| Crawford Memorial Hospital | |
|
1101 N Allen St Robinson IL 62454-1168 | |
| (618) 544-8600 | |
| (618) 546-2641 |
| Full Name | Crawford Memorial Hospital |
|---|---|
| Speciality | Internal Medicine |
| Location | 1101 N Allen St, Robinson, Illinois |
| Authorized Official Name and Position | Debbie Kiehl (PRACTICE MANAGMENT OFFICER) |
| Authorized Official Contact | 6185448600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Crawford Memorial Hospital 1101 N Allen St Robinson IL 62454-1168 Ph: (618) 544-8600 | Crawford Memorial Hospital 1101 N Allen St Robinson IL 62454-1168 Ph: (618) 544-8600 |
| NPI Number | 1861423287 |
|---|---|
| Provider Enumeration Date | 07/05/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 7719898071 |
|---|---|
| Medicare Enrollment ID | O20040205000950 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861423287 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Amira Bahu |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1245202068 PECOS PAC ID: 9931006756 Enrollment ID: I20031218000332 |
| Provider Name | Sharon Smith |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1083779698 PECOS PAC ID: 8325947328 Enrollment ID: I20040113000092 |
| Provider Name | Don Manarang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205833860 PECOS PAC ID: 1951294057 Enrollment ID: I20040203000964 |
| Provider Name | Robert Haag |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1376590554 PECOS PAC ID: 3072402239 Enrollment ID: I20040315000457 |
| Provider Name | William Moore |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1194766832 PECOS PAC ID: 2062302078 Enrollment ID: I20040316000073 |
| Provider Name | Richard B Warshell |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1336119163 PECOS PAC ID: 7214828219 Enrollment ID: I20040322000061 |
| Provider Name | Jeffrey Cullen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1861463101 PECOS PAC ID: 8527050632 Enrollment ID: I20040331000149 |
| Provider Name | Robert Knudson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1235170069 PECOS PAC ID: 1153318555 Enrollment ID: I20040428000383 |
| Provider Name | Robert Nordstrom |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1639112113 PECOS PAC ID: 3870584527 Enrollment ID: I20040520001244 |
| Provider Name | Thomas Scaggs |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1245295187 PECOS PAC ID: 1456336833 Enrollment ID: I20040621000742 |
| Provider Name | Robert E Cranston |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1457460057 PECOS PAC ID: 9234114638 Enrollment ID: I20040621000939 |
| Provider Name | Napoleon B Knight |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1669438198 PECOS PAC ID: 3476538885 Enrollment ID: I20040621000970 |
| Provider Name | John Becker |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1316988694 PECOS PAC ID: 4688651664 Enrollment ID: I20040707000988 |
| Provider Name | Phillip D Barnell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114943057 PECOS PAC ID: 9638157324 Enrollment ID: I20040709000495 |
| Provider Name | Jerrold C Willis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1467407072 PECOS PAC ID: 8921086539 Enrollment ID: I20040709001419 |
| Provider Name | John R Willis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326095670 PECOS PAC ID: 2567440175 Enrollment ID: I20040709001422 |
| Provider Name | Tamara Walls |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1982651188 PECOS PAC ID: 0244202000 Enrollment ID: I20040811000933 |
| Provider Name | Stephen F Israel |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1376539700 PECOS PAC ID: 8628045176 Enrollment ID: I20040914000475 |
| Provider Name | Philip Witkop |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1770550782 PECOS PAC ID: 5092783027 Enrollment ID: I20040917000963 |
| Provider Name | Chinedu Uzoma Maduakolam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114912557 PECOS PAC ID: 7517952039 Enrollment ID: I20041006000361 |
| Provider Name | Craig Russo |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1790727659 PECOS PAC ID: 7214999457 Enrollment ID: I20041101000223 |
| Provider Name | Robert T Walsh |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1225028202 PECOS PAC ID: 7012978778 Enrollment ID: I20041103000998 |
| Provider Name | Jacqueline A Treschuk-bahn |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1578533840 PECOS PAC ID: 5092778696 Enrollment ID: I20041104001044 |
| Provider Name | Carol J Bergbower |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1346281763 PECOS PAC ID: 1355304528 Enrollment ID: I20041109000247 |
| Provider Name | Kevin Coakley |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1033166418 PECOS PAC ID: 7911974852 Enrollment ID: I20041112000292 |
| Provider Name | Andrew Sherrick |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1689615767 PECOS PAC ID: 1759358690 Enrollment ID: I20041112000391 |
| Provider Name | Michael M Rafati |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1467512848 PECOS PAC ID: 9638133259 Enrollment ID: I20041115000180 |
| Provider Name | John Schlepphorst |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1366480022 PECOS PAC ID: 2860456050 Enrollment ID: I20041117000516 |
| Provider Name | Lucy Christopherson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1154378354 PECOS PAC ID: 8123082344 Enrollment ID: I20041117000755 |
| Provider Name | John Felker |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1679514996 PECOS PAC ID: 9931163052 Enrollment ID: I20041117000880 |
| Provider Name | Kanchan Gupta |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1972544526 PECOS PAC ID: 3072577154 Enrollment ID: I20041118000093 |
| Provider Name | David M Ayoub |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1861448037 PECOS PAC ID: 0749257681 Enrollment ID: I20041118000207 |
| Provider Name | Daniel Knight |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1932124997 PECOS PAC ID: 9739178005 Enrollment ID: I20050207000775 |
| Provider Name | Batuk N Ramolia |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1609843325 PECOS PAC ID: 9739131764 Enrollment ID: I20050217000474 |
| Provider Name | Mary Ludolph |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1376580225 PECOS PAC ID: 8729011838 Enrollment ID: I20050917000449 |
| Provider Name | Rashid F Kysia |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1225141005 PECOS PAC ID: 4183646698 Enrollment ID: I20051228000089 |
| Provider Name | Charles Neal |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1164463816 PECOS PAC ID: 7012984958 Enrollment ID: I20060117000887 |
| Provider Name | Casey Muehle |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1134167893 PECOS PAC ID: 9739156670 Enrollment ID: I20060117000913 |
| Provider Name | Rupal R Parmar |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1003846247 PECOS PAC ID: 6608881586 Enrollment ID: I20060214000370 |
| Provider Name | Eleanor U Atienza Tennison |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255310546 PECOS PAC ID: 9133135577 Enrollment ID: I20060222000700 |
| Provider Name | Gary A Tennison |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518946813 PECOS PAC ID: 9739195173 Enrollment ID: I20060222000742 |
| Provider Name | Ryan Watson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1548202757 PECOS PAC ID: 3779595509 Enrollment ID: I20060619000158 |
| Provider Name | Vamsi Krishna Vasireddy |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1801802996 PECOS PAC ID: 3971508789 Enrollment ID: I20060929000457 |
| Provider Name | John R Beck |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083686158 PECOS PAC ID: 3678579489 Enrollment ID: I20061018000057 |
| Provider Name | Niko I Keys |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1881783793 PECOS PAC ID: 9436159266 Enrollment ID: I20070102000027 |
| Provider Name | Sandra Jean Knuth |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1720073067 PECOS PAC ID: 5698775112 Enrollment ID: I20070108000311 |
| Provider Name | Rushdi H Alul |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1649365529 PECOS PAC ID: 6608876917 Enrollment ID: I20070111000140 |
| Provider Name | Hisham T Youssef |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1720078629 PECOS PAC ID: 8325140346 Enrollment ID: I20070222000289 |
| Provider Name | David Rotman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730204405 PECOS PAC ID: 1658475389 Enrollment ID: I20070405000078 |
| Provider Name | Daniel L Shekleton |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1699830174 PECOS PAC ID: 6507966983 Enrollment ID: I20070713000761 |
| Provider Name | Mark Kiplagat Rotich |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659393601 PECOS PAC ID: 3971694100 Enrollment ID: I20070802000294 |
| Provider Name | Joseph Baima |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1144380049 PECOS PAC ID: 7719058593 Enrollment ID: I20080623000234 |
| Provider Name | Naveen Chapa |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1649479650 PECOS PAC ID: 2860566312 Enrollment ID: I20080801000317 |
| Provider Name | Robert Burke |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1124074885 PECOS PAC ID: 7618057258 Enrollment ID: I20090204000513 |
| Provider Name | Robin S Biermann |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1255348546 PECOS PAC ID: 2365599743 Enrollment ID: I20090423000389 |
| Provider Name | Jennifer Sharp |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1972705218 PECOS PAC ID: 8729151162 Enrollment ID: I20090710000424 |
| Provider Name | Mary Joelle Curry |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1093936627 PECOS PAC ID: 0840342358 Enrollment ID: I20090714000697 |
| Provider Name | Michael A Blain |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801076146 PECOS PAC ID: 6709938020 Enrollment ID: I20090717000387 |
| Provider Name | Aaron Settler |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1235175779 PECOS PAC ID: 3779638119 Enrollment ID: I20090908000489 |
| Provider Name | David Butler |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1093765844 PECOS PAC ID: 4981762143 Enrollment ID: I20091008000232 |
| Provider Name | Juan J Jimenez |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1174548911 PECOS PAC ID: 7012054927 Enrollment ID: I20091027000061 |
| Provider Name | Gregory P Kastner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659361525 PECOS PAC ID: 4981614518 Enrollment ID: I20100116000238 |
| Provider Name | Fred D Scott |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1780674655 PECOS PAC ID: 4587706338 Enrollment ID: I20100118000025 |
| Provider Name | Robert Riggs |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1063492817 PECOS PAC ID: 1254473929 Enrollment ID: I20100118000288 |
| Provider Name | Robert K Reuter |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1831205657 PECOS PAC ID: 2769526672 Enrollment ID: I20100216000511 |
| Provider Name | Joseph L Kunzelman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1588654057 PECOS PAC ID: 0547396970 Enrollment ID: I20100324001166 |
| Provider Name | John D Rogers |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023086295 PECOS PAC ID: 0840329389 Enrollment ID: I20100521000564 |
| Provider Name | Curtis Settlemoir |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1487875910 PECOS PAC ID: 2961533831 Enrollment ID: I20100622000438 |
| Provider Name | Brandon Wynn |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326250234 PECOS PAC ID: 0547391773 Enrollment ID: I20100701000313 |
| Provider Name | Eileen Figuerres |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1093936635 PECOS PAC ID: 6103958715 Enrollment ID: I20100717000124 |
| Provider Name | Marc A Apostol |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1508081688 PECOS PAC ID: 6901938513 Enrollment ID: I20100717000145 |
| Provider Name | Philip Vincent Bacidore |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1891793634 PECOS PAC ID: 1557418969 Enrollment ID: I20100816000100 |
| Provider Name | Preston S Reilly |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1033114137 PECOS PAC ID: 4789681560 Enrollment ID: I20101109001418 |
| Provider Name | Keri J Mullins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710143367 PECOS PAC ID: 5092900340 Enrollment ID: I20101111000984 |
| Provider Name | James Y Park |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1285830307 PECOS PAC ID: 6305031212 Enrollment ID: I20101117000283 |
| Provider Name | Peter M Mccool |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1306044847 PECOS PAC ID: 3274620133 Enrollment ID: I20101129000094 |
| Provider Name | Larry Faines |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1558490128 PECOS PAC ID: 3971799081 Enrollment ID: I20101130001341 |
| Provider Name | Atif Jaleel |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1306092283 PECOS PAC ID: 5890982714 Enrollment ID: I20101203001241 |
| Provider Name | Lynna R Titsworth |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1912204041 PECOS PAC ID: 1759564909 Enrollment ID: I20110324000792 |
| Provider Name | Saima Safdar |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1336449214 PECOS PAC ID: 8426233826 Enrollment ID: I20110429000026 |
| Provider Name | Kenneth Winkler |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1982769782 PECOS PAC ID: 0547316622 Enrollment ID: I20110429000426 |
| Provider Name | Gerald Riley |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1184821894 PECOS PAC ID: 0143301689 Enrollment ID: I20110613000761 |
| Provider Name | Mustafa Hindi |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1225273915 PECOS PAC ID: 3476721705 Enrollment ID: I20110712000573 |
| Provider Name | Michael J Jennewein |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1548288145 PECOS PAC ID: 7012979909 Enrollment ID: I20110808000358 |
| Provider Name | Benjamin A Feinzimer |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1205003142 PECOS PAC ID: 3375712672 Enrollment ID: I20111209000629 |
| Provider Name | Brian K Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124180708 PECOS PAC ID: 9537335716 Enrollment ID: I20120110000819 |
| Provider Name | Catherine Barteau |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1578521746 PECOS PAC ID: 7618079468 Enrollment ID: I20120215000266 |
| Provider Name | Joshua Rieke |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1528289055 PECOS PAC ID: 5597934729 Enrollment ID: I20120525000238 |
| Provider Name | Adam W Taves |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1003038746 PECOS PAC ID: 9032374129 Enrollment ID: I20120621000700 |
| Provider Name | Nicholas Hilpipre |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1154529444 PECOS PAC ID: 7113182205 Enrollment ID: I20120621000709 |
| Provider Name | Jayant Amberker |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1235391616 PECOS PAC ID: 3577728260 Enrollment ID: I20120716000173 |
| Provider Name | Kyle A Hardiman |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1609136746 PECOS PAC ID: 2860648821 Enrollment ID: I20120807000171 |
| Provider Name | Jose Ochoa |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1134454630 PECOS PAC ID: 0547427098 Enrollment ID: I20120921000349 |
| Provider Name | Alexander Ryan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1912232422 PECOS PAC ID: 9032374277 Enrollment ID: I20130227000091 |
| Provider Name | Randy Balmforth |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1366642738 PECOS PAC ID: 0244480739 Enrollment ID: I20130626000577 |
| Provider Name | Stephanie Swope |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1164484846 PECOS PAC ID: 0547295164 Enrollment ID: I20130702000034 |
| Provider Name | Matthew M Donaldson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1982894853 PECOS PAC ID: 2668636713 Enrollment ID: I20130709000191 |
| Provider Name | Chester Harrison |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1518134402 PECOS PAC ID: 2668612987 Enrollment ID: I20130710000634 |
| Provider Name | April L Cox |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1417155169 PECOS PAC ID: 2163679218 Enrollment ID: I20131105000408 |
| Provider Name | Agustin Bello |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538480017 PECOS PAC ID: 9133354889 Enrollment ID: I20131105000667 |
| Provider Name | Twee T Do |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1952334179 PECOS PAC ID: 8628128915 Enrollment ID: I20140416002000 |
| Provider Name | Patrick David Rhoades |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1487816765 PECOS PAC ID: 4284875790 Enrollment ID: I20140522001739 |
| Provider Name | Rebecca Baggett |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1285894576 PECOS PAC ID: 7618101072 Enrollment ID: I20140714000658 |
| Provider Name | Edward Price Odell Harter |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1841452463 PECOS PAC ID: 8426275744 Enrollment ID: I20140811001842 |
| Provider Name | Marisa Blitstein |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1194914465 PECOS PAC ID: 1557527751 Enrollment ID: I20140813000079 |
| Provider Name | Christopher Norbet |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1003044819 PECOS PAC ID: 6103066543 Enrollment ID: I20140813000173 |
| Provider Name | Aaron Konrad |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1114177102 PECOS PAC ID: 0840345401 Enrollment ID: I20140828001682 |
| Provider Name | Edward W Gradman |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1366830432 PECOS PAC ID: 6406171248 Enrollment ID: I20150219000264 |
| Provider Name | Jenna L Kintner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316345598 PECOS PAC ID: 8527384825 Enrollment ID: I20150304001113 |
| Provider Name | Heath Aaron Laughlin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1376854257 PECOS PAC ID: 7810216447 Enrollment ID: I20150604001600 |
| Provider Name | Kyle Hayden |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1245465343 PECOS PAC ID: 3072731041 Enrollment ID: I20150623001396 |
| Provider Name | Parvish Pradip Shah |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1407084452 PECOS PAC ID: 8426272865 Enrollment ID: I20150624001238 |
| Provider Name | Jason Michael Cox |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1710117577 PECOS PAC ID: 9032334990 Enrollment ID: I20150624001795 |
| Provider Name | Justin Mark Brooks |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1659682524 PECOS PAC ID: 8921319419 Enrollment ID: I20150625000124 |
| Provider Name | Ronald Hidalgo |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1033352596 PECOS PAC ID: 7618192246 Enrollment ID: I20150625000213 |
| Provider Name | Brandon Snyder |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1528296167 PECOS PAC ID: 4587976972 Enrollment ID: I20150626000647 |
| Provider Name | Olufenwa Milhouse |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1225353717 PECOS PAC ID: 1850515958 Enrollment ID: I20150716002243 |
| Provider Name | Minesh Suresh Patel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1811131089 PECOS PAC ID: 8123243623 Enrollment ID: I20150728005286 |
| Provider Name | Walline T Driver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548364755 PECOS PAC ID: 2769430933 Enrollment ID: I20150805006570 |
| Provider Name | Marlissa Boyles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316314933 PECOS PAC ID: 3870809072 Enrollment ID: I20150902002783 |
| Provider Name | Laura Darko |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1639443245 PECOS PAC ID: 3678882164 Enrollment ID: I20151023000953 |
| Provider Name | Stephanie Myers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760855571 PECOS PAC ID: 1557662681 Enrollment ID: I20151215001858 |
| Provider Name | Jamie R. Knoblett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942678404 PECOS PAC ID: 9234433822 Enrollment ID: I20160202000457 |
| Provider Name | Joseph Grazaitis |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1255797825 PECOS PAC ID: 6608173562 Enrollment ID: I20160321002423 |
| Provider Name | Maureen Ann Kidd |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1811912488 PECOS PAC ID: 6406889211 Enrollment ID: I20160930000700 |
| Provider Name | Kristina M. Schnepper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902350499 PECOS PAC ID: 1951683499 Enrollment ID: I20170118002002 |
| Provider Name | Mary B Loftin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750415741 PECOS PAC ID: 1254225394 Enrollment ID: I20170228000436 |
| Provider Name | Yanxu Liu |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1972919967 PECOS PAC ID: 1759507999 Enrollment ID: I20170525000049 |
| Provider Name | Adam Christopher King |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1881905750 PECOS PAC ID: 8426340258 Enrollment ID: I20170606001140 |
| Provider Name | Michael C Burke |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1962761742 PECOS PAC ID: 5092080028 Enrollment ID: I20171002001344 |
| Provider Name | Tal Pollak |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770831158 PECOS PAC ID: 9234370982 Enrollment ID: I20171102003619 |
| Provider Name | Yekaterina Fayn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699934471 PECOS PAC ID: 8820276223 Enrollment ID: I20171214003136 |
| Provider Name | Louba Rodenko Laurie |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1124067798 PECOS PAC ID: 4789598244 Enrollment ID: I20180322002002 |
| Provider Name | William L Devault |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1215909718 PECOS PAC ID: 4880652809 Enrollment ID: I20180323000578 |
| Provider Name | Jenna N Hardiman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497263792 PECOS PAC ID: 5799048252 Enrollment ID: I20180413002247 |
| Provider Name | Terry R Perkins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679552681 PECOS PAC ID: 1951322676 Enrollment ID: I20180419002381 |
| Provider Name | Lucas Kyle Buckley |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1194040634 PECOS PAC ID: 6901127257 Enrollment ID: I20180420002432 |
| Provider Name | James C Sibbett |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1962849992 PECOS PAC ID: 7315244845 Enrollment ID: I20180809000809 |
| Provider Name | Cody William Becksvoort |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831572619 PECOS PAC ID: 1658685342 Enrollment ID: I20181005001338 |
| Provider Name | Jason P Carmichael |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1528279031 PECOS PAC ID: 2668566290 Enrollment ID: I20181024002403 |
| Provider Name | Arpit A Patel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1215235361 PECOS PAC ID: 4981976529 Enrollment ID: I20181217002047 |
| Provider Name | Mickey Steven Chabak |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1831359512 PECOS PAC ID: 1153548896 Enrollment ID: I20190501000125 |
| Provider Name | Rodrigo Lopez Costa |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1770712259 PECOS PAC ID: 7214178979 Enrollment ID: I20190501000158 |
| Provider Name | Robert Pearson Schuh |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1689015141 PECOS PAC ID: 1850525585 Enrollment ID: I20190502000738 |
| Provider Name | Stephen Swearingen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1306853627 PECOS PAC ID: 8123176005 Enrollment ID: I20190626003345 |
| Provider Name | John Michael Irish |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1619318235 PECOS PAC ID: 9133474034 Enrollment ID: I20190806004139 |
| Provider Name | Usama Bukhari |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568818128 PECOS PAC ID: 8527352459 Enrollment ID: I20190820002240 |
| Provider Name | Holly E Harmon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013579820 PECOS PAC ID: 3971835380 Enrollment ID: I20191104001250 |
| Provider Name | Amanda L Talamantes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194238980 PECOS PAC ID: 6406109230 Enrollment ID: I20191106001179 |
| Provider Name | Behrad Golshani |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1225304652 PECOS PAC ID: 8123397627 Enrollment ID: I20191214000007 |
| Provider Name | Kristen M Walk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285276162 PECOS PAC ID: 7810321726 Enrollment ID: I20200102000095 |
| Provider Name | Bryan Belikoff |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1922366632 PECOS PAC ID: 6204065857 Enrollment ID: I20200311000912 |
| Provider Name | Michael Friedman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871742924 PECOS PAC ID: 0547424442 Enrollment ID: I20200311001425 |
| Provider Name | Michael G Fazio |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1811123433 PECOS PAC ID: 4880914761 Enrollment ID: I20200318000081 |
| Provider Name | Krista K Schulte |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730630740 PECOS PAC ID: 6901184654 Enrollment ID: I20200508001773 |
| Provider Name | Jude Regis |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1669867974 PECOS PAC ID: 7810296035 Enrollment ID: I20200520001387 |
| Provider Name | Katie J Parker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467086892 PECOS PAC ID: 0244651388 Enrollment ID: I20200528001646 |
| Provider Name | Amanda J Harrington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548889942 PECOS PAC ID: 8628495827 Enrollment ID: I20200902002832 |
| Provider Name | Tomasz P Lis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003122151 PECOS PAC ID: 8325273832 Enrollment ID: I20200909000994 |
| Provider Name | Joanna G Edwards |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063947067 PECOS PAC ID: 7911276456 Enrollment ID: I20201012000804 |
| Provider Name | Donnetta R Burgess |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730786161 PECOS PAC ID: 2264844067 Enrollment ID: I20201221001426 |
| Provider Name | Mark Cabelin |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1386601185 PECOS PAC ID: 3577595701 Enrollment ID: I20210107000022 |
| Provider Name | Erin E Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376149542 PECOS PAC ID: 6002220084 Enrollment ID: I20210203000484 |
| Provider Name | Derek Keeler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891382636 PECOS PAC ID: 5193139053 Enrollment ID: I20210204001095 |
| 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 | Adeleke Oni |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1265707590 PECOS PAC ID: 8921316290 Enrollment ID: I20211108000832 |
| Provider Name | Candis Nicole Bell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013275767 PECOS PAC ID: 0840601340 Enrollment ID: I20211110000742 |
| Provider Name | Abed Alfattah J Abu Fares |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467947580 PECOS PAC ID: 9739578816 Enrollment ID: I20211110002498 |
| Provider Name | Amy Lynn Roden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184013153 PECOS PAC ID: 2860713807 Enrollment ID: I20220113001491 |
| Provider Name | Kelsey Park |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1689245656 PECOS PAC ID: 5092109793 Enrollment ID: I20220223000369 |
| Provider Name | Eliahu Litman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881668861 PECOS PAC ID: 9133183247 Enrollment ID: I20220301001113 |
| Provider Name | Christian D Capanna |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1962995118 PECOS PAC ID: 4183032717 Enrollment ID: I20220520001584 |
| Provider Name | Ana Werner Watts |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1205062833 PECOS PAC ID: 9830347970 Enrollment ID: I20220520001893 |
| Provider Name | Angela York |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063457612 PECOS PAC ID: 5890773774 Enrollment ID: I20220613002460 |
| Provider Name | Wesley Douglas Wylie |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548215197 PECOS PAC ID: 7416005491 Enrollment ID: I20220614000695 |
| Provider Name | Nevine Mahmoud |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1265608038 PECOS PAC ID: 1850551680 Enrollment ID: I20220714003298 |
| Provider Name | Daniel George Hsu |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1437642121 PECOS PAC ID: 4284989237 Enrollment ID: I20220802002602 |
| Provider Name | Bryan A Feinstein |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1417419771 PECOS PAC ID: 4486032794 Enrollment ID: I20220822003409 |
| Provider Name | Joseph Y Abdayem |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134375157 PECOS PAC ID: 0749462588 Enrollment ID: I20220903000429 |
| Provider Name | Nathan Carroll |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1124752779 PECOS PAC ID: 4385028612 Enrollment ID: I20220906000031 |
| Provider Name | Cassi N Fiscus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689207946 PECOS PAC ID: 5193154813 Enrollment ID: I20221029000141 |
| Provider Name | Jill M Cucinella |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285087973 PECOS PAC ID: 3971898867 Enrollment ID: I20230214001435 |
| Provider Name | Syed Naseeruddin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1760599575 PECOS PAC ID: 6901183383 Enrollment ID: I20230303000132 |
| Provider Name | Jeffrey Scott Gudes |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1508272220 PECOS PAC ID: 5799052528 Enrollment ID: I20230330001866 |
| Provider Name | Geoffrey Fey |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1053415364 PECOS PAC ID: 5799742383 Enrollment ID: I20230421001181 |
| Provider Name | Tal Pollak |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1770831158 PECOS PAC ID: 9234370982 Enrollment ID: I20230425002839 |
| Provider Name | Scott S Dalane |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1821436692 PECOS PAC ID: 4486997715 Enrollment ID: I20230824001209 |
| Provider Name | Parth Patel |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1841813342 PECOS PAC ID: 7810311230 Enrollment ID: I20230830000417 |
| Provider Name | Joseph F. Pazona |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1447422951 PECOS PAC ID: 7012087471 Enrollment ID: I20230830001573 |
| Provider Name | Brianne M Rehg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376170977 PECOS PAC ID: 3375965833 Enrollment ID: I20230925003275 |
| Provider Name | Richard Pica |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1093782898 PECOS PAC ID: 5496775058 Enrollment ID: I20231120002244 |
| Provider Name | Katherine E Midgett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417418757 PECOS PAC ID: 6406205970 Enrollment ID: I20231208001732 |
| Provider Name | Jason M Richart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487432480 PECOS PAC ID: 9032568118 Enrollment ID: I20231214001983 |
| Provider Name | Frank Madonna |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558338350 PECOS PAC ID: 9830003474 Enrollment ID: I20240118000465 |
| Provider Name | Robert Haake |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1659869147 PECOS PAC ID: 5597129106 Enrollment ID: I20240129000868 |
| Provider Name | Theodore B Jefferson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1568495091 PECOS PAC ID: 2062454572 Enrollment ID: I20240201000908 |
| Provider Name | Cindy Yuen |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1902230477 PECOS PAC ID: 0345510061 Enrollment ID: I20240223003318 |
| Provider Name | Theodore Whitford |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1063480630 PECOS PAC ID: 4486609864 Enrollment ID: I20240307000791 |
| Provider Name | Sue Miller |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1457376659 PECOS PAC ID: 7214911015 Enrollment ID: I20240315003534 |
| Provider Name | Vikash Khurana |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649341025 PECOS PAC ID: 9032215082 Enrollment ID: I20240501002440 |
Crawford Memorial Hospital Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1101 North Allen Street, Robinson, IL 62454 Phone: 618-544-3699 Fax: 618-546-7636 | |
Cmh Rural Health - Med Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1000 N Allen St Ste A, Robinson, IL 62454 Phone: 618-544-2500 | |
Michael W Elliott Ii Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 807 W Craft St, Robinson, IL 62454 Phone: 618-546-5052 Fax: 618-544-2094 | |
David D Rotman Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1002 N Allen St, Robinson, IL 62454 Phone: 618-544-7050 Fax: 618-544-3738 |