| Sara Lee Fordham, | |
|
403 E 1st St, Dixon, IL 61021-3116 | |
| (815) 288-5531 | |
| Not Available |
| Full Name | Sara Lee Fordham |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 5 Years |
| Location | 403 E 1st St, Dixon, Illinois |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871141465 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 209019936 (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Katherine Shaw Bethea Hospital | Dixon, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Ksb Medical Group Inc | 7911890009 | 74 |
| Entity Name | Ksb Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073592119 PECOS PAC ID: 7911890009 Enrollment ID: O20040203000860 |
| Entity Name | Rna Of Rockford, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1336326388 PECOS PAC ID: 3870662398 Enrollment ID: O20080522000639 |
| Mailing Address | Practice Location Address |
|---|---|
| Sara Lee Fordham, 403 E 1st St, Dixon, IL 61021-3116 Ph: (815) 288-5531 | Sara Lee Fordham, 403 E 1st St, Dixon, IL 61021-3116 Ph: (815) 288-5531 |
Christina Iyer, PMHNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 629 N Galena Ave, Dixon, IL 61021 Phone: 815-288-1235 Fax: 815-288-0034 | |
Ms. Janet I. Malmberg, APN, RNC, WHNP. Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 309 South Galena Ave, Suite 100, Dixon, IL 61021 Phone: 815-284-3371 Fax: 815-288-1811 | |
Valarie Pfoutz, APN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 403 E 1st St, Dixon, IL 61021 Phone: 815-288-5531 | |
Audra Danielle Washo, APN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 403 E 1st St, Dixon, IL 61021 Phone: 815-284-5710 Fax: 815-285-5893 | |
Kristina Kay Mershon, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2600 N Brinton Ave, Dixon, IL 61021 Phone: 815-288-5561 | |
Jill C Obrien, ANP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 102 S Hennepin Ave, Dixon, IL 61021 Phone: 815-285-8520 Fax: 815-285-8903 | |
Jacqueline D Keck, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 841 N Galena Ave, Suite 200, Dixon, IL 61021 Phone: 815-285-2273 Fax: 815-285-2276 |