| Cgh Medical Center | |
|
100 E Le Fevre Rd Sterling IL 61081-1278 | |
| (815) 625-0400 | |
| (815) 625-2747 |
| Full Name | Cgh Medical Center |
|---|---|
| Speciality | General Acute Care Hospital |
| Location | 100 E Le Fevre Rd, Sterling, Illinois |
| Authorized Official Name and Position | Paul A Steinke (CEO) |
| Authorized Official Contact | 8156250400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cgh Medical Center 100 E Le Fevre Rd Sterling IL 61081-1278 Ph: (815) 625-0400 | Cgh Medical Center 100 E Le Fevre Rd Sterling IL 61081-1278 Ph: (815) 625-0400 |
| NPI Number | 1902854623 |
|---|---|
| Provider Enumeration Date | 05/05/2006 |
| Last Update Date | 08/13/2024 |
| Certification Date | 08/13/2024 |
| Medicare PECOS PAC ID | 6103723267 |
|---|---|
| Medicare Enrollment ID | O20031217000054 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902854623 | NPI | - | NPPES |
| L011619 | Other | TRICARE | |
| CE7487 | Other | IL | RAILROAD MEDICARE |
| IL0101 | Other | IL | JOHN DEERE |
| Provider Name | Atul Sheth |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942392212 PECOS PAC ID: 4284530288 Enrollment ID: I20031210000622 |
| Provider Name | David F Kavanaugh |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1437176070 PECOS PAC ID: 8921904871 Enrollment ID: I20031212000171 |
| Provider Name | David C Hulsey |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1316992969 PECOS PAC ID: 8426955667 Enrollment ID: I20031216000809 |
| Provider Name | Marc J Ovadia |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1356342398 PECOS PAC ID: 5597660902 Enrollment ID: I20031217000573 |
| Provider Name | Rafat R Padaria |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1497734388 PECOS PAC ID: 7911809488 Enrollment ID: I20040123001056 |
| Provider Name | Mark W Kovach |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1336128222 PECOS PAC ID: 1850293366 Enrollment ID: I20040124000148 |
| Provider Name | Jane L Kotecki |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1760451793 PECOS PAC ID: 4789578774 Enrollment ID: I20040211000152 |
| Provider Name | Abraham H Steinberg |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1285628305 PECOS PAC ID: 2264429059 Enrollment ID: I20040426000813 |
| Provider Name | Kim M Treviranus |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1225118128 PECOS PAC ID: 1456333582 Enrollment ID: I20040603000106 |
| Provider Name | John A Strom |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1184714149 PECOS PAC ID: 1254313141 Enrollment ID: I20040603001305 |
| Provider Name | Danish Haque |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1336193093 PECOS PAC ID: 0446235410 Enrollment ID: I20040623000385 |
| Provider Name | Jason A Reter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902856859 PECOS PAC ID: 7416933650 Enrollment ID: I20040628000858 |
| Provider Name | Eric Kuhns |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699725549 PECOS PAC ID: 8820074073 Enrollment ID: I20040628000897 |
| Provider Name | Marcia Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114977063 PECOS PAC ID: 9234115486 Enrollment ID: I20040628000919 |
| Provider Name | Henry S Oh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225088172 PECOS PAC ID: 8123004397 Enrollment ID: I20040628001086 |
| Provider Name | Juan M Ibarra |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1891817565 PECOS PAC ID: 5193718245 Enrollment ID: I20040629000674 |
| Provider Name | Robert Alan June |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1871528059 PECOS PAC ID: 5597738179 Enrollment ID: I20040813000228 |
| Provider Name | Jennifer L Roberts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386851160 PECOS PAC ID: 5991770877 Enrollment ID: I20040902000219 |
| Provider Name | David S West |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1790714285 PECOS PAC ID: 1557339041 Enrollment ID: I20040922000706 |
| Provider Name | Todd H Chaffin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1053421230 PECOS PAC ID: 9537073978 Enrollment ID: I20040922001160 |
| Provider Name | Robert P Pode |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1982677597 PECOS PAC ID: 4587632740 Enrollment ID: I20040924000332 |
| Provider Name | Maurice L Binns |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1467450684 PECOS PAC ID: 1658340617 Enrollment ID: I20040928000229 |
| Provider Name | Steven R Turner |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1235187378 PECOS PAC ID: 4587631759 Enrollment ID: I20040930000178 |
| Provider Name | Aswartha R Pothula |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1497734396 PECOS PAC ID: 5698739985 Enrollment ID: I20041206000419 |
| Provider Name | Faraz M Manazir |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1104805092 PECOS PAC ID: 6901860246 Enrollment ID: I20041206000452 |
| Provider Name | Nancy Hang Tran |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457393209 PECOS PAC ID: 1456317627 Enrollment ID: I20041209000071 |
| Provider Name | Joshua J Wade |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1386724235 PECOS PAC ID: 3375509425 Enrollment ID: I20041209000652 |
| Provider Name | Virginia Heal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346292034 PECOS PAC ID: 8729036520 Enrollment ID: I20050108000040 |
| Provider Name | Ayman S Alzubi |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1306843339 PECOS PAC ID: 1850349499 Enrollment ID: I20050110001050 |
| Provider Name | Angel R Blazquez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245280155 PECOS PAC ID: 7214986249 Enrollment ID: I20050118000300 |
| Provider Name | Dmitry Sukenik |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1811985443 PECOS PAC ID: 9638129836 Enrollment ID: I20050126000042 |
| Provider Name | Daniel Knight |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1932124997 PECOS PAC ID: 9739178005 Enrollment ID: I20050207000775 |
| Provider Name | Abdullah Altayeh |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1831191584 PECOS PAC ID: 0345284030 Enrollment ID: I20050614000476 |
| Provider Name | Mir A Alikhan |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1225127863 PECOS PAC ID: 1153366406 Enrollment ID: I20050627000997 |
| Provider Name | Govind N Ramadurai |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1184673089 PECOS PAC ID: 5496782864 Enrollment ID: I20050722000145 |
| Provider Name | Maxime A Gilles |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1093762494 PECOS PAC ID: 6901834423 Enrollment ID: I20050727000168 |
| Provider Name | Dirk De Haas |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1568578250 PECOS PAC ID: 3072407022 Enrollment ID: I20050801000013 |
| Provider Name | Robert Sharpe |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588631329 PECOS PAC ID: 9234168139 Enrollment ID: I20050811000083 |
| Provider Name | Paul Steinke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548359656 PECOS PAC ID: 3678543774 Enrollment ID: I20050916000841 |
| Provider Name | Vincent J Racanelli |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730299926 PECOS PAC ID: 7618901547 Enrollment ID: I20050921000118 |
| Provider Name | Marc A Stees |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1356430458 PECOS PAC ID: 7911932330 Enrollment ID: I20051004000738 |
| Provider Name | Syed M Husain |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1619998119 PECOS PAC ID: 5294751798 Enrollment ID: I20051024000143 |
| Provider Name | Argyro Sylvia Hatseras |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1194791871 PECOS PAC ID: 1850315045 Enrollment ID: I20060113000691 |
| Provider Name | Binoy Kamal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295805174 PECOS PAC ID: 5799793212 Enrollment ID: I20060324000569 |
| Provider Name | Danca Luchici |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376553743 PECOS PAC ID: 2567356868 Enrollment ID: I20060407000206 |
| Provider Name | Naseer H Nasser |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1063436582 PECOS PAC ID: 7315956562 Enrollment ID: I20060417000222 |
| Provider Name | Mathai S Karingada |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831125988 PECOS PAC ID: 7618971045 Enrollment ID: I20060828000041 |
| Provider Name | Azra M Ali |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700804028 PECOS PAC ID: 3678577020 Enrollment ID: I20060828000160 |
| Provider Name | Vinod Alluri |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548279870 PECOS PAC ID: 1254336357 Enrollment ID: I20060925000093 |
| Provider Name | Edmund P Coyne |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1114906138 PECOS PAC ID: 4587566047 Enrollment ID: I20061017000544 |
| Provider Name | Vijayaraghavan R Rajendran |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1679552517 PECOS PAC ID: 5395742886 Enrollment ID: I20061025000603 |
| Provider Name | Kathleen J Keyes |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1316926264 PECOS PAC ID: 9830198670 Enrollment ID: I20061205000579 |
| Provider Name | James Erl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982787289 PECOS PAC ID: 9830291657 Enrollment ID: I20070226000553 |
| Provider Name | Tracey Aude |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487734448 PECOS PAC ID: 5092817452 Enrollment ID: I20070305000018 |
| Provider Name | Anupama Upadhyay |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467407890 PECOS PAC ID: 3173576709 Enrollment ID: I20070411000199 |
| Provider Name | Kimberly A Wolfe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376695122 PECOS PAC ID: 1557467230 Enrollment ID: I20070427000045 |
| Provider Name | Meredith Jeanne Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154419778 PECOS PAC ID: 3274631833 Enrollment ID: I20070605000298 |
| Provider Name | Wael Mazen Abdo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740284074 PECOS PAC ID: 8628963394 Enrollment ID: I20070615000462 |
| Provider Name | Sarah T Heeren |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1205924099 PECOS PAC ID: 6507965472 Enrollment ID: I20070619000416 |
| Provider Name | Julie M Zuidema |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1245312701 PECOS PAC ID: 1557460029 Enrollment ID: I20070625000150 |
| Provider Name | Muhammad Azharuddin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851490460 PECOS PAC ID: 4587631353 Enrollment ID: I20070703000178 |
| Provider Name | Curtis H Coyle |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1700974359 PECOS PAC ID: 9335249283 Enrollment ID: I20070709000047 |
| Provider Name | Matthew B Cutter |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1972693067 PECOS PAC ID: 9638279581 Enrollment ID: I20070709000109 |
| Provider Name | Concha Sitter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629167713 PECOS PAC ID: 4688774011 Enrollment ID: I20070713000292 |
| Provider Name | Karen A Habben |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1003998576 PECOS PAC ID: 0446350821 Enrollment ID: I20070713000732 |
| Provider Name | Phong D Dang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447394465 PECOS PAC ID: 7719087121 Enrollment ID: I20070714000186 |
| Provider Name | Cynthia J Wadsworth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447330311 PECOS PAC ID: 8921108218 Enrollment ID: I20070716000624 |
| Provider Name | Tyler Gilbert Gunderson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1477765014 PECOS PAC ID: 7012018807 Enrollment ID: I20070724000171 |
| Provider Name | Polly A Nobis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063500304 PECOS PAC ID: 0345341947 Enrollment ID: I20070726000583 |
| Provider Name | Laurie A Zollinger |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1992887947 PECOS PAC ID: 0840381133 Enrollment ID: I20070731000603 |
| Provider Name | Jeffrey A Dyke |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1316029879 PECOS PAC ID: 8820180318 Enrollment ID: I20070829000217 |
