| Edward Medical Group | |
|
130 N Weber Rd Suite 100 Bolingbrook IL 60440-1564 | |
| (630) 646-5777 | |
| (630) 646-5729 |
| Full Name | Edward Medical Group |
|---|---|
| Speciality | Clinic/Center |
| Location | 130 N Weber Rd, Bolingbrook, Illinois |
| Authorized Official Name and Position | William G. Kottman (PRESIDENT) |
| Authorized Official Contact | 6306463950 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Edward Medical Group 27555 Diehl Rd Warrenville IL 60555 Ph: (630) 646-3950 | Edward Medical Group 130 N Weber Rd Suite 100 Bolingbrook IL 60440-1564 Ph: (630) 646-5777 |
| NPI Number | 1962452912 |
|---|---|
| Provider Enumeration Date | 05/11/2006 |
| Last Update Date | 03/27/2009 |
| Medicare PECOS PAC ID | 4284531484 |
|---|---|
| Medicare Enrollment ID | O20031216000616 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962452912 | NPI | - | NPPES |
| 9919630 | Other | IL | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Li Zhang |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1184611881 PECOS PAC ID: 3375442528 Enrollment ID: I20040107000178 |
| Provider Name | Tanmoy Chandra |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285719260 PECOS PAC ID: 2668372558 Enrollment ID: I20040108000969 |
| Provider Name | Elaine M Biester |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1841300464 PECOS PAC ID: 2163324583 Enrollment ID: I20040124000270 |
| Provider Name | Lisa M Chorzempaschainis |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1629085444 PECOS PAC ID: 0042112468 Enrollment ID: I20040124000295 |
| Provider Name | Susan M Fedinec |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770549958 PECOS PAC ID: 1052213717 Enrollment ID: I20040126000021 |
| Provider Name | Michelle E Sweet Albores |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316908759 PECOS PAC ID: 3779485156 Enrollment ID: I20040126000204 |
| Provider Name | Lisa A Walinski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952354250 PECOS PAC ID: 9830084490 Enrollment ID: I20040220001007 |
| Provider Name | John M Saran |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720075849 PECOS PAC ID: 5092602748 Enrollment ID: I20040228000098 |
| Provider Name | Jennifer A Chludzinski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538156567 PECOS PAC ID: 9032006796 Enrollment ID: I20040228000147 |
| Provider Name | Vasant R Acharya |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1124035944 PECOS PAC ID: 0244129583 Enrollment ID: I20040313000442 |
| Provider Name | Patricia J Shanley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952424020 PECOS PAC ID: 1951293596 Enrollment ID: I20040327000208 |
| Provider Name | Thomas A Scaletta |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1861564957 PECOS PAC ID: 3274429832 Enrollment ID: I20040401001218 |
| Provider Name | Khalid M Malik |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1881684231 PECOS PAC ID: 7315933009 Enrollment ID: I20040420001266 |
| Provider Name | Mary Therese Pasciak |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427127505 PECOS PAC ID: 0143217992 Enrollment ID: I20040426001312 |
| Provider Name | Colleen P Andreoni |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427036110 PECOS PAC ID: 5890784508 Enrollment ID: I20040508000063 |
| Provider Name | Michelle Meziere |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1245266675 PECOS PAC ID: 9638169915 Enrollment ID: I20040518000103 |
| Provider Name | Dawn Marie Tutt |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1710905047 PECOS PAC ID: 8820089428 Enrollment ID: I20040521000824 |
| Provider Name | Dorothy T Prusek |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871592378 PECOS PAC ID: 0345221115 Enrollment ID: I20040527000247 |
| Provider Name | Daniel P Sullivan |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1104872944 PECOS PAC ID: 1658283205 Enrollment ID: I20040601000346 |
| Provider Name | Andrew D Yu |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1124088653 PECOS PAC ID: 8527040880 Enrollment ID: I20040602000499 |
| Provider Name | Daryl D Wilson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1346309150 PECOS PAC ID: 3173505229 Enrollment ID: I20040603000254 |
| Provider Name | Henry C Echiverri |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1356347264 PECOS PAC ID: 7012992498 Enrollment ID: I20040621000792 |
| Provider Name | Kristine S Warnes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871543264 PECOS PAC ID: 3678559515 Enrollment ID: I20040629001460 |
| Provider Name | David J Schlieben |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1538166210 PECOS PAC ID: 3173500832 Enrollment ID: I20040701000547 |
| Provider Name | Maria I Quejada |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1558348722 PECOS PAC ID: 1850371741 Enrollment ID: I20040721001528 |
| Provider Name | Amaryllis Gil |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1235116591 PECOS PAC ID: 1254301435 Enrollment ID: I20040727000231 |
| Provider Name | Therese W Zeman |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1174539472 PECOS PAC ID: 1254302961 Enrollment ID: I20040805000214 |
| Provider Name | Andrew Stephen Korcek |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1588630495 PECOS PAC ID: 7517938160 Enrollment ID: I20040805000615 |
| Provider Name | Joseph J Kash |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1043297971 PECOS PAC ID: 9032182340 Enrollment ID: I20040816000613 |
| Provider Name | Scott M Guth |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1568422962 PECOS PAC ID: 1850367434 Enrollment ID: I20040903001161 |
| Provider Name | Elizabeth A Pector |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841239787 PECOS PAC ID: 9436125069 Enrollment ID: I20040908000240 |
| Provider Name | Michelle F Albovias |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1093798662 PECOS PAC ID: 8123094406 Enrollment ID: I20040908000738 |
| Provider Name | Tina Bhargava |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699761783 PECOS PAC ID: 1052388980 Enrollment ID: I20040910001232 |
| Provider Name | Justin R. Macariola-coad |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1215963798 PECOS PAC ID: 9234106808 Enrollment ID: I20040913001384 |
| Provider Name | Vinayak V Dongre |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326193541 PECOS PAC ID: 4789652470 Enrollment ID: I20040922000284 |
| Provider Name | Kevin M Jackson |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1821103581 PECOS PAC ID: 1456329697 Enrollment ID: I20040924000169 |
| Provider Name | Suzanne L Wallace |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356316590 PECOS PAC ID: 5496714776 Enrollment ID: I20041004000923 |
| Provider Name | Megan K Swiatek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316115520 PECOS PAC ID: 0244299451 Enrollment ID: I20041005000031 |
| Provider Name | Sonya R Tolani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215986997 PECOS PAC ID: 0547229031 Enrollment ID: I20041008001297 |
| Provider Name | Phamela B De Guzman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568674844 PECOS PAC ID: 2860452869 Enrollment ID: I20041014000203 |
| Provider Name | Samir D Undevia |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1740228857 PECOS PAC ID: 9830150267 Enrollment ID: I20041020000172 |
| Provider Name | Teresa Elizabeth Grant |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922091412 PECOS PAC ID: 8628039054 Enrollment ID: I20041020000197 |
| Provider Name | Thomas Slonka |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386765642 PECOS PAC ID: 2365404506 Enrollment ID: I20041101000258 |
| Provider Name | Beatrice Klade |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1689640567 PECOS PAC ID: 8729049812 Enrollment ID: I20041109000227 |
| Provider Name | Marilyn L Evrard |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1760471031 PECOS PAC ID: 4284547225 Enrollment ID: I20041112001190 |
| Provider Name | Lisa C Pellegrini |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801849161 PECOS PAC ID: 9638136161 Enrollment ID: I20041215000951 |
| Provider Name | Shyamsunder R Chakilum |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295706521 PECOS PAC ID: 7113985029 Enrollment ID: I20041223000147 |
| Provider Name | Peter B Petratos |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1487612297 PECOS PAC ID: 2466400361 Enrollment ID: I20050107000127 |
| Provider Name | Kristin A Mock |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255380762 PECOS PAC ID: 3971552217 Enrollment ID: I20050113000769 |
| Provider Name | Melany Danehy |
|---|---|
| Provider Type | Practitioner - Neuropsychiatry |
| Provider Identifiers | NPI Number: 1952387318 PECOS PAC ID: 2264482264 Enrollment ID: I20050127000484 |
| Provider Name | Therese M Hiller Kozubik |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821195496 PECOS PAC ID: 7719939503 Enrollment ID: I20050221000558 |
| Provider Name | Jacqueline P Svara |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154417160 PECOS PAC ID: 7416900527 Enrollment ID: I20050301000789 |
| Provider Name | Ravi R Nemivant |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1003883463 PECOS PAC ID: 4284680158 Enrollment ID: I20050323001069 |
| Provider Name | Nooshig L Salvador |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1144200502 PECOS PAC ID: 3870549322 Enrollment ID: I20050328000665 |
| Provider Name | Robert R Payton |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1285748582 PECOS PAC ID: 6800843624 Enrollment ID: I20050406000722 |
| Provider Name | Brian A Couri |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1891761284 PECOS PAC ID: 4981651379 Enrollment ID: I20050407000614 |
| Provider Name | David J Piazza |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1528172897 PECOS PAC ID: 4082661806 Enrollment ID: I20050412000911 |
| Provider Name | Yolanda Co |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811985054 PECOS PAC ID: 1052350576 Enrollment ID: I20050425001142 |
| Provider Name | Kaleem M Khan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619917713 PECOS PAC ID: 5496795601 Enrollment ID: I20050506000527 |
| Provider Name | Kimberly A Clohecy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386655579 PECOS PAC ID: 3870534001 Enrollment ID: I20050518000826 |
| Provider Name | Ali Shaibani |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1023041720 PECOS PAC ID: 2961445101 Enrollment ID: I20050608000375 |
| Provider Name | Alexander Hantel |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1083691349 PECOS PAC ID: 0143258640 Enrollment ID: I20050727000045 |
| Provider Name | Hiam H Eldewek |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639128309 PECOS PAC ID: 9234167792 Enrollment ID: I20050727000447 |
| Provider Name | Thomas S Bartuska |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801972245 PECOS PAC ID: 1052360039 Enrollment ID: I20050808001209 |
| Provider Name | Elizabeth Harvey |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1568576783 PECOS PAC ID: 7315978129 Enrollment ID: I20050822000946 |
| Provider Name | Manju Chackissery Joseph |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1881601664 PECOS PAC ID: 2668403429 Enrollment ID: I20050822001310 |
| Provider Name | Deana M Ruby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477585800 PECOS PAC ID: 4486685583 Enrollment ID: I20050829000660 |
| Provider Name | George I Salti |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1306847702 PECOS PAC ID: 7315979341 Enrollment ID: I20050909000808 |
| Provider Name | Jaime Villanueva |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1295796217 PECOS PAC ID: 4284668310 Enrollment ID: I20050920000703 |
| Provider Name | Susan E Ahmari |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1356328058 PECOS PAC ID: 0547285637 Enrollment ID: I20051007000450 |
| Provider Name | Catherine C Camilleri |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699752204 PECOS PAC ID: 8527083617 Enrollment ID: I20051007000463 |
| Provider Name | Walter J Whang |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245217942 PECOS PAC ID: 7315924123 Enrollment ID: I20051007000493 |
| Provider Name | Juan G Flores |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1093931909 PECOS PAC ID: 9638195878 Enrollment ID: I20051018000455 |
| Provider Name | Lawrence Frank |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1861468811 PECOS PAC ID: 9133146301 Enrollment ID: I20051027000142 |
| Provider Name | Michael J Martin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962415513 PECOS PAC ID: 7012934680 Enrollment ID: I20051102000322 |
