| Ahs Il Medical Group Llc | |
|
2100 Madison Ave Granite City IL 62040-4713 | |
| (818) 666-0602 | |
| Not Available |
| Full Name | Ahs Il Medical Group Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2100 Madison Ave, Granite City, Illinois |
| Authorized Official Name and Position | Jonathan E Burket (COMPLIANCE) |
| Authorized Official Contact | 8186660602 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ahs Il Medical Group Llc 4273 S State Route 159 Glen Carbon IL 62034-3224 Ph: (186) 288-2297 | Ahs Il Medical Group Llc 2100 Madison Ave Granite City IL 62040-4713 Ph: (818) 666-0602 |
| NPI Number | 1659098101 |
|---|---|
| Provider Enumeration Date | 10/25/2022 |
| Last Update Date | 10/12/2023 |
| Medicare PECOS PAC ID | 5496111676 |
|---|---|
| Medicare Enrollment ID | O20230512001300 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659098101 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Jeffrey Arendell |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1386668218 PECOS PAC ID: 4082503867 Enrollment ID: I20040311000187 |
| Provider Name | Raghu Kanumuri |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1700869112 PECOS PAC ID: 0042101446 Enrollment ID: I20040324000303 |
| Provider Name | Benedict Painter |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1154314839 PECOS PAC ID: 6305831769 Enrollment ID: I20040419001147 |
| Provider Name | Lawrence T Harmon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275526956 PECOS PAC ID: 8224023684 Enrollment ID: I20040419001235 |
| Provider Name | Debabrata Ray |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1699861583 PECOS PAC ID: 5799774691 Enrollment ID: I20040506001576 |
| Provider Name | Gustavo Vonderlancken |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1881683282 PECOS PAC ID: 8123004603 Enrollment ID: I20040625000460 |
| Provider Name | Scott A Wong |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1275604498 PECOS PAC ID: 5991767055 Enrollment ID: I20041101000430 |
| Provider Name | Paul Jerome Scherer |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1881679181 PECOS PAC ID: 7315914439 Enrollment ID: I20041104001175 |
| Provider Name | Peter J Anderson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1548245848 PECOS PAC ID: 8123095247 Enrollment ID: I20041108000385 |
| Provider Name | Abiodun A Sangoseni |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194710483 PECOS PAC ID: 2668424052 Enrollment ID: I20050214000771 |
| Provider Name | Timothy Hipskind |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265439640 PECOS PAC ID: 8022059591 Enrollment ID: I20050513000790 |
| Provider Name | Brian Erickson |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1629064225 PECOS PAC ID: 5698792042 Enrollment ID: I20060328000584 |
| Provider Name | Crystal S Jesenick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396831616 PECOS PAC ID: 7416953369 Enrollment ID: I20061017000103 |
| Provider Name | Rajinder Kumar Mahay |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669490421 PECOS PAC ID: 8820050487 Enrollment ID: I20061020000148 |
| Provider Name | Murtuza H Bahrainwala |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871590679 PECOS PAC ID: 8628032695 Enrollment ID: I20070613000043 |
| Provider Name | Travis L Bullock |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1699810507 PECOS PAC ID: 8325144272 Enrollment ID: I20080115000058 |
| Provider Name | Lyndon F Hohenkirk |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1841243565 PECOS PAC ID: 4082517693 Enrollment ID: I20080904000023 |
| Provider Name | Ameha A Hagos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073763991 PECOS PAC ID: 2264588151 Enrollment ID: I20091027000726 |
| Provider Name | Jeffrey A Parres |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1619951027 PECOS PAC ID: 3678460169 Enrollment ID: I20100629000801 |
| Provider Name | Elizabeth P Mincy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922233576 PECOS PAC ID: 4981729480 Enrollment ID: I20100920001135 |
| Provider Name | Melissa L Kalaher |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629161765 PECOS PAC ID: 2567588056 Enrollment ID: I20100921001259 |
| Provider Name | Brad C White |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1205810512 PECOS PAC ID: 8325935810 Enrollment ID: I20101214000940 |
| Provider Name | Courtney Shands |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1902880362 PECOS PAC ID: 1850288341 Enrollment ID: I20110104000799 |
| Provider Name | Matthew Spellman |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1205810520 PECOS PAC ID: 3274545843 Enrollment ID: I20110105000708 |
| Provider Name | Danielle Bogue |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295062537 PECOS PAC ID: 2466632930 Enrollment ID: I20110216000107 |