| Provider Name | Preethi Donakonda |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376559161 PECOS PAC ID: 2163519703 Enrollment ID: I20071030000384 |
| Provider Name | Bryan J Kemker |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1366439390 PECOS PAC ID: 1557449139 Enrollment ID: I20080422000930 |
| Provider Name | Keith R Martin |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1801007190 PECOS PAC ID: 6406768829 Enrollment ID: I20080521000797 |
| Provider Name | Sara E Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649471434 PECOS PAC ID: 6709956303 Enrollment ID: I20080609000756 |
| Provider Name | Vasantha L Gona |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114983798 PECOS PAC ID: 7214939834 Enrollment ID: I20080710000728 |
| Provider Name | Edward P Hanlon |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1255538153 PECOS PAC ID: 7214003375 Enrollment ID: I20080915000136 |
| Provider Name | Mark F Buettner |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1861474421 PECOS PAC ID: 9931293271 Enrollment ID: I20081111000779 |
| Provider Name | Sathish Kumar Cullath Harikrishnan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861421869 PECOS PAC ID: 1355348087 Enrollment ID: I20090110000210 |
| Provider Name | Eyas A Youssef |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1487774642 PECOS PAC ID: 4880791805 Enrollment ID: I20090420000549 |
| Provider Name | Jennifer L Sangston |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1851301683 PECOS PAC ID: 8426107954 Enrollment ID: I20090512000616 |
| Provider Name | Rajbir K Dhillon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871615096 PECOS PAC ID: 2163572066 Enrollment ID: I20090616000302 |
| Provider Name | Eric K Riley |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1396922639 PECOS PAC ID: 5799836011 Enrollment ID: I20090626000488 |
| Provider Name | Ryan C Enke |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1053320317 PECOS PAC ID: 2567466550 Enrollment ID: I20090702000361 |
| Provider Name | Keith L Pham |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1700058344 PECOS PAC ID: 7315012259 Enrollment ID: I20090727000486 |
| Provider Name | Mirza Omer M Baig |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285720490 PECOS PAC ID: 2668471715 Enrollment ID: I20090805000141 |
| Provider Name | John J Luckey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629230768 PECOS PAC ID: 0042363111 Enrollment ID: I20090806000693 |
| Provider Name | Crystal L Snider |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700098845 PECOS PAC ID: 5496807018 Enrollment ID: I20090807000498 |
| Provider Name | Daniel E Vera |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1851476212 PECOS PAC ID: 7517013238 Enrollment ID: I20090922000583 |
| Provider Name | Michael Joseph Bommarito |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1235150939 PECOS PAC ID: 5799785283 Enrollment ID: I20091021000351 |
| Provider Name | Brian Olshansky |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962483347 PECOS PAC ID: 2062552110 Enrollment ID: I20091221000486 |
| Provider Name | Sharma Saith |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1225013683 PECOS PAC ID: 9335051077 Enrollment ID: I20100127000252 |
| Provider Name | Carrie A Menet |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1821323585 PECOS PAC ID: 6709921364 Enrollment ID: I20100306000373 |
| Provider Name | Hassan A Kieso |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407812050 PECOS PAC ID: 0244360576 Enrollment ID: I20100614000453 |
| Provider Name | John M Hahn |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1548260961 PECOS PAC ID: 6406806140 Enrollment ID: I20100730000548 |
| Provider Name | Jeffrey P Lemay |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1588752877 PECOS PAC ID: 0941113575 Enrollment ID: I20100902000785 |
| Provider Name | Frank E Tugwell |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1780764696 PECOS PAC ID: 9436273083 Enrollment ID: I20100902000912 |
| Provider Name | Iyad A Jundi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518055144 PECOS PAC ID: 9032233622 Enrollment ID: I20100903000173 |
| Provider Name | William Gardiner Bird |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952490062 PECOS PAC ID: 7810800448 Enrollment ID: I20100903000222 |
| Provider Name | Shawn P Hanlon |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1194813972 PECOS PAC ID: 3870617483 Enrollment ID: I20100903000399 |
| Provider Name | Robert A Whittaker |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1821178617 PECOS PAC ID: 1951425487 Enrollment ID: I20100903000785 |
| Provider Name | Peter P Toth |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861572869 PECOS PAC ID: 6709785744 Enrollment ID: I20100913001112 |
| Provider Name | Chester R Delacruz |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1477643567 PECOS PAC ID: 9133245384 Enrollment ID: I20100925000118 |
| Provider Name | Eric Gale |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093802944 PECOS PAC ID: 2860685369 Enrollment ID: I20101015001079 |
| Provider Name | Suman Gopal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174612238 PECOS PAC ID: 5597870345 Enrollment ID: I20101015001274 |
| Provider Name | Susan R Provow |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861580128 PECOS PAC ID: 5890803928 Enrollment ID: I20101019000956 |
| Provider Name | Jorge Monteagudo |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1891877817 PECOS PAC ID: 7719188622 Enrollment ID: I20101019001187 |
| Provider Name | Eric Paul Schaffert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306004247 PECOS PAC ID: 9537214929 Enrollment ID: I20101020001246 |
| Provider Name | Richard M Styczynski |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245329366 PECOS PAC ID: 4385725050 Enrollment ID: I20101026000168 |
| Provider Name | Beatrice Marie Correa |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1487838546 PECOS PAC ID: 2961696133 Enrollment ID: I20101101001555 |
