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DR. CHARLES TATE JR. MD
NPI 1982456752
Student in an Organized Health Care Education/Training Program in Peoria, IL

Active since April 03, 2024
530 NE GLEN OAK AVE, PEORIA, IL 61637(309) 655-2109 Get Directions Write a Review

NPPES record last updated: April 3, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Charles Tate Jr. Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. CHARLES TATE JR. MD (NPI 1982456752) is an individual student in an organized health care education/training program in Peoria, Illinois and active in the NPI registry since April 2024.

NPPES Registry Identity

NPI1982456752
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. CHARLES TATE JR.Credential: MD
Location Address530 NE GLEN OAK AVEPeoria, IL 61637-0001
Mailing Address530 Ne Glen Oak AvePeoria, IL 61637-0001 · (309) 655-2109
Phone(309) 655-2109
Sole ProprietorNo
Enumeration DateApril 3, 2024
NPPES CertifiedApril 3, 2024
✔ NPI 1982456752 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

530 NE GLEN OAK AVE, Peoria, IL 61637
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MISS CARA L PHILLIPS PHARMD
Pharmacist
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2285
SAMIR SAXENA MD
Internal Medicine
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 624-8818
CENTRAL ILLINOIS PATHOLOGY, SC
Pathology (Anatomic Pathology & Clinical Pathology)
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 624-9011
DR. RAHUL K. CHAWLA MD
Pediatrics (Pediatric Critical Care Medicine)
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2250
DR. LAYNE T. LOVELL M.D.
Family Medicine
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2000
MICHELLE L BERTKE APN,CNP
Nurse Practitioner (Family)
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2312
PAMELA PECENKA ANP
Nurse Practitioner
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2323
MARC D SQUILLANTE D.O.
Emergency Medicine
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2553

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Charles Tate's NPI number?

The NPI number for Charles Tate is 1982456752. It was assigned to this individual provider in the NPPES registry on April 3, 2024.

Where is Charles Tate located?

Charles Tate practices at 530 NE Glen Oak Ave, Peoria, IL 61637. The listed phone number is (309) 655-2109.

What is Charles Tate's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Charles Tate was last updated on April 3, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.