Kathy Ann Anderson, MD | |
2240 Gateway Dr, Sycamore, IL 60178 | |
(815) 756-8571 | |
(815) 756-1790 |
Full Name | Kathy Ann Anderson |
---|---|
Gender | Female |
Speciality | Ophthalmology |
Location | 2240 Gateway Dr, Sycamore, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1124088455 | NPI | - | NPPES |
036071921 | Medicaid | IL | |
L71596 | Other | IL | MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207W00000X | Ophthalmology | 036071921 (Illinois) | Primary |
Entity Name | Premier Eye Care & Surgery Ltd |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1306905005 PECOS PAC ID: 6305826520 Enrollment ID: O20040720001128 |
Mailing Address | Practice Location Address |
---|---|
Kathy Ann Anderson, MD 2240 Gateway Dr, Sycamore, IL 60178 Ph: (815) 756-8571 | Kathy Ann Anderson, MD 2240 Gateway Dr, Sycamore, IL 60178 Ph: (815) 756-8571 |
Dr. Raneem Rajjoub, Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 1630 Gateway Dr Ste 300, Sycamore, IL 60178 Phone: 800-243-2587 | |
Thomas Wayne Tilton, DO Ophthalmology Medicare: Not Enrolled in Medicare Practice Location: 2240 Gateway Dr, Sycamore, IL 60178 Phone: 815-756-8571 Fax: 815-756-1790 | |
Dr. Matthew Charles Johnson, M.D. Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 2240 Gateway Dr, Sycamore, IL 60178 Phone: 815-756-7136 |