Paul Pedersen, | |
1701 E College Ave, Bloomington, IL 61704-2101 | |
(309) 664-3120 | |
(309) 663-5742 |
Full Name | Paul Pedersen |
---|---|
Gender | Male |
Speciality | Internal Medicine |
Experience | 47 Years |
Location | 1701 E College Ave, Bloomington, 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 |
---|---|---|---|
1053403675 | NPI | - | NPPES |
036059949 | Medicaid | IL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 036-059949 (Illinois) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Osf Home Health-eastern Region | Normal, IL | Home health agency |
St Joseph Medical Center | Bloomington, IL | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Osf Multi-specialty Group | 3678889789 | 1552 |
Entity Name | Osf Multi-specialty Group |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1922445527 PECOS PAC ID: 3678889789 Enrollment ID: O20150904000279 |
Mailing Address | Practice Location Address |
---|---|
Paul Pedersen, 1701 E College Ave, Bloomington, IL 61704-2101 Ph: (309) 664-3120 | Paul Pedersen, 1701 E College Ave, Bloomington, IL 61704-2101 Ph: (309) 664-3120 |
Dr. Venkata Ranganadh Dodda, M.D Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1505 Eastland Dr, Suite 320, Bloomington, IL 61701 Phone: 309-661-2368 | |
Kumarpal Shrishrimal, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1302 Franklin Ave, Ste 3000, Bloomington, IL 61701 Phone: 309-676-8123 Fax: 309-676-8455 | |
Mr. Kenneth Schoenig, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1228 Towanda Ave Ste 1, Bloomington, IL 61701 Phone: 309-454-5900 Fax: 309-454-2820 | |
Dr. Robert Edward Clark, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1228 Towanda Ave Ste 1, Bloomington, IL 61701 Phone: 309-454-5900 Fax: 309-454-2820 | |
Robert Bruha, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1404 Eastland Dr Ste 103, Bloomington, IL 61701 Phone: 309-676-8123 Fax: 309-676-8455 | |
Kenneth H. Inoue, Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1505 Eastland Dr, Bloomington, IL 61701 Phone: 309-661-2368 Fax: 309-662-9709 |