| Kirby Medical Center | |
|
1000 Medical Center Dr Monticello IL 61856-2116 | |
| (217) 762-2115 | |
| (217) 762-1502 |
| Full Name | Kirby Medical Center |
|---|---|
| Speciality | Family Medicine |
| Location | 1000 Medical Center Dr, Monticello, Illinois |
| Authorized Official Name and Position | Steven D. Tenhouse (CEO) |
| Authorized Official Contact | 2177621501 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kirby Medical Center 1000 Medical Center Dr Monticello IL 61856-2116 Ph: (217) 762-2115 | Kirby Medical Center 1000 Medical Center Dr Monticello IL 61856-2116 Ph: (217) 762-2115 |
| NPI Number | 1386635373 |
|---|---|
| Provider Enumeration Date | 10/31/2005 |
| Last Update Date | 12/11/2020 |
| Medicare PECOS PAC ID | 6901791144 |
|---|---|
| Medicare Enrollment ID | O20050801000320 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386635373 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 0002758 (Illinois) | Primary |
| Provider Name | Bradley A Peterson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1730145269 PECOS PAC ID: 2062314560 Enrollment ID: I20040124000129 |
| Provider Name | Naveed Ahamad Adoni |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881644177 PECOS PAC ID: 9335037605 Enrollment ID: I20040308001341 |
| Provider Name | Douglas J Jones |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1649287210 PECOS PAC ID: 4789670845 Enrollment ID: I20040423000077 |
| Provider Name | Brian C Yocks |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811954878 PECOS PAC ID: 2860483658 Enrollment ID: I20040520000773 |
| Provider Name | Andrea Tirpak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629139266 PECOS PAC ID: 7517949076 Enrollment ID: I20040607001167 |
| Provider Name | Ikechukwu L Uzoaru |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1518023035 PECOS PAC ID: 8022091578 Enrollment ID: I20040608000236 |
| Provider Name | Mitchell A Sussman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1427097104 PECOS PAC ID: 4385627165 Enrollment ID: I20040611000669 |
| Provider Name | Michael F Hegarty |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1083630933 PECOS PAC ID: 0345223095 Enrollment ID: I20040611001268 |
| Provider Name | Mary F Hartman |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1558368282 PECOS PAC ID: 7618956178 Enrollment ID: I20040717000259 |
| Provider Name | John Sudkamp |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1730141524 PECOS PAC ID: 8123929858 Enrollment ID: I20040729000746 |
| Provider Name | Randolph S Martin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366436818 PECOS PAC ID: 4082694484 Enrollment ID: I20040802001325 |
| Provider Name | Allison Hinch |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1891756987 PECOS PAC ID: 3678542909 Enrollment ID: I20041001000977 |
| Provider Name | Teresa D Duncan |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1679669378 PECOS PAC ID: 9830158971 Enrollment ID: I20041005001036 |
| Provider Name | Erik K Kooba |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1477503167 PECOS PAC ID: 3173582541 Enrollment ID: I20041013001293 |
| Provider Name | Zheng G Liu |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1841210952 PECOS PAC ID: 7416917471 Enrollment ID: I20041013001317 |
| Provider Name | Rana H Mahmood |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1043363211 PECOS PAC ID: 6800859885 Enrollment ID: I20041111000221 |
| Provider Name | Stuart F Baker |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1114918489 PECOS PAC ID: 3476521881 Enrollment ID: I20050211000630 |
| Provider Name | Eileen Frances Couture |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1841396215 PECOS PAC ID: 5597712307 Enrollment ID: I20050404001109 |
| Provider Name | Greg David Daley |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1043385859 PECOS PAC ID: 3476592726 Enrollment ID: I20050427000351 |
| Provider Name | Momin Muzaffar |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1588690812 PECOS PAC ID: 3173559655 Enrollment ID: I20050715000588 |
| Provider Name | Thomas W Deschler |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1760408868 PECOS PAC ID: 3375571417 Enrollment ID: I20050801000022 |
| Provider Name | Sharon R Woods |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1508843475 PECOS PAC ID: 9931138245 Enrollment ID: I20050808000289 |
| Provider Name | Farah S Gaudier |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1407875628 PECOS PAC ID: 6507899457 Enrollment ID: I20050913000125 |
| Provider Name | Douglas W Morton |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1134143555 PECOS PAC ID: 8729984414 Enrollment ID: I20051213000144 |
| Provider Name | James E Manint |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376534420 PECOS PAC ID: 7911892161 Enrollment ID: I20051228000244 |
| Provider Name | Narain D Mandhan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730170655 PECOS PAC ID: 7517852767 Enrollment ID: I20051228000257 |
| Provider Name | Reinaldo Sanchez Torres |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1467468553 PECOS PAC ID: 9335144237 Enrollment ID: I20060928000122 |
| Provider Name | Sanjay S Mehta |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1477572022 PECOS PAC ID: 0941205777 Enrollment ID: I20060928000467 |
| Provider Name | Andrea V Brasch |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1740353457 PECOS PAC ID: 4880694710 Enrollment ID: I20061228000059 |
| Provider Name | Lisa F Kamm |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1467536532 PECOS PAC ID: 5193726677 Enrollment ID: I20070125000513 |
| Provider Name | Elizabeth E Kuntz |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1982677159 PECOS PAC ID: 6002895109 Enrollment ID: I20070822001485 |
| Provider Name | Martin A Kuntz |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1346220522 PECOS PAC ID: 2961304134 Enrollment ID: I20070906000503 |
| Provider Name | John M Furry |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1245237304 PECOS PAC ID: 0446344394 Enrollment ID: I20070921000790 |
| Provider Name | Shane R Fancher |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1427055433 PECOS PAC ID: 8022045616 Enrollment ID: I20070921000797 |
| Provider Name | Scott Evan Grossberg |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801831078 PECOS PAC ID: 8224041116 Enrollment ID: I20071015000294 |
| Provider Name | Scott Richard Santeler |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1346430667 PECOS PAC ID: 2163595794 Enrollment ID: I20080715000828 |
| Provider Name | Dean Hoffmeister |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1346441805 PECOS PAC ID: 5092816470 Enrollment ID: I20080725000116 |
| Provider Name | Naveen Chapa |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1649479650 PECOS PAC ID: 2860566312 Enrollment ID: I20080801000317 |
| Provider Name | Deanna Y Hitchens |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1598942740 PECOS PAC ID: 4082780960 Enrollment ID: I20080828000299 |
| Provider Name | Stephanie K Weber |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1205992112 PECOS PAC ID: 1052487196 Enrollment ID: I20080915000019 |
| Provider Name | Ronald Eugene Baker |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1437315124 PECOS PAC ID: 6608944202 Enrollment ID: I20081009000476 |
| Provider Name | Michael D Carroll |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1457386351 PECOS PAC ID: 3476595265 Enrollment ID: I20090313000077 |
| Provider Name | David P Chan |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1427057595 PECOS PAC ID: 1153471701 Enrollment ID: I20090603000079 |
| Provider Name | April Lynn Dickenson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1417127457 PECOS PAC ID: 9830260009 Enrollment ID: I20090721000658 |
| Provider Name | Mbu Mongwa |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1295947083 PECOS PAC ID: 2264480748 Enrollment ID: I20090901000450 |
| Provider Name | Frank J Bellafiore |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1730103201 PECOS PAC ID: 0840345328 Enrollment ID: I20090904000378 |
| Provider Name | Chunling Gong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952572661 PECOS PAC ID: 7416002811 Enrollment ID: I20090909000270 |
| Provider Name | Benjamin J Rhee |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1013957935 PECOS PAC ID: 8921014267 Enrollment ID: I20090909000466 |
| Provider Name | Juan J Jimenez |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1174548911 PECOS PAC ID: 7012054927 Enrollment ID: I20091027000061 |