| Provider Name | Jeffrey D Williamsonlink |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1760536353 PECOS PAC ID: 8123047693 Enrollment ID: I20051114000834 |
| Provider Name | Tina Maria Vinson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083668404 PECOS PAC ID: 9638199151 Enrollment ID: I20051129000943 |
| Provider Name | Bonnie L Mcmanus |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1336277029 PECOS PAC ID: 1254351463 Enrollment ID: I20051202000491 |
| Provider Name | Lara Ellison |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528079803 PECOS PAC ID: 8527089275 Enrollment ID: I20051209000577 |
| Provider Name | Elena Pirozhnik |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1073612800 PECOS PAC ID: 6406870658 Enrollment ID: I20060116000103 |
| Provider Name | Joseph Kinder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558374546 PECOS PAC ID: 9234143561 Enrollment ID: I20060126000047 |
| Provider Name | Elizabeth I Semkiu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932248424 PECOS PAC ID: 6002820842 Enrollment ID: I20060131000680 |
| Provider Name | Celia Wanamaker Thomas |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1932110145 PECOS PAC ID: 5890700645 Enrollment ID: I20060215000253 |
| Provider Name | Peggy L Mateski Price |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285727115 PECOS PAC ID: 5597770370 Enrollment ID: I20060215000558 |
| Provider Name | Janet M Gifford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962413112 PECOS PAC ID: 5799791786 Enrollment ID: I20060228000733 |
| Provider Name | Timothy J Collins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376644435 PECOS PAC ID: 4587671045 Enrollment ID: I20060308000858 |
| Provider Name | Cheryl Ann Boss |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760436109 PECOS PAC ID: 5890706261 Enrollment ID: I20060523000066 |
| Provider Name | Douglas D Tran |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144270976 PECOS PAC ID: 0648281980 Enrollment ID: I20060525000176 |
| Provider Name | Lisa Stucky - Marshall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124073713 PECOS PAC ID: 8426069675 Enrollment ID: I20060601000114 |
| Provider Name | Robert J Kany |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1215990106 PECOS PAC ID: 6103821939 Enrollment ID: I20060928000482 |
| Provider Name | Edyta K Straczynski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558396085 PECOS PAC ID: 8022014919 Enrollment ID: I20061017000400 |
| Provider Name | Min Kyung Kim |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1003914771 PECOS PAC ID: 8921004755 Enrollment ID: I20061018000292 |
| Provider Name | Elizabeth M Gall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689761017 PECOS PAC ID: 8426055906 Enrollment ID: I20061025000485 |
| Provider Name | Molly M Dcosta |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033199369 PECOS PAC ID: 8921097395 Enrollment ID: I20061130000203 |
| Provider Name | Rohini S Bhat |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700988706 PECOS PAC ID: 4880693696 Enrollment ID: I20061205000296 |
| Provider Name | Judith Beauregard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770685869 PECOS PAC ID: 4688673668 Enrollment ID: I20061221000048 |
| Provider Name | Sandra Lynn Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982762720 PECOS PAC ID: 7012917669 Enrollment ID: I20070104000083 |
| Provider Name | Barry E Rabin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275562779 PECOS PAC ID: 6406856608 Enrollment ID: I20070112000119 |
| Provider Name | Sandra A Mazur |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588651509 PECOS PAC ID: 4789684937 Enrollment ID: I20070116000342 |
| Provider Name | Madhavi R Manubolu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194890459 PECOS PAC ID: 5799787594 Enrollment ID: I20070207000562 |
| Provider Name | Mary Ann Hollenback |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841339405 PECOS PAC ID: 7214039312 Enrollment ID: I20070220000583 |
| Provider Name | Mohammad Azharuddin Khan |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1922008143 PECOS PAC ID: 5193740041 Enrollment ID: I20070222000086 |
| Provider Name | Sheila M Treftz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023074051 PECOS PAC ID: 5193828119 Enrollment ID: I20070313000257 |
| Provider Name | June G Zaragoza |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1346389772 PECOS PAC ID: 3173626967 Enrollment ID: I20070315000394 |
| Provider Name | Kevin W Regan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205823275 PECOS PAC ID: 3779687769 Enrollment ID: I20070402000019 |
| Provider Name | Timothy Tyrrell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578551719 PECOS PAC ID: 9133223134 Enrollment ID: I20070402000034 |
| Provider Name | Jean Houlihan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952398885 PECOS PAC ID: 5890890073 Enrollment ID: I20070417000314 |
| Provider Name | Francis Stanley Lichon |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1437379435 PECOS PAC ID: 9436256724 Enrollment ID: I20070522000140 |
| Provider Name | Cheri L Sprietler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942236658 PECOS PAC ID: 1658479431 Enrollment ID: I20070601000058 |
| Provider Name | Constantine J Wonais |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457340267 PECOS PAC ID: 9234238510 Enrollment ID: I20070627000521 |
| Provider Name | Susan C Budds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851426613 PECOS PAC ID: 2860593001 Enrollment ID: I20070718000596 |
| Provider Name | Kimberly A Rohan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982749750 PECOS PAC ID: 4587765730 Enrollment ID: I20070718000605 |
| Provider Name | Mir Jaffer Asif |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1477759389 PECOS PAC ID: 4082715693 Enrollment ID: I20070726000660 |
| Provider Name | Oana Olaru |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1669466447 PECOS PAC ID: 9032149943 Enrollment ID: I20070731000288 |
| Provider Name | John R Born |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225063357 PECOS PAC ID: 1951492388 Enrollment ID: I20070814000392 |
| Provider Name | Michael J Caron |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1275738023 PECOS PAC ID: 1759472137 Enrollment ID: I20070814000819 |
| Provider Name | Kelli M Keller |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1730207820 PECOS PAC ID: 5395837371 Enrollment ID: I20070822000836 |
| Provider Name | Diane R Nurceski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023125952 PECOS PAC ID: 1557453578 Enrollment ID: I20070822001185 |
| Provider Name | Mark D Gomez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174728430 PECOS PAC ID: 1355433962 Enrollment ID: I20070827000471 |
| Provider Name | Anne E Tague |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255521308 PECOS PAC ID: 9335235803 Enrollment ID: I20071013000014 |
| Provider Name | Rosemarie Batiste |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245434851 PECOS PAC ID: 4880782317 Enrollment ID: I20071117000032 |
| Provider Name | Donald Lussky |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1255447470 PECOS PAC ID: 3072603125 Enrollment ID: I20071213000440 |
| Provider Name | Jeffrey Scott Bram |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679752943 PECOS PAC ID: 9133209299 Enrollment ID: I20080102000628 |
| Provider Name | Philip G Janicak |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891993754 PECOS PAC ID: 2567543887 Enrollment ID: I20080112000112 |
| Provider Name | Ankur Singal |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1629092028 PECOS PAC ID: 0143225425 Enrollment ID: I20080317000611 |
| Provider Name | Steven Stakenas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558459099 PECOS PAC ID: 0749367118 Enrollment ID: I20080409000418 |
| Provider Name | Jennifer B Gagesch |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1689782773 PECOS PAC ID: 6901975051 Enrollment ID: I20080515000628 |
| Provider Name | M Joann Wright |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1932325701 PECOS PAC ID: 1456420009 Enrollment ID: I20080521000901 |
| Provider Name | David J Mcelligott |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1891966982 PECOS PAC ID: 2365514890 Enrollment ID: I20080627000555 |
| Provider Name | Zaid W Jabbar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730351115 PECOS PAC ID: 2365514809 Enrollment ID: I20080628000035 |
| Provider Name | Mansoina Baweja |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1629052089 PECOS PAC ID: 4486655461 Enrollment ID: I20080628000037 |
| Provider Name | Jobby J Mampilly |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1639340029 PECOS PAC ID: 1456423672 Enrollment ID: I20080703000434 |
| Provider Name | Lekshmi Venugopal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164682597 PECOS PAC ID: 9335212695 Enrollment ID: I20080718000518 |
| Provider Name | Andrea M Priest |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1407823362 PECOS PAC ID: 3173697786 Enrollment ID: I20080730000751 |
| Provider Name | Adam T Schriedel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386815504 PECOS PAC ID: 5890869259 Enrollment ID: I20080801000510 |
| Provider Name | Moses S Tomacruz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144414921 PECOS PAC ID: 4385718253 Enrollment ID: I20080811000675 |
| Provider Name | Tanya P Pitroda |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1245491034 PECOS PAC ID: 5890860795 Enrollment ID: I20080812000242 |
| Provider Name | Janandana K Jeganmohan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942468145 PECOS PAC ID: 2264507466 Enrollment ID: I20080822000576 |
| Provider Name | Peter T Schubel |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1265591069 PECOS PAC ID: 7315012523 Enrollment ID: I20080822000625 |
| Provider Name | Lilia Protaziuk |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962676585 PECOS PAC ID: 9335215888 Enrollment ID: I20080905000632 |
| Provider Name | Francine L Long |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063406924 PECOS PAC ID: 5193791838 Enrollment ID: I20080924000732 |
| Provider Name | Melissa N Kwak |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467668111 PECOS PAC ID: 1850469107 Enrollment ID: I20081014000258 |
| Provider Name | Reem Beckerly |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1437314630 PECOS PAC ID: 2365500659 Enrollment ID: I20081028000489 |
| Provider Name | Sameer A Ansari |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1932214152 PECOS PAC ID: 0042216640 Enrollment ID: I20081029000429 |
| Provider Name | Michael J Siefert |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1306993324 PECOS PAC ID: 3274692439 Enrollment ID: I20081104000206 |
| Provider Name | Christine M Hopkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144481946 PECOS PAC ID: 3678633583 Enrollment ID: I20081122000038 |
| Provider Name | Daniel D Gauthier |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740273499 PECOS PAC ID: 5799846580 Enrollment ID: I20081211000755 |
| Provider Name | John R Gleason |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912990532 PECOS PAC ID: 2264338516 Enrollment ID: I20081211000757 |
| Provider Name | Tomas A Jakstys |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316930068 PECOS PAC ID: 8325035975 Enrollment ID: I20081224000168 |
| Provider Name | Daniel S Sikic |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306839055 PECOS PAC ID: 7810059987 Enrollment ID: I20081224000179 |
| Provider Name | Maria D Sutkus |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447243100 PECOS PAC ID: 0345303103 Enrollment ID: I20090106000466 |
| Provider Name | Richard W Mason |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1003809625 PECOS PAC ID: 3274594924 Enrollment ID: I20090107000138 |
| Provider Name | Eric J Janota |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659364305 PECOS PAC ID: 3779570320 Enrollment ID: I20090107000150 |
| Provider Name | Anne Schneider |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992972988 PECOS PAC ID: 8729143714 Enrollment ID: I20090206000329 |
| Provider Name | Julie Anne Lendzion |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1063632768 PECOS PAC ID: 6103973102 Enrollment ID: I20090408000533 |
| Provider Name | Mary Howard Schramer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1992753784 PECOS PAC ID: 4284781097 Enrollment ID: I20090414000518 |
