Dr Phillip Greene, MD | |
9515 Holy Cross Ln Ste 112, Breese, IL 62230-3618 | |
(618) 526-7271 | |
(618) 526-7313 |
Full Name | Dr Phillip Greene |
---|---|
Gender | Male |
Speciality | Family Medicine |
Location | 9515 Holy Cross Ln Ste 112, Breese, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1346248481 | NPI | - | NPPES |
08232205 | Other | IL | BLUE CROSS BLUE SHIELD |
P00351075 | Other | IL | RAIL ROAD MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 2004007494 (Missouri) | Secondary |
207Q00000X | Family Medicine | 036114809 (Illinois) | Primary |
Entity Name | Clinical Medical Services Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1497132286 PECOS PAC ID: 3375857394 Enrollment ID: O20150805006875 |
Entity Name | Superior Healthcare Physical Medicine Of West County Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1467825224 PECOS PAC ID: 6507162062 Enrollment ID: O20160309000729 |
Entity Name | Simply Health Integrated Medical Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1679175988 PECOS PAC ID: 7810309796 Enrollment ID: O20201217001600 |
Entity Name | Anodyne Of Manchester, Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1376149393 PECOS PAC ID: 4082029376 Enrollment ID: O20210218002368 |
Mailing Address | Practice Location Address |
---|---|
Dr Phillip Greene, MD 6810 State Route 162, Box 215, Maryville, IL 62062-8501 Ph: (618) 391-6405 | Dr Phillip Greene, MD 9515 Holy Cross Ln Ste 112, Breese, IL 62230-3618 Ph: (618) 526-7271 |
Roch Andre Lefebvre, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 9401 Holy Cross Ln, Suite 112, Breese, IL 62230 Phone: 618-526-7271 Fax: 618-526-7313 | |
Alex Franklin Workman, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 9401 Holy Cross Ln Ste 112, Breese, IL 62230 Phone: 618-526-7271 | |
Jonathan Vaughn Osborn, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 9401 Holy Cross Ln, Suite 112, Breese, IL 62230 Phone: 618-526-7271 Fax: 618-526-7313 | |
Timothy Manson Beaty, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 9401 Holy Cross Ln, Suite 112, Breese, IL 62230 Phone: 618-526-7271 Fax: 618-526-7313 | |
Dr. Arnel A Garcia, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 9401 Holy Cross Ln, Breese, IL 62230 Phone: 618-526-7271 Fax: 618-526-7313 |