| Provider Name | Denise J Krone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902163942 PECOS PAC ID: 9133382377 Enrollment ID: I20120525000114 |
| Provider Name | James Rybak |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1801042700 PECOS PAC ID: 6103068564 Enrollment ID: I20130814000394 |
| Provider Name | Jose Daniel Perez Porcel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427289917 PECOS PAC ID: 5395979447 Enrollment ID: I20131004000052 |
| Provider Name | Faqir Ahmad |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1487684957 PECOS PAC ID: 8325004583 Enrollment ID: I20140311000266 |
| Provider Name | Kevin Kuria |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033535968 PECOS PAC ID: 3870716509 Enrollment ID: I20140527000168 |
| Provider Name | Cari L Stefani |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508286477 PECOS PAC ID: 3870712821 Enrollment ID: I20140924000942 |
| Provider Name | Delora Brooks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659622330 PECOS PAC ID: 9537311808 Enrollment ID: I20141103001224 |
| Provider Name | Sherry L Franklin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528457306 PECOS PAC ID: 9638499643 Enrollment ID: I20150616002472 |
| Provider Name | Carol Candler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770942716 PECOS PAC ID: 0446557136 Enrollment ID: I20160323001819 |
| Provider Name | Kristine M Costello |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922469402 PECOS PAC ID: 5496053183 Enrollment ID: I20160413001232 |
| Provider Name | Theresa D Mcfadin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831553908 PECOS PAC ID: 4688963812 Enrollment ID: I20160511002076 |
| Provider Name | Gautam Datta |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568688414 PECOS PAC ID: 6406957851 Enrollment ID: I20160901000093 |
| Provider Name | Charmaine E Edwards |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1972586253 PECOS PAC ID: 1557451234 Enrollment ID: I20161110001707 |
| Provider Name | Janae M Korte |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396288502 PECOS PAC ID: 5395029300 Enrollment ID: I20170310000610 |
| Provider Name | Toni L Ostmann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790224970 PECOS PAC ID: 7012292733 Enrollment ID: I20170327002116 |
| Provider Name | Robert Bell |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1851371082 PECOS PAC ID: 8820124803 Enrollment ID: I20170405001369 |
| Provider Name | Emily M Cottrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295262459 PECOS PAC ID: 5193093946 Enrollment ID: I20170620000286 |
| Provider Name | Melissa Bounds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831630458 PECOS PAC ID: 5496023988 Enrollment ID: I20170626002079 |
| Provider Name | Grant Gerdelman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1215292933 PECOS PAC ID: 6800198235 Enrollment ID: I20170724000649 |
| Provider Name | Sonda Rena Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679003628 PECOS PAC ID: 1355612888 Enrollment ID: I20170802001337 |
| Provider Name | Laurie Hopper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255853081 PECOS PAC ID: 8123394590 Enrollment ID: I20171030003433 |
| Provider Name | Jacob Colman Blakeman |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1760749261 PECOS PAC ID: 1052613122 Enrollment ID: I20180220000537 |
| Provider Name | Megan Wood |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407052996 PECOS PAC ID: 0244495521 Enrollment ID: I20180420002056 |
| Provider Name | Gregory B Auffenberg |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1396977328 PECOS PAC ID: 0941513402 Enrollment ID: I20180717000433 |
| Provider Name | Jacob Ark |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1891053716 PECOS PAC ID: 3870896715 Enrollment ID: I20180806001223 |
| Provider Name | Seth Strope |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1427109248 PECOS PAC ID: 9638271794 Enrollment ID: I20181120002351 |
| Provider Name | Kaleena D Galletta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740787795 PECOS PAC ID: 3375808959 Enrollment ID: I20190401001061 |
| Provider Name | Ammar Barakat |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1588994289 PECOS PAC ID: 3678766243 Enrollment ID: I20190603000094 |
| Provider Name | Louis A Aliperti |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1861810350 PECOS PAC ID: 5193022614 Enrollment ID: I20190730003012 |
| Provider Name | Leann Nitz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952701666 PECOS PAC ID: 2769709658 Enrollment ID: I20190816001914 |
| Provider Name | Barry N Rosenblum |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1750318341 PECOS PAC ID: 8729987789 Enrollment ID: I20190905003215 |
| Provider Name | Donald Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366090573 PECOS PAC ID: 3971835786 Enrollment ID: I20191029000651 |
