Philip D Pan, MD | |
520 N 4th St, Springfield, IL 62702-5238 | |
(217) 545-8000 | |
(217) 757-8161 |
Full Name | Philip D Pan |
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Gender | Male |
Speciality | Psychiatry & Neurology - Psychiatry |
Location | 520 N 4th St, Springfield, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1548248180 | NPI | - | NPPES |
036086766 | Medicaid | IL | |
036-086766 | Other | IL | STATE LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084F0202X | Psychiatry & Neurology - Forensic Psychiatry | 036-086766 (Illinois) | Secondary |
2084P0800X | Psychiatry & Neurology - Psychiatry | 036-086766 (Illinois) | Primary |
Entity Name | Board Of Trustees Of Southern Illinois University |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1396097960 PECOS PAC ID: 4486667888 Enrollment ID: O20130424001019 |
Mailing Address | Practice Location Address |
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Philip D Pan, MD Po Box 19639, Springfield, IL 62794-9639 Ph: (217) 545-8000 | Philip D Pan, MD 520 N 4th St, Springfield, IL 62702-5238 Ph: (217) 545-8000 |
Madeleine Elizabeth Brindle, MD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 319 E Madison St Fl 3, Springfield, IL 62701 Phone: 217-545-8229 Fax: 217-545-2275 | |
Jacob Manoj Kitchener, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 421 N 9th St, Springfield, IL 62702 Phone: 217-757-6868 Fax: 177-576-8672 | |
Dr. Kripakaran M Puvalai, MD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 1124 South Sixth Street, Springfield, IL 62703 Phone: 217-523-3143 Fax: 217-523-7695 | |
Dr. Basar Cenik, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 520 N 4th St, Springfield, IL 62702 Phone: 217-545-8000 Fax: 217-747-1351 | |
Dr. Oyoyo Francess Sawyer, MD, MPH Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 319 E Madison St Fl 3, Springfield, IL 62701 Phone: 217-545-8229 Fax: 217-545-2275 | |
Dr. Abdullah Alsawaf, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 751 N Rutledge St, Suite 3100, Springfield, IL 62702 Phone: 217-545-8000 Fax: 217-545-7363 | |
James M Gilchrist, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 751 N Rutledge St, Ste 3100, Springfield, IL 62702 Phone: 217-545-8000 Fax: 217-545-7363 |