| Provider Name | Jeffrey Ryan Pua |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689831778 PECOS PAC ID: 3274684923 Enrollment ID: I20090619000452 |
| Provider Name | Ahmed N Hassan |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1548426745 PECOS PAC ID: 8123179348 Enrollment ID: I20090630000202 |
| Provider Name | Matthew M Dunne |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1588853113 PECOS PAC ID: 7416008529 Enrollment ID: I20090701000374 |
| Provider Name | Michael C Hurley |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1407099872 PECOS PAC ID: 1658423835 Enrollment ID: I20090720000056 |
| Provider Name | Kevin Pandya |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1972759298 PECOS PAC ID: 3173676459 Enrollment ID: I20090804000455 |
| Provider Name | William R Broderick |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1164696464 PECOS PAC ID: 4082769005 Enrollment ID: I20090827000138 |
| Provider Name | Jennifer M Felske |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1801897566 PECOS PAC ID: 4183779986 Enrollment ID: I20090831000420 |
| Provider Name | Asha S Muthalaly |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619144680 PECOS PAC ID: 0648326744 Enrollment ID: I20090915000132 |
| Provider Name | Gina Marie Delaurentis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346395654 PECOS PAC ID: 4688710080 Enrollment ID: I20091014000680 |
| Provider Name | Sanjeeb Khatua |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770777658 PECOS PAC ID: 5799822482 Enrollment ID: I20091029000266 |
| Provider Name | Lauren L Fleps |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720210107 PECOS PAC ID: 1557409463 Enrollment ID: I20091113000436 |
| Provider Name | Lea Q Lisowski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669687315 PECOS PAC ID: 6800938762 Enrollment ID: I20100115000417 |
| Provider Name | Patrick J Odonnell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831186964 PECOS PAC ID: 3476698036 Enrollment ID: I20100306000321 |
| Provider Name | James A Lengemann |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447247572 PECOS PAC ID: 9830234491 Enrollment ID: I20100306000326 |
| Provider Name | Jennifer M Ray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962736488 PECOS PAC ID: 1951436047 Enrollment ID: I20100315000506 |
| Provider Name | Ronald J Glas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720075484 PECOS PAC ID: 0840327110 Enrollment ID: I20100416000797 |
| Provider Name | Tayfun M Ozgen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780671818 PECOS PAC ID: 3274661392 Enrollment ID: I20100511001032 |
| Provider Name | Joseph A Giordano |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275520934 PECOS PAC ID: 7113056631 Enrollment ID: I20100521000271 |
| Provider Name | Robert S Czepiel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538156294 PECOS PAC ID: 7911036439 Enrollment ID: I20100521000296 |
| Provider Name | Caren T Corrigan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225365794 PECOS PAC ID: 8527197953 Enrollment ID: I20100524000763 |
| Provider Name | Betty L Hsia |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1871588137 PECOS PAC ID: 7618943119 Enrollment ID: I20100604000824 |
| Provider Name | Barbara A Emery-stolzer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982698841 PECOS PAC ID: 1557337292 Enrollment ID: I20100604001045 |
| Provider Name | Mary Dea |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518951474 PECOS PAC ID: 6002882503 Enrollment ID: I20100608000085 |
| Provider Name | Richard E Erickson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1023019643 PECOS PAC ID: 6406757772 Enrollment ID: I20100714000357 |
| Provider Name | Debarati Bose |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982823100 PECOS PAC ID: 9638201114 Enrollment ID: I20100719000814 |
| Provider Name | Kellen Kyoung Wo Choi |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1164423786 PECOS PAC ID: 5991838823 Enrollment ID: I20100729000447 |
| Provider Name | Ghassan Aldurra |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699781310 PECOS PAC ID: 7214060011 Enrollment ID: I20100730000438 |
| Provider Name | Hsienta Fang |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1760562474 PECOS PAC ID: 0446383764 Enrollment ID: I20100805001107 |
| Provider Name | Karen L Druzak |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1861591612 PECOS PAC ID: 8325062532 Enrollment ID: I20100809001095 |
| Provider Name | Jeanne Bernice Schramm |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033356837 PECOS PAC ID: 9638229750 Enrollment ID: I20100813000546 |
| Provider Name | Yonghua Zhang |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1740503960 PECOS PAC ID: 4183758725 Enrollment ID: I20100817001578 |
| Provider Name | Vinod G Motiani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700891231 PECOS PAC ID: 9335273606 Enrollment ID: I20100823000709 |
| Provider Name | Jon Potter Aagaard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750496923 PECOS PAC ID: 6103870969 Enrollment ID: I20100827000248 |
| Provider Name | Fowzia S Ghouse |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215923826 PECOS PAC ID: 9436118452 Enrollment ID: I20100913001071 |
| Provider Name | Linda A Anderson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1528058195 PECOS PAC ID: 0042335614 Enrollment ID: I20100920000605 |
| Provider Name | Leonard Salvatoe Piazza |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1083633663 PECOS PAC ID: 3173558889 Enrollment ID: I20100925000162 |
| Provider Name | Rodney T Caniglia |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1770518318 PECOS PAC ID: 4082649793 Enrollment ID: I20100925000181 |
| Provider Name | Tiffani L Mckenna |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750697447 PECOS PAC ID: 5698891620 Enrollment ID: I20100928000750 |
| Provider Name | Catherine A Ruetten |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891744439 PECOS PAC ID: 4183761430 Enrollment ID: I20100929000027 |
| Provider Name | Lucio A Pavone |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1790966844 PECOS PAC ID: 0547452708 Enrollment ID: I20101006000287 |
| Provider Name | Iris A Seitz |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1316197858 PECOS PAC ID: 6305038043 Enrollment ID: I20101013000279 |
| Provider Name | Cynthia Yarshen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912114497 PECOS PAC ID: 1254524481 Enrollment ID: I20101020001327 |
| Provider Name | Timothy J Ruetten |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194773499 PECOS PAC ID: 5890755029 Enrollment ID: I20101030000260 |
| Provider Name | Laura Scott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467768358 PECOS PAC ID: 2163616483 Enrollment ID: I20101101000806 |
| Provider Name | Kinjal Shah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295937464 PECOS PAC ID: 2860686714 Enrollment ID: I20101104000552 |
| Provider Name | Thomas R Carver |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1851474753 PECOS PAC ID: 8022202290 Enrollment ID: I20101104000902 |
| Provider Name | Elaine Lawrence |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194793711 PECOS PAC ID: 7012102304 Enrollment ID: I20101111001540 |
| Provider Name | Ketan Morker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275652240 PECOS PAC ID: 7315133022 Enrollment ID: I20101119001144 |
| Provider Name | Casey E Henry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871821884 PECOS PAC ID: 8426245861 Enrollment ID: I20101210000084 |
| Provider Name | Christine Bollier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710293576 PECOS PAC ID: 1153510722 Enrollment ID: I20110112001021 |
| Provider Name | Charles L Lawler |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356324867 PECOS PAC ID: 6305035858 Enrollment ID: I20110113001091 |
| Provider Name | Mary L Kelly |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912087560 PECOS PAC ID: 1254520612 Enrollment ID: I20110117000028 |
| Provider Name | Joseph Dearie |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1770697989 PECOS PAC ID: 3072410752 Enrollment ID: I20110121000975 |
| Provider Name | David J Aguiar |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1679660229 PECOS PAC ID: 7719072834 Enrollment ID: I20110131000114 |
| Provider Name | Ligia N Rioja |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1700871787 PECOS PAC ID: 8224032057 Enrollment ID: I20110216000136 |
| Provider Name | Christine Marie Dahl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548565880 PECOS PAC ID: 1355524794 Enrollment ID: I20110323000418 |
| Provider Name | Mohammad K Khan |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1982912655 PECOS PAC ID: 2264616796 Enrollment ID: I20110407000718 |
| Provider Name | Tamika C Berkley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528365491 PECOS PAC ID: 4688859283 Enrollment ID: I20110426000156 |
| Provider Name | Sachin J Bhalerao |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083759344 PECOS PAC ID: 5092990382 Enrollment ID: I20110502000455 |
| Provider Name | Jane M Pelosi Kelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275730574 PECOS PAC ID: 1153506126 Enrollment ID: I20110506000653 |
| Provider Name | Jessy Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538323456 PECOS PAC ID: 3971780982 Enrollment ID: I20110531000347 |
| Provider Name | Estrella Rubi Gamez-dominguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821389578 PECOS PAC ID: 1951588912 Enrollment ID: I20110601000063 |
| Provider Name | Matthew J Baugh |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1942309125 PECOS PAC ID: 4486831179 Enrollment ID: I20110606000674 |
| Provider Name | Gokul N Solai |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689979197 PECOS PAC ID: 1759568140 Enrollment ID: I20110613000395 |
| Provider Name | Maribeth Maney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619260304 PECOS PAC ID: 7517145857 Enrollment ID: I20110711000070 |
| Provider Name | Kathryn A Walker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235396201 PECOS PAC ID: 7618011420 Enrollment ID: I20110805000706 |
| Provider Name | Faisal Akbari |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1740598705 PECOS PAC ID: 3971772724 Enrollment ID: I20110811000492 |
| Provider Name | Mark L Fehr |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1275781338 PECOS PAC ID: 8527238914 Enrollment ID: I20110822000295 |
| Provider Name | Gregory Goska |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376790071 PECOS PAC ID: 8628248812 Enrollment ID: I20110825000424 |
| Provider Name | Ronald A Zimmermann |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1346404985 PECOS PAC ID: 5991976300 Enrollment ID: I20110915000247 |
| Provider Name | Anna Risty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295020774 PECOS PAC ID: 0446422182 Enrollment ID: I20110930000539 |
| Provider Name | Bob G William |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114111028 PECOS PAC ID: 9234301912 Enrollment ID: I20111003000407 |
| Provider Name | Jacqueline Ross |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609038009 PECOS PAC ID: 9032382734 Enrollment ID: I20111025000284 |
| Provider Name | Laura M Lopez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649556747 PECOS PAC ID: 4981879939 Enrollment ID: I20111202000622 |
| Provider Name | Caryn S Josh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356628275 PECOS PAC ID: 4880869668 Enrollment ID: I20111206000277 |
| Provider Name | Sulaiman Mohammad |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1407185499 PECOS PAC ID: 2264624568 Enrollment ID: I20111208000078 |
| Provider Name | Dorothy Z Warzocha |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598716722 PECOS PAC ID: 7618940024 Enrollment ID: I20111209000631 |
| Provider Name | Jennifer A Duffy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649557927 PECOS PAC ID: 6406022466 Enrollment ID: I20111222000384 |
| Provider Name | Rebecca K Jaster |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578708624 PECOS PAC ID: 3971770066 Enrollment ID: I20120112000297 |
| Provider Name | Kevin Kelly |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1356305882 PECOS PAC ID: 0547227571 Enrollment ID: I20120117000400 |
| Provider Name | Tawana L Edgeson-steiner |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1639449911 PECOS PAC ID: 3870750961 Enrollment ID: I20120201000221 |
| Provider Name | Christine Gresik |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1225298045 PECOS PAC ID: 5092973503 Enrollment ID: I20120229000512 |
