| Blessing Physician Services | |
|
927 Broadway St Quincy IL 62301-2719 | |
| (217) 224-6423 | |
| (217) 223-9142 |
| Full Name | Blessing Physician Services |
|---|---|
| Speciality | Clinic/Center |
| Location | 927 Broadway St, Quincy, Illinois |
| Authorized Official Name and Position | Tim Moore (VP FINANCE / CAO) |
| Authorized Official Contact | 2172231200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blessing Physician Services Po Box 7005 1005 Broadway Quincy IL 62305-7005 Ph: (217) 224-6423 | Blessing Physician Services 927 Broadway St Quincy IL 62301-2719 Ph: (217) 224-6423 |
| NPI Number | 1851311641 |
|---|---|
| Provider Enumeration Date | 07/21/2006 |
| Last Update Date | 11/27/2023 |
| Medicare PECOS PAC ID | 5991616138 |
|---|---|
| Medicare Enrollment ID | O20050222000479 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851311641 | NPI | - | NPPES |
| 132035 | Other | BLUE SHEIL OF ILLINOIS | |
| DD0203 | Other | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Idol R Mitchell |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1508850694 PECOS PAC ID: 6507763984 Enrollment ID: I20031215000432 |
| Provider Name | Alejandro Mendez Castillo |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1649255076 PECOS PAC ID: 2567361322 Enrollment ID: I20031231000416 |
| Provider Name | Joseph Judge |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1841202462 PECOS PAC ID: 9931092202 Enrollment ID: I20040203000119 |
| Provider Name | Alan Richard Obert |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023116993 PECOS PAC ID: 5890686968 Enrollment ID: I20040320000520 |
| Provider Name | Michael E Kirkpatrick |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871517862 PECOS PAC ID: 2062493976 Enrollment ID: I20040526001500 |
| Provider Name | David C Lieber |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1558462408 PECOS PAC ID: 2860473543 Enrollment ID: I20040527001186 |
| Provider Name | Abby M Reich |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700966124 PECOS PAC ID: 4284601394 Enrollment ID: I20040916000567 |
| Provider Name | Salvador Sanchez Zuniga |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982799086 PECOS PAC ID: 4587628268 Enrollment ID: I20041112000568 |
| Provider Name | Barry A Werries |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1962481366 PECOS PAC ID: 6103895693 Enrollment ID: I20041130000412 |
| Provider Name | Steven W Krause |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1386628519 PECOS PAC ID: 9234195884 Enrollment ID: I20041206000219 |
| Provider Name | Pamela P Friye |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1639156383 PECOS PAC ID: 8325093479 Enrollment ID: I20050322000415 |
| Provider Name | Gina Dietrich |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1184648974 PECOS PAC ID: 2860448347 Enrollment ID: I20050328000968 |
| Provider Name | John D Hammock |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1912082975 PECOS PAC ID: 7618919101 Enrollment ID: I20050525000268 |
| Provider Name | Cesar Sobremonte Arguelles |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518944248 PECOS PAC ID: 7012944036 Enrollment ID: I20050721000434 |
| Provider Name | Kelly J Rife |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942273883 PECOS PAC ID: 0749218600 Enrollment ID: I20050801001129 |
| Provider Name | William C Severino |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1659464493 PECOS PAC ID: 3173551777 Enrollment ID: I20050803000483 |
| Provider Name | Timothi J Beth |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629083431 PECOS PAC ID: 2264462084 Enrollment ID: I20050822000063 |
| Provider Name | Steven R Ginos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740298942 PECOS PAC ID: 1456344126 Enrollment ID: I20050822000078 |
| Provider Name | Crystal L Perry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689682528 PECOS PAC ID: 8325078140 Enrollment ID: I20050822000089 |
| Provider Name | Ronald St Hill |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316032147 PECOS PAC ID: 0648201822 Enrollment ID: I20050826000852 |
| Provider Name | Matthew Kuhn |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1992818991 PECOS PAC ID: 8426000324 Enrollment ID: I20050928001014 |
| Provider Name | Scott M Hough |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1821102781 PECOS PAC ID: 3678590072 Enrollment ID: I20051025000800 |
| Provider Name | Christopher Ross Solaro |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1831314186 PECOS PAC ID: 2567481906 Enrollment ID: I20051115000991 |
| Provider Name | Syam Reddy |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1780652180 PECOS PAC ID: 1355361841 Enrollment ID: I20051129000711 |
| Provider Name | Irving L Schwartz |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1831103092 PECOS PAC ID: 4880615558 Enrollment ID: I20051208000846 |
| Provider Name | Joseph Lane |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548485873 PECOS PAC ID: 6103848841 Enrollment ID: I20051222000316 |
| Provider Name | Loretta Anne Baustian |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1538153408 PECOS PAC ID: 4082637921 Enrollment ID: I20060106000325 |
| Provider Name | Venu Reddy |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1164429957 PECOS PAC ID: 3971592213 Enrollment ID: I20060207000034 |
| Provider Name | Melissa Kay Penn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255439105 PECOS PAC ID: 1153338009 Enrollment ID: I20060317000048 |
| Provider Name | Nanjappa C Somanna |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1306850615 PECOS PAC ID: 2264441369 Enrollment ID: I20060418000734 |
| Provider Name | Adnan Mushtaq |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1467409284 PECOS PAC ID: 8820093925 Enrollment ID: I20060925000068 |
| Provider Name | Roula Y Tanios |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1205857141 PECOS PAC ID: 0143226936 Enrollment ID: I20061019000050 |
| Provider Name | John R S Deguzman |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1376567354 PECOS PAC ID: 1658378922 Enrollment ID: I20061030000225 |
| Provider Name | Pierre E Raad |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1407877418 PECOS PAC ID: 1557368834 Enrollment ID: I20061030000239 |
| Provider Name | Asad Rafiq |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1295879666 PECOS PAC ID: 5799887170 Enrollment ID: I20070305000162 |
| Provider Name | Darr W Leutz |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1225069057 PECOS PAC ID: 2567564438 Enrollment ID: I20070320000170 |
| Provider Name | Daniel L Moore |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1750576641 PECOS PAC ID: 6204923998 Enrollment ID: I20071026000665 |
| Provider Name | Pierre S Charles |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1457369480 PECOS PAC ID: 5294818712 Enrollment ID: I20080211000058 |
| Provider Name | Walid Hafez |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1902814957 PECOS PAC ID: 9739267899 Enrollment ID: I20080415000671 |
| Provider Name | Richard Ohalloran |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1528143971 PECOS PAC ID: 7618910654 Enrollment ID: I20080429000570 |
| Provider Name | Jennifer A. Holcomb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639330400 PECOS PAC ID: 8729153457 Enrollment ID: I20080814000750 |
| Provider Name | Carl Nicholas Valentin |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1356505788 PECOS PAC ID: 0840366365 Enrollment ID: I20080908000353 |
| Provider Name | Jeffrey R Cook |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1952353518 PECOS PAC ID: 1254483480 Enrollment ID: I20090717000509 |
| Provider Name | Chad A Noggle |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1063654796 PECOS PAC ID: 6709938673 Enrollment ID: I20090723000711 |
| Provider Name | James E Uhles |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1427270941 PECOS PAC ID: 5496892234 Enrollment ID: I20091027000458 |
| Provider Name | Duane Anthony Hanzel |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1467442251 PECOS PAC ID: 5597807784 Enrollment ID: I20100127000040 |
| Provider Name | Lee Roy W Johnson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841385937 PECOS PAC ID: 8820124886 Enrollment ID: I20100329000902 |
| Provider Name | Antony Wollaston |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1326263682 PECOS PAC ID: 9537299334 Enrollment ID: I20100604000388 |
| Provider Name | Jack Lyons |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1104877851 PECOS PAC ID: 0446143804 Enrollment ID: I20100728001027 |
| Provider Name | Wesley D Creech |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1548424567 PECOS PAC ID: 3173690757 Enrollment ID: I20101014000228 |
| Provider Name | Lanny E Stiles |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508951781 PECOS PAC ID: 1759576549 Enrollment ID: I20101105000728 |
| Provider Name | Mary F Barthel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194729087 PECOS PAC ID: 5294893434 Enrollment ID: I20111006000719 |
| Provider Name | Rajesh Kannan Ethiraj |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1669667242 PECOS PAC ID: 4082878590 Enrollment ID: I20120613000672 |
| Provider Name | Lauren A Welch |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1205199973 PECOS PAC ID: 8628224797 Enrollment ID: I20120804000102 |
| Provider Name | Nicollette Marie Haubrich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619212107 PECOS PAC ID: 2466607882 Enrollment ID: I20130308000305 |
