Cecelia B Bacom, CNM | |
6201 Roosevelt Rd, Berwyn, IL 60402-1108 | |
(708) 386-0845 | |
(708) 386-8472 |
Full Name | Cecelia B Bacom |
---|---|
Gender | Female |
Speciality | Advanced Practice Midwife |
Location | 6201 Roosevelt Rd, Berwyn, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1932141637 | NPI | - | NPPES |
209001981 | Medicaid | IL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367A00000X | Advanced Practice Midwife | 209001981 (Illinois) | Primary |
Entity Name | Pcc Community Wellness Center |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1871516799 PECOS PAC ID: 1557270139 Enrollment ID: O20040206000415 |
Mailing Address | Practice Location Address |
---|---|
Cecelia B Bacom, CNM 6201 Roosevelt Rd, Berwyn, IL 60402-1108 Ph: (708) 386-0845 | Cecelia B Bacom, CNM 6201 Roosevelt Rd, Berwyn, IL 60402-1108 Ph: (708) 386-0845 |
Katherine E Herold, APN Advanced Practice Midwife Medicare: Accepting Medicare Assignments Practice Location: 6201 Roosevelt Rd, Berwyn, IL 60402 Phone: 708-386-0845 Fax: 708-386-8472 | |
Tera Martin, CNM Advanced Practice Midwife Medicare: Medicare Enrolled Practice Location: 6201 Roosevelt Rd, Berwyn, IL 60402 Phone: 708-386-0845 Fax: 708-386-8472 | |
Danielle Kraessig, CNM Advanced Practice Midwife Medicare: Accepting Medicare Assignments Practice Location: 6201 Roosevelt Rd, Berwyn, IL 60402 Phone: 708-386-0845 Fax: 708-386-8472 | |
Annette R Payot, CNM Advanced Practice Midwife Medicare: Medicare Enrolled Practice Location: 6201 Roosevelt Rd, Berwyn, IL 60402 Phone: 708-386-0845 Fax: 708-386-8472 | |
Katherine Malone Wehrmann, CNM Advanced Practice Midwife Medicare: Medicare Enrolled Practice Location: 6201 Roosevelt Rd, Berwyn, IL 60402 Phone: 708-386-0845 | |
Sydney Elizabeth Lammers, CNM, APRN Advanced Practice Midwife Medicare: Not Enrolled in Medicare Practice Location: 6201 Roosevelt Rd, Berwyn, IL 60402 Phone: 708-386-0845 | |
Lorna Davis, CNM Advanced Practice Midwife Medicare: Medicare Enrolled Practice Location: 6201 Roosevelt Rd, Berwyn, IL 60402 Phone: 708-386-0845 |