Anderson Medical Group, Llc | |
6810 State Route 162 Suite 215 Maryville IL 62062-8501 | |
(618) 288-5711 | |
(618) 288-4088 |
Full Name | Anderson Medical Group, Llc |
---|---|
Speciality | Clinic/Center |
Location | 6810 State Route 162, Maryville, Illinois |
Authorized Official Name and Position | Michael Marshall (CFO) |
Authorized Official Contact | 6183916402 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Anderson Medical Group, Llc 6810 State Route 162 Suite 215 Maryville IL 62062-8501 Ph: (618) 288-5711 | Anderson Medical Group, Llc 6810 State Route 162 Suite 215 Maryville IL 62062-8501 Ph: (618) 288-5711 |
NPI Number | 1700807716 |
---|---|
Provider Enumeration Date | 07/22/2006 |
Last Update Date | 02/11/2020 |
Medicare PECOS PAC ID | 5193792018 |
---|---|
Medicare Enrollment ID | O20040910001137 |
Identifier | Type | State | Issuer |
---|---|---|---|
1700807716 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
Provider Name | Dennis M Hurford |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1497708259 PECOS PAC ID: 5294633376 Enrollment ID: I20031229000145 |
Provider Name | Barbara Joy Foner |
---|---|
Provider Type | Practitioner - Critical Care (intensivists) |
Provider Identifiers | NPI Number: 1437141090 PECOS PAC ID: 7113820804 Enrollment ID: I20040129001022 |
Provider Name | Brett R Grebing |
---|---|
Provider Type | Practitioner - Orthopedic Surgery |
Provider Identifiers | NPI Number: 1447252978 PECOS PAC ID: 9537054424 Enrollment ID: I20040219000197 |
Provider Name | Patrice L Staten |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1154481364 PECOS PAC ID: 7214835941 Enrollment ID: I20040414001315 |
Provider Name | Rodney L Lupardus |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1710946280 PECOS PAC ID: 4183610876 Enrollment ID: I20040420001310 |
Provider Name | Jason E Barnett |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1295728988 PECOS PAC ID: 7911980032 Enrollment ID: I20040610000387 |
Provider Name | Sophia Y Rostovtseva |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1427042381 PECOS PAC ID: 8224013743 Enrollment ID: I20040621000252 |
Provider Name | Kristen L Ferguson |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1750308227 PECOS PAC ID: 6608843263 Enrollment ID: I20040927000763 |
Provider Name | Charles A Lane |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1164581468 PECOS PAC ID: 4284696329 Enrollment ID: I20041101000325 |
Provider Name | Scott A Wong |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1275604498 PECOS PAC ID: 5991767055 Enrollment ID: I20041101000430 |
Provider Name | Kyle P Shepperson |
---|---|
Provider Type | Practitioner - Orthopedic Surgery |
Provider Identifiers | NPI Number: 1407831704 PECOS PAC ID: 5395708911 Enrollment ID: I20041104001093 |
Provider Name | Paul Jerome Scherer |
---|---|
Provider Type | Practitioner - Orthopedic Surgery |
Provider Identifiers | NPI Number: 1881679181 PECOS PAC ID: 7315914439 Enrollment ID: I20041104001175 |
Provider Name | Timothy Joseph Penn |
---|---|
Provider Type | Practitioner - Orthopedic Surgery |
Provider Identifiers | NPI Number: 1124003439 PECOS PAC ID: 5597732610 Enrollment ID: I20041104001189 |
Provider Name | Peter J Anderson |
---|---|
Provider Type | Practitioner - Orthopedic Surgery |
Provider Identifiers | NPI Number: 1548245848 PECOS PAC ID: 8123095247 Enrollment ID: I20041108000385 |
Provider Name | Sajjan K Nemani |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1649220542 PECOS PAC ID: 2668437195 Enrollment ID: I20041124000183 |
Provider Name | Dean F Schueler |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1417916099 PECOS PAC ID: 2961468616 Enrollment ID: I20041206000146 |
Provider Name | Riaz A Naseer |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1245345537 PECOS PAC ID: 0547227043 Enrollment ID: I20041222000222 |
Provider Name | Michael E Mandis |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1821065764 PECOS PAC ID: 8820047699 Enrollment ID: I20050119000426 |
Provider Name | Mohammad A Zaman |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1346350196 PECOS PAC ID: 6002701471 Enrollment ID: I20051108000936 |
Provider Name | Eric D Lopatin |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1356381271 PECOS PAC ID: 5597787838 Enrollment ID: I20051229000562 |
Provider Name | Robert C Mckee |
---|---|
Provider Type | Practitioner - Plastic And Reconstructive Surgery |