| Provider Name | Charone T Tolbert |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1033386461 PECOS PAC ID: 6305988361 Enrollment ID: I20130417000299 |
| Provider Name | Luc Tchapnda |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801044763 PECOS PAC ID: 3779750310 Enrollment ID: I20130503000320 |
| Provider Name | Harsha V Polavarapu |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1982864476 PECOS PAC ID: 9133368251 Enrollment ID: I20130621000474 |
| Provider Name | Schvon Cummings |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225297807 PECOS PAC ID: 1759548779 Enrollment ID: I20140130000750 |
| Provider Name | Julie Ann Barry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689889834 PECOS PAC ID: 4183857386 Enrollment ID: I20140423001258 |
| Provider Name | Ashley E Akhtar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801216064 PECOS PAC ID: 2668690694 Enrollment ID: I20140904000595 |
| Provider Name | Eliot Nissenbaum |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1326082454 PECOS PAC ID: 1759275365 Enrollment ID: I20150227001480 |
| Provider Name | Lyndell Lomax |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639560410 PECOS PAC ID: 5890012843 Enrollment ID: I20150331002608 |
| Provider Name | Glenda M Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023086527 PECOS PAC ID: 5799675211 Enrollment ID: I20150521001354 |
| Provider Name | David Jay Eckersley |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1427318310 PECOS PAC ID: 5294048567 Enrollment ID: I20150715001052 |
| Provider Name | Jessica Curry |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1467741355 PECOS PAC ID: 4082927231 Enrollment ID: I20150717001122 |
| Provider Name | Rebecca A Reed |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053797258 PECOS PAC ID: 5597070813 Enrollment ID: I20150817000543 |
| Provider Name | Prashanth Podaralla |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1730226952 PECOS PAC ID: 5496886699 Enrollment ID: I20150820012020 |
| Provider Name | Brian Robert Snyder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558380584 PECOS PAC ID: 4284601451 Enrollment ID: I20150903002464 |
| Provider Name | Sara Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720352180 PECOS PAC ID: 9234374794 Enrollment ID: I20151012000257 |
| Provider Name | Sean A Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568781177 PECOS PAC ID: 6709196728 Enrollment ID: I20151103002999 |
| Provider Name | Karl Nguyen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1477564094 PECOS PAC ID: 4688867930 Enrollment ID: I20151105000873 |
| Provider Name | Kelli Lunt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821420779 PECOS PAC ID: 5294045936 Enrollment ID: I20151109000460 |
| Provider Name | Andrew Dunn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093078420 PECOS PAC ID: 2567680598 Enrollment ID: I20151110001159 |
| Provider Name | Kerri L Henderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447611009 PECOS PAC ID: 3375833098 Enrollment ID: I20160608000511 |
| Provider Name | Emmanuel P Bessay |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1881914315 PECOS PAC ID: 0648562082 Enrollment ID: I20160706000700 |
| Provider Name | Ashley Jo Martin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1447696125 PECOS PAC ID: 1052551561 Enrollment ID: I20160719002712 |
| Provider Name | Gurdarshan Sandhu |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1083902852 PECOS PAC ID: 1456528926 Enrollment ID: I20160817000026 |
| Provider Name | Mandy Mcallister |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639522873 PECOS PAC ID: 4789979030 Enrollment ID: I20160825000627 |
| Provider Name | Matthew P Cormier |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831109347 PECOS PAC ID: 6901092170 Enrollment ID: I20160907002145 |
| Provider Name | Rochell G Sharpe-hultz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215481247 PECOS PAC ID: 1557657616 Enrollment ID: I20160915002307 |
| Provider Name | Shanna Dierker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558728337 PECOS PAC ID: 6406154608 Enrollment ID: I20160927002680 |
| Provider Name | Nickolas J Gillette |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598074353 PECOS PAC ID: 1658543160 Enrollment ID: I20161116000945 |
| Provider Name | Michael Nellestein |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1104848662 PECOS PAC ID: 2567416571 Enrollment ID: I20161222001315 |
| Provider Name | Brandi Mae Heinecke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821530817 PECOS PAC ID: 8426331810 Enrollment ID: I20170209000312 |
| Provider Name | Imtiaz Ismail |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1114369170 PECOS PAC ID: 4587806393 Enrollment ID: I20170308000926 |
| Provider Name | Julie Eftink |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275926610 PECOS PAC ID: 7719263714 Enrollment ID: I20170405001331 |
| Provider Name | Kenton Snyder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407388598 PECOS PAC ID: 7810264991 Enrollment ID: I20170519001306 |
| Provider Name | Myron Jones |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1225106420 PECOS PAC ID: 6204928492 Enrollment ID: I20170613002337 |
| Provider Name | Melissa Matrisch |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1811215064 PECOS PAC ID: 3476861568 Enrollment ID: I20170717002826 |
| Provider Name | Michael Behrens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194255083 PECOS PAC ID: 3476824095 Enrollment ID: I20170801000032 |
| Provider Name | Ginger Torrez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568991206 PECOS PAC ID: 4688945165 Enrollment ID: I20170801003319 |
| Provider Name | Patricia Hirner |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1114906716 PECOS PAC ID: 6305986969 Enrollment ID: I20170802003094 |
| Provider Name | Michael C Burke |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1962761742 PECOS PAC ID: 5092080028 Enrollment ID: I20171002001344 |
| Provider Name | Jessica E Althide |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366960130 PECOS PAC ID: 4385910223 Enrollment ID: I20171020002789 |
| Provider Name | Jennifer Kamps |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1518307305 PECOS PAC ID: 6800162496 Enrollment ID: I20171026001466 |
| Provider Name | Anandi Subbian |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396740197 PECOS PAC ID: 4082641329 Enrollment ID: I20171212002414 |
| Provider Name | Lowell Johnston Helmke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528584208 PECOS PAC ID: 0345508628 Enrollment ID: I20171213003311 |
| Provider Name | Taylor N Welch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831629575 PECOS PAC ID: 4981962263 Enrollment ID: I20171213003373 |
| Provider Name | Amber Michelle Lithila |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467961748 PECOS PAC ID: 3173881836 Enrollment ID: I20171229001868 |
| Provider Name | Erik Nothold |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1588112403 PECOS PAC ID: 0547529588 Enrollment ID: I20180118002765 |
| Provider Name | Katherine Thomure |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043727522 PECOS PAC ID: 8820358633 Enrollment ID: I20180215001490 |
| Provider Name | Diane Nutter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295708113 PECOS PAC ID: 7214920107 Enrollment ID: I20180222002388 |
| Provider Name | Jolinn Tripp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275060154 PECOS PAC ID: 4385905264 Enrollment ID: I20180312000828 |
| Provider Name | Lori George |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205330669 PECOS PAC ID: 4587927876 Enrollment ID: I20180419001959 |
| Provider Name | Annslee Fahy |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1659869444 PECOS PAC ID: 3870857584 Enrollment ID: I20180522000041 |
| Provider Name | Amy Lee Bates |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255836326 PECOS PAC ID: 8628333903 Enrollment ID: I20180608000009 |
| Provider Name | Jason Mitchell Little |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255835237 PECOS PAC ID: 7810243136 Enrollment ID: I20180628002481 |
| Provider Name | Kelsey Gray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952899940 PECOS PAC ID: 7416204698 Enrollment ID: I20180718003829 |
| Provider Name | Joy M Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558853143 PECOS PAC ID: 2264780626 Enrollment ID: I20180802000078 |
| Provider Name | Jennifer Martin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336697010 PECOS PAC ID: 8325397938 Enrollment ID: I20180815001219 |
| Provider Name | Elise Scoggin |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1023420361 PECOS PAC ID: 1052537313 Enrollment ID: I20180821003499 |
| Provider Name | Benham Panbehi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871889063 PECOS PAC ID: 3375859762 Enrollment ID: I20180919003375 |
| Provider Name | Brent Jacobson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1962623447 PECOS PAC ID: 3577741933 Enrollment ID: I20181114002432 |
| Provider Name | Ali Abbas Al-saraf |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1033451711 PECOS PAC ID: 6305149378 Enrollment ID: I20181119000945 |
| Provider Name | Kweon Stambaugh |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1063494185 PECOS PAC ID: 4688617715 Enrollment ID: I20190107000004 |
| Provider Name | Erin Bowers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053883140 PECOS PAC ID: 7113264920 Enrollment ID: I20190131001482 |
| Provider Name | Erik J Meidl |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891774469 PECOS PAC ID: 4183764459 Enrollment ID: I20190218000220 |
| Provider Name | John P Olson |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1568494771 PECOS PAC ID: 5698793404 Enrollment ID: I20190219002472 |
| Provider Name | Kamal Akhtar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720543838 PECOS PAC ID: 2769722065 Enrollment ID: I20190410000139 |
| Provider Name | Clark Andelin |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1013114453 PECOS PAC ID: 9638347487 Enrollment ID: I20190419000827 |
| Provider Name | Stacy Lowary |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093274524 PECOS PAC ID: 2264774504 Enrollment ID: I20190507000547 |
| Provider Name | Olumide Ayodeji Faniyan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1255780342 PECOS PAC ID: 4981998754 Enrollment ID: I20190718000215 |
| Provider Name | Mark Robert Wavrunek |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1194107607 PECOS PAC ID: 4981998390 Enrollment ID: I20190719002626 |
| Provider Name | Josue Acevedo |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1427325034 PECOS PAC ID: 8224304043 Enrollment ID: I20190912001455 |
| Provider Name | Amanda Rose Platt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376109488 PECOS PAC ID: 5092045674 Enrollment ID: I20190924003297 |
| Provider Name | Kyla R Kasparie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689169575 PECOS PAC ID: 0345597175 Enrollment ID: I20191111001635 |
| Provider Name | Nichole Stanley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851938476 PECOS PAC ID: 2365877214 Enrollment ID: I20200122003020 |
| Provider Name | Randi N. Donaldson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528627007 PECOS PAC ID: 7719313329 Enrollment ID: I20200130000285 |
| Provider Name | Dana R Knox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285273144 PECOS PAC ID: 4284060708 Enrollment ID: I20200131001901 |
| Provider Name | Terin Blanchard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508150863 PECOS PAC ID: 2769792563 Enrollment ID: I20200208000165 |
| Provider Name | Fernando Bonanni |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1720080864 PECOS PAC ID: 8921903881 Enrollment ID: I20200211001904 |
| Provider Name | Lisa Marie Orton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386274843 PECOS PAC ID: 6608203880 Enrollment ID: I20200228000040 |
| Provider Name | Laura Starman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720618457 PECOS PAC ID: 8527496850 Enrollment ID: I20200319000528 |
| Provider Name | Benjamin Bukey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598294696 PECOS PAC ID: 3173892684 Enrollment ID: I20200401003076 |
| Provider Name | Kara C Moon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780177931 PECOS PAC ID: 6709215288 Enrollment ID: I20200403002239 |
| Provider Name | Mark R Mount |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1811950264 PECOS PAC ID: 7416921945 Enrollment ID: I20200418000297 |
| Provider Name | Nikki Murphy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053880112 PECOS PAC ID: 1759711468 Enrollment ID: I20200421001397 |
| Provider Name | Neill M Wright |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1770500209 PECOS PAC ID: 8224186432 Enrollment ID: I20200514000715 |
| Provider Name | Jose R Santiago Rodriguez |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1184992265 PECOS PAC ID: 5395023956 Enrollment ID: I20200521001190 |
| Provider Name | Alexis L Schantz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386265551 PECOS PAC ID: 2668894866 Enrollment ID: I20200616003450 |
| Provider Name | Alvin Joseph Gonzales Dandan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174835706 PECOS PAC ID: 3274836721 Enrollment ID: I20200805000204 |
| Provider Name | Matthew T Winterton |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1740675552 PECOS PAC ID: 0749606291 Enrollment ID: I20200814001788 |
| Provider Name | Angie L Rose |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326677535 PECOS PAC ID: 4587081930 Enrollment ID: I20200908000520 |
| Provider Name | Bryan J Pimlott |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1396761318 PECOS PAC ID: 9739138009 Enrollment ID: I20200912000027 |
| Provider Name | David G Levinsohn |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1174532121 PECOS PAC ID: 0042291262 Enrollment ID: I20200914001596 |
| Provider Name | Quazi A Mostufa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083137897 PECOS PAC ID: 7719231034 Enrollment ID: I20200915002742 |
| Provider Name | Joel Leonard Primus |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033695820 PECOS PAC ID: 0042638207 Enrollment ID: I20200921001162 |
| Provider Name | William A Andel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821048372 PECOS PAC ID: 2163598897 Enrollment ID: I20200922001448 |
| Provider Name | Farooq Junaid |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1720328842 PECOS PAC ID: 6305138132 Enrollment ID: I20200928002947 |
| Provider Name | John Vu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457881765 PECOS PAC ID: 3577833755 Enrollment ID: I20200929000878 |
| Provider Name | Torre L Craine |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417411786 PECOS PAC ID: 5193145183 Enrollment ID: I20201013001133 |
| Provider Name | Holly Henderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710034954 PECOS PAC ID: 5496991457 Enrollment ID: I20201030000880 |
| Provider Name | Oleg Yurevich |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1326482571 PECOS PAC ID: 6305183542 Enrollment ID: I20201103000964 |
| Provider Name | Olivia Louise Patterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932716925 PECOS PAC ID: 6709296445 Enrollment ID: I20201107000000 |
| Provider Name | Osama Nusrat |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720433220 PECOS PAC ID: 5294168191 Enrollment ID: I20201117003494 |
| Provider Name | Andrea Nikole Leezer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710593124 PECOS PAC ID: 2668883299 Enrollment ID: I20201202002633 |
| Provider Name | Veronica Lynn Roth-phillips |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699376202 PECOS PAC ID: 5395157978 Enrollment ID: I20201228000036 |
| Provider Name | Stephen Kelminson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1538167804 PECOS PAC ID: 4284682667 Enrollment ID: I20210210003306 |
| Provider Name | Bruce Bertrand |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1215918891 PECOS PAC ID: 1355307315 Enrollment ID: I20210211002629 |
| Provider Name | Gregory P Mclennan |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1912160052 PECOS PAC ID: 8628209327 Enrollment ID: I20210215001511 |
| Provider Name | Melvin Omodon |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1902192438 PECOS PAC ID: 6507175148 Enrollment ID: I20210222001790 |
| Provider Name | Sonia L Behrens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629534227 PECOS PAC ID: 5294140240 Enrollment ID: I20210224002614 |
| Provider Name | Michael A Todora |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1063465920 PECOS PAC ID: 2567446941 Enrollment ID: I20210311000751 |
| Provider Name | Muhammad Iqbal |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1548249931 PECOS PAC ID: 2062431547 Enrollment ID: I20210331002350 |
| Provider Name | Erin Wood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972190510 PECOS PAC ID: 8820406416 Enrollment ID: I20210420002246 |
| Provider Name | Alicia Anne Reis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083296396 PECOS PAC ID: 7618376450 Enrollment ID: I20210526003149 |
| Provider Name | Ayub Suleiman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1306287396 PECOS PAC ID: 6204125818 Enrollment ID: I20210601001868 |
| Provider Name | Andrew Harrison |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1073812715 PECOS PAC ID: 7315232766 Enrollment ID: I20210607000408 |
| Provider Name | Carla Ramas |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1356676431 PECOS PAC ID: 8628260262 Enrollment ID: I20210607000873 |
| Provider Name | Bradley Holland |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1578910741 PECOS PAC ID: 7911290465 Enrollment ID: I20210623001742 |
| Provider Name | Lance Knecht |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1417937418 PECOS PAC ID: 7719913417 Enrollment ID: I20210629000731 |
| Provider Name | Shamit Desai |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1285074104 PECOS PAC ID: 2961747555 Enrollment ID: I20210715004030 |
| Provider Name | Namratha Ramavaram |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1679006886 PECOS PAC ID: 5698044121 Enrollment ID: I20210730001985 |
| Provider Name | Laurel Sexton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205405883 PECOS PAC ID: 6507260353 Enrollment ID: I20210802002349 |
| Provider Name | Umama Adil |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1033524368 PECOS PAC ID: 7416255112 Enrollment ID: I20210804002269 |
| Provider Name | Nathan Priddy |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1982846077 PECOS PAC ID: 9931413150 Enrollment ID: I20210816000018 |
| Provider Name | Todd Klausner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1407821283 PECOS PAC ID: 0244226280 Enrollment ID: I20210816001467 |
| Provider Name | Peter Peer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1669431748 PECOS PAC ID: 4082698485 Enrollment ID: I20210902003329 |
| Provider Name | Mohammadali Mojarrad |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1487035887 PECOS PAC ID: 9931494069 Enrollment ID: I20210908003560 |
| Provider Name | Aparna Devi Yepuri |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1699205229 PECOS PAC ID: 5890183925 Enrollment ID: I20211022000980 |
| Provider Name | Haritha Yepuri |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1265919146 PECOS PAC ID: 5092064717 Enrollment ID: I20211026002265 |
| Provider Name | Shrey Thawait |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1952558561 PECOS PAC ID: 6305066697 Enrollment ID: I20211027002153 |
| Provider Name | Dawn Elizabeth Koch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124601695 PECOS PAC ID: 7517356249 Enrollment ID: I20211117002686 |
| Provider Name | Umut Gomceli |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1972932911 PECOS PAC ID: 1557608072 Enrollment ID: I20211203001227 |
| Provider Name | Lindsey Michele Rush |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447913207 PECOS PAC ID: 0143611772 Enrollment ID: I20211215001825 |
| Provider Name | Mannachanallur Ramakrishnan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1003806738 PECOS PAC ID: 3072507458 Enrollment ID: I20220121002285 |
| Provider Name | Senem Salar-gomceli |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1225383029 PECOS PAC ID: 6103169347 Enrollment ID: I20220210001094 |
| Provider Name | Allen Missoi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1467682229 PECOS PAC ID: 6204051006 Enrollment ID: I20220421002148 |
| Provider Name | Nia Sawyer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1033400718 PECOS PAC ID: 5991023590 Enrollment ID: I20220524002308 |
| Provider Name | Laila Holmes |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1518974260 PECOS PAC ID: 3870597578 Enrollment ID: I20220729002871 |
| Provider Name | David Samuelson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1568451508 PECOS PAC ID: 6406758770 Enrollment ID: I20220816003714 |
| Provider Name | Tanner Craig Eiben |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710472964 PECOS PAC ID: 5597012393 Enrollment ID: I20220823001483 |
| Provider Name | Justin Hartupee |
|---|---|
| Provider Type | Practitioner - Advanced Heart Failure And Transplant Cardiology |
| Provider Identifiers | NPI Number: 1053632422 PECOS PAC ID: 9537399266 Enrollment ID: I20221107001612 |
| Provider Name | Lee Friedman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1992867360 PECOS PAC ID: 2163577107 Enrollment ID: I20230123002012 |
| Provider Name | Chassidy Mae Schroder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427754209 PECOS PAC ID: 2668847153 Enrollment ID: I20230414001831 |
| Provider Name | Geoffrey Fey |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1053415364 PECOS PAC ID: 5799742383 Enrollment ID: I20230421001181 |
| Provider Name | Amber Curry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609438993 PECOS PAC ID: 8921463613 Enrollment ID: I20230502002950 |
| Provider Name | Gregory Krivonyak |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1770772725 PECOS PAC ID: 5193891166 Enrollment ID: I20230516003362 |
| Provider Name | John Werner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1710120175 PECOS PAC ID: 9739317967 Enrollment ID: I20230707000276 |
| Provider Name | Scott S Dalane |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1821436692 PECOS PAC ID: 4486997715 Enrollment ID: I20230824001209 |
Siu Center For Family Medicine - Transitions Of Western Illinois Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4409 Maine St Ste 100, Quincy, IL 62305 Phone: 217-919-9139 Fax: 217-223-0461 | |
Blessing Express Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 420 N 34th St, Quincy, IL 62301 Phone: 217-214-9626 Fax: 217-214-9627 | |
Blessing Walk-in Clinic Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1400 Harrison St, Quincy, IL 62301 Phone: 217-223-8400 | |
Siu Center For Family Medicine - Adams County Dental Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 330 Vermont St Ste 100, Quincy, IL 62301 Phone: 217-222-8440 | |
Blessing Walk-in Clinic Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3700 Broadway St, Quincy, IL 62305 Phone: 217-228-1060 | |
Blessing Fastcare Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3200 Broadway St, Quincy, IL 62301 Phone: 217-223-8400 Fax: 217-223-9945 | |
Board Of Trustees Of Southern Illinois University Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 205 S 24th St Ste 100, Quincy, IL 62301 Phone: 217-224-9484 Fax: 217-224-7950 |