| Provider Name | Lauren K Sidwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720629470 PECOS PAC ID: 7416380407 Enrollment ID: I20191205000698 |
| Provider Name | Jeramie Lynn Rosales Rodriguez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205290319 PECOS PAC ID: 0547515124 Enrollment ID: I20200709001348 |
| Provider Name | James P Lovinggood |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1558328633 PECOS PAC ID: 5698761138 Enrollment ID: I20210331000830 |
| Provider Name | Steven W Bigg |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1932166162 PECOS PAC ID: 5092766626 Enrollment ID: I20210408001450 |
| Provider Name | Joshua L Gibson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427646496 PECOS PAC ID: 6406265198 Enrollment ID: I20210510002396 |
| Provider Name | Nelson Yu |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1447297601 PECOS PAC ID: 3779554233 Enrollment ID: I20210518002361 |
| Provider Name | Crystle Kay Laugavitz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386220259 PECOS PAC ID: 5294134672 Enrollment ID: I20210604002678 |
| Provider Name | Alicia M Whorton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508490806 PECOS PAC ID: 4486082740 Enrollment ID: I20210622001508 |
| Provider Name | Jennings Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285148882 PECOS PAC ID: 0749542926 Enrollment ID: I20210629000523 |
| Provider Name | Armand Aslan Kachigian |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1275676975 PECOS PAC ID: 5496646507 Enrollment ID: I20210714002060 |
| Provider Name | Sandra Blazek |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942721295 PECOS PAC ID: 8527390392 Enrollment ID: I20211013002312 |
| Provider Name | Jennifer Mary Joy Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013686203 PECOS PAC ID: 0749679850 Enrollment ID: I20211111000509 |
| Provider Name | Karen K Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407327588 PECOS PAC ID: 5799020475 Enrollment ID: I20211123001573 |
| Provider Name | Mohamad A Albsheri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447508874 PECOS PAC ID: 3779891379 Enrollment ID: I20220125002720 |
| Provider Name | Tavia N Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568813061 PECOS PAC ID: 7517251754 Enrollment ID: I20220429001918 |
| Provider Name | Renee M Lindner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497424766 PECOS PAC ID: 5799166443 Enrollment ID: I20220713001316 |
| Provider Name | David Shiyu Zhu |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1821440751 PECOS PAC ID: 9436441458 Enrollment ID: I20220921003340 |
| Provider Name | Shawn M Nies |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356094650 PECOS PAC ID: 6002292273 Enrollment ID: I20220927000156 |
| Provider Name | Dane Wallace |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528787744 PECOS PAC ID: 7012393143 Enrollment ID: I20220927003038 |
| Provider Name | Kaitlyn Drost |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376267666 PECOS PAC ID: 1759759756 Enrollment ID: I20221123000465 |
| Provider Name | Riyadh Salih |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215590039 PECOS PAC ID: 1456688001 Enrollment ID: I20221201001144 |
| Provider Name | Laura Ann Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710604780 PECOS PAC ID: 6002287323 Enrollment ID: I20230125001146 |
| Provider Name | April L Schmidt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558468546 PECOS PAC ID: 6901804954 Enrollment ID: I20230215002587 |
| Provider Name | Zachary Wade Orr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184221160 PECOS PAC ID: 7517374010 Enrollment ID: I20230607002471 |
Heartland Healthcare Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2044 Madison Ave, Suite 15, Granite City, IL 62040 Phone: 618-798-8652 Fax: 618-798-8116 | |
Apexnetwork Physical Therapy Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3908 Maryville Rd Ste 2, Granite City, IL 62040 Phone: 618-709-4125 | |
Granite City Clinic Corp Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2044 Madison Ave, Suite 27, Granite City, IL 62040 Phone: 618-451-7600 Fax: 618-451-7685 | |
Old Six Mile Inpatient Services, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2100 Madison Ave, Granite City, IL 62040 Phone: 618-798-3000 | |
Chestnut Family Health Center Granite City Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 50 Northgate Industrial Dr, Granite City, IL 62040 Phone: 618-512-1919 Fax: 618-512-1920 | |
American Healthcare Systems Illinois Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2100 Madison Ave, Granite City, IL 62040 Phone: 818-666-0602 | |
Sihf Hud 2 Facility Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1832 Cleveland Blvd, Granite City, IL 62040 Phone: 618-397-3303 Fax: 618-397-7802 |