Emilia B David-restivo, MD | |
4 Memorial Dr Ste 210, Alton, IL 62002 | |
(618) 463-0649 | |
(618) 465-3390 |
Full Name | Emilia B David-restivo |
---|---|
Gender | Female |
Speciality | Pediatrics |
Location | 4 Memorial Dr Ste 210, 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 |
---|---|---|---|
1902909492 | NPI | - | NPPES |
N6122 | Other | TX | TX LICENSE |
2006017929 | Other | MO | MO LICENSE |
036116491 | Other | IL | LICENSE NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 2006017929 (Missouri) | Secondary |
208000000X | Pediatrics | 036-116491 (Illinois) | Primary |
Entity Name | Southern Illinois Healthcare Foundation, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1013198712 PECOS PAC ID: 1456256874 Enrollment ID: O20031126000641 |
Mailing Address | Practice Location Address |
---|---|
Emilia B David-restivo, MD 4 Memorial Dr Ste 210, Alton, IL 62002-6751 Ph: (618) 463-0649 | Emilia B David-restivo, MD 4 Memorial Dr Ste 210, Alton, IL 62002 Ph: (618) 463-0649 |
Dr. Sirisak Suntharasantic, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 4 Memorial Dr Ste 210, Alton, IL 62002 Phone: 618-463-0649 Fax: 618-463-3390 | |
Dr. Shelby Ann Markel, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 4 Memorial Dr Ste 110, Alton, IL 62002 Phone: 618-474-1711 Fax: 618-462-2643 | |
Dr. Kelly J Lindsey, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1 Professional Dr, Suite 250, Alton, IL 62002 Phone: 618-463-8636 Fax: 618-463-8640 | |
Dr. John H. Giroux, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 550 Landmarks Blvd, Alton, IL 62002 Phone: 618-463-0649 Fax: 618-465-3390 | |
Mrs. Janis M. Robinson, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 4 Memorial Dr., Ste 110, Alton, IL 62002 Phone: 618-474-1711 Fax: 618-474-2793 | |
Dr. Laura Pulaski Barton, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 4 Memorial Dr., Ste 110, Alton, IL 62002 Phone: 618-474-1711 Fax: 618-474-1711 | |
Cindy L Durr, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 4 Memorial Drive, Suite 110, Alton, IL 62002 Phone: 618-474-1711 Fax: 618-474-2793 |