Provider Identifiers | NPI Number: 1528142312 PECOS PAC ID: 5799799979 Enrollment ID: I20060126000468 |
Provider Name | Rodney L Greeling |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1700960572 PECOS PAC ID: 4587678149 Enrollment ID: I20060202000729 |
Provider Name | David B Yablonsky |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1780665901 PECOS PAC ID: 6800808676 Enrollment ID: I20060616000056 |
Provider Name | Rafe M Heng |
---|---|
Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1477560126 PECOS PAC ID: 4082718325 Enrollment ID: I20070327000370 |
Provider Name | William Thom |
---|---|
Provider Type | Practitioner - Anesthesiology |
Provider Identifiers | NPI Number: 1225015456 PECOS PAC ID: 2466480736 Enrollment ID: I20070912000451 |
Provider Name | David E Johnson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1477742047 PECOS PAC ID: 8921195736 Enrollment ID: I20071025000520 |
Provider Name | Tibor C Kopjas |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1952332918 PECOS PAC ID: 5698863975 Enrollment ID: I20071120000554 |
Provider Name | Henry E Purcell |
---|---|
Provider Type | Practitioner - Nephrology |
Provider Identifiers | NPI Number: 1467530410 PECOS PAC ID: 3375450257 Enrollment ID: I20071215000117 |
Provider Name | Larry Curtis Dobbs |
---|---|
Provider Type | Practitioner - Otolaryngology |
Provider Identifiers | NPI Number: 1881628931 PECOS PAC ID: 4587754361 Enrollment ID: I20071217000584 |
Provider Name | Paulo S Bicalho |
---|---|
Provider Type | Practitioner - Orthopedic Surgery |
Provider Identifiers | NPI Number: 1487606810 PECOS PAC ID: 8921188178 Enrollment ID: I20071231000323 |
Provider Name | Laura S Bird |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1295720993 PECOS PAC ID: 6709786072 Enrollment ID: I20080707000215 |
Provider Name | Jessica L Sheehan |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1467654772 PECOS PAC ID: 7315038890 Enrollment ID: I20080709000672 |
Provider Name | Edmundo Alejandro Rodriguez-frias |
---|---|
Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1912117912 PECOS PAC ID: 0941363881 Enrollment ID: I20090120000469 |
Provider Name | Sriraj Kanungo |
---|---|
Provider Type | Practitioner - Nephrology |
Provider Identifiers | NPI Number: 1548355621 PECOS PAC ID: 0547281776 Enrollment ID: I20090204000135 |
Provider Name | Jeffrey T Fierstein |
---|---|
Provider Type | Practitioner - Otolaryngology |
Provider Identifiers | NPI Number: 1740259043 PECOS PAC ID: 8628074010 Enrollment ID: I20090306000482 |
Provider Name | Patrick S Zimmermann |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1194749218 PECOS PAC ID: 9032143938 Enrollment ID: I20100109000131 |
Provider Name | Michelle P Mulligan |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1194721936 PECOS PAC ID: 2961546775 Enrollment ID: I20100217000583 |
Provider Name | Michael E Mulligan |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1417953316 PECOS PAC ID: 9133296247 Enrollment ID: I20100222000602 |
Provider Name | George Tzelepis |
---|---|
Provider Type | Practitioner - Pulmonary Disease |
Provider Identifiers | NPI Number: 1497769558 PECOS PAC ID: 9436156924 Enrollment ID: I20110210000290 |
Provider Name | Danielle Bogue |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1295062537 PECOS PAC ID: 2466632930 Enrollment ID: I20110216000107 |
Provider Name | Joann M Wilson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1073762308 PECOS PAC ID: 1456532258 Enrollment ID: I20110228000508 |
Provider Name | Mark S Fedder |
---|---|
Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1922009943 PECOS PAC ID: 1153503602 Enrollment ID: I20110304000782 |
Provider Name | Ronald John Gould |
---|---|
Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1811042708 PECOS PAC ID: 1759472129 Enrollment ID: I20120209000141 |
Provider Name | Pei C Chung |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1669609988 PECOS PAC ID: 7810042827 Enrollment ID: I20120316000723 |
Provider Name | Karen L Ridenour |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1720347933 PECOS PAC ID: 5092971440 Enrollment ID: I20120730000466 |
Provider Name | Kelley R Campbell |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1245590074 PECOS PAC ID: 8729234695 Enrollment ID: I20120808000480 |
Provider Name | Richard H Wikiera |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1093962896 PECOS PAC ID: 2163664194 Enrollment ID: I20130805000139 |