| Provider Name | Cheryl Lorenzin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417226986 PECOS PAC ID: 1052570884 Enrollment ID: I20120313000977 |
| Provider Name | Kristine Nichols |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356614796 PECOS PAC ID: 7810157781 Enrollment ID: I20120330000054 |
| Provider Name | Marie E Monhardt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952682742 PECOS PAC ID: 5294998555 Enrollment ID: I20120523000631 |
| Provider Name | Caitlin A Cheney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376817668 PECOS PAC ID: 4486818481 Enrollment ID: I20120601000477 |
| Provider Name | Sarah Maria Sarhaddi |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1184983397 PECOS PAC ID: 2668628744 Enrollment ID: I20120806000157 |
| Provider Name | Kristin M Wiese |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1619103280 PECOS PAC ID: 7810144128 Enrollment ID: I20120821000872 |
| Provider Name | Ehteshamuddin Syed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992932073 PECOS PAC ID: 3274780978 Enrollment ID: I20120831000578 |
| Provider Name | Pranav Tailor |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1063663649 PECOS PAC ID: 4688867823 Enrollment ID: I20120904000729 |
| Provider Name | Kimberly M Mckinnon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124257241 PECOS PAC ID: 1456502285 Enrollment ID: I20121103000047 |
| Provider Name | Mais Trabolsi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154563914 PECOS PAC ID: 8921259292 Enrollment ID: I20121114000109 |
| Provider Name | Mydhili Nandanan Moorthie |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982847810 PECOS PAC ID: 7911158043 Enrollment ID: I20121119000151 |
| Provider Name | Janet M Moloney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750691507 PECOS PAC ID: 3072764133 Enrollment ID: I20121119000449 |
| Provider Name | Samantha R Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689926784 PECOS PAC ID: 1557513157 Enrollment ID: I20121205000475 |
| Provider Name | Durre S Khalil |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1487896940 PECOS PAC ID: 8921251885 Enrollment ID: I20130102000074 |
| Provider Name | Hurmina Muqtadar |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1366647232 PECOS PAC ID: 9830342641 Enrollment ID: I20130103000185 |
| Provider Name | Patricia N Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457609554 PECOS PAC ID: 5890949887 Enrollment ID: I20130128000367 |
| Provider Name | Monica A Martens |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710142740 PECOS PAC ID: 2062686710 Enrollment ID: I20130312000458 |
| Provider Name | Gail M Marich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255678751 PECOS PAC ID: 2961647813 Enrollment ID: I20130325000075 |
| Provider Name | Laura Setlur |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770710287 PECOS PAC ID: 6204072697 Enrollment ID: I20130409000075 |
| Provider Name | Mohammed Siddiqui |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639456122 PECOS PAC ID: 8729224720 Enrollment ID: I20130417000630 |
| Provider Name | Kathy M Plakovic |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730103433 PECOS PAC ID: 2163426784 Enrollment ID: I20130423000374 |
| Provider Name | Stacy N Gill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487905956 PECOS PAC ID: 2062658628 Enrollment ID: I20130426000424 |
| Provider Name | Jill Wozny |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427351451 PECOS PAC ID: 9032357462 Enrollment ID: I20130524000306 |
| Provider Name | John J Mcanelly |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1538480165 PECOS PAC ID: 3274772181 Enrollment ID: I20130625000234 |
| Provider Name | Andrea J Perri |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104169234 PECOS PAC ID: 9931349743 Enrollment ID: I20130627000789 |
| Provider Name | Bradley Cutler |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1477781649 PECOS PAC ID: 3274774922 Enrollment ID: I20130723000973 |
| Provider Name | Jaime A Martinez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962713909 PECOS PAC ID: 4082856554 Enrollment ID: I20130813000246 |
| Provider Name | Ashley T Muhr |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891016499 PECOS PAC ID: 1355584384 Enrollment ID: I20130823000553 |
| Provider Name | Nicholas A Love |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992016901 PECOS PAC ID: 5395988240 Enrollment ID: I20130826000550 |
| Provider Name | Yayati Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992010516 PECOS PAC ID: 9739313891 Enrollment ID: I20131004000199 |
| Provider Name | Neha Shah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861710733 PECOS PAC ID: 9830323674 Enrollment ID: I20131009001383 |
| Provider Name | Arun Ragothaman |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1477871341 PECOS PAC ID: 1153555909 Enrollment ID: I20131009001538 |
| Provider Name | Carol Anne Crews |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508108036 PECOS PAC ID: 3072747450 Enrollment ID: I20131018001027 |
| Provider Name | Kristin A Strausbaugh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780016162 PECOS PAC ID: 9436384856 Enrollment ID: I20131021000275 |
| Provider Name | George A Aghia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811218142 PECOS PAC ID: 1153556592 Enrollment ID: I20131021001027 |
| Provider Name | Tara Reimer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821424300 PECOS PAC ID: 8820223431 Enrollment ID: I20131106000812 |
| Provider Name | Maureen T Gardner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578998100 PECOS PAC ID: 9739315730 Enrollment ID: I20131121001669 |
| Provider Name | April D Krakar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437586799 PECOS PAC ID: 1355577149 Enrollment ID: I20131127000788 |
| Provider Name | Melissa S Rowland |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1942540869 PECOS PAC ID: 6800023086 Enrollment ID: I20131213000973 |
| Provider Name | Sarah D Bucek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750719811 PECOS PAC ID: 1052548245 Enrollment ID: I20131213001405 |
| Provider Name | Kristin E Yates |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679903322 PECOS PAC ID: 6608003694 Enrollment ID: I20131219000821 |
| Provider Name | Melissa A Kreiter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992013791 PECOS PAC ID: 6406023845 Enrollment ID: I20131223001302 |
| Provider Name | William B Schueler |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1780726505 PECOS PAC ID: 3678743549 Enrollment ID: I20140203000552 |
| Provider Name | Gail Gannon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639502230 PECOS PAC ID: 9436388956 Enrollment ID: I20140204000329 |
| Provider Name | Alison M Lennhardt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366866501 PECOS PAC ID: 2769612076 Enrollment ID: I20140306001905 |
| Provider Name | Sarah C Gresk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407273709 PECOS PAC ID: 5698908382 Enrollment ID: I20140505000407 |
| Provider Name | Julie A Zimmer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760802219 PECOS PAC ID: 2062635170 Enrollment ID: I20140519000589 |
| Provider Name | Nazli Bavani |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1437438660 PECOS PAC ID: 8820211584 Enrollment ID: I20140527001104 |
| Provider Name | Ross P Sweeney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215204524 PECOS PAC ID: 1850515818 Enrollment ID: I20140612001426 |
| Provider Name | Dara N Pumphrey-ruiz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215258876 PECOS PAC ID: 3779708680 Enrollment ID: I20140709002347 |
| Provider Name | Anthony J Sikora |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295859536 PECOS PAC ID: 7911965892 Enrollment ID: I20140710001881 |
| Provider Name | Edward R Kessler |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1427205699 PECOS PAC ID: 4981820784 Enrollment ID: I20140731001736 |
| Provider Name | Christine Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427478817 PECOS PAC ID: 1456578764 Enrollment ID: I20140811001313 |
| Provider Name | Jonathan T Gibson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740579820 PECOS PAC ID: 7315164639 Enrollment ID: I20140811001523 |
| Provider Name | Mary C Vercellino |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1760767966 PECOS PAC ID: 4486871209 Enrollment ID: I20140818002692 |
| Provider Name | Kevin B Bockhold |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1063648475 PECOS PAC ID: 5496973935 Enrollment ID: I20140826000961 |
| Provider Name | Sandra E Dempsey |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1487067690 PECOS PAC ID: 0648499335 Enrollment ID: I20140911000007 |
| Provider Name | Zaineb S Qayyum |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346534161 PECOS PAC ID: 9335368901 Enrollment ID: I20140912001008 |
| Provider Name | Neal D Ghelani |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1841604014 PECOS PAC ID: 7719107531 Enrollment ID: I20140930000645 |
| Provider Name | Dylan M Panuska |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1841699220 PECOS PAC ID: 0840411294 Enrollment ID: I20141028001707 |
| Provider Name | Karen L Eisele |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790047710 PECOS PAC ID: 9436377629 Enrollment ID: I20141029002170 |
| Provider Name | Dina P Fioretti |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831520238 PECOS PAC ID: 5597987610 Enrollment ID: I20141105001125 |
| Provider Name | Jennifer Serdiuk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255734877 PECOS PAC ID: 9830411800 Enrollment ID: I20141202000458 |
| Provider Name | Kimberly M Otto |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649672668 PECOS PAC ID: 8527381391 Enrollment ID: I20141231000760 |
| Provider Name | Shannon M Jarot |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194069633 PECOS PAC ID: 1759606791 Enrollment ID: I20150213001114 |
| Provider Name | Sathyakiran B Madoori |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164716056 PECOS PAC ID: 9133359276 Enrollment ID: I20150227001554 |
| Provider Name | Beverly A Wendell |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1366840407 PECOS PAC ID: 0244556363 Enrollment ID: I20150309002164 |
| Provider Name | Abigail M Murphy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164812988 PECOS PAC ID: 4880911593 Enrollment ID: I20150317002438 |
| Provider Name | Mary Anne Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255737433 PECOS PAC ID: 7214255199 Enrollment ID: I20150407000049 |
| Provider Name | Sandi E Jiongco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225428741 PECOS PAC ID: 6204154032 Enrollment ID: I20150407002109 |
| Provider Name | Jonathan Edwards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164820312 PECOS PAC ID: 1951620673 Enrollment ID: I20150430002475 |
| Provider Name | Mary C Keane |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043551807 PECOS PAC ID: 9739325887 Enrollment ID: I20150501001636 |
| Provider Name | Ruth E Mirza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992845747 PECOS PAC ID: 8224097274 Enrollment ID: I20150513000815 |
| Provider Name | Marie Steta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588055958 PECOS PAC ID: 6507186632 Enrollment ID: I20150513001515 |
| Provider Name | Omar Shamsi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053599233 PECOS PAC ID: 7810055225 Enrollment ID: I20150521001161 |
| Provider Name | Brett Collander |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1497088322 PECOS PAC ID: 8426378043 Enrollment ID: I20150522000132 |
| Provider Name | Sergio A Sosa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912305707 PECOS PAC ID: 1355661760 Enrollment ID: I20150527001587 |
| Provider Name | Robert Hung |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770769432 PECOS PAC ID: 2769508696 Enrollment ID: I20150527001903 |
| Provider Name | Farrukh Chaudhry |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1003077900 PECOS PAC ID: 3577794023 Enrollment ID: I20150603002151 |
| Provider Name | Virginia K Hathcock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497020234 PECOS PAC ID: 0345403713 Enrollment ID: I20150611003198 |
| Provider Name | Grace Salame |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1518229897 PECOS PAC ID: 1951613009 Enrollment ID: I20150702001758 |
| Provider Name | James S Andjelic |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861871717 PECOS PAC ID: 7517279490 Enrollment ID: I20150707000869 |
