# MICHAEL D. TARANTINO, M.D. S.C.

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

## Provider details

- **NPI number:** 1740430784
- **Authorized official:** MR. MICHAEL D. TARANTINO M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (309) 370-6124

## 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:** 2 OLD FARM LN, WASHINGTON, IL 61571-9733
- **Mailing address phone:** (309) 370-6124
- **Mailing address fax:** (309) 693-3913

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2080P0207X | Pediatric Hematology & Oncology Physician | — | NULL | Yes |
| 2080P0207X | Pediatric Hematology & Oncology Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/26/2008
- **Last updated:** 07/15/2022