Active NPI
Tyler Hall Cornelius, M.D.
- Diagnostic Radiology Physician
- Kankakee, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 036-146042
- Practice address
- 350 N Wall St
Kankakee, IL 60901-2901 - Phone
- (815) 933-1671
- NPI assigned
- Apr 1, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 036-146042 | IL | Primary |
Addresses
Primary practice location
350 N Wall St
Kankakee, IL 60901-2901
Mailing address
111 Oakwood Rd
East Peoria, IL 61611-1853
Phone (847) 406-7016
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
111 Oakwood Rd
East Peoria, IL 61611-1853
Phone (309) 740-4272
7527 Brookbank Rd
Willowbrook, IL 60527-2312
Phone (906) 786-5707
8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050
Hospital & facility affiliations
- Saint Francis Medical Center
- Silver Cross Hospital and Medical Centers
- St Joseph Medical Center
- Osf Saint Elizabeth MDL Ctr
- Osf Little Company of Mary Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-146042 | IL | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central PA Pharmacy LLC. | Current | Accepting new patients | |
| Cira Michigan PC | Diagnostic Radiology | Current | Accepting new patients |
| Central Illinois Radiological Associates, LTD. | Diagnostic Radiology | Current | Accepting new patients |
| Osf Multi-Specialty Group | Current | Accepting new patients |
Locations
5200 Reliable Pkwy
Chicago, IL 60686
Phone (309) 671-8748
350 N Wall St
Kankakee, IL 60901
Phone (815) 935-7500
530neglen Oak Ave
Peoria, IL 61636
Phone (309) 685-1054
530 NE Glen Oak Ave
Peoria, IL 61637
Phone (309) 655-2553
111 Oakwood Rd
Peoria, IL 61611
Phone (586) 412-4144
8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050
535 Park Ave E
Princeton, IL 61356
Phone (815) 875-4531
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
dba Central Illinois Radiological Associates
- Diagnostic Radiology Physician
- Peoria, IL
- NPI 1538192828
-
- Internal Medicine Physician
- Peoria, IL
- NPI 1922445527
-
dba patton pharmacy and v&s variety
- Community/Retail Pharmacy
- Patton, PA
- NPI 1578541413
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba OSF Little Company of Mary Medical Center
- General Acute Care Hospital
- Evergreen Park, IL
- NPI 1215572045
-
dba OSF Saint Elizabeth Medical Center
- General Acute Care Hospital
- Peru, IL
- NPI 1588713440
-
- Rehabilitation Hospital Unit
- New Lenox, IL
- NPI 1003933797
-
dba Silver Cross Hospital
- General Acute Care Hospital
- New Lenox, IL
- NPI 1568553519
-
dba OSF Saint Joseph Medical Center
- General Acute Care Hospital
- Bloomington, IL
- NPI 1619916806
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1364774400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701043200000",
"number": "1447593116",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 OAKWOOD RD",
"city": "EAST PEORIA",
"state": "IL",
"postal_code": "616111853",
"telephone_number": "847-406-7016"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "350 N WALL ST",
"city": "KANKAKEE",
"state": "IL",
"postal_code": "609012901",
"telephone_number": "815-933-1671"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORNELIUS",
"first_name": "TYLER",
"middle_name": "HALL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-04-01",
"last_updated": "2023-11-27",
"certification_date": "2023-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "IL",
"license": "036-146042",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Kankakee, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.