| Provider Name | Krystle Cordova Gadrinab-jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417219437 PECOS PAC ID: 0143448340 Enrollment ID: I20150708001436 |
| Provider Name | Viveka Boddipalli |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1225262934 PECOS PAC ID: 9537471065 Enrollment ID: I20150710002473 |
| Provider Name | Nadia A Mirza |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669678009 PECOS PAC ID: 8426227257 Enrollment ID: I20150724011020 |
| Provider Name | Ruth T. Dubyel |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1134408446 PECOS PAC ID: 0345554739 Enrollment ID: I20150729008388 |
| Provider Name | Julie M Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598025298 PECOS PAC ID: 0547488769 Enrollment ID: I20150730011951 |
| Provider Name | Kimberly Marie-dubois Bannon |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1447549829 PECOS PAC ID: 8729392592 Enrollment ID: I20150806012661 |
| Provider Name | Matthew B Siegel |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1639333263 PECOS PAC ID: 5890949176 Enrollment ID: I20150820011506 |
| Provider Name | Riddhi Pakrasi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114283215 PECOS PAC ID: 4385950732 Enrollment ID: I20150831000888 |
| Provider Name | Teena Aikara Joseph |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033595491 PECOS PAC ID: 5294041596 Enrollment ID: I20150901002636 |
| Provider Name | Hillary Loehman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669858791 PECOS PAC ID: 4587971866 Enrollment ID: I20150918001139 |
| Provider Name | Jessica J Dickinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972987436 PECOS PAC ID: 3476861493 Enrollment ID: I20150924001545 |
| Provider Name | Tiffany E Kendrigan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669854576 PECOS PAC ID: 4981912078 Enrollment ID: I20151009002054 |
| Provider Name | Charles G Ritli |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164570438 PECOS PAC ID: 8820306913 Enrollment ID: I20151009002364 |
| Provider Name | Mary C Briegel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417269077 PECOS PAC ID: 2769791813 Enrollment ID: I20151012002380 |
| Provider Name | Margaret M Gaynor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164890869 PECOS PAC ID: 2668781345 Enrollment ID: I20151020001640 |
| Provider Name | Arkadiy Y Konyukhov |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1689832933 PECOS PAC ID: 7810121738 Enrollment ID: I20151112002945 |
| Provider Name | Shara Ann M Brankin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154792406 PECOS PAC ID: 6406156702 Enrollment ID: I20151118000561 |
| Provider Name | Elsie-linda Nketia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376911461 PECOS PAC ID: 8123328226 Enrollment ID: I20151120002598 |
| Provider Name | Azam Tayyebi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245605088 PECOS PAC ID: 6709187727 Enrollment ID: I20151217000055 |
| Provider Name | Tonette Havala |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1487950309 PECOS PAC ID: 7113228677 Enrollment ID: I20151229001105 |
| Provider Name | Eric Dane Roberts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669554465 PECOS PAC ID: 1759314982 Enrollment ID: I20151230002558 |
| Provider Name | Kimberly S Ricci |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831562859 PECOS PAC ID: 4688976624 Enrollment ID: I20160107000630 |
| Provider Name | Callan M Marcus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144692021 PECOS PAC ID: 2163724014 Enrollment ID: I20160108001056 |
| Provider Name | Ausra Simmert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386009686 PECOS PAC ID: 1658673215 Enrollment ID: I20160113002463 |
| Provider Name | Zena F Goldenberg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497164974 PECOS PAC ID: 7416250394 Enrollment ID: I20160127001224 |
| Provider Name | Margaret Wright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841670437 PECOS PAC ID: 0749590123 Enrollment ID: I20160201000846 |
| Provider Name | Megan Kenny |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194199331 PECOS PAC ID: 3476857749 Enrollment ID: I20160205002144 |
| Provider Name | Jennifer Susan Kenneavy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376814715 PECOS PAC ID: 5597069765 Enrollment ID: I20160209000534 |
| Provider Name | Lisa R Murphy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891152815 PECOS PAC ID: 1052615010 Enrollment ID: I20160211001409 |
| Provider Name | Maureen Marquez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235500877 PECOS PAC ID: 1153625124 Enrollment ID: I20160211001773 |
| Provider Name | Andrew J Hornung |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265897755 PECOS PAC ID: 8224331368 Enrollment ID: I20160217001805 |
| Provider Name | Amy M Batista |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770844060 PECOS PAC ID: 9739339581 Enrollment ID: I20160315001763 |
| Provider Name | Peter Joseph Giordano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326400037 PECOS PAC ID: 9739487596 Enrollment ID: I20160411001861 |
| Provider Name | Brian C Myre |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1194986703 PECOS PAC ID: 1456539246 Enrollment ID: I20160510001856 |
| Provider Name | Ashley L Gallick-sokol |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912368994 PECOS PAC ID: 3870883978 Enrollment ID: I20160601002807 |
| Provider Name | Rebecca J Mclaughlin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881092021 PECOS PAC ID: 5395035182 Enrollment ID: I20160607001694 |
| Provider Name | Anna Sorokin |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1881861342 PECOS PAC ID: 8527201623 Enrollment ID: I20160607002225 |
| Provider Name | Michael Casey |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1346506409 PECOS PAC ID: 1850607235 Enrollment ID: I20160629002025 |
| Provider Name | George Alexander Jones |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1386820439 PECOS PAC ID: 2062585599 Enrollment ID: I20160713002828 |
| Provider Name | Katherine J O'donnell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558711580 PECOS PAC ID: 7618260829 Enrollment ID: I20160726002063 |
| Provider Name | Stacy Landon Centeno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508215450 PECOS PAC ID: 8224321443 Enrollment ID: I20160726002219 |
| Provider Name | Ameer Alwafai |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1255644779 PECOS PAC ID: 6901190362 Enrollment ID: I20160808000829 |
| Provider Name | Mihir Patel |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1992047575 PECOS PAC ID: 6406150291 Enrollment ID: I20160808001004 |
| Provider Name | Alyssa Papuga |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144665654 PECOS PAC ID: 2466773262 Enrollment ID: I20160823000956 |
| Provider Name | Christopher R Shinneman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1144545245 PECOS PAC ID: 2365688124 Enrollment ID: I20160823002387 |
| Provider Name | Laura Meehan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164887519 PECOS PAC ID: 4183919517 Enrollment ID: I20160824003192 |
| Provider Name | Alison L Sage |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427495241 PECOS PAC ID: 5193958577 Enrollment ID: I20160830003067 |
| Provider Name | Gregory B Jasinski |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164735403 PECOS PAC ID: 0345495693 Enrollment ID: I20160831001772 |
| Provider Name | Hollis W Walker |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1053622290 PECOS PAC ID: 2365745155 Enrollment ID: I20160901001219 |
| Provider Name | Adam Spurlock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821541582 PECOS PAC ID: 3274829148 Enrollment ID: I20160901002629 |
| Provider Name | Kathleen Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427404516 PECOS PAC ID: 1254627730 Enrollment ID: I20160909000242 |
| Provider Name | Anu Mathur |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326306937 PECOS PAC ID: 8820231673 Enrollment ID: I20160913002151 |
| Provider Name | Jonathan Kross |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134579196 PECOS PAC ID: 9234426321 Enrollment ID: I20160916000890 |
| Provider Name | Osaama H Khan |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1124494711 PECOS PAC ID: 1254628365 Enrollment ID: I20160916001569 |
| Provider Name | Catherine Stachnik |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1740572247 PECOS PAC ID: 8022313600 Enrollment ID: I20160930000081 |
| Provider Name | Nicholas Ryan Mathenia |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1720377328 PECOS PAC ID: 0840593463 Enrollment ID: I20160930000288 |
| Provider Name | Justin Paul Jamison |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740573427 PECOS PAC ID: 3779873799 Enrollment ID: I20160930000289 |
| Provider Name | Nitika Pant |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619264413 PECOS PAC ID: 5698062982 Enrollment ID: I20160930000503 |
| Provider Name | Stephanie Lee Labedz |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1831431386 PECOS PAC ID: 7012227366 Enrollment ID: I20161011000165 |
| Provider Name | Courtney J Harley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003361049 PECOS PAC ID: 6709164536 Enrollment ID: I20161031000688 |
| Provider Name | Jessica L Setlak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942658927 PECOS PAC ID: 1850679549 Enrollment ID: I20161101000444 |
| Provider Name | Jyoti Shah |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740558261 PECOS PAC ID: 2567612393 Enrollment ID: I20161103002434 |
| Provider Name | Gabrielle C Zaura |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821546870 PECOS PAC ID: 9335427822 Enrollment ID: I20161103002470 |
| Provider Name | Aaron Steven Barker Weiner |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1225441306 PECOS PAC ID: 4789802026 Enrollment ID: I20161108001822 |
| Provider Name | Sarah Elizabeth Chewning |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326494683 PECOS PAC ID: 9436438561 Enrollment ID: I20161114001473 |
| Provider Name | Megan Overcash |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922559673 PECOS PAC ID: 4486933207 Enrollment ID: I20161118002141 |
| Provider Name | Robin Contreras |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043376536 PECOS PAC ID: 9739468422 Enrollment ID: I20161121002082 |
| Provider Name | Chelessa Usselman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225309230 PECOS PAC ID: 6507145208 Enrollment ID: I20161121002326 |
| Provider Name | Sara Rusk |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1689116261 PECOS PAC ID: 2668752148 Enrollment ID: I20161130000726 |
| Provider Name | Kelly Olenski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689064867 PECOS PAC ID: 3476833815 Enrollment ID: I20161201000539 |
| Provider Name | Saher Imtiaz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568883825 PECOS PAC ID: 5496035222 Enrollment ID: I20161213000876 |
| Provider Name | Lauren R Manzara |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235573247 PECOS PAC ID: 4486934270 Enrollment ID: I20161214000275 |
| Provider Name | Jason Vick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770037947 PECOS PAC ID: 5991086126 Enrollment ID: I20170103000192 |
| Provider Name | Danielle Degrado |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942758776 PECOS PAC ID: 8921389917 Enrollment ID: I20170105002177 |
| Provider Name | Nicole M Limon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750789756 PECOS PAC ID: 6800177817 Enrollment ID: I20170106000618 |
| Provider Name | Susan Mangano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598200701 PECOS PAC ID: 3173806650 Enrollment ID: I20170207001616 |
| Provider Name | Elizabeth C Francis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114380235 PECOS PAC ID: 0840574364 Enrollment ID: I20170301001406 |
| Provider Name | Mclorn D Whitt |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1588961775 PECOS PAC ID: 8224312541 Enrollment ID: I20170306002471 |
| Provider Name | Megan E Mietelski |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1184949216 PECOS PAC ID: 4880902493 Enrollment ID: I20170314000836 |
| Provider Name | Carla A Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346780756 PECOS PAC ID: 1254616121 Enrollment ID: I20170316001661 |
| Provider Name | Henry Legaspi |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1023459088 PECOS PAC ID: 9032419049 Enrollment ID: I20170322001294 |
| Provider Name | Ashley A. Crull |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1093255929 PECOS PAC ID: 5597040139 Enrollment ID: I20170323000320 |
