Stuart Hickerson, | |
12528 Sr 78, Havana, IL 62644-6866 | |
(309) 543-4253 | |
Not Available |
Full Name | Stuart Hickerson |
---|---|
Gender | Male |
Speciality | Emergency Medicine |
Experience | 35 Years |
Location | 12528 Sr 78, Havana, 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 |
---|---|---|---|
1073629374 | NPI | - | NPPES |
036083126 | Medicaid | IL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207PE0004X | Emergency Medicine - Emergency Medical Services | 036083126 (Illinois) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Osf Hospice - Eastern Region | Normal, IL | Hospice |
Proctor Hospital | Peoria, IL | Hospital |
Osf Saint Lukes Medical Center | Kewanee, IL | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Osf Multi-specialty Group | 3678889789 | 1552 |
Entity Name | Mcdonough County Hospital District |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1669420766 PECOS PAC ID: 0446140180 Enrollment ID: O20040611000228 |
Entity Name | Osf Healthcare System |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1679606073 PECOS PAC ID: 4284541806 Enrollment ID: O20070503000249 |
Entity Name | Epss Peoria Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1831421056 PECOS PAC ID: 1850587007 Enrollment ID: O20101130000569 |
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 |
Entity Name | Epss Llc - Central Series |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1538680467 PECOS PAC ID: 6204192016 Enrollment ID: O20171110002604 |
Mailing Address | Practice Location Address |
---|---|
Stuart Hickerson, 3333 N Seminary St, Galesburg, IL 61401-1251 Ph: () - | Stuart Hickerson, 12528 Sr 78, Havana, IL 62644-6866 Ph: (309) 543-4253 |