| Provider Name | Nicole R Howell |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1679778815 PECOS PAC ID: 0648363812 Enrollment ID: I20100519000457 |
| Provider Name | Christopher K Bodine |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1396775185 PECOS PAC ID: 8729029020 Enrollment ID: I20100825000554 |
| Provider Name | Glen E. Dust |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477555738 PECOS PAC ID: 5395716575 Enrollment ID: I20100901000604 |
| Provider Name | Steve C Hong |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1154536530 PECOS PAC ID: 0042336224 Enrollment ID: I20100924000644 |
| Provider Name | Uday R Shankar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992901185 PECOS PAC ID: 9133213077 Enrollment ID: I20101007000481 |
| Provider Name | James Y Park |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1285830307 PECOS PAC ID: 6305031212 Enrollment ID: I20101117000283 |
| Provider Name | James A Enderle |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1851553903 PECOS PAC ID: 5799968459 Enrollment ID: I20110811000840 |
| Provider Name | Brian J Wheatley |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1114149770 PECOS PAC ID: 0143490243 Enrollment ID: I20110829000361 |
| Provider Name | Sara Elizabeth Eades Wade |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1740558428 PECOS PAC ID: 6002079472 Enrollment ID: I20120522001032 |
| Provider Name | Gregory A Babcock |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1093722738 PECOS PAC ID: 9234132838 Enrollment ID: I20120731000246 |
| Provider Name | Marc D Knepp |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1568686277 PECOS PAC ID: 0446421960 Enrollment ID: I20120828000835 |
| Provider Name | Marshall B Hay |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1780683391 PECOS PAC ID: 7416959218 Enrollment ID: I20130125000269 |
| Provider Name | Alexia M Beccue |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1609030428 PECOS PAC ID: 8426202300 Enrollment ID: I20130130000103 |
| Provider Name | Danny W Beal |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1184769887 PECOS PAC ID: 3072693902 Enrollment ID: I20130227000167 |
| Provider Name | Jamey L Witmer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487992780 PECOS PAC ID: 4082859780 Enrollment ID: I20130401000092 |
| Provider Name | Nadia Nasreen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780913228 PECOS PAC ID: 1658518717 Enrollment ID: I20130508000512 |
| Provider Name | Laci M Rascher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083057368 PECOS PAC ID: 9436399292 Enrollment ID: I20130628000376 |
| Provider Name | Donald N Sullivan |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1154511517 PECOS PAC ID: 4486894508 Enrollment ID: I20130719000134 |
| Provider Name | Jacob D Sams |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1730340498 PECOS PAC ID: 5395985410 Enrollment ID: I20130719000187 |
| Provider Name | Behrang Khoie |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1275720955 PECOS PAC ID: 5092987107 Enrollment ID: I20130813000250 |
| Provider Name | Jeremy Hogg |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1386834299 PECOS PAC ID: 9830264530 Enrollment ID: I20130815000621 |
| Provider Name | Patricia Henry |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629308663 PECOS PAC ID: 1850533126 Enrollment ID: I20130815000705 |
| Provider Name | David C Liss |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659713139 PECOS PAC ID: 5698919256 Enrollment ID: I20130920000467 |
| Provider Name | Anuj Garg |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1679585905 PECOS PAC ID: 9537165063 Enrollment ID: I20131101000558 |
| Provider Name | Ashley N Rosenbery |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1942625546 PECOS PAC ID: 0143452292 Enrollment ID: I20140404000174 |
| Provider Name | Crickett J Engelbrecht |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962812826 PECOS PAC ID: 6507080520 Enrollment ID: I20140613001086 |
| Provider Name | Daniel Mandel |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1932300357 PECOS PAC ID: 9830375633 Enrollment ID: I20141001002140 |
| Provider Name | Brian Beeman |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1033384722 PECOS PAC ID: 5799964839 Enrollment ID: I20141007002175 |