Provider Name | Billie L Vincent |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1639508039 PECOS PAC ID: 7911134812 Enrollment ID: I20131223000806 |
Provider Name | Jessica Lynn Walker |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1639476369 PECOS PAC ID: 1759512213 Enrollment ID: I20140326000663 |
Provider Name | Matthew Cary |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1619233525 PECOS PAC ID: 8325201296 Enrollment ID: I20140505001172 |
Provider Name | Amanda L Patterson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1518362946 PECOS PAC ID: 8921324377 Enrollment ID: I20150303001360 |
Provider Name | Christy T Weiss |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1437549367 PECOS PAC ID: 7618294281 Enrollment ID: I20150318001952 |
Provider Name | Alyssa R Loepker |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1992194401 PECOS PAC ID: 1557688868 Enrollment ID: I20150326000212 |
Provider Name | Tara A Topper |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1649660200 PECOS PAC ID: 7618297482 Enrollment ID: I20150519000024 |
Provider Name | Ann Altgilbers |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1447638887 PECOS PAC ID: 1658682885 Enrollment ID: I20150615001910 |
Provider Name | Emily A Yakel |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1215302781 PECOS PAC ID: 5496058638 Enrollment ID: I20160122000563 |
Provider Name | Erin Alcazar |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1457698607 PECOS PAC ID: 8921243940 Enrollment ID: I20160205002483 |
Provider Name | Sheena Eslinger |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1942675673 PECOS PAC ID: 7618272030 Enrollment ID: I20160223002328 |
Provider Name | Randi Hummel |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1386005635 PECOS PAC ID: 3072811009 Enrollment ID: I20160407001356 |
Provider Name | Ruth Holley |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1396107587 PECOS PAC ID: 9931499944 Enrollment ID: I20160603000714 |
Provider Name | Erin M Wright |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1922307115 PECOS PAC ID: 4688981012 Enrollment ID: I20161108000640 |
Provider Name | Angela Marie Kage |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1881145159 PECOS PAC ID: 4385923408 Enrollment ID: I20161114000895 |
Provider Name | Angela Marie Lytle |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1770025868 PECOS PAC ID: 8325328727 Enrollment ID: I20161130001883 |
Provider Name | Janae M Korte |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1396288502 PECOS PAC ID: 5395029300 Enrollment ID: I20170310000610 |
Provider Name | Alyssa M Martz |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1043757867 PECOS PAC ID: 5597040121 Enrollment ID: I20170322002764 |
Provider Name | Danielle N Fries |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1093256612 PECOS PAC ID: 9739465667 Enrollment ID: I20170417000001 |
Provider Name | Srimannarayana Marella |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1861745218 PECOS PAC ID: 1951535129 Enrollment ID: I20170511001222 |
Provider Name | Beth A Denmon |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1609304401 PECOS PAC ID: 9537439187 Enrollment ID: I20170714001370 |
Provider Name | Michael J Walter |
---|---|
Provider Type | Practitioner - Critical Care (intensivists) |
Provider Identifiers | NPI Number: 1629096359 PECOS PAC ID: 6305871401 Enrollment ID: I20170824000003 |
Provider Name | Megan Mihelcic |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1205263589 PECOS PAC ID: 1658509500 Enrollment ID: I20170828004286 |
Provider Name | Kayla B Wuebbels |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1417474511 PECOS PAC ID: 3375819386 Enrollment ID: I20171018003384 |
Provider Name | Eddie L Paulk |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1003813601 PECOS PAC ID: 4284618463 Enrollment ID: I20171129000036 |
Provider Name | Kelly A Martin |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1619123353 PECOS PAC ID: 4284992025 Enrollment ID: I20171227001341 |
Provider Name | Megan Springman |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1740793389 PECOS PAC ID: 7618236217 Enrollment ID: I20180104000973 |
Provider Name | Cayla Denise Wester |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1699274001 PECOS PAC ID: 9931461225 Enrollment ID: I20180327000113 |
Provider Name | Saulat Mushtaq |
---|---|
Provider Type | Practitioner - Rheumatology |
