# THE BLEEDING AND CLOTTING DISORDERS INSTITUTE

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639508567
- **Authorized official:** MICHAEL TARANTINO M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (309) 692-5337

## Contact information

- **Practice address:** 427 W NORTHMOOR RD, PEORIA, IL 61614-3542
- **Practice address phone:** (309) 692-5337
- **Practice address fax:** (309) 693-3913
- **Mailing address:** 427 W NORTHMOOR RD, PEORIA, IL 61614-3542
- **Mailing address phone:** (309) 692-5337
- **Mailing address fax:** (309) 693-3913

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336S0011X | Specialty Pharmacy | 054-017718 | IL | Yes |

## Other

- **Enumeration date:** 11/01/2013
- **Last updated:** 07/30/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 398680716 | — | IL |
| 01 | — | 7225372 | BCBS OF IL | — |