OrganizationActive
The Bleeding and Clotting Disorders Institute
NPI 1639508567 · Specialty Pharmacy · Peoria, IL
Provider details
- NPI number
- 1639508567
- Entity type
- Organization
- Primary specialty
- Specialty PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Michael Tarantino, Medical Director(309) 692-5337
- License
- 054-017718 (IL)
Specialties & taxonomies
Suppliers
Practice location
427 W Northmoor Rd
Peoria, IL 61614-3542
Phone: (309) 692-5337
Fax: (309) 693-3913
Approximate (ZIP-level) locationGet directions
Mailing address
427 W Northmoor Rd
Peoria, IL 61614-3542
Registry dates
- Enumerated
- 2013-11-01
- Last updated
- 2021-07-30
- Certified
- 2021-06-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.