Revathi Swaminathan, M.D.

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

036062991 Issued in IL

Practice address

221 NE Glen Oak Ave
Peoria, IL 61636-0001

Phone

(309) 672-5700

Fax

(309) 671-2774

NPI assigned

Jun 16, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Proctor Health Systems

  • Family Medicine Physician
  • Peoria, IL
  • NPI 1134173917
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457395200000",
    "number": "1841234929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 MAYO DR",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614011211",
            "telephone_number": "309-344-2831",
            "fax_number": "309-344-2014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616360001",
            "telephone_number": "309-672-5700",
            "fax_number": "309-671-2774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWAMINATHAN",
        "first_name": "REVATHI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-16",
        "last_updated": "2016-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "IL",
            "license": "036062991",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "P00310337",
            "identifier": "RAILROAD MED PIN",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036062991",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "254642",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CM5868",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pamela Taylor Sutton, LCPC
• Dynae Marie Svendsen, PTA
• Amy Svob, APN
• Christine Svoboda, LCSW
• Alesia Svymbersky, PA-C
• Swanson Therapuetic Services LLC
• Rebecca Swanson, C-FNP
• Samantha Kay Swanson
• Suzette R Swanson, APN
• Cynthia L.M. Swigart, CFNP

• Radiation Oncology Physician in Peoria, IL
• Providers in Peoria, IL by specialty
• Radiation Oncology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.