| Kishwaukee Physician Group Inc | |
|
1 Kish Hospital Dr Dekalb IL 60115-9602 | |
| (815) 756-1521 | |
| Not Available |
| Full Name | Kishwaukee Physician Group Inc |
|---|---|
| Speciality | General Practice |
| Location | 1 Kish Hospital Dr, Dekalb, Illinois |
| Authorized Official Name and Position | Christine Zydek (DIRECTOR OF FINANCE) |
| Authorized Official Contact | 8157482986 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kishwaukee Physician Group Inc Po Box 487 Dekalb IL 60115-0487 Ph: (815) 756-1521 | Kishwaukee Physician Group Inc 1 Kish Hospital Dr Dekalb IL 60115-9602 Ph: (815) 756-1521 |
| NPI Number | 1932480605 |
|---|---|
| Provider Enumeration Date | 09/07/2011 |
| Last Update Date | 04/16/2018 |
| Medicare PECOS PAC ID | 3870768054 |
|---|---|
| Medicare Enrollment ID | O20111216000435 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932480605 | NPI | - | NPPES |
| Provider Name | Erik D Englehart |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679581367 PECOS PAC ID: 7214832716 Enrollment ID: I20031205000642 |
| Provider Name | Nitzet M Velez |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1629080775 PECOS PAC ID: 1254237589 Enrollment ID: I20031209000315 |
| Provider Name | Thomas Dennison |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588673719 PECOS PAC ID: 8729987276 Enrollment ID: I20040105000473 |
| Provider Name | David H Sui |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1477565521 PECOS PAC ID: 6204821887 Enrollment ID: I20040421001163 |
| Provider Name | Orest P Rywak |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1689618035 PECOS PAC ID: 1658352026 Enrollment ID: I20040601000527 |
| Provider Name | Asra F Khan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023018322 PECOS PAC ID: 5597747139 Enrollment ID: I20040607000376 |
| Provider Name | Ghori Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326072042 PECOS PAC ID: 0042290454 Enrollment ID: I20040728000001 |
| Provider Name | Margaret B Bialas |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1629001946 PECOS PAC ID: 2769454578 Enrollment ID: I20040811001206 |
| Provider Name | Azeem S Haleem |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1154366706 PECOS PAC ID: 6709855935 Enrollment ID: I20040924001005 |
| Provider Name | Sajit Bux |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1467488957 PECOS PAC ID: 5597725887 Enrollment ID: I20041012000651 |
| Provider Name | Bruce Brantman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1437203528 PECOS PAC ID: 8224090717 Enrollment ID: I20041027000906 |
| Provider Name | Jonathan Charles Parker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548309982 PECOS PAC ID: 3678518917 Enrollment ID: I20050627000924 |
| Provider Name | Chetan N Choksi |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1780886663 PECOS PAC ID: 3274563622 Enrollment ID: I20050816000770 |
| Provider Name | Andrew P Oleksyn |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1992732754 PECOS PAC ID: 8022046838 Enrollment ID: I20050921000397 |
| Provider Name | Khurram Qadir |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1639158777 PECOS PAC ID: 1254358922 Enrollment ID: I20051101000755 |
| Provider Name | Pitamber Persaud |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265489108 PECOS PAC ID: 7315961588 Enrollment ID: I20060119000092 |
| Provider Name | Stephen R Goldman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1477577492 PECOS PAC ID: 8527064021 Enrollment ID: I20061005000434 |
| Provider Name | Gregory J Conrad |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1730222126 PECOS PAC ID: 7911000716 Enrollment ID: I20070315000455 |
| Provider Name | Pramod N Patel |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1447465992 PECOS PAC ID: 3971604398 Enrollment ID: I20070728000122 |
| Provider Name | Stephen C Withrow |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1447263041 PECOS PAC ID: 6002907425 Enrollment ID: I20070814000261 |
| Provider Name | Michael Hohlastos |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1376743914 PECOS PAC ID: 5294827945 Enrollment ID: I20070824000855 |
| Provider Name | Ilaxi P Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629087861 PECOS PAC ID: 4284715517 Enrollment ID: I20080112000183 |
| Provider Name | Alan F Singer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982794236 PECOS PAC ID: 1254410590 Enrollment ID: I20080512000354 |
| Provider Name | Shaun K Mathen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770744476 PECOS PAC ID: 1254409444 Enrollment ID: I20080930000791 |
| Provider Name | Syed S Jafri |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1982801791 PECOS PAC ID: 5799871380 Enrollment ID: I20091021000333 |
| Provider Name | Lea Q Lisowski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669687315 PECOS PAC ID: 6800938762 Enrollment ID: I20100115000417 |
