MEDICARE: DR. PETER ROODHOUSE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician		IL

General Provider Information

NPI Number	:	1760439962
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PETER ROODHOUSE M.D.

Provider Business Mailing Address
First Line	:	1338 MOUND AVE
Second Line	:
City	:	JACKSONVILLE
State	:	IL
Zip	:	62650-2252
Country	:	US
Telephone Number	:	217-243-4835
Fax Number	:

Provider Business Practice Location Address
First Line	:	1600 W WALNUT ST
Second Line	:
City	:	JACKSONVILLE
State	:	IL
Zip	:	62650-1136
Country	:	US
Telephone Number	:	217-245-9541
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2006
Last Update Date	:	07/08/2007

Similar Medicare Providers

1609873249 — DR. CHARLES MILTON SHEAFF MD
Practice Location Address:

1600 W WALNUT ST , EAST WING 2ND FLOOR
JACKSONVILLE, IL
62650-1136

Practice Phone: 217-479-5821
Practice Fax: 217-243-7406

1851387609 — DR. STEVEN T LILLPOP M.D.
Practice Location Address:

1600 W WALNUT ST
JACKSONVILLE, IL
62650-1136

Practice Phone: 217-245-5437
Practice Fax: 217-243-3113

1922096973 — DR. DANNY M. SARTORE M.D.
Practice Location Address:

1600 W WALNUT ST , PASSAVANT AREA HOSPITAL
JACKSONVILLE, IL
62650-1136

Practice Phone: 217-245-9541
Practice Fax:

1063487775 — DR. JOHN C. DAILEY M.D.
Practice Location Address:

1600 W WALNUT ST
JACKSONVILLE, IL
62650-1136

Practice Phone: 217-243-9426
Practice Fax: 217-243-1647

1902874092 — KRIS ALAN SCHWIDERSKI A.T.,C.
Practice Location Address:

1600 W WALNUT ST
JACKSONVILLE, IL
62650-1136

Practice Phone: 217-245-9541
Practice Fax: 217-479-5675

1053351874 — JEFFREY L OLEJNIK LLC
Practice Location Address:

1600 W WALNUT ST
JACKSONVILLE, IL
62650-1136

Practice Phone: 217-243-5930
Practice Fax: 217-243-8073

Directions to “ DR. PETER ROODHOUSE M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.