Dr Stanley J Sidwell Iv, MD | |
1 Memorial Dr, Alton, IL 62002-6722 | |
(618) 463-7240 | |
(618) 463-7216 |
Full Name | Dr Stanley J Sidwell Iv |
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Gender | Male |
Speciality | Internal Medicine |
Location | 1 Memorial Dr, Alton, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1073529475 | NPI | - | NPPES |
0360634071 | Medicaid | IL |
Taxonomy | Type | License (State) | Status |
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207R00000X | Internal Medicine | R5A64 (Missouri) | Secondary |
207R00000X | Internal Medicine | 036063407 (Illinois) | Primary |
Entity Name | Illinois Hospitalists Llp |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1871832931 PECOS PAC ID: 8224275862 Enrollment ID: O20130520000092 |
Mailing Address | Practice Location Address |
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Dr Stanley J Sidwell Iv, MD 670 Mason Ridge Center Dr, Suite 300, Saint Louis, MO 63141-8573 Ph: (618) 463-7240 | Dr Stanley J Sidwell Iv, MD 1 Memorial Dr, Alton, IL 62002-6722 Ph: (618) 463-7240 |
Ibrahim B.i. Elayyan, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1 Saint Anthonys Way, Alton, IL 62002 Phone: 314-317-0600 Fax: 314-317-0606 | |
Dr. Barry Michael Mossman, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 2 Memorial Dr, Ste 220, Alton, IL 62002 Phone: 618-474-1723 Fax: 618-474-6989 | |
Dr. Matthew Austin Nations, D.O. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1 Memorial Dr, Alton, IL 62002 Phone: 618-463-7240 | |
Mr. David Robert Riedel, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 4 Memorial Dr Ste 230, Alton, IL 62002 Phone: 618-463-7874 Fax: 618-463-7846 | |
Dr. Edward B Blair Jr., M.D. Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 2 Saint Anthonys Way, Suite 205, Alton, IL 62002 Phone: 618-462-2222 Fax: 618-463-5004 | |
Dr. William Ray Bartley, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1 Professional Dr, Suite 220, Alton, IL 62002 Phone: 618-463-8626 Fax: 618-463-8688 |