Dr Thaddeus Manczko, MD | |
350 N Wall St, Kankakee, IL 60901-2901 | |
(815) 933-1671 | |
Not Available |
Full Name | Dr Thaddeus Manczko |
---|---|
Gender | Male |
Speciality | Emergency Medicine - Emergency Medical Services |
Location | 350 N Wall St, Kankakee, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1073553004 | NPI | - | NPPES |
036100560-7 | Medicaid | IL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207PE0004X | Emergency Medicine - Emergency Medical Services | 036-100560 (Illinois) | Primary |
Entity Name | Travis County Emergency Physicians Pa |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1962440933 PECOS PAC ID: 0840289468 Enrollment ID: O20040510000492 |
Mailing Address | Practice Location Address |
---|---|
Dr Thaddeus Manczko, MD 2000 Green Rd, Suite 300, Ann Arbor, MI 48105-1598 Ph: (734) 995-3764 | Dr Thaddeus Manczko, MD 350 N Wall St, Kankakee, IL 60901-2901 Ph: (815) 933-1671 |
Dr. Renee Lori Peksa-sink, D.O. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 350 N Wall St, Kankakee, IL 60901 Phone: 815-935-7500 | |
Dr. Vernell Johnson Iii, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 500 W Court St, Kankakee, IL 60901 Phone: 815-937-2100 | |
Steven Decker, D.O. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 350 N Wall St, Kankakee, IL 60901 Phone: 815-933-1671 | |
Dr. Brian Crowley, D.O. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 500 W Court St, Kankakee, IL 60901 Phone: 815-937-2100 | |
John Lacheta, DO Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 350 N Wall St, Kankakee, IL 60901 Phone: 815-933-1671 | |
Timothy Moran, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 500 W Court St, Kankakee, IL 60901 Phone: 815-937-2100 |