| Michael Niel Fenner, MD | |
|
1600 W Walnut St, Jacksonville, IL 62650-1136 | |
| (217) 528-7541 | |
| Not Available |
| Full Name | Michael Niel Fenner |
|---|---|
| Gender | Male |
| Speciality | Surgery |
| Location | 1600 W Walnut St, Jacksonville, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578660445 | NPI | - | NPPES |
| R01571 | Other | IL | MEDICARE PTAN |
| MD3077 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | 5616 (Alaska) | Secondary |
| 208600000X | Surgery | 036080188 (Illinois) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Michael Niel Fenner, MD 1025 S 6th St, Springfield, IL 62703-2403 Ph: (217) 528-7541 | Michael Niel Fenner, MD 1600 W Walnut St, Jacksonville, IL 62650-1136 Ph: (217) 528-7541 |
Abigail S White, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 15 Founders Ln, Jacksonville, IL 62650 Phone: 217-528-7541 | |
Dr. Ladonna J Bryan, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 1600 W Walnut St, Passavant Surgical Associates, Jacksonville, IL 62650 Phone: 217-479-5821 Fax: 217-243-7406 | |
Daniel M Hallam, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 1600 W Walnut St, Jacksonville, IL 62650 Phone: 217-528-7541 Fax: 217-528-7541 | |
Dr. Charles Milton Sheaff, MD Surgery Medicare: Medicare Enrolled Practice Location: 1600 W Walnut St, East Wing 2nd Floor, Jacksonville, IL 62650 Phone: 217-479-5821 Fax: 217-243-7406 |