Amelia Mathews, | |
301 N 8th St, Suite Pav 4a, Springfield, IL 62701-1041 | |
(217) 545-8000 | |
(217) 545-0130 |
Full Name | Amelia Mathews |
---|---|
Gender | Female |
Speciality | Pediatrics |
Location | 301 N 8th St, Springfield, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1700806338 | NPI | - | NPPES |
036136695 | Medicaid | IL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 036-136695 (Illinois) | Primary |
Entity Name | Siu Physicians & Surgeons Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1558385989 PECOS PAC ID: 2365352820 Enrollment ID: O20031222000769 |
Mailing Address | Practice Location Address |
---|---|
Amelia Mathews, 301 N 8th St, Po Box 19658, Springfield, IL 62701-1041 Ph: (217) 545-8000 | Amelia Mathews, 301 N 8th St, Suite Pav 4a, Springfield, IL 62701-1041 Ph: (217) 545-8000 |
Stephanie E. Wojtowicz, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2532 Farragut Dr, Springfield, IL 62704 Phone: 217-787-9424 | |
Claudine Gillison, Pediatrics Medicare: Medicare Enrolled Practice Location: 2532 Farragut Dr, Springfield, IL 62704 Phone: 217-528-7541 | |
Gopinathan Gangadharan Nambiar, Pediatrics Medicare: Medicare Enrolled Practice Location: 2901 Old Jacksonville Rd, Springfield, IL 62704 Phone: 217-698-9722 Fax: 217-391-0392 | |
Dr. Susan M. Soler, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2532 Farragut Dr, Springfield, IL 62704 Phone: 217-787-9424 | |
Dr. Kimberly Nichole Powell, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 415 N 9th St, Suite 4w16, Springfield, IL 62702 Phone: 217-545-8000 Fax: 217-757-6654 | |
Misty M. Phillips, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2532 Farragut Dr, Springfield, IL 62704 Phone: 217-528-7541 | |
Tracy P Milbrandt, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 301 N 8th St, Springfield, IL 62701 Phone: 217-545-4238 Fax: 217-545-2303 |