Provider Identifiers | NPI Number: 1518080605 PECOS PAC ID: 2668666298 Enrollment ID: I20180330000014 |
Provider Name | Tara S Hilmes |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1275064768 PECOS PAC ID: 1951665827 Enrollment ID: I20180430001593 |
Provider Name | Katie Marie Krueger |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1922515220 PECOS PAC ID: 9133484447 Enrollment ID: I20180606003446 |
Provider Name | Justin Bradley Hill |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1477797645 PECOS PAC ID: 4587971486 Enrollment ID: I20180814001728 |
Provider Name | Kelsy B Wasmuth |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1336659838 PECOS PAC ID: 4587917158 Enrollment ID: I20181029001609 |
Provider Name | Kaleena D Galletta |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1740787795 PECOS PAC ID: 3375808959 Enrollment ID: I20190401001061 |
Provider Name | Sara M Grotefendt |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1255805594 PECOS PAC ID: 8820339740 Enrollment ID: I20190402002622 |
Provider Name | Lindsey Michelle Senci |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1649771544 PECOS PAC ID: 9537401534 Enrollment ID: I20190423000919 |
Provider Name | Ryan Parker |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1912478231 PECOS PAC ID: 5698008233 Enrollment ID: I20190613000270 |
Provider Name | Gina Marie Vernace |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1427408392 PECOS PAC ID: 4284991613 Enrollment ID: I20190627003075 |
Provider Name | Sujata Sitaula |
---|---|
Provider Type | Practitioner - Endocrinology |
Provider Identifiers | NPI Number: 1548678261 PECOS PAC ID: 1759670938 Enrollment ID: I20190710000891 |
Provider Name | Kristen James |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1770977100 PECOS PAC ID: 6406183664 Enrollment ID: I20190809002203 |
Provider Name | Jamie M Schneider |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1245791847 PECOS PAC ID: 0244569705 Enrollment ID: I20190909001301 |
Provider Name | Bryson Thomas Whalen |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1255727301 PECOS PAC ID: 9436468428 Enrollment ID: I20191011000682 |
Provider Name | Larissa L Jones |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1730508433 PECOS PAC ID: 7416171319 Enrollment ID: I20191028001680 |
Provider Name | Patricia Teschke |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1790045417 PECOS PAC ID: 0446550909 Enrollment ID: I20200320000348 |
Provider Name | Neill M Wright |
---|---|
Provider Type | Practitioner - Neurosurgery |
Provider Identifiers | NPI Number: 1770500209 PECOS PAC ID: 8224186432 Enrollment ID: I20200514000715 |
Provider Name | Jenny M Daniels |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1346783230 PECOS PAC ID: 1456638048 Enrollment ID: I20200623000225 |
Provider Name | Joel Franco |
---|---|
Provider Type | Practitioner - Otolaryngology |
Provider Identifiers | NPI Number: 1891108452 PECOS PAC ID: 9931401361 Enrollment ID: I20200717003011 |
Provider Name | Tonya Ann Bosaw |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1821600693 PECOS PAC ID: 2264842376 Enrollment ID: I20201030001900 |
Provider Name | Tara Marie White |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1619561594 PECOS PAC ID: 7719393396 Enrollment ID: I20210305000231 |
Provider Name | Jacob Wengert |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1689097768 PECOS PAC ID: 9537391792 Enrollment ID: I20210623001834 |
Provider Name | Stephen J Johans |
---|---|
Provider Type | Practitioner - Neurosurgery |
Provider Identifiers | NPI Number: 1013273580 PECOS PAC ID: 7012219454 Enrollment ID: I20210820002725 |
Provider Name | Sarah J Fouke |
---|---|
Provider Type | Practitioner - Neurosurgery |
Provider Identifiers | NPI Number: 1154433712 PECOS PAC ID: 3476551409 Enrollment ID: I20210825001012 |
Provider Name | Jacob William Matsil |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1427537521 PECOS PAC ID: 3274882097 Enrollment ID: I20210916002606 |
Provider Name | Brendan M Fong |
---|---|
Provider Type | Practitioner - Neurosurgery |
Provider Identifiers | NPI Number: 1245670504 PECOS PAC ID: 2860621885 Enrollment ID: I20211005003090 |
Provider Name | Tina A Winter |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1922676675 PECOS PAC ID: 0941699896 Enrollment ID: I20211115001037 |
Provider Name | Katie Marie Albrecht |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1528735149 PECOS PAC ID: 6002207370 Enrollment ID: I20211221000544 |
