Mr Karl Raymond Gundersen, MD | |
2120 Madison Ave, Ste 405, Granite City, IL 62040 | |
(618) 876-0653 | |
(618) 876-0654 |
Full Name | Mr Karl Raymond Gundersen |
---|---|
Gender | Male |
Speciality | Psychiatry |
Experience | 28 Years |
Location | 2120 Madison Ave, Granite City, Illinois |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1548362775 | NPI | - | NPPES |
205739907 | Other | MO | MEDICAID |
036105102 | Medicaid | IL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | 036105102 (Illinois) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Mellow Medical Inc A Professional Corporation | 3375767403 | 31 |
Entity Name | Mellow Medical Inc A Professional Corporation |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1407275886 PECOS PAC ID: 3375767403 Enrollment ID: O20140611002222 |
Mailing Address | Practice Location Address |
---|---|
Mr Karl Raymond Gundersen, MD 2120 Madison Ave, Ste 405, Granite City, IL 62040 Ph: (618) 876-0653 | Mr Karl Raymond Gundersen, MD 2120 Madison Ave, Ste 405, Granite City, IL 62040 Ph: (618) 876-0653 |
Dr. Sarita Sharma, MD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 2166 Madison Ave, Granite City, IL 62040 Phone: 618-452-3301 | |
Dr. Arif Habib, MD Psychiatry & Neurology Medicare: May Accept Medicare Assignments Practice Location: 2120 Madison Ave, Ste 404, Granite City, IL 62040 Phone: 618-876-7515 Fax: 618-876-7596 | |
Seth Tilzer, M.D. Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 2100 Madison Ave., Gateway Regional Medical Center, Granite City, IL 62040 Phone: 618-798-3012 |