| Capitol Community Health Center | |
|
2239 E Cook St Springfield IL 62703-1944 | |
| (217) 788-2300 | |
| (217) 788-2343 |
| Full Name | Capitol Community Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 2239 E Cook St, Springfield, Illinois |
| Authorized Official Name and Position | Cindy Kavanagh (ACCOUNTANT) |
| Authorized Official Contact | 2177882300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Capitol Community Health Center 2239 E Cook St Springfield IL 62703-1944 Ph: (217) 788-2300 | Capitol Community Health Center 2239 E Cook St Springfield IL 62703-1944 Ph: (217) 788-2300 |
| NPI Number | 1861480709 |
|---|---|
| Provider Enumeration Date | 10/13/2005 |
| Last Update Date | 09/02/2016 |
| Medicare PECOS PAC ID | 3274445762 |
|---|---|
| Medicare Enrollment ID | O20031106000319 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861480709 | NPI | - | NPPES |
| Provider Name | Gerard Tolentino |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1588652580 PECOS PAC ID: 8325951320 Enrollment ID: I20031106000405 |
| Provider Name | Edgard A Cumpa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497743488 PECOS PAC ID: 6204883838 Enrollment ID: I20050405001127 |
| Provider Name | Michael M Murphy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922217629 PECOS PAC ID: 8022143619 Enrollment ID: I20100322000463 |
| Provider Name | Dora B Ramos |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1265420251 PECOS PAC ID: 5799809927 Enrollment ID: I20100825000458 |
| Provider Name | Hwa Long Chen |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1104854918 PECOS PAC ID: 2668658592 Enrollment ID: I20110510000875 |
| Provider Name | Rebecca Holland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770996225 PECOS PAC ID: 5395047294 Enrollment ID: I20160125002194 |
| Provider Name | Ashley N Dyas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245680719 PECOS PAC ID: 1658664974 Enrollment ID: I20160725002082 |
| Provider Name | Lisa L Henderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801256813 PECOS PAC ID: 7113214156 Enrollment ID: I20160920000403 |
| Provider Name | Mastan Rao Indlamuri |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134561913 PECOS PAC ID: 6608147798 Enrollment ID: I20170808002841 |
| Provider Name | Alicia Altheimer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760863716 PECOS PAC ID: 8527370048 Enrollment ID: I20181113001442 |
| Provider Name | Haris Zia |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1639739600 PECOS PAC ID: 1850726274 Enrollment ID: I20200113002235 |
| Provider Name | Heather Fulhorst |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043870314 PECOS PAC ID: 6608204383 Enrollment ID: I20200311000859 |
| Provider Name | Maria Steriu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386168391 PECOS PAC ID: 3577812155 Enrollment ID: I20200811001221 |
| Provider Name | Claire Sexton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144898073 PECOS PAC ID: 6305240722 Enrollment ID: I20210806002904 |
| Provider Name | Mohit Verinder Sahni |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083276828 PECOS PAC ID: 6901287606 Enrollment ID: I20220712003627 |
| Provider Name | Michelle Stegmann |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1124777982 PECOS PAC ID: 6305220609 Enrollment ID: I20220906002630 |
| Provider Name | Ankush Katkade |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1063179919 PECOS PAC ID: 9638543002 Enrollment ID: I20230327000710 |
| Provider Name | Armyda Montoya Novoa |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1255957684 PECOS PAC ID: 0648630764 Enrollment ID: I20230720001019 |
| Provider Name | Jessica Marie Mcrill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700525391 PECOS PAC ID: 3971967712 Enrollment ID: I20230913001252 |
| Provider Name | Isabel Rose Butterfield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154035111 PECOS PAC ID: 6103280748 Enrollment ID: I20230914002187 |
| Provider Name | Melissa E Johnson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1386125060 PECOS PAC ID: 3870035637 Enrollment ID: I20240607001355 |
| Provider Name | Teresa Rogers |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1568950814 PECOS PAC ID: 1658723077 Enrollment ID: I20240613002832 |
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