Provider Name | Elizabeth Ann Dawson |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1437505062 PECOS PAC ID: 8022302504 Enrollment ID: I20211230001123 |
Provider Name | Scott H Purvines |
---|---|
Provider Type | Practitioner - Neurosurgery |
Provider Identifiers | NPI Number: 1669436739 PECOS PAC ID: 9537190152 Enrollment ID: I20220208001525 |
Provider Name | Michael N Polinsky |
---|---|
Provider Type | Practitioner - Neurosurgery |
Provider Identifiers | NPI Number: 1134183205 PECOS PAC ID: 7810927324 Enrollment ID: I20220209001629 |
Provider Name | Jeremy Cole Hollingsead |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1376000232 PECOS PAC ID: 5597005017 Enrollment ID: I20220314001515 |
Provider Name | Andrew S Youkilis |
---|---|
Provider Type | Practitioner - Neurosurgery |
Provider Identifiers | NPI Number: 1740244813 PECOS PAC ID: 4284664780 Enrollment ID: I20220318000926 |
Provider Name | Sarah Saller Travers |
---|---|
Provider Type | Practitioner - Neurosurgery |
Provider Identifiers | NPI Number: 1699193748 PECOS PAC ID: 6406258391 Enrollment ID: I20220524000946 |
Provider Name | Joshua Dwaine Lentz |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1134781412 PECOS PAC ID: 6103205679 Enrollment ID: I20220614002485 |
Provider Name | Srishti Sharma |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1053843052 PECOS PAC ID: 2567731532 Enrollment ID: I20220629003658 |
Provider Name | Ha Thuy Hatley |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1437718384 PECOS PAC ID: 3870829062 Enrollment ID: I20220705000452 |
Provider Name | Laurie Sparr |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1447766621 PECOS PAC ID: 8022342104 Enrollment ID: I20220720002613 |
Provider Name | Srikanth Nadella |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1740599109 PECOS PAC ID: 9537396635 Enrollment ID: I20220907001768 |
Provider Name | Melissa Armstead |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1326599911 PECOS PAC ID: 5294114773 Enrollment ID: I20221208001755 |
Provider Name | Paige Cosmas |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1689388175 PECOS PAC ID: 6709257967 Enrollment ID: I20230125003499 |
Provider Name | Shelby Smiley |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1326755430 PECOS PAC ID: 7911378195 Enrollment ID: I20230413002404 |
Provider Name | Nellie Britton |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1538863808 PECOS PAC ID: 8224493226 Enrollment ID: I20230426002205 |
Provider Name | Brenon Abernathie |
---|---|
Provider Type | Practitioner - Plastic And Reconstructive Surgery |
Provider Identifiers | NPI Number: 1497916977 PECOS PAC ID: 7214152099 Enrollment ID: I20230512001380 |
Provider Name | Michael J Reiter |
---|---|
Provider Type | Practitioner - Orthopedic Surgery |
Provider Identifiers | NPI Number: 1285051482 PECOS PAC ID: 7719200682 Enrollment ID: I20230828002401 |
Provider Name | Beth Blankley |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1366191355 PECOS PAC ID: 2769869437 Enrollment ID: I20230927002555 |
Provider Name | Stephanie M Johnson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1437936549 PECOS PAC ID: 0446603112 Enrollment ID: I20240129004478 |
Provider Name | Robin Risky |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1073267266 PECOS PAC ID: 5991169575 Enrollment ID: I20240410003650 |
Laura Bird, Md, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2704 N Center St, Maryville, IL 62062 Phone: 618-288-0656 Fax: 618-288-0736 | |
Metro East Healthcare Limited Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2133 Vadalabene Dr Ste 5b, Maryville, IL 62062 Phone: 618-288-7605 Fax: 618-288-7644 | |
Easy Lab Tech, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2203 N Center St, Maryville, IL 62062 Phone: 618-772-7222 | |
Innovative Women's Healthcare, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2016 Vadalabene Dr Ste D, Maryville, IL 62062 Phone: 618-444-5475 | |
Maryville Women's Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2016 Vadalabene Dr, Maryville, IL 62062 Phone: 618-288-2970 Fax: 618-288-3572 | |
Mark Fedder, Md, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6810 State Route 162, Suite 211, Maryville, IL 62062 Phone: 618-288-0346 Fax: 618-288-0349 | |
Cep America - Illinois Snf, Llp Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6800 State Route 162, Maryville, IL 62062 Phone: 618-288-5711 |