DAVID TRACHTENBARG MD NPI 1952318719

Family Medicine in Peoria, IL

About DAVID TRACHTENBARG

David Trachtenbarg is a provider in Peoria, IL with more than 43 years of experience. The NPI number assigned to this provider is 1952318719. The practitioner's primary taxonomy code is Family Medicine (207Q00000X). The provider is registered as an individual and their NPI record was last updated 10 years ago. David Trachtenbarg is registered with Medicare and accepts claims assignment.

NPI1952318719 Additional informationCallout TooltipNational Provider Indentifier (NPI)
The 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider Name DAVID TRACHTENBARG MD
Provider Location Address815 MAIN ST PEORIA, IL 61602 Additional informationCallout TooltipProvider location address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address5100 RELIABLE PKWY CHICAGO, IL 60686 Additional informationCallout TooltipProvider mailing address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
GenderMale
NPI Entity TypeIndividual Additional informationCallout TooltipEntity type code
The code describing the type of health care provider that is being assigned an NPI.
Codes are:
1 = (Person): individual human being who furnishes health care;
2 = (Non-person): entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO).
Medical School NameUNIVERSITY OF ILLINOIS AT CHICAGO HEALTH SCIENCE CENTER
Graduation Year1975
Is Sole Proprietor?No
Is Organization Subpart?N/A Additional informationCallout TooltipWhat is a subpart?
Subparts are the components and separate physical locations of organization health care providers. Examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Enumeration Date08-02-2006 Additional informationCallout TooltipProvider enumeration date
The date the provider was assigned a unique identifier (assigned an NPI)
Last Update Date07-08-2007 Additional informationCallout TooltipLast update date
The date that a record was last updated or changed.

Business Address

DAVID TRACHTENBARG MD
815 MAIN ST
PEORIA, IL
ZIP 61602
Phone: (309) 672-4977
Get Directions

Mailing Address

DAVID TRACHTENBARG MD
5100 RELIABLE PKWY
CHICAGO, IL
ZIP 60686
Phone: (309) 672-4809

Primary Taxonomy

Taxonomy Code207Q00000X Additional informationCallout TooltipPrimary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
ClassificationFamily Medicine
TypeAllopathic & Osteopathic Physicians
License StateIL
Taxonomy DescriptionFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
L99921MEDICARE ID-TYPE UNSPECIFIED (04)IL
008428OTHER (01)IL
472301OTHER (01)IL
IL01S5OTHER (01)IL
7215059OTHER (01)IL
C43554MEDICARE UPIN (02)IL
0360538361MEDICAID (05)IL

Map Location


DAVID TRACHTENBARG MD address is 815 MAIN ST PEORIA, IL 61602

Other Providers at the same location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1184631418 MARIAN PARR FNP
Individual
Nurse Practitioner (Family)815 MAIN ST
PEORIA, IL 61602
(309) 672-4977
1225224835 ANNE PADWOJSKI APN
Individual
Nurse Practitioner815 MAIN ST
PEORIA, IL 61602
(309) 672-4977
1255451803 DARREN CONKLIN DO
Individual
Family Medicine815 MAIN ST
PEORIA, IL 61602
(309) 672-4977
1295932150 DIMPLE SAHAY MD
Individual
Student in an Organized Health Care Education/Training Program815 MAIN ST
PEORIA, IL 61602
(309) 672-4977
1376856559 JOHN LIDVALL MD
Individual
Student in an Organized Health Care Education/Training Program815 MAIN ST
PEORIA, IL 61602
(309) 672-4977
1407862022 GLENN MILLER MD
Individual
Family Medicine815 MAIN ST
PEORIA, IL 61602
(309) 672-4977
1427071786 LORENA BREJC LCSW
Individual
Social Worker815 MAIN ST SUITE B
PEORIA, IL 61602
(309) 672-4908
1437163540 JOHN COON MD
Individual
Family Medicine815 MAIN ST SUITE B
PEORIA, IL 61602
(309) 672-4908
1457573818 ERIN MARTIN MD
Individual
Family Medicine815 MAIN ST
PEORIA, IL 61602
(309) 672-4977
1497762587 ROBERTA VAN ZANT DO
Individual
Family Medicine815 MAIN ST
PEORIA, IL 61602
(309) 672-4977
1508880089 ANITA COON FNP
Individual
Nurse Practitioner815 MAIN ST
PEORIA, IL 61602
(309) 672-4977
1508958307 TRINA SCOTT
Individual
Family Medicine815 MAIN ST
PEORIA, IL 61602
(309) 672-4977
1568485795 ISHANI ALI MD
Individual
Internal Medicine (Geriatric Medicine)815 MAIN ST
PEORIA, IL 61602
(309) 672-4908
1619981370 THOMAS GOLEMON MD
Individual
Family Medicine815 MAIN ST
PEORIA, IL 61602
(309) 672-4977
1710149224DR. MAHWESH JAVED MD
Individual
Family Medicine815 MAIN ST
PEORIA, IL 61602
(309) 672-5522
1710991633 JOAN GOLEMON MD
Individual
Family Medicine815 MAIN ST
PEORIA, IL 61602
(309) 672-4977
1740294347 CRAIG GRIEBEL MD
Individual
Family Medicine815 MAIN ST
PEORIA, IL 61602
(309) 672-4977
1780699124 PATTI OVERCASH FNP
Individual
Nurse Practitioner (Family)815 MAIN ST
PEORIA, IL 61602
(309) 672-4977
1821149618 DEBORAH RUFUS APN
Individual
Nurse Practitioner815 MAIN ST
PEORIA, IL 61602
(309) 672-4977
1922235944 JOSHUA SAWLAW MD
Individual
Family Medicine815 MAIN ST
PEORIA, IL 61602
(309) 672-4977