| Provider Name | Matthew Kevin Nickerson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1609918218 PECOS PAC ID: 9638367915 Enrollment ID: I20101230000955 |
| Provider Name | Barbara E Tieman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386612133 PECOS PAC ID: 7719176700 Enrollment ID: I20110106000236 |
| Provider Name | George Tzelepis |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1497769558 PECOS PAC ID: 9436156924 Enrollment ID: I20110210000290 |
| Provider Name | Kyung Yoo |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1992946511 PECOS PAC ID: 6507919479 Enrollment ID: I20110811000223 |
| Provider Name | Gregory Goska |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376790071 PECOS PAC ID: 8628248812 Enrollment ID: I20110825000424 |
| Provider Name | Laurel Kietzman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1336331222 PECOS PAC ID: 7214108273 Enrollment ID: I20110922000662 |
| Provider Name | Donna J Cook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083992499 PECOS PAC ID: 4284808189 Enrollment ID: I20111110000390 |
| Provider Name | David S Almasy |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1285833707 PECOS PAC ID: 3678657103 Enrollment ID: I20111206000805 |
| Provider Name | Cordus Easington |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912169822 PECOS PAC ID: 9335320688 Enrollment ID: I20120307000830 |
| Provider Name | Rajiv Mallik |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1285806935 PECOS PAC ID: 3274694526 Enrollment ID: I20120504000576 |
| Provider Name | Ajay Kumar Varma Buddaraju |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1548247448 PECOS PAC ID: 3577639137 Enrollment ID: I20120706000500 |
| Provider Name | Samuel L Johnston |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1184832271 PECOS PAC ID: 8527182245 Enrollment ID: I20120921000334 |
| Provider Name | Ryan N Chellin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1952536104 PECOS PAC ID: 2365691540 Enrollment ID: I20121003000374 |
| Provider Name | Khanh L Nguyen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1174677975 PECOS PAC ID: 0345332979 Enrollment ID: I20121019000386 |
| Provider Name | Tareq Zaza |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1447287412 PECOS PAC ID: 9638320443 Enrollment ID: I20121102000408 |
| Provider Name | Geoffrey N Wright |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1306195458 PECOS PAC ID: 5294987103 Enrollment ID: I20121128000434 |
| Provider Name | Heather A Wakefield |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1972700789 PECOS PAC ID: 0345492518 Enrollment ID: I20121214000469 |
| Provider Name | Nicholas Ree |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1164644845 PECOS PAC ID: 8820241920 Enrollment ID: I20130130000169 |
| Provider Name | Brian D Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043585573 PECOS PAC ID: 8123272853 Enrollment ID: I20130206000051 |
| Provider Name | Steven C Kim |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1750331195 PECOS PAC ID: 2365485588 Enrollment ID: I20130219000228 |
| Provider Name | Wendy S Burke |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1033454244 PECOS PAC ID: 9032356233 Enrollment ID: I20130507000568 |
| Provider Name | Eyad Karzoun |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1649470196 PECOS PAC ID: 2466693403 Enrollment ID: I20130802000270 |
| Provider Name | Young Song |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1679712640 PECOS PAC ID: 7911149869 Enrollment ID: I20130806000638 |
| Provider Name | Thomas C Isaacson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104884311 PECOS PAC ID: 9335156462 Enrollment ID: I20130816000537 |
| Provider Name | Steven T Singh |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1629232699 PECOS PAC ID: 2365676673 Enrollment ID: I20130927000372 |
| Provider Name | Tabassum Y Nafsi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396931069 PECOS PAC ID: 3577797901 Enrollment ID: I20131017001683 |
| Provider Name | Kristine M Morland-schultz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922383280 PECOS PAC ID: 8325272768 Enrollment ID: I20131017001924 |
| Provider Name | Navneesh Sharma |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1922319805 PECOS PAC ID: 6709010176 Enrollment ID: I20131022000452 |
| Provider Name | Whittney J Zumdahl |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1346438306 PECOS PAC ID: 9931335577 Enrollment ID: I20131204000137 |
| Provider Name | Lynne M Coffey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316214182 PECOS PAC ID: 7517194152 Enrollment ID: I20131205001657 |
| Provider Name | Melissa J Armstrong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194150862 PECOS PAC ID: 4789811092 Enrollment ID: I20131212000559 |
| Provider Name | Jessica D White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689002313 PECOS PAC ID: 2365679248 Enrollment ID: I20131223000117 |
| Provider Name | Eliona A Corrigan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1154639979 PECOS PAC ID: 8022248855 Enrollment ID: I20140224000268 |
| Provider Name | Stephanie R Ernst |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902236953 PECOS PAC ID: 3577795475 Enrollment ID: I20140408001001 |
| Provider Name | Khawaja Rahman |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1508865239 PECOS PAC ID: 7214980218 Enrollment ID: I20140602002095 |
| Provider Name | Stephanie A Woodfall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609294297 PECOS PAC ID: 0244454189 Enrollment ID: I20140614000000 |
| Provider Name | Fahad M Iqbal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285848291 PECOS PAC ID: 1759438963 Enrollment ID: I20140616001505 |
| Provider Name | Brian P Cone |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1578859328 PECOS PAC ID: 7113153354 Enrollment ID: I20140618001248 |
| Provider Name | Ashok K Maini |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1184910325 PECOS PAC ID: 6901023779 Enrollment ID: I20140819001476 |
| Provider Name | Thomas F King |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1649456211 PECOS PAC ID: 3072754720 Enrollment ID: I20140916000505 |
| Provider Name | Amanda L Foit |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023426475 PECOS PAC ID: 9931327251 Enrollment ID: I20141023000327 |
| Provider Name | Anna Bida-dudun |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1669444782 PECOS PAC ID: 8022098599 Enrollment ID: I20141107000233 |
| Provider Name | Lorri J Mostad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427461540 PECOS PAC ID: 1951523851 Enrollment ID: I20141110000499 |
| Provider Name | Mia B Mcdermott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609272533 PECOS PAC ID: 0749502474 Enrollment ID: I20141208000231 |
| Provider Name | Norma E Alvarado-urrutia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003216052 PECOS PAC ID: 2668794330 Enrollment ID: I20141208001534 |
| Provider Name | Kirsten L Harn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609272491 PECOS PAC ID: 9335462266 Enrollment ID: I20141230001419 |
| Provider Name | Shannon M Scroggins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447657689 PECOS PAC ID: 2668795329 Enrollment ID: I20150105000390 |
| Provider Name | Kevin Rogers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831595701 PECOS PAC ID: 2567787955 Enrollment ID: I20150205001666 |
| Provider Name | Tracy L Binius |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194049676 PECOS PAC ID: 1557687480 Enrollment ID: I20150311001465 |
| Provider Name | Aja Maia Murphy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467604942 PECOS PAC ID: 0648444018 Enrollment ID: I20150403000879 |
| Provider Name | Cassie L Wiersema |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194127977 PECOS PAC ID: 7618295403 Enrollment ID: I20150407000759 |
| Provider Name | Yevgeny Bulbin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1437384047 PECOS PAC ID: 1557519345 Enrollment ID: I20150423001630 |
| Provider Name | Liang Ge |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1891087508 PECOS PAC ID: 3274759568 Enrollment ID: I20150701001078 |
| Provider Name | Lindsay R Wohrley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326432782 PECOS PAC ID: 1557674348 Enrollment ID: I20150722006304 |
| Provider Name | Bharat N Raju |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720217581 PECOS PAC ID: 9830346477 Enrollment ID: I20150910000175 |
| Provider Name | Kalpesh A Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225322068 PECOS PAC ID: 8224251673 Enrollment ID: I20150923001762 |
| Provider Name | Drew Carroll |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1144696113 PECOS PAC ID: 7911215868 Enrollment ID: I20150928000072 |
| Provider Name | Melissa A Duncan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770959504 PECOS PAC ID: 2466761325 Enrollment ID: I20151016001096 |
| Provider Name | Evan Ray Skinner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265801393 PECOS PAC ID: 1254640840 Enrollment ID: I20151022000009 |
| Provider Name | Maher N Younes |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1326249715 PECOS PAC ID: 8224284237 Enrollment ID: I20160404001051 |
| Provider Name | Manoj Sreedharan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1427499441 PECOS PAC ID: 0244462463 Enrollment ID: I20160601001489 |
| Provider Name | Carl Pavel |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1326067950 PECOS PAC ID: 9133359615 Enrollment ID: I20160623001941 |
| Provider Name | Jeffrey Robert Thormeyer |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1043421274 PECOS PAC ID: 8921245622 Enrollment ID: I20160829001065 |
| Provider Name | Matthew J Wolf |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902246820 PECOS PAC ID: 2264675487 Enrollment ID: I20160912000454 |
| Provider Name | Suraj Bopanna |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1740433291 PECOS PAC ID: 9436390325 Enrollment ID: I20161005000384 |
| Provider Name | Srikanth Reddy Kasula |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1497080709 PECOS PAC ID: 9537453725 Enrollment ID: I20161215002215 |
| Provider Name | Tushar Murli Advani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881918415 PECOS PAC ID: 9739461484 Enrollment ID: I20170113000145 |
| Provider Name | Ismaila Bello |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1679803274 PECOS PAC ID: 8325360449 Enrollment ID: I20170123000328 |
| Provider Name | Jennifer M Garriott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487106597 PECOS PAC ID: 6507149374 Enrollment ID: I20170202000733 |
| Provider Name | Aamir I Malik |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1396757928 PECOS PAC ID: 7911916762 Enrollment ID: I20170322002143 |
| Provider Name | Toni L Ikens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477091726 PECOS PAC ID: 2365727872 Enrollment ID: I20170324001214 |
| Provider Name | Lyndi K Lemay |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1467990408 PECOS PAC ID: 3476839846 Enrollment ID: I20170419001888 |
| Provider Name | Melissa Kay Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942744495 PECOS PAC ID: 9638456007 Enrollment ID: I20170512000737 |
| Provider Name | Julie A Wardell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699207985 PECOS PAC ID: 1759658420 Enrollment ID: I20170531000403 |
| Provider Name | Hasan Al Janabi |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1255530119 PECOS PAC ID: 8426228008 Enrollment ID: I20170705001400 |
| Provider Name | Trevan M Burn |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1306362439 PECOS PAC ID: 2062787682 Enrollment ID: I20171009000741 |
| Provider Name | Allison N Loggins |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1356869234 PECOS PAC ID: 8628344876 Enrollment ID: I20171017000075 |
| Provider Name | Ashlea L Canady |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1730443193 PECOS PAC ID: 6608197140 Enrollment ID: I20171019002746 |
| Provider Name | Tal Pollak |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770831158 PECOS PAC ID: 9234370982 Enrollment ID: I20171102003619 |
| Provider Name | Angela M Stralow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871011635 PECOS PAC ID: 2062778129 Enrollment ID: I20171107001124 |
| Provider Name | Allison J Yemm |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1932613148 PECOS PAC ID: 2961761440 Enrollment ID: I20180108001549 |
| Provider Name | Staci L Dirks |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1962801597 PECOS PAC ID: 4981963956 Enrollment ID: I20180119001241 |
| Provider Name | Courtney A Mohr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992200018 PECOS PAC ID: 8921355991 Enrollment ID: I20180721000052 |
| Provider Name | Tina M Frank |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356846901 PECOS PAC ID: 9234488388 Enrollment ID: I20180822002042 |
| Provider Name | Farzan Eskandari |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1366685794 PECOS PAC ID: 2365666021 Enrollment ID: I20180823001168 |
| Provider Name | Jerry Wayne Catt |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1285991299 PECOS PAC ID: 7315255056 Enrollment ID: I20181001001130 |
| Provider Name | Brianne E Hamstra |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1164871786 PECOS PAC ID: 2466704325 Enrollment ID: I20181004001812 |
| Provider Name | Lauren E Cecchetti |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629553888 PECOS PAC ID: 0345593976 Enrollment ID: I20181030000591 |
| Provider Name | Obrad S Kokanovic |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1528358660 PECOS PAC ID: 7012173529 Enrollment ID: I20181107000631 |
| Provider Name | Marissa Stridiron |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154635811 PECOS PAC ID: 2668664251 Enrollment ID: I20181113000644 |
| Provider Name | Mark Alter |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1730263617 PECOS PAC ID: 5991855330 Enrollment ID: I20181113000752 |
| Provider Name | Christopher R Richards |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1952631715 PECOS PAC ID: 0648401927 Enrollment ID: I20181113000932 |
| Provider Name | Elton J Smith |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679526784 PECOS PAC ID: 1759487614 Enrollment ID: I20181113001187 |
| Provider Name | Rhonda R Lampen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1760412621 PECOS PAC ID: 2163477308 Enrollment ID: I20181113001463 |
| Provider Name | Suraya Kawadry |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336431667 PECOS PAC ID: 4284938358 Enrollment ID: I20181113001808 |
| Provider Name | Douglas M Ikelheimer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508979519 PECOS PAC ID: 1759347396 Enrollment ID: I20181113001982 |
| Provider Name | Nelly Norrell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881897486 PECOS PAC ID: 2668633033 Enrollment ID: I20181113002966 |
| Provider Name | Dugan C Repass |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1255813721 PECOS PAC ID: 8527312081 Enrollment ID: I20181120000121 |
| Provider Name | Shawna E Kester |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1083196307 PECOS PAC ID: 2567716038 Enrollment ID: I20181120000514 |
| Provider Name | Teresa A Stout |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285979336 PECOS PAC ID: 2264786508 Enrollment ID: I20181126001985 |
| Provider Name | Pamela A Capp |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1730261298 PECOS PAC ID: 2062757875 Enrollment ID: I20181226001439 |
| Provider Name | Jackie Greve |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902370703 PECOS PAC ID: 2567701212 Enrollment ID: I20190225002455 |
| Provider Name | Theresa A Rogers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770055881 PECOS PAC ID: 6103165089 Enrollment ID: I20190312001268 |
| Provider Name | Debra H Bowman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1861605990 PECOS PAC ID: 9638232564 Enrollment ID: I20190409002203 |
| Provider Name | Laurie A Buckman |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1013473305 PECOS PAC ID: 0941542740 Enrollment ID: I20190426001296 |
| Provider Name | Jennifer L Adamson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1174080758 PECOS PAC ID: 0941542567 Enrollment ID: I20190501002043 |
| Provider Name | Susan M Burnette |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730658147 PECOS PAC ID: 9133461510 Enrollment ID: I20190506000448 |
| Provider Name | Linsey N Mcbride |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1124585716 PECOS PAC ID: 6002158482 Enrollment ID: I20190506000656 |
| Provider Name | Rebecca L Vos |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1508323197 PECOS PAC ID: 8921340332 Enrollment ID: I20190506001791 |
| Provider Name | Nathan C Ackert |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1063970051 PECOS PAC ID: 5991047219 Enrollment ID: I20190506002521 |
| Provider Name | Erika L Stach |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295296838 PECOS PAC ID: 8022341999 Enrollment ID: I20190607001042 |
| Provider Name | Sammi Dali |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1407825722 PECOS PAC ID: 5092793505 Enrollment ID: I20190701000262 |
| Provider Name | Nicholas Otten |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013277714 PECOS PAC ID: 2264651108 Enrollment ID: I20190708001553 |
| Provider Name | Preeti M Joseph |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1730229121 PECOS PAC ID: 5597832394 Enrollment ID: I20190716000135 |
| Provider Name | Michael N Daley |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1992159206 PECOS PAC ID: 4981997707 Enrollment ID: I20190729000241 |
| Provider Name | Mahubah Abdallah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841752284 PECOS PAC ID: 7517295603 Enrollment ID: I20190828000708 |
| Provider Name | Morgan L Rivera |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1417476375 PECOS PAC ID: 8527397975 Enrollment ID: I20190910001466 |
| Provider Name | Ahmed Faraz Siddiqui |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235584541 PECOS PAC ID: 5092044198 Enrollment ID: I20190916002577 |
| Provider Name | Edita A Danaiata |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003389503 PECOS PAC ID: 1355670456 Enrollment ID: I20190916002592 |
| Provider Name | Garrett William Fleming |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1255606430 PECOS PAC ID: 7214208594 Enrollment ID: I20191002002548 |
| Provider Name | Amanda C Dawson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508329871 PECOS PAC ID: 7810229739 Enrollment ID: I20191025002524 |
| Provider Name | Kelli J Jepson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437706876 PECOS PAC ID: 0648502427 Enrollment ID: I20191028002401 |
| Provider Name | Morgan A Jacobs |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1497306302 PECOS PAC ID: 4486086022 Enrollment ID: I20191119003265 |
| Provider Name | Danielle M Saunders |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477196723 PECOS PAC ID: 2567890130 Enrollment ID: I20200313000034 |
| Provider Name | Lindsay M Rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780231134 PECOS PAC ID: 1254769805 Enrollment ID: I20200316000139 |
| Provider Name | Maria C Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508497660 PECOS PAC ID: 8921437641 Enrollment ID: I20200401001077 |
| Provider Name | Bao L Dang |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1740502509 PECOS PAC ID: 2567628779 Enrollment ID: I20200428000363 |
| Provider Name | Ahmed Muhammad S Ghadai |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1447504402 PECOS PAC ID: 1254573884 Enrollment ID: I20200626000748 |
| Provider Name | Syed M Imam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699202408 PECOS PAC ID: 8527339514 Enrollment ID: I20200807000711 |
| Provider Name | Jaziel Chavira |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114535903 PECOS PAC ID: 8426477241 Enrollment ID: I20200929000796 |
| Provider Name | Anja D Wolf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083238299 PECOS PAC ID: 4880004423 Enrollment ID: I20201110001098 |
| Provider Name | Kathryn Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073138467 PECOS PAC ID: 1658785621 Enrollment ID: I20210203000023 |
| Provider Name | Junaid Sa Malik |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1598859852 PECOS PAC ID: 9032156922 Enrollment ID: I20210204002011 |
| Provider Name | Jamie Lorraine Evans |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962664789 PECOS PAC ID: 6901044379 Enrollment ID: I20210208001928 |
| Provider Name | Michelle L Hahn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689990590 PECOS PAC ID: 0648303875 Enrollment ID: I20210308001996 |
| Provider Name | Laura L Skoog |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1376122408 PECOS PAC ID: 1759799406 Enrollment ID: I20210416001528 |
| Provider Name | Rebecca Cady |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609456110 PECOS PAC ID: 0345644738 Enrollment ID: I20210806001759 |
| Provider Name | Alhareth Alsayed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447601059 PECOS PAC ID: 8224369400 Enrollment ID: I20210903002470 |
| Provider Name | Linesse Md Vega |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114105897 PECOS PAC ID: 6002047206 Enrollment ID: I20210921000130 |
| Provider Name | Jobelle D Gamboa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205504552 PECOS PAC ID: 9234536673 Enrollment ID: I20210927003541 |
| Provider Name | Angela M Tschosik-johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811665185 PECOS PAC ID: 8123426897 Enrollment ID: I20211011001101 |
| Provider Name | Micah W Mcneill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174193312 PECOS PAC ID: 2466840509 Enrollment ID: I20211022001256 |
| Provider Name | Hetal Brahmbhatt |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841283199 PECOS PAC ID: 7012958580 Enrollment ID: I20211102001359 |
| Provider Name | Curt Pinchuck |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275532871 PECOS PAC ID: 2668420399 Enrollment ID: I20211202000466 |
| Provider Name | Savannah L De La Fuente |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1750053716 PECOS PAC ID: 5991197212 Enrollment ID: I20220119001165 |
| Provider Name | Jonathan Dargo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1760649594 PECOS PAC ID: 4385891431 Enrollment ID: I20220214001599 |
| Provider Name | Muhammad Rehan Azher Puri |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972850170 PECOS PAC ID: 0749591055 Enrollment ID: I20220302001404 |
| Provider Name | Joseph Divincenzo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740201425 PECOS PAC ID: 3577475649 Enrollment ID: I20220310001108 |
| Provider Name | Efrain Aguilar Murillo |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1467865444 PECOS PAC ID: 6103119250 Enrollment ID: I20220412001813 |
| Provider Name | Molly A Mammosser |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1649925116 PECOS PAC ID: 3779970868 Enrollment ID: I20220419002488 |
| Provider Name | Brian Michael Kuchay |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235422056 PECOS PAC ID: 6608027255 Enrollment ID: I20220523000117 |
| Provider Name | Marisa Garcia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528712858 PECOS PAC ID: 9931587029 Enrollment ID: I20220601002501 |
| Provider Name | Sarah Cook |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487944450 PECOS PAC ID: 9931415528 Enrollment ID: I20220614002766 |
| Provider Name | Mary Fahrmeier |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245252303 PECOS PAC ID: 4880657527 Enrollment ID: I20220720000119 |
| Provider Name | Jessica A Birkey |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1093446239 PECOS PAC ID: 4880076280 Enrollment ID: I20220802001307 |
| Provider Name | Musaddiq Tariq |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326465436 PECOS PAC ID: 7012338924 Enrollment ID: I20220812002664 |
| Provider Name | Tshiswaka B Kayembe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164477766 PECOS PAC ID: 2466351168 Enrollment ID: I20220829002525 |
| Provider Name | Erica A Armstrong |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1093484461 PECOS PAC ID: 8527444504 Enrollment ID: I20220928001236 |
| Provider Name | Twinkle Singh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235545757 PECOS PAC ID: 6608167044 Enrollment ID: I20221026000728 |
| Provider Name | James Barclay |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164468393 PECOS PAC ID: 6103809017 Enrollment ID: I20221027000515 |
| Provider Name | David M Hanrahan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033347125 PECOS PAC ID: 2163835398 Enrollment ID: I20221028000330 |
| Provider Name | Karen Severson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689787426 PECOS PAC ID: 0840364030 Enrollment ID: I20221028000829 |
| Provider Name | Roxanne Gillian Mcmillan |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1336366160 PECOS PAC ID: 1759468267 Enrollment ID: I20221213002315 |
| Provider Name | Lauren Prest |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881012235 PECOS PAC ID: 3971804147 Enrollment ID: I20221220000225 |
| Provider Name | Jeremiah Brewer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679968697 PECOS PAC ID: 8426366378 Enrollment ID: I20221221002344 |
| Provider Name | Mark N Friedman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1932181849 PECOS PAC ID: 5092732388 Enrollment ID: I20230106001755 |
| Provider Name | Seema Kapur |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1639299209 PECOS PAC ID: 3173674694 Enrollment ID: I20230216001614 |
| Provider Name | Desiree L Burke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104542372 PECOS PAC ID: 9739545583 Enrollment ID: I20230519002181 |
| Provider Name | Anna Chacon |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1073950689 PECOS PAC ID: 8527207919 Enrollment ID: I20230602002371 |
| Provider Name | Nora N Ekeanya |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154749844 PECOS PAC ID: 8628370467 Enrollment ID: I20230627001574 |
| Provider Name | Michael J Brennan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1811550981 PECOS PAC ID: 4587998208 Enrollment ID: I20230714002748 |
| Provider Name | Mark Talmage |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114038403 PECOS PAC ID: 7810989365 Enrollment ID: I20230810002266 |
| Provider Name | Abby Fredrickson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376063370 PECOS PAC ID: 0547685125 Enrollment ID: I20230825002712 |
| Provider Name | Steven Sharp |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366890857 PECOS PAC ID: 9436443256 Enrollment ID: I20230922003698 |
| Provider Name | Anita Pairitz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851376230 PECOS PAC ID: 8325092703 Enrollment ID: I20230929000228 |
| Provider Name | Neil Bhupendra Jariwala |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710206545 PECOS PAC ID: 0941425607 Enrollment ID: I20231003001374 |
| Provider Name | Pradeep Bollu |
|---|---|
| Provider Type | Practitioner - Neuropsychiatry |
| Provider Identifiers | NPI Number: 1598094393 PECOS PAC ID: 1456595263 Enrollment ID: I20231018000141 |
| Provider Name | Omotola Ajibade |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841571841 PECOS PAC ID: 4789049057 Enrollment ID: I20231020001584 |
| Provider Name | Stephanie Ann Bennington |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619453040 PECOS PAC ID: 8426300872 Enrollment ID: I20231025001422 |
| Provider Name | John Murchison |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1467895581 PECOS PAC ID: 0648543280 Enrollment ID: I20231101002705 |
| Provider Name | Matthew A Weeks |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1619239936 PECOS PAC ID: 6103130653 Enrollment ID: I20231212001505 |
| Provider Name | Beriah Rf Zigler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801670930 PECOS PAC ID: 3173974706 Enrollment ID: I20240109000872 |
| Provider Name | Angela Ekeresi Green |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114196995 PECOS PAC ID: 0547386054 Enrollment ID: I20240215002319 |
| Provider Name | Destinee T Delemos |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1356635858 PECOS PAC ID: 9436301868 Enrollment ID: I20240328003302 |
| Provider Name | Cassie A Welt |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1265759922 PECOS PAC ID: 2365684818 Enrollment ID: I20240329001485 |
| Provider Name | Jaclyn A Brandmeyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881224376 PECOS PAC ID: 1254749732 Enrollment ID: I20240418003534 |
Lutheran Social Services Of Illinois Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1901 1st Ave, Sterling, IL 61081 Phone: 815-626-7333 Fax: 815-626-8752 | |
Sinnissippi Centers, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2611 Woodlawn Rd, Sterling, IL 61081 Phone: 815-625-0013 Fax: 815-625-0197 | |
Pathways Counseling Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 208 E 4th St, Sterling, IL 61081 Phone: 815-625-5583 Fax: 630-845-8463 | |
Sinnissippi Centers, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2611 Woodlawn Rd, Sterling, IL 61081 Phone: 815-625-0013 | |
New Beginnings Counseling Center Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 110 E Lynn Blvd, Sterling, IL 61081 Phone: 309-445-0801 | |
Sinnissippi Centers Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2104 E 23rd St, Sterling, IL 61081 Phone: 815-622-0938 | |
Moeller, Myers & Associates, Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 302 E 5th St, Sterling, IL 61081 Phone: 815-626-8760 Fax: 815-626-8066 |