Deaconess Illinois Crossroads Family Clinic Wayne City | |
1209 W Robinson St Wayne City IL 62895-9672 | |
(618) 895-2050 | |
(618) 895-2056 |
Full Name | Deaconess Illinois Crossroads Family Clinic Wayne City |
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Speciality | Clinic/Center |
Location | 1209 W Robinson St, Wayne City, Illinois |
Authorized Official Name and Position | Amber Lipe (CFO) |
Authorized Official Contact | 6189987020 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Deaconess Illinois Crossroads Family Clinic Wayne City Po Box 34142 Belfast ME 04915-0619 Ph: (812) 450-6815 | Deaconess Illinois Crossroads Family Clinic Wayne City 1209 W Robinson St Wayne City IL 62895-9672 Ph: (618) 895-2050 |
NPI Number | 1528785284 |
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Provider Enumeration Date | 10/24/2022 |
Last Update Date | 08/07/2024 |
Medicare PECOS PAC ID | 0143692178 |
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Medicare Enrollment ID | O20230221000097 |
Identifier | Type | State | Issuer |
---|---|---|---|
1528785284 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Provider Name | Suzanne Mary Burge |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1467456798 PECOS PAC ID: 7416991096 Enrollment ID: I20050615000197 |
Provider Name | Eric S Graham |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1720120462 PECOS PAC ID: 2365502838 Enrollment ID: I20081114000138 |
Provider Name | Dennon W Davis |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1689788630 PECOS PAC ID: 3072597350 Enrollment ID: I20100526001006 |
Provider Name | William D Huffstutler |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1578513420 PECOS PAC ID: 7517097801 Enrollment ID: I20100614000089 |
Provider Name | Nicole Kennedy |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1780902486 PECOS PAC ID: 4183893431 Enrollment ID: I20131009000357 |
Provider Name | Sonya L Mckinney |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1407221484 PECOS PAC ID: 1658675707 Enrollment ID: I20160210000590 |
Provider Name | Diana Vaughn |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1588185888 PECOS PAC ID: 7315201076 Enrollment ID: I20180503002226 |
Provider Name | Cynthia Dawn Phillips |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1841785185 PECOS PAC ID: 9739439720 Enrollment ID: I20180913000004 |
Provider Name | Tracy Adele Caswell |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1407407885 PECOS PAC ID: 4880027010 Enrollment ID: I20191202002738 |
Provider Name | Megan Nicole Plummer |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1487271557 PECOS PAC ID: 8729406319 Enrollment ID: I20200914002372 |
Provider Name | Amber S Bruce |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1932705050 PECOS PAC ID: 5092118083 Enrollment ID: I20210728003076 |
Provider Name | Christina Kay Frymire |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1922750785 PECOS PAC ID: 1153716188 Enrollment ID: I20220309002797 |
Provider Name | Jennifer L Felchlia |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1114659703 PECOS PAC ID: 1850776956 Enrollment ID: I20220909001166 |
Provider Name | Bayly Lynn Adams |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1295443653 PECOS PAC ID: 9931574852 Enrollment ID: I20230406002172 |
Provider Name | Johanna Shea Estes |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1558685156 PECOS PAC ID: 0244361830 Enrollment ID: I20230706002057 |
Crossroads Family Medicine Of Wayne City Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1209 W Robinson St, Wayne City, IL 62895 Phone: 618-895-2050 Fax: 618-895-2056 | |
Crossroads Family Medicine Of Wayne City Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1209 W Robinson St, Wayne City, IL 62895 Phone: 618-895-2050 Fax: 618-895-2056 | |
Crossroads Family Medicine Of Wayne City Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1209 W Robinson St, Wayne City, IL 62895 Phone: 618-895-2050 Fax: 618-895-2056 |