Tarantino, Michael D
Tarantino, Michael D is an sole proprietor health care provider with primary practice located at 427 W Northmoor Rd , Peoria IL 61614-3542. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology, which is considered as his primary health care specialty. Tarantino, Michael D can be contacted via phone (309) 692-5337.Contact Information
Primary practice address
427 W Northmoor Rd
Peoria IL 61614-3542
Phone: (309) 692-5337
Fax: (309) 693-3913
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology | 2080P0207X | 29978 | Kentucky |
| Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology | 2080P0207X | 036-101239 | Illinois |
Profile Details
| NPI number | 1396731063 |
|---|---|
| LBN Legal business name | Tarantino, Michael D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 27th, 2005 |
| Last updated | Jul 30th, 2021 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1396731063 | NPPES |
| Other | P00096725 | RAILROAD MEDICARE | |
| Other | 64299787 | RAILROAD MEDICARE | |
| Other | 7225372 | RAILROAD MEDICARE |
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