Individual provider Active NPI

Tyler Hall Cornelius, M.D.

  • Diagnostic Radiology Physician
  • Kankakee, IL
National Provider Identifier
1447593116
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
036-146042 Issued in IL
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

Updated by the provider on Nov 27, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190516001317 IL Practitioner - Diagnostic Radiology 4880987585 Reassigns benefits to 3 organizations

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
Central Illinois Radiological Associates LTDGroup PAC ID 9436061827, 205 clinicians
Cira Michigan PCGroup PAC ID 7113355264, 89 clinicians
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

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

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-146042ILMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central PA Pharmacy LLC. Current Accepting new patients
Cira Michigan PC Diagnostic Radiology CurrentSince Jan 1, 2026 Accepting new patients
Central Illinois Radiological Associates, LTD. Diagnostic Radiology CurrentSince Jul 1, 2019 Accepting new patients
Osf Multi-Specialty Group CurrentSince Aug 20, 2025 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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

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

Verify at the official NPI Registry.