Provider Demographics
NPI:1245244862
Name:MCGEE, JAMES L (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:L
Last Name:MCGEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 NE GLEN OAK AVE
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61637-0001
Mailing Address - Country:US
Mailing Address - Phone:309-655-2000
Mailing Address - Fax:309-655-7869
Practice Address - Street 1:530 NE GLEN OAK AVE
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61637-0001
Practice Address - Country:US
Practice Address - Phone:309-655-6810
Practice Address - Fax:309-655-4041
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2008-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-0541282085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILCE2365OtherMEDICARE RAILROAD GRP
IL036054128Medicaid
52725OtherHEALTH ALLIANCE
05723077OtherBLUE CROSS GROUP #
IL0115OtherJOHN DEERE
036054128OtherBLUE CROSS PIN
800850OtherMEDICARE GROUP NO.
526100OtherHEALTHLINK
L69924Medicare PIN
800850OtherMEDICARE GROUP NO.
05723077OtherBLUE CROSS GROUP #
L02147Medicare ID - Type Unspecified
ILCE2365OtherMEDICARE RAILROAD GRP
539000Medicare ID - Type UnspecifiedMEDICARE GROUP #
920004949Medicare PIN