| Provider Name | William Manzo |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1689712408 PECOS PAC ID: 5890768170 Enrollment ID: I20141204001138 |
| Provider Name | Kinza Gul |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255609541 PECOS PAC ID: 3274856919 Enrollment ID: I20150102001410 |
| Provider Name | John Kim |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1497799613 PECOS PAC ID: 8729234356 Enrollment ID: I20150211001873 |
| Provider Name | Brett Yockey |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1346400850 PECOS PAC ID: 9032257860 Enrollment ID: I20150504002446 |
| Provider Name | Rachel Hayden |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1942693692 PECOS PAC ID: 0749509297 Enrollment ID: I20150505000539 |
| Provider Name | Kyle Minor |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1306001227 PECOS PAC ID: 7719163823 Enrollment ID: I20150720002527 |
| Provider Name | Brent Kaufmann |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053549121 PECOS PAC ID: 4587897350 Enrollment ID: I20150812006416 |
| Provider Name | Daniel Votava |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1790046126 PECOS PAC ID: 9335465525 Enrollment ID: I20150819008247 |
| Provider Name | Sarah Cherian |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1982970638 PECOS PAC ID: 0648586461 Enrollment ID: I20150825002804 |
| Provider Name | Santia T Fitzpatrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710343330 PECOS PAC ID: 6406150309 Enrollment ID: I20160215000470 |
| Provider Name | Jason Huston |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1124288915 PECOS PAC ID: 5890979512 Enrollment ID: I20160422000245 |
| Provider Name | Melissa R Huston |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1407161433 PECOS PAC ID: 6305014382 Enrollment ID: I20160504002268 |
| Provider Name | Karen P Wiarda |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1174733224 PECOS PAC ID: 3678741386 Enrollment ID: I20160722002144 |
| Provider Name | Uday Kanakadandi |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1003086182 PECOS PAC ID: 9931273018 Enrollment ID: I20160805002029 |
| Provider Name | Ibrahim Shaik |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912197831 PECOS PAC ID: 7517154479 Enrollment ID: I20160822001987 |
| Provider Name | Lauren Louise Fore |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609216548 PECOS PAC ID: 1759515315 Enrollment ID: I20160831001797 |
| Provider Name | James Hlubocky |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1235441635 PECOS PAC ID: 1850522269 Enrollment ID: I20160906001687 |
| Provider Name | Edward C Elliott |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1083957088 PECOS PAC ID: 0345484606 Enrollment ID: I20160928000262 |
| Provider Name | Youssef Elias |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1972828291 PECOS PAC ID: 8123327558 Enrollment ID: I20161007000420 |
| Provider Name | Samir Turakhia |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1942590906 PECOS PAC ID: 9234427147 Enrollment ID: I20161010000939 |
| Provider Name | Aaron C Radish |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1578970851 PECOS PAC ID: 7012214786 Enrollment ID: I20161018001652 |
| Provider Name | Michael J Smith |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1861491599 PECOS PAC ID: 8921992520 Enrollment ID: I20161230001626 |
| Provider Name | Bruk Endale |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1538368204 PECOS PAC ID: 7517100340 Enrollment ID: I20170320001457 |
| Provider Name | Walid Yousef Halees |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1306387774 PECOS PAC ID: 0547545972 Enrollment ID: I20170327000366 |
| Provider Name | Kelsey M Thacker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245765296 PECOS PAC ID: 6002183381 Enrollment ID: I20170517002865 |
| Provider Name | Syed Javed H Zaidi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1255646675 PECOS PAC ID: 8426354648 Enrollment ID: I20170821003444 |
| Provider Name | Evelyn Huang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295152205 PECOS PAC ID: 6305061151 Enrollment ID: I20170821003461 |
| Provider Name | Pardeep Kumar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013324748 PECOS PAC ID: 1153693189 Enrollment ID: I20170824003790 |
