Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Jacob Alexander Reshetar, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1780326652

Dr. Jacob Alexander Reshetar, MD is an Emergency Medicine in Peoria, Illinois. Qualified in 2022, 4 years ago. Practices with Emergency Group of Arizona Professional Corporation, a 98-clinician group and accepts Medicare assignment. Licensed in Arizona and Illinois.

Years since qualifying
4
Licensed in
AZ, IL
In the registry since
2022
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone: (309) 655-2000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 74729 (AZ)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X (IL)

Record details

NPI number1780326652
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 11, 2022
Last updated in NPPESMarch 17, 2026
Certification dateMarch 17, 2026
Mailing address530 Ne Glen Oak Ave, Peoria, IL 61637-0001

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyEMERGENCY MEDICINE
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Emergency Group Of Arizona Professional Corporation — 98 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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