DR. JOHNNATAN MARIN MD NPI 1164059259

NPI Information

  • NPI: 1164059259
  • Provider Name: DR. JOHNNATAN MARIN, MD
  • Classification: Emergency Medicine - 207P00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 530 NE GLEN OAK AVE
    PEORIA, IL
    ZIP 61637
  • Phone: (309) 655-2553

Map and Directions

Get Directions

NPI Details

DR. Johnnatan Marin, MD is an emergency medicine in Peoria, IL with 6 years of experience. The provider is an emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. DR. Johnnatan Marin, MD NPI is 1164059259. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: GEORGE WASHINGTON UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2020

The provider's business location address is:

530 NE GLEN OAK AVE
PEORIA, IL
ZIP 61637-005
Phone: (309) 655-2553
Fax: (309) 655-2602

The NPI 1164059259 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/26/2020 and was last updated on 6/16/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207P00000XEmergency MedicineME156427FLORIDANo
2207P00000XEmergency MedicineU3937TEXASNo
3207P00000XEmergency Medicine01092367AINDIANANo
4207P00000XEmergency Medicine036165712ILLINOISYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI