| Killian And Associates Sc | |
|
1020 S 5th St Springfield IL 62703-2312 | |
| (217) 544-3143 | |
| (217) 544-4436 |
| Full Name | Killian And Associates Sc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1020 S 5th St, Springfield, Illinois |
| Authorized Official Name and Position | Terry M Killian (OWNER) |
| Authorized Official Contact | 2175443143 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Killian And Associates Sc 1020 S 5th St Springfield IL 62703-2312 Ph: (217) 544-3143 | Killian And Associates Sc 1020 S 5th St Springfield IL 62703-2312 Ph: (217) 544-3143 |
| NPI Number | 1487642708 |
|---|---|
| Provider Enumeration Date | 10/11/2005 |
| Last Update Date | 02/14/2023 |
| Certification Date | 02/14/2023 |
| Medicare PECOS PAC ID | 4082503610 |
|---|---|
| Medicare Enrollment ID | O20040312000214 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487642708 | NPI | - | NPPES |
| 036076560 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 042007661 (Illinois) | Primary |
| Provider Name | Virginia L Thompson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093703068 PECOS PAC ID: 0547150567 Enrollment ID: I20040316000125 |
| Provider Name | Terry M Killian |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447248869 PECOS PAC ID: 5799674339 Enrollment ID: I20100603000119 |
| Provider Name | Jordan Kelly Mandeville |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972387504 PECOS PAC ID: 8921545641 Enrollment ID: I20240731000034 |
| Provider Name | Patricia J Follin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376531707 PECOS PAC ID: 3870034333 Enrollment ID: I20240924002720 |
| Provider Name | Michelle D Tebrugge |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1316281777 PECOS PAC ID: 0840721502 Enrollment ID: I20241004002138 |
| Provider Name | Karma L Carpenter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467625764 PECOS PAC ID: 8921530098 Enrollment ID: I20241014003548 |
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