| Provider Name | Anne Marie M Fetter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689078875 PECOS PAC ID: 9335424720 Enrollment ID: I20170327002931 |
| Provider Name | Sara E Horvath |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871024786 PECOS PAC ID: 2062797376 Enrollment ID: I20170329001961 |
| Provider Name | Ariel Bernstein |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801334008 PECOS PAC ID: 9032494117 Enrollment ID: I20170403001223 |
| Provider Name | Ingrid C Kanady |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750813580 PECOS PAC ID: 6103102827 Enrollment ID: I20170412001875 |
| Provider Name | Melyssa Kyle Deubler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174069728 PECOS PAC ID: 3476839911 Enrollment ID: I20170417001466 |
| Provider Name | Laura M Barnes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265475768 PECOS PAC ID: 0143122762 Enrollment ID: I20170426000451 |
| Provider Name | Dawn M Kunz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093264756 PECOS PAC ID: 4688951684 Enrollment ID: I20170428002087 |
| Provider Name | Donald R Cantrell |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1477828085 PECOS PAC ID: 8426335936 Enrollment ID: I20170511000532 |
| Provider Name | Deanna L Hoole |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639603814 PECOS PAC ID: 7911284278 Enrollment ID: I20170516000207 |
| Provider Name | Melissa A Robles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831644863 PECOS PAC ID: 5698042752 Enrollment ID: I20170522002039 |
| Provider Name | Kathleen B Mcgreal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366982860 PECOS PAC ID: 0547537532 Enrollment ID: I20170523000603 |
| Provider Name | Drew A Spencer |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1164748026 PECOS PAC ID: 4082916325 Enrollment ID: I20170615000430 |
| Provider Name | Christopher Ochoa |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1952690182 PECOS PAC ID: 5193028314 Enrollment ID: I20170619000444 |
| Provider Name | Ryan R Sullivan |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1063701241 PECOS PAC ID: 9931400371 Enrollment ID: I20170623002215 |
| Provider Name | Catherine E Aler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134584964 PECOS PAC ID: 6406125434 Enrollment ID: I20170707001320 |
| Provider Name | Kristen J. Olszewski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922533397 PECOS PAC ID: 3971872714 Enrollment ID: I20170710002838 |
| Provider Name | Brittany Ann Foote |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730620576 PECOS PAC ID: 2163791831 Enrollment ID: I20170712001400 |
| Provider Name | Ernest John Emery |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336501824 PECOS PAC ID: 0345534111 Enrollment ID: I20170712002301 |
| Provider Name | Waldemar Nowak |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1619256534 PECOS PAC ID: 2062705601 Enrollment ID: I20170718000610 |
| Provider Name | Michael Michael Alagna |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508301656 PECOS PAC ID: 1951671312 Enrollment ID: I20170719000000 |
| Provider Name | Matthew Thomas Morrin |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1598007130 PECOS PAC ID: 2668774894 Enrollment ID: I20170803000001 |
| Provider Name | Jade Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447771787 PECOS PAC ID: 4880965912 Enrollment ID: I20170807003444 |
| Provider Name | Pablo N Quintana |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043624760 PECOS PAC ID: 4486946811 Enrollment ID: I20170808002715 |
| Provider Name | Lourdes Juarez |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1598105835 PECOS PAC ID: 4981975901 Enrollment ID: I20170809000314 |
| Provider Name | Kun Peng |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1790985349 PECOS PAC ID: 9739337577 Enrollment ID: I20170829000236 |
| Provider Name | Vicente Arcos |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1831480888 PECOS PAC ID: 3678705282 Enrollment ID: I20170830002411 |
| Provider Name | Delia M Lacavera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174718787 PECOS PAC ID: 8325133135 Enrollment ID: I20170901002146 |
| Provider Name | Angela Marie Labedz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366804247 PECOS PAC ID: 9739453721 Enrollment ID: I20170914000582 |
| Provider Name | Faith Flaherty |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1740717909 PECOS PAC ID: 6002180999 Enrollment ID: I20170915001006 |
| Provider Name | Tonya Laree Collins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659821197 PECOS PAC ID: 6002180585 Enrollment ID: I20170921002629 |
| Provider Name | Enes M Mugnolo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609396860 PECOS PAC ID: 7719251164 Enrollment ID: I20170922002223 |
| Provider Name | Stephen A Trevick |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1861634776 PECOS PAC ID: 0941442370 Enrollment ID: I20170928001031 |
| Provider Name | Mahvish Hamid |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215348545 PECOS PAC ID: 7214229020 Enrollment ID: I20171017000001 |
| Provider Name | Paul D Regan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629595053 PECOS PAC ID: 2466728613 Enrollment ID: I20171017000010 |
| Provider Name | Brittany Conrad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083133706 PECOS PAC ID: 5193091346 Enrollment ID: I20171017000023 |
| Provider Name | Katelyn L Kline |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396264297 PECOS PAC ID: 3375819238 Enrollment ID: I20171019002497 |
| Provider Name | Megan M Kotlarz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750757845 PECOS PAC ID: 9436451796 Enrollment ID: I20171025000118 |
| Provider Name | Kristen M Mehta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588027809 PECOS PAC ID: 1052687746 Enrollment ID: I20171025000450 |
| Provider Name | Tiana M Carrillo Calderon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619388923 PECOS PAC ID: 9537464359 Enrollment ID: I20171107002122 |
| Provider Name | Lani J Destree |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316186083 PECOS PAC ID: 8628334042 Enrollment ID: I20171117000023 |
| Provider Name | Jessica L Littlefield |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730216292 PECOS PAC ID: 6002173986 Enrollment ID: I20171130002757 |
| Provider Name | Jeanine M Murphy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619495017 PECOS PAC ID: 0446517320 Enrollment ID: I20171130002843 |
| Provider Name | Amish K Doshi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578903613 PECOS PAC ID: 0648567735 Enrollment ID: I20171219002020 |
| Provider Name | Kaitlyn R Rosales |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457877839 PECOS PAC ID: 6305104316 Enrollment ID: I20171221000592 |
| Provider Name | Alan E Long |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1194933945 PECOS PAC ID: 1557660644 Enrollment ID: I20171229000376 |
| Provider Name | Alex B Behar |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1184064099 PECOS PAC ID: 6901104777 Enrollment ID: I20180102001453 |
| Provider Name | Rey Sriaroon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407199003 PECOS PAC ID: 4183929193 Enrollment ID: I20180201000672 |
| Provider Name | Rebecca Harty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518472463 PECOS PAC ID: 3870854292 Enrollment ID: I20180228000566 |
| Provider Name | Christine M Marneris |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1396930046 PECOS PAC ID: 5698037505 Enrollment ID: I20180312002532 |
| Provider Name | Katelyn Marie Hazelett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700393139 PECOS PAC ID: 2264794791 Enrollment ID: I20180322000284 |
| Provider Name | Meghan T Kennedy |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1720431026 PECOS PAC ID: 3678835022 Enrollment ID: I20180322001390 |
| Provider Name | Nicole M Warmac |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821591421 PECOS PAC ID: 6406110550 Enrollment ID: I20180426000752 |
| Provider Name | Jacqueline R Schmidt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144728783 PECOS PAC ID: 2365707098 Enrollment ID: I20180531000094 |
| Provider Name | Carla B Poindexter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013301480 PECOS PAC ID: 9739444266 Enrollment ID: I20180604000386 |
| Provider Name | Heather C Mcleland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174029615 PECOS PAC ID: 4284989468 Enrollment ID: I20180611002768 |
| Provider Name | Amber L Simpson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861998437 PECOS PAC ID: 0648525105 Enrollment ID: I20180625001552 |
| Provider Name | Rami Martini |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1972997948 PECOS PAC ID: 8123323805 Enrollment ID: I20180626002916 |
| Provider Name | Basel Imam |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1245573542 PECOS PAC ID: 2365711785 Enrollment ID: I20180703001689 |
| Provider Name | Mohammed S Azeem |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1144583030 PECOS PAC ID: 4082961594 Enrollment ID: I20180716000154 |
| Provider Name | Ashley K Pinckney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891287926 PECOS PAC ID: 8820345150 Enrollment ID: I20180718001634 |
| Provider Name | Matthew R De La Torre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043714165 PECOS PAC ID: 2961759618 Enrollment ID: I20180726000544 |
| Provider Name | Fadi S Dahdaleh |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1235424656 PECOS PAC ID: 3375783467 Enrollment ID: I20180731003262 |
| Provider Name | Shannon M Kirby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598137390 PECOS PAC ID: 8729336664 Enrollment ID: I20180808002907 |
| Provider Name | Lauren A Gustafson |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1881107787 PECOS PAC ID: 9830448208 Enrollment ID: I20180817001023 |
| Provider Name | Fayeza Mohammed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780071050 PECOS PAC ID: 9335498740 Enrollment ID: I20180817002759 |
| Provider Name | Elizabeth W Montgomery |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487149878 PECOS PAC ID: 6002165396 Enrollment ID: I20180820002711 |
| Provider Name | Courtney E Alvarez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841784139 PECOS PAC ID: 6800146549 Enrollment ID: I20180830001428 |
| Provider Name | Liara Micaela Tillman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487984431 PECOS PAC ID: 8921358672 Enrollment ID: I20180830001779 |
| Provider Name | Tiffany L Bongiorno |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912182148 PECOS PAC ID: 9638429392 Enrollment ID: I20180830002352 |
| Provider Name | Angela J Kostner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023406980 PECOS PAC ID: 8820314982 Enrollment ID: I20180906000813 |
| Provider Name | Denise Valero Ficht |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821477241 PECOS PAC ID: 4486945185 Enrollment ID: I20180914000372 |
| Provider Name | Nisha Dsilva |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1043551500 PECOS PAC ID: 1153619960 Enrollment ID: I20180926001487 |
| Provider Name | Colleen Elizabeth Pasciak |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366819526 PECOS PAC ID: 9032461082 Enrollment ID: I20181003000004 |
| Provider Name | Lauren Campbell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790216331 PECOS PAC ID: 7810249588 Enrollment ID: I20181008000804 |
| Provider Name | Cara Anne Martinez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346722535 PECOS PAC ID: 2961754304 Enrollment ID: I20181011002603 |
| Provider Name | Mary T Lyons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174006290 PECOS PAC ID: 5597018838 Enrollment ID: I20181102000839 |
| Provider Name | Gina T Gedutis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700363827 PECOS PAC ID: 3274886411 Enrollment ID: I20181105002606 |
| Provider Name | Heather P Bautista |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1265982003 PECOS PAC ID: 2668726761 Enrollment ID: I20181108000066 |
| Provider Name | Michael M Sigman |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1982831699 PECOS PAC ID: 4587892260 Enrollment ID: I20181205001538 |
| Provider Name | Yogen Patel |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1104264506 PECOS PAC ID: 1951692177 Enrollment ID: I20181218000880 |
| Provider Name | Lindsey Garnett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437634987 PECOS PAC ID: 5496090482 Enrollment ID: I20181219002351 |