| Provider Name | Christine L Valentine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801121405 PECOS PAC ID: 2264576669 Enrollment ID: I20100224000039 |
| Provider Name | Dhaval N Thakkar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720090871 PECOS PAC ID: 9335149962 Enrollment ID: I20100224000496 |
| Provider Name | Roger L Haab |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386653517 PECOS PAC ID: 7517967144 Enrollment ID: I20100224000510 |
| Provider Name | Jay D Burstein |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1699784827 PECOS PAC ID: 5799785325 Enrollment ID: I20100525000829 |
| Provider Name | Patrick D Mcinerney |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1164492062 PECOS PAC ID: 1456481159 Enrollment ID: I20100622000820 |
| Provider Name | Jack A Wagoner |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1518979665 PECOS PAC ID: 8527964824 Enrollment ID: I20101201000246 |
| Provider Name | Peter A Baum |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1164431391 PECOS PAC ID: 2961308275 Enrollment ID: I20110210000192 |
| Provider Name | Scott J Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518269539 PECOS PAC ID: 8527242593 Enrollment ID: I20110415000503 |
| Provider Name | Grzegorz Blecharz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811150071 PECOS PAC ID: 1153591912 Enrollment ID: I20110902000595 |
| Provider Name | Christine Weis |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1841451549 PECOS PAC ID: 4082880802 Enrollment ID: I20111229000050 |
| Provider Name | Kimberly A Bauer |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1295946473 PECOS PAC ID: 5890944144 Enrollment ID: I20121002000751 |
| Provider Name | Wendell R Malalis |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1962692418 PECOS PAC ID: 6800045014 Enrollment ID: I20121003000768 |
| Provider Name | David S Phillips |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1669484713 PECOS PAC ID: 4789684317 Enrollment ID: I20121110000169 |
| Provider Name | William Y Asihene |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1023161940 PECOS PAC ID: 9830107085 Enrollment ID: I20121217000047 |
| Provider Name | Teresa K Farris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114262656 PECOS PAC ID: 8628211760 Enrollment ID: I20130821000557 |
| Provider Name | Mayuri Morker |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1598059982 PECOS PAC ID: 6002038759 Enrollment ID: I20141112001915 |
| Provider Name | Suzanne R Cook |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1134138365 PECOS PAC ID: 6608920053 Enrollment ID: I20150310000245 |
| Provider Name | Jason Foreman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1073567871 PECOS PAC ID: 8729090659 Enrollment ID: I20150812006309 |
| Provider Name | Jacqueline D Keck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326411539 PECOS PAC ID: 0042513426 Enrollment ID: I20160119000760 |
| Provider Name | Sarina G Jeswani |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1912347329 PECOS PAC ID: 5294020863 Enrollment ID: I20160822000672 |
| Provider Name | Bhavisha Patel |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1407134505 PECOS PAC ID: 8820221518 Enrollment ID: I20160829003000 |
| Provider Name | Sujata A Morker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497097893 PECOS PAC ID: 7214225416 Enrollment ID: I20161004000281 |
| Provider Name | Amy Harmon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568814432 PECOS PAC ID: 2769764984 Enrollment ID: I20170124001899 |
| Provider Name | Deborah A Henschler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376067165 PECOS PAC ID: 9830463041 Enrollment ID: I20170926002936 |
| Provider Name | Carol L Roggeman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750899431 PECOS PAC ID: 2264793470 Enrollment ID: I20180305001814 |
Umesh P. Goswami, Md Sc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 625 Bethany Rd, Suite 3, Dekalb, IL 60115 Phone: 815-758-5100 Fax: 815-758-5144 | |
Northern Illinois University Health Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 518 Lucinda Ave, Health Services Building, Dekalb, IL 60115 Phone: 815-753-1311 Fax: 815-753-9570 | |
G N Endocrinology Ltd Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: Five Kish Hospital Dr, Suite 201, Dekalb, IL 60115 Phone: 815-748-8335 Fax: 815-748-8340 | |
Greater Family Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1121 School St, Dekalb, IL 60115 Phone: 815-754-2258 | |
Center For Counseling Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 14 Health Services Drive, Dekalb, IL 60115 Phone: 815-758-8616 Fax: 815-758-7569 | |
Community Cares Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3100 Sycamore Rd, Suite 1024, Dekalb, IL 60115 Phone: 815-752-3253 | |
Center For Family Health Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2550 N Annie Glidden Rd, Dekalb, IL 60115 Phