Dr Theodore D Fifer, MD FACS | |
14900 N Court 9, Effingham, IL 62401-7640 | |
(217) 994-6162 | |
(217) 342-7094 |
Full Name | Dr Theodore D Fifer |
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Gender | Male |
Speciality | Surgery - Plastic And Reconstructive Surgery |
Location | 14900 N Court 9, Effingham, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1508034596 | NPI | - | NPPES |
036-084136 | Medicaid | IL | |
025-00076 | Other | IL | BLUE CROSS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2082S0105X | Plastic Surgery - Surgery Of The Hand | 036084136 (Illinois) | Secondary |
2086S0122X | Surgery - Plastic And Reconstructive Surgery | 036084136 (Illinois) | Primary |
Entity Name | Illinois Department Of Human Services |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1003960394 PECOS PAC ID: 9830003920 Enrollment ID: O20031113000414 |
Mailing Address | Practice Location Address |
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Dr Theodore D Fifer, MD FACS 14900 N Court 9, Effingham, IL 62401-7640 Ph: (217) 994-6162 | Dr Theodore D Fifer, MD FACS 14900 N Court 9, Effingham, IL 62401-7640 Ph: (217) 994-6162 |
Dr. Kevin D Malone, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 1104 W Evergreen Ave, Effingham, IL 62401 Phone: 217-347-2500 Fax: 217-342-9775 | |
Lisa A Kowalski, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 300 N Maple St, Effingham, IL 62401 Phone: 217-342-4151 Fax: 217-347-3033 | |
Jason J Mcallaster, D.O. Surgery Medicare: Accepting Medicare Assignments Practice Location: 300 N Maple St, Effingham, IL 62401 Phone: 217-342-4151 Fax: 217-342-4190 | |
Dr. Patrick Kyle Stewart, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 901 Medical Park Dr Ste 100, Effingham, IL 62401 Phone: 217-347-7400 | |
Kevin A Calder, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 900 W Temple Ave, Effingham, IL 62401 Phone: 217-540-2350 | |
Dr. Mohammed Iyoob Mohammed Ilyas, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 904 Medical Park Dr Ste 2, Effingham, IL 62401 Phone: 217-347-2255 | |
Dr. Ruben D Boyajian, MD Surgery Medicare: May Accept Medicare Assignments Practice Location: 900 West Temple Avenue, Building B - Suite 2500, Effingham, IL 62401 Phone: 217-347-2255 Fax: 217-342-6910 |