| Provider Name | Gina Dizon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225531577 PECOS PAC ID: 0143565614 Enrollment ID: I20190103000406 |
| Provider Name | Erin C Daley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083185904 PECOS PAC ID: 2961740410 Enrollment ID: I20190208001174 |
| Provider Name | Sarah Kr Ringness |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730655309 PECOS PAC ID: 3375881501 Enrollment ID: I20190214000904 |
| Provider Name | Jennifer A. Spangler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255803052 PECOS PAC ID: 3173862844 Enrollment ID: I20190226000173 |
| Provider Name | Rosilyn Kattiyaman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215407358 PECOS PAC ID: 3274872767 Enrollment ID: I20190227002381 |
| Provider Name | Sobia Sadiq |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1629330303 PECOS PAC ID: 7113159492 Enrollment ID: I20190315001381 |
| Provider Name | Eamann Ayyad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083171813 PECOS PAC ID: 3476893611 Enrollment ID: I20190326000100 |
| Provider Name | Sania S Raza |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1396974457 PECOS PAC ID: 3971795105 Enrollment ID: I20190408002388 |
| Provider Name | Hunan Ali Chaudhry |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1609213958 PECOS PAC ID: 8224329347 Enrollment ID: I20190424001221 |
| Provider Name | Karyn M Kudrna |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699234211 PECOS PAC ID: 9638411564 Enrollment ID: I20190425000680 |
| Provider Name | Ashley S Verbus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215401591 PECOS PAC ID: 4385986231 Enrollment ID: I20190425001929 |
| Provider Name | Cecilia Wild |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912466756 PECOS PAC ID: 8628310307 Enrollment ID: I20190429002036 |
| Provider Name | Heather Marvin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699234195 PECOS PAC ID: 5193067361 Enrollment ID: I20190509000137 |
| Provider Name | Anna Elisabeth Kast |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1376998187 PECOS PAC ID: 8426340803 Enrollment ID: I20190524000228 |
| Provider Name | Michael Palash |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881048767 PECOS PAC ID: 2961737382 Enrollment ID: I20190708002129 |
| Provider Name | Ishtiaq A Habib |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467800961 PECOS PAC ID: 5294061644 Enrollment ID: I20190724000322 |
| Provider Name | Dawen Zhang |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1215341425 PECOS PAC ID: 9335364744 Enrollment ID: I20190813001823 |
| Provider Name | Michael Kimes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548616857 PECOS PAC ID: 0840588489 Enrollment ID: I20190815002002 |
| Provider Name | Godwin Flores |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366095333 PECOS PAC ID: 5698003846 Enrollment ID: I20190826002166 |
| Provider Name | Rebecca C Gary |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699293092 PECOS PAC ID: 2961731625 Enrollment ID: I20190906000376 |
| Provider Name | James S Nitti |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1194106872 PECOS PAC ID: 9739479486 Enrollment ID: I20190910001709 |
| Provider Name | Marie R Zahorick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942862479 PECOS PAC ID: 6608106109 Enrollment ID: I20190926000867 |
| Provider Name | Sandra Marie Pena |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932563996 PECOS PAC ID: 3476836099 Enrollment ID: I20191003001333 |
| Provider Name | Sharon Christy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750736013 PECOS PAC ID: 2365734829 Enrollment ID: I20191008000636 |
| Provider Name | Kathleen M Omerod |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477818557 PECOS PAC ID: 1355597824 Enrollment ID: I20191015000002 |
| Provider Name | Odolina Pope |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629626684 PECOS PAC ID: 0648501007 Enrollment ID: I20191016000867 |
| Provider Name | Niket K Shah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376985630 PECOS PAC ID: 8022399815 Enrollment ID: I20191023001914 |
| Provider Name | Jennifer Jump |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508408345 PECOS PAC ID: 2860724598 Enrollment ID: I20191030002369 |
| Provider Name | Leslie A Greskowiak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164998332 PECOS PAC ID: 5496087967 Enrollment ID: I20191101002021 |
| Provider Name | Melissa Rita Beno-tokarz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235508714 PECOS PAC ID: 9133552425 Enrollment ID: I20191126002899 |
| Provider Name | Jasmine Diaz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760031660 PECOS PAC ID: 6204269947 Enrollment ID: I20191210002735 |
| Provider Name | Laura H Millard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861619140 PECOS PAC ID: 5799751368 Enrollment ID: I20191213001995 |
| Provider Name | Lauren Woodard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619465416 PECOS PAC ID: 1355690207 Enrollment ID: I20200416000061 |
| Provider Name | Jennie R Hackman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740816065 PECOS PAC ID: 6507296712 Enrollment ID: I20200430000216 |
| Provider Name | Tina Doretti |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750912770 PECOS PAC ID: 2163843491 Enrollment ID: I20200522000342 |
| Provider Name | Daniel S Coomes |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1851705271 PECOS PAC ID: 1052734928 Enrollment ID: I20200710000887 |
| Provider Name | Maulik V Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124559117 PECOS PAC ID: 9537431366 Enrollment ID: I20200831000210 |
| Provider Name | Sandra Maria Manley-eichler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487289914 PECOS PAC ID: 5092132456 Enrollment ID: I20200831001086 |
| Provider Name | Sonal Varma |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326489436 PECOS PAC ID: 8022311398 Enrollment ID: I20200917000275 |
| Provider Name | Rand Naffouje |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1124469267 PECOS PAC ID: 2264655539 Enrollment ID: I20200928003135 |
| Provider Name | Arpit Devendra Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740711050 PECOS PAC ID: 5799054466 Enrollment ID: I20201001003390 |
| Provider Name | Daniel John Pappas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053762807 PECOS PAC ID: 6406275627 Enrollment ID: I20201007001328 |
| Provider Name | Kushal Patel |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1811307846 PECOS PAC ID: 2264769447 Enrollment ID: I20201007002551 |
| Provider Name | Ryan Thomas Herbert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578880068 PECOS PAC ID: 1456522697 Enrollment ID: I20201016000690 |
| Provider Name | Zahab Shahid Ahsan |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1629497045 PECOS PAC ID: 2769707850 Enrollment ID: I20201020000511 |
| Provider Name | Kelly Jane Lydon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891308060 PECOS PAC ID: 9638589914 Enrollment ID: I20201028002004 |
| Provider Name | Kelly Hundman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366071797 PECOS PAC ID: 5597175794 Enrollment ID: I20201029000083 |
| Provider Name | Sana Syed |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1023496882 PECOS PAC ID: 4981930740 Enrollment ID: I20201109001809 |
| Provider Name | Kimberly Delapp |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1679990121 PECOS PAC ID: 9537381009 Enrollment ID: I20201117002580 |
| Provider Name | Samantha L Cerqua |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518564194 PECOS PAC ID: 8426469750 Enrollment ID: I20201118000254 |
| Provider Name | Jyoti Kanda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912544180 PECOS PAC ID: 3476964511 Enrollment ID: I20201123000552 |
| Provider Name | Hussam Syed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861903494 PECOS PAC ID: 7719246610 Enrollment ID: I20201204000472 |
| Provider Name | Vinny Sharma |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1922427004 PECOS PAC ID: 6305156498 Enrollment ID: I20201205000142 |
| Provider Name | Harman Grewal |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1851551576 PECOS PAC ID: 2668644899 Enrollment ID: I20201222001021 |
| Provider Name | Kristin Elizabeth Katsenes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861021073 PECOS PAC ID: 4183037260 Enrollment ID: I20210109000116 |
| Provider Name | Alicia Noyes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154917201 PECOS PAC ID: 0941614853 Enrollment ID: I20210203002215 |
| Provider Name | Hollie Amber Balazs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659965804 PECOS PAC ID: 6608282058 Enrollment ID: I20210309002144 |
| Provider Name | Alan Mellow |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790861714 PECOS PAC ID: 2668501941 Enrollment ID: I20210330000111 |
| Provider Name | Sarah Krippel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780267526 PECOS PAC ID: 9830598952 Enrollment ID: I20210521002100 |
| Provider Name | Anne Dougherty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558384487 PECOS PAC ID: 2567414089 Enrollment ID: I20210615000930 |
| Provider Name | Timothy Jordan Stear |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1730543984 PECOS PAC ID: 2365737517 Enrollment ID: I20210618000413 |
| Provider Name | Astrid Marshall |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1457884108 PECOS PAC ID: 5496085904 Enrollment ID: I20210623002242 |
| Provider Name | Kathryn Maria Ghanayem Kubilius |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467942409 PECOS PAC ID: 0042648859 Enrollment ID: I20210625000113 |
| Provider Name | Brian Thomas Skraba |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801488721 PECOS PAC ID: 2668875956 Enrollment ID: I20210723002124 |
| Provider Name | Lori Hutcherson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1093102683 PECOS PAC ID: 6608279773 Enrollment ID: I20210727002294 |
| Provider Name | Andrew Wiele |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1447663539 PECOS PAC ID: 3173748399 Enrollment ID: I20210805000380 |
| Provider Name | Justine Nicole Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073180188 PECOS PAC ID: 0749684280 Enrollment ID: I20210805003164 |
| Provider Name | Franklin Chang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114423043 PECOS PAC ID: 5991109431 Enrollment ID: I20210805003294 |
| Provider Name | Suzanne Oddo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912512823 PECOS PAC ID: 0749685469 Enrollment ID: I20210818003067 |
| Provider Name | Francis Antony |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023400728 PECOS PAC ID: 4688079064 Enrollment ID: I20210824000055 |
| Provider Name | Jasmine Johnson |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1114400868 PECOS PAC ID: 4688070956 Enrollment ID: I20210913000678 |
| Provider Name | Jeremy Sugrue |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1407199235 PECOS PAC ID: 8325357502 Enrollment ID: I20210914000378 |
| Provider Name | Yi Hwa Kim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366936189 PECOS PAC ID: 4385072206 Enrollment ID: I20210915001111 |
| Provider Name | Christine Yaeger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750055570 PECOS PAC ID: 4385041466 Enrollment ID: I20210916003228 |
| Provider Name | Tobin Jacob Tito |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124616602 PECOS PAC ID: 9335547066 Enrollment ID: I20211012000197 |
| Provider Name | Myat Thuya Nyunt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871262824 PECOS PAC ID: 5193113439 Enrollment ID: I20211019002508 |
| Provider Name | Thuyen Nguyen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336803899 PECOS PAC ID: 7517356264 Enrollment ID: I20211118000208 |
| Provider Name | Michelle Verner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912673336 PECOS PAC ID: 8224427984 Enrollment ID: I20211118000749 |
| Provider Name | Ann Marie Schubert |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1952063885 PECOS PAC ID: 0749671188 Enrollment ID: I20211220001610 |
| Provider Name | Darette Marocchi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841878758 PECOS PAC ID: 9335530336 Enrollment ID: I20211230001446 |
| Provider Name | Jacqueline Marie Nichols |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821752494 PECOS PAC ID: 8628469590 Enrollment ID: I20220104000227 |
| Provider Name | Liang Xue |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1750623849 PECOS PAC ID: 7810280062 Enrollment ID: I20220309002220 |