| Provider Name | Haseeb Ilias Basha |
|---|---|
| Provider Type | Practitioner - Advanced Heart Failure And Transplant Cardiology |
| Provider Identifiers | NPI Number: 1194039198 PECOS PAC ID: 0547526477 Enrollment ID: I20171109002317 |
| Provider Name | Dana L Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518484716 PECOS PAC ID: 2062779911 Enrollment ID: I20171130001473 |
| Provider Name | Bryce Yantis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841709862 PECOS PAC ID: 5193082097 Enrollment ID: I20171201000338 |
| Provider Name | Elizabeth D Mcgarry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508291584 PECOS PAC ID: 3173882917 Enrollment ID: I20180124000442 |
| Provider Name | Jennifer Shawn Mahannah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407360530 PECOS PAC ID: 2961762943 Enrollment ID: I20180213000921 |
| Provider Name | Mohammad Al-akchar |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1730561903 PECOS PAC ID: 4284980467 Enrollment ID: I20180629002224 |
| Provider Name | Bimal Vyas |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1366769945 PECOS PAC ID: 6305167172 Enrollment ID: I20180806001843 |
| Provider Name | Imran Khan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1053750935 PECOS PAC ID: 8022251867 Enrollment ID: I20180906000436 |
| Provider Name | Osama Alsara |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689967705 PECOS PAC ID: 1759691793 Enrollment ID: I20181008002650 |
| Provider Name | Jennifer T Behrens |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1992737563 PECOS PAC ID: 2163425349 Enrollment ID: I20181109001959 |
| Provider Name | Victoria O Famuyide |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497999627 PECOS PAC ID: 5890944896 Enrollment ID: I20181119000645 |
| Provider Name | Anatoliy Vaysberg |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1275973711 PECOS PAC ID: 0749530475 Enrollment ID: I20190124002359 |
| Provider Name | Emmanuel A Omoba |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1346342342 PECOS PAC ID: 7517868938 Enrollment ID: I20190328000255 |
| Provider Name | Tara Shutt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528621265 PECOS PAC ID: 6608119813 Enrollment ID: I20190509002102 |
| Provider Name | Timothy Leland Shih |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023351830 PECOS PAC ID: 1850600032 Enrollment ID: I20190905000646 |
| Provider Name | Peter L Mills |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1407241755 PECOS PAC ID: 9335459064 Enrollment ID: I20190909000817 |
| Provider Name | Holly Marie Chapman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851951552 PECOS PAC ID: 5597095729 Enrollment ID: I20191001001361 |
| Provider Name | Blake A Weis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801236617 PECOS PAC ID: 7214255447 Enrollment ID: I20191007002767 |
| Provider Name | Kelly Donnelly |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1407414402 PECOS PAC ID: 7113258658 Enrollment ID: I20191014002687 |
| Provider Name | Alina Konnikova Brener |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1154716330 PECOS PAC ID: 1153676549 Enrollment ID: I20200109000348 |
| Provider Name | Sharif Nasr |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1568845360 PECOS PAC ID: 4284937368 Enrollment ID: I20200616003058 |
| Provider Name | Tonya Suzanne Bowrey |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1730339987 PECOS PAC ID: 4385067800 Enrollment ID: I20200630003140 |
| Provider Name | Kelley Evans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356934442 PECOS PAC ID: 1052727906 Enrollment ID: I20210302000169 |
| Provider Name | Katelynn Nichole Hayes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548853229 PECOS PAC ID: 9931515731 Enrollment ID: I20210302002377 |
| Provider Name | Hafez Haerian |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1861653958 PECOS PAC ID: 8325366289 Enrollment ID: I20210322001788 |
| Provider Name | Gregory E Punch |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1386802312 PECOS PAC ID: 0840438107 Enrollment ID: I20210706001931 |
| Provider Name | Duat Bui |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1033597554 PECOS PAC ID: 8426364795 Enrollment ID: I20210812003946 |
