Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Johnnatan Marin, MD

Individual provider Emergency Medicine Physician · NPI 1164059259

Dr. Johnnatan Marin, MD is an Emergency Medicine in Peoria, Illinois. Graduated from George Washington University School of Medicine in 2020, 6 years ago. Practices with Professional Emergency Physicians PC, a 75-clinician group, works from 5 locations and accepts Medicare assignment. Licensed in Florida, Illinois, Indiana and Texas.

Years since qualifying
6
Trained at
George Washington University School of Medicine
Licensed in
FL, IL, IN, TX
In the registry since
2020
Specialties on file
4
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 61637-1005
Phone: (309) 655-2553
Fax: (309) 655-2602
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (4)

  • 1611 Nw 12th Ave, Miami, FL 33136-1005 — (704) 302-4621
  • 405 W Jackson St, Carbondale, IL 62901-1462 — (618) 549-0721
  • 201 S 14th St, Herrin, IL 62948-3631 — (618) 942-2171
  • 2 S Hospital Dr, Murphysboro, IL 62966-3333 — (618) 684-3156

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 036165712 (IL)
Emergency Medicine Physician Taxonomy 207P00000X · Licence ME156427 (FL)
Emergency Medicine Physician Taxonomy 207P00000X · Licence U3937 (TX)
Emergency Medicine Physician Taxonomy 207P00000X · Licence 01092367A (IN)

Record details

NPI number1164059259
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 26, 2020
Last updated in NPPESJune 16, 2025
Certification dateJune 16, 2025
Mailing address130 Nw 199th St, Miami, FL 33169-2919

Medicare enrollment

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

Medicare specialtyEMERGENCY MEDICINE
Medical schoolGEORGE WASHINGTON UNIVERSITY SCHOOL OF MEDICINE
Graduated 2020 (6 years in practice)
Group practice Professional Emergency Physicians Pc — 75 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations8 on file with Medicare

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