| Provider Name | Jack Patrick Kane |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164184214 PECOS PAC ID: 7911392337 Enrollment ID: I20220322002877 |
| Provider Name | Lindsey Alisen Harrington |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1548401441 PECOS PAC ID: 2163817313 Enrollment ID: I20220324002519 |
| Provider Name | Theresa Kosovrasti |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124797816 PECOS PAC ID: 0143615336 Enrollment ID: I20220325001029 |
| Provider Name | Christina Wong |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679023527 PECOS PAC ID: 0042606493 Enrollment ID: I20220412000329 |
| Provider Name | Ashley Lupo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508518317 PECOS PAC ID: 2365838588 Enrollment ID: I20220414001958 |
| Provider Name | Kelly Lynn Erickson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083377550 PECOS PAC ID: 4284021346 Enrollment ID: I20220420002262 |
| Provider Name | Melanie Margarita Wilke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194490714 PECOS PAC ID: 4284021254 Enrollment ID: I20220420003173 |
| Provider Name | Inga Clemens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285384198 PECOS PAC ID: 9638556418 Enrollment ID: I20220517000978 |
| Provider Name | Joseph Heng |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1700270154 PECOS PAC ID: 3274852892 Enrollment ID: I20220601001390 |
| Provider Name | Steven D Pearson |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1144609256 PECOS PAC ID: 2860704798 Enrollment ID: I20220712003739 |
| Provider Name | Natalie Dreher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164993630 PECOS PAC ID: 5991187650 Enrollment ID: I20220728001057 |
| Provider Name | Meghana Injam |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1821483181 PECOS PAC ID: 5092010009 Enrollment ID: I20220728001510 |
| Provider Name | Shaheen Jadidi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588124077 PECOS PAC ID: 9335473016 Enrollment ID: I20220728002636 |
| Provider Name | Daniel M Heiferman |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1891037370 PECOS PAC ID: 1052612603 Enrollment ID: I20220728002685 |
| Provider Name | Yuri Zermeno |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1003310186 PECOS PAC ID: 7012399280 Enrollment ID: I20220804000781 |
| Provider Name | Angela Dea |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033842919 PECOS PAC ID: 2860874039 Enrollment ID: I20220804001027 |
| Provider Name | Amanda Marie Biskup |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124766506 PECOS PAC ID: 6901289883 Enrollment ID: I20220810003758 |
| Provider Name | Ahmad Nourallah |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1164965992 PECOS PAC ID: 7911288014 Enrollment ID: I20220811003640 |
| Provider Name | Brij Ashokkumar Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750841102 PECOS PAC ID: 5799016101 Enrollment ID: I20220821000057 |
| Provider Name | Ezequiel R Mora |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912641879 PECOS PAC ID: 5991188153 Enrollment ID: I20220821000060 |
| Provider Name | Teresa Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609394212 PECOS PAC ID: 9537543202 Enrollment ID: I20220829003531 |
| Provider Name | Joseph Lawrence Graham |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1578095295 PECOS PAC ID: 6608144688 Enrollment ID: I20220830004208 |
| Provider Name | Ramez Nader Abdalla |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1407410392 PECOS PAC ID: 9436484706 Enrollment ID: I20220915002173 |
| Provider Name | Rajul M Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982269239 PECOS PAC ID: 5496081788 Enrollment ID: I20220920003173 |
| Provider Name | Gustavo Chagoya Gazcon |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1538555081 PECOS PAC ID: 5991011017 Enrollment ID: I20220923000247 |
| Provider Name | Cortney Cole |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013446905 PECOS PAC ID: 3577948744 Enrollment ID: I20220923002902 |
| Provider Name | Erin Marie Sebo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104461045 PECOS PAC ID: 9032594213 Enrollment ID: I20220924000178 |
| Provider Name | Jimmy Zhu |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1467816249 PECOS PAC ID: 4486945094 Enrollment ID: I20220929002823 |
| Provider Name | Abigail Richmond |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114652997 PECOS PAC ID: 1951787381 Enrollment ID: I20221007001395 |
| Provider Name | Christina R Lyon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437545183 PECOS PAC ID: 1850662297 Enrollment ID: I20221007002379 |
| Provider Name | Brandy J Coleman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376297937 PECOS PAC ID: 7911373220 Enrollment ID: I20221011002153 |
| Provider Name | Brittany Bisaillon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568192425 PECOS PAC ID: 8123495447 Enrollment ID: I20221031000081 |
| Provider Name | Ralph Hermes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669032769 PECOS PAC ID: 1254661838 Enrollment ID: I20221103002983 |
| Provider Name | Joseph G Pepitone |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770014920 PECOS PAC ID: 1254602246 Enrollment ID: I20221109000202 |
| Provider Name | Maryl Louisa Pinotti |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528629375 PECOS PAC ID: 1456683895 Enrollment ID: I20221116000344 |
| Provider Name | Lauren Feng |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437680279 PECOS PAC ID: 9931512613 Enrollment ID: I20221116001274 |
| Provider Name | Lori Lynn Marek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124752092 PECOS PAC ID: 5991173239 Enrollment ID: I20221117002912 |
| Provider Name | Beth Gomez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831816966 PECOS PAC ID: 6002284288 Enrollment ID: I20221118001082 |
| Provider Name | Aisha Besanna Seals |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952023467 PECOS PAC ID: 1557739661 Enrollment ID: I20221122000129 |
| Provider Name | Jayne Marie Corrigan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750027199 PECOS PAC ID: 0042688970 Enrollment ID: I20221123002245 |
| Provider Name | Kohl Mitchell Mayberry |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295028256 PECOS PAC ID: 4688808223 Enrollment ID: I20221128001447 |
| Provider Name | Hilda Bonsu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558018754 PECOS PAC ID: 8123497476 Enrollment ID: I20221208003122 |
| Provider Name | Jill Newberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760107742 PECOS PAC ID: 9436528189 Enrollment ID: I20221220000688 |
| Provider Name | Kelly Harpole |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083299390 PECOS PAC ID: 0648688143 Enrollment ID: I20230109001185 |
| Provider Name | Donna Stewart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578275202 PECOS PAC ID: 1557732476 Enrollment ID: I20230131002711 |
| Provider Name | Kelli Phelan |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1619694106 PECOS PAC ID: 8325419203 Enrollment ID: I20230201001502 |
| Provider Name | Elizabeth Podlasek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699496752 PECOS PAC ID: 3577935444 Enrollment ID: I20230202003001 |
| Provider Name | Haley Judith Singer |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1033820568 PECOS PAC ID: 4183096993 Enrollment ID: I20230203001498 |
| Provider Name | Margaret Ann Cappello |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902238819 PECOS PAC ID: 0648642462 Enrollment ID: I20230203001887 |
| Provider Name | Yolanda Chenoweth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801354410 PECOS PAC ID: 5294107686 Enrollment ID: I20230213000996 |
| Provider Name | Shireen Khan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1841601101 PECOS PAC ID: 8628327772 Enrollment ID: I20230223000871 |
| Provider Name | Stephanie Bucz |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1770058877 PECOS PAC ID: 7416320528 Enrollment ID: I20230309002678 |
| Provider Name | Casey Houts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053023820 PECOS PAC ID: 6103290903 Enrollment ID: I20230317001253 |
| Provider Name | Michelle L Reich |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1245951003 PECOS PAC ID: 9234504085 Enrollment ID: I20230407001197 |
| Provider Name | Aaron Huth |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356808414 PECOS PAC ID: 6800261249 Enrollment ID: I20230417001523 |
| Provider Name | Shahid Ahsan |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1740208180 PECOS PAC ID: 0941262810 Enrollment ID: I20230606000271 |
| Provider Name | Raquel Alyssa Bischoff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740970748 PECOS PAC ID: 7416316674 Enrollment ID: I20230706000886 |
| Provider Name | Nancy Tate-julu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245924414 PECOS PAC ID: 5597125260 Enrollment ID: I20230713002490 |
| Provider Name | Morta Lapkus |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1245689603 PECOS PAC ID: 4981994498 Enrollment ID: I20230720000066 |
| Provider Name | Ella Pearl Zuniga |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013607589 PECOS PAC ID: 2860853603 Enrollment ID: I20230726003354 |
| Provider Name | Eric Daniel Jung |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1922413335 PECOS PAC ID: 8921372814 Enrollment ID: I20230727000743 |
| Provider Name | Allison Noel Block |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1376040089 PECOS PAC ID: 2769812080 Enrollment ID: I20230804002049 |
| Provider Name | Julia Mitkova Manikatova |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164113437 PECOS PAC ID: 9830550904 Enrollment ID: I20230804003347 |
| Provider Name | Angela Quiroz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174212088 PECOS PAC ID: 4082076492 Enrollment ID: I20230817000951 |
| Provider Name | Natasha Kadakia |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1811484199 PECOS PAC ID: 8426305814 Enrollment ID: I20230822001497 |
| Provider Name | Alla Jusufi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609496850 PECOS PAC ID: 7618339706 Enrollment ID: I20230822002118 |
| Provider Name | Safiya Elahi |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1740784362 PECOS PAC ID: 7911252671 Enrollment ID: I20230828003429 |
| Provider Name | Lindy Kate Luchowski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033801089 PECOS PAC ID: 2961865688 Enrollment ID: I20230829001909 |
| Provider Name | Meghan Gorski |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1144670555 PECOS PAC ID: 2163803016 Enrollment ID: I20230901002125 |
| Provider Name | Christine Marie Reed |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609324383 PECOS PAC ID: 0143684233 Enrollment ID: I20230907002398 |
| Provider Name | Caroline Dluski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134809304 PECOS PAC ID: 3476908609 Enrollment ID: I20231009001452 |
| Provider Name | Jasshan M Mehrotra |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1194135368 PECOS PAC ID: 6305147398 Enrollment ID: I20231016002854 |
| Provider Name | Yumna Ahmad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952938284 PECOS PAC ID: 6800212416 Enrollment ID: I20231113002678 |
| Provider Name | Nancy J Kuhlman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760067912 PECOS PAC ID: 7315394103 Enrollment ID: I20231116000870 |
| Provider Name | Nikola Nadia Roszko Augustynowicz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104604255 PECOS PAC ID: 4183072655 Enrollment ID: I20231121003009 |
Boling Medical Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 899 S Weber Rd, Suite G, Bolingbrook, IL 60490 Phone: 630-226-1800 Fax: 630-226-4226 | |
Associates Of Inpatient Management Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1000 Remington Blvd, Ste 200, Bolingbrook, IL 60440 Phone: 630-312-7865 | |
Bolingbrook Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 329 Remington Blvd, Ste 100, Bolingbrook, IL 60440 Phone: 630-759-4800 Fax: 630-759-6927 | |
Sabs Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 899 S Weber Rd, Suite A, Bolingbrook, IL 60490 Phone: 630-544-7283 Fax: 708-221-6631 | |
Premier Occupational Health Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 550 E Boughton Rd, # 140, Bolingbrook, IL 60440 Phone: 630-972-0733 | |
Presence Healthcare Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1000 Remington Blvd Ste 100, Bolingbrook, IL 60440 Phone: 630-914-2468 | |
Medical Home Care Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 167 W Boughton Rd Ste C, Bolingbrook, IL 60440 Phone: 331-871-6674 |