MEDICARE: CARDIAC THORACIC & ENDOVASCULAR THERAPIES, S.C.

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	2086S0129X	Vascular Surgery Physician		IL
2	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician		IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00059260	OTHER	IL	RETIRED RAILROAD MEDICARE
4	DS6728	OTHER	IL	RETIRED RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	7232062	OTHER	IL	BLUE SHIELD PROVIDER NO

General Provider Information

NPI Number	:	1962417485
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARDIAC THORACIC & ENDOVASCULAR THERAPIES, S.C.

Provider Business Mailing Address
First Line	:	2420 W NEBRASKA AVE
Second Line	:
City	:	PEORIA
State	:	IL
Zip	:	61604-3112
Country	:	US
Telephone Number	:	309-680-5000
Fax Number	:	309-680-1002

Provider Business Practice Location Address
First Line	:	2420 W NEBRASKA AVE
Second Line	:
City	:	PEORIA
State	:	IL
Zip	:	61604-3112
Country	:	US
Telephone Number	:	309-680-5000
Fax Number	:	309-680-1002

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	DR. JAMES BERTRAM WILLIAMS
Credential	:	MD
Telephone Number	:	309-680-8666

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	01/30/2015

Similar Medicare Providers

1265433882 — DR. JAMES BERTRAM WILLIAMS M.D.
Practice Location Address:

2420 W NEBRASKA AVE
PEORIA, IL
61604-3112

Practice Phone: 309-680-5000
Practice Fax: 309-680-1002

1366424756 — PEORIA EYE CLINIC, LTD
Practice Location Address:

2422 W NEBRASKA AVE
PEORIA, IL
61604-3112

Practice Phone: 309-676-2020
Practice Fax: 309-673-2020

1134804420 — HEARTLAND VASCULAR CARE PLLC
Practice Location Address:

2420 W NEBRASKA AVE
PEORIA, IL
61604-3112

Practice Phone: 309-680-5000
Practice Fax:

1093521627 — MIRIAM GEIGER PLLC
Practice Location Address:

3112 N NORTH ST
PEORIA, IL
61604-1564

Practice Phone: 510-684-9063
Practice Fax:

1629126222 — SUDHA CHERUKURI MD
Practice Location Address:

420 NE GLEN OAK AVE STE 401
PEORIA, IL
61603-3112

Practice Phone: 309-676-8123
Practice Fax: 309-676-8455

1619007275 — DAVID C ROSBOROUGH MD
Practice Location Address:

420 NE GLEN OAK AVE STE 401
PEORIA, IL
61603-3112

Practice Phone: 309-676-8123
Practice Fax: 309-676-8455

Directions to “CARDIAC THORACIC & ENDOVASCULAR THERAPIES, S.C. ” 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.