-5654 | |
Not Available |
Full Name | Bradley Reatherford |
---|---|
Gender | Male |
Speciality | Certified Registered Nurse Anesthetist (crna) |
Experience | 15 Years |
Location | 221 Northeast Ave, Peoria, Illinois |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1326288812 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
163W00000X | Registered Nurse | 041334740 (Illinois) | Secondary |
367500000X | Nurse Anesthetist, Certified Registered | 209007657 (Illinois) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
St Joseph Medical Center | Bloomington, IL | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
North American Partners In Anesthesia Illinois Llc | 1052576519 | 306 |
Entity Name | Methodist Medical Center Of Illinois |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1164474755 PECOS PAC ID: 1355259714 Enrollment ID: O20070924000481 |
Entity Name | North American Partners In Anesthesia Illinois Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1699032524 PECOS PAC ID: 1052576519 Enrollment ID: O20120706000534 |
Entity Name | Tcom Specialty Physicians Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1144712563 PECOS PAC ID: 8527318831 Enrollment ID: O20180907001266 |
Entity Name | Vitalz Anesthesia Unlimited Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1013474071 PECOS PAC ID: 8224379383 Enrollment ID: O20190418000548 |
Mailing Address | Practice Location Address |
---|---|
Bradley Reatherford, 1652 Belclare Rd, Normal, IL 61761-4925 Ph: (217) 454-0780 | Bradley Reatherford, 221 Northeast Ave, Peoria, IL 61636-0001 Ph: (309) 672-5654 |
Melissa Terhark, C.R.N.A Nurse Anesthetist - CR Medicare: May Accept Medicare Assignments Practice Location: 8600 North State Route 91, Suite #250, Peoria, IL 61615 Phone: 309-692-5394 Fax: 309-692-2538 | |
Bradley Alan Kirkenir, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 7309 N Knoxville Ave, Peoria, IL 61614 Phone: 217-528-7541 | |
Mathew J Maupin, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 5401 N. Knoxville Suite 416, Peoria, IL 61528 Phone: 309-692-7246 Fax: 309-692-7226 | |
Sandra M Krahn, CRNA Nurse Anesthetist - CR Medicare: May Accept Medicare Assignments Practice Location: 221 Ne Glen Oak Ave, Peoria, IL 61636 Phone: 309-672-5522 | |
Adam Randel Osborne, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 221 Ne Glen Oak Ave, Peoria, IL 61636 Phone: 309-672-5550 | |
Dr. Samantha Mae Aufderhaar, DNP, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637 Phone: 309-655-2000 | |
Mr. Gary L Boniger, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 8600 N State Route 91, Suite 250, Peoria, IL 61615 Phone: 309-692-5393 Fax: 309-692-2538 |