| Provider Name | Shashi Kariyawasam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902216088 PECOS PAC ID: 1951690817 Enrollment ID: I20210917002747 |
| Provider Name | Jessica Rae Clapp |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982375309 PECOS PAC ID: 9133527989 Enrollment ID: I20211007002768 |
| Provider Name | Kristie Krigbaum |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245836147 PECOS PAC ID: 9537557830 Enrollment ID: I20211019000552 |
| Provider Name | Timothy James Johnson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1598732711 PECOS PAC ID: 2264481266 Enrollment ID: I20211111002197 |
| Provider Name | Elizabeth Williams |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1609194554 PECOS PAC ID: 9638560238 Enrollment ID: I20211215000487 |
| Provider Name | Rowan Crozier |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1295473866 PECOS PAC ID: 4880072727 Enrollment ID: I20220603002241 |
| Provider Name | Dylan Curry Graff |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1588222962 PECOS PAC ID: 3173857612 Enrollment ID: I20220730000024 |
| Provider Name | Brandi Hicks |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1942497797 PECOS PAC ID: 0547421208 Enrollment ID: I20221003002872 |
| Provider Name | Saurabh Verma |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1659785665 PECOS PAC ID: 8426396821 Enrollment ID: I20221121001164 |
| Provider Name | Suneel Kumar |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1275816654 PECOS PAC ID: 7416175989 Enrollment ID: I20221215001119 |
| Provider Name | Versha Kumar Thourani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598128118 PECOS PAC ID: 8426340142 Enrollment ID: I20221216001805 |
| Provider Name | Stanislav Belchuk |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1164816674 PECOS PAC ID: 9931419074 Enrollment ID: I20230111000556 |
| Provider Name | Osama Elbuluk |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1538533229 PECOS PAC ID: 3971848375 Enrollment ID: I20230127001332 |
| Provider Name | Qi Xiao |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1437690724 PECOS PAC ID: 7911276894 Enrollment ID: I20230215001910 |
| Provider Name | David Kimball |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1053798082 PECOS PAC ID: 1254646250 Enrollment ID: I20230808000689 |
| Provider Name | Arielle Esther Vansyckel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1790218907 PECOS PAC ID: 1951657667 Enrollment ID: I20230816003242 |
| Provider Name | Dora M Pelletier |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1790448900 PECOS PAC ID: 6901295195 Enrollment ID: I20230906001905 |
| Provider Name | Daniel Warren |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1285166298 PECOS PAC ID: 4486985645 Enrollment ID: I20230915002060 |
| Provider Name | John Michael Ocenar Aguilar |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1528417102 PECOS PAC ID: 5092008185 Enrollment ID: I20230920000168 |
| Provider Name | Cydney Longley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700562816 PECOS PAC ID: 9436503158 Enrollment ID: I20230929000718 |
| Provider Name | Braxton Mcclung |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1497934202 PECOS PAC ID: 1850553934 Enrollment ID: I20240125002994 |
| Provider Name | Myles M Mitsunaga |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1437577517 PECOS PAC ID: 5698005940 Enrollment ID: I20240205002833 |
| Provider Name | Danielle Pare |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629629324 PECOS PAC ID: 3870920119 Enrollment ID: I20240221000546 |
| Provider Name | Kayla Michelle Sheets |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912775438 PECOS PAC ID: 5193162485 Enrollment ID: I20240321003951 |
| Provider Name | Andrea Dunlap |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952008690 PECOS PAC ID: 6709224967 Enrollment ID: I20240405003719 |
| Provider Name | Julie Baldinger |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811493851 PECOS PAC ID: 8022366186 Enrollment ID: I20240410003036 |
Adams Enterprises Of East Central Illinois Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1109 N State St, Monticello, IL 61856 Phone: 217-762-8576 Fax: 217-762-8578 | |
Kirby Medical Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1000 Medical Center Dr, Monticello, IL 61856 Phone: 217-762-2115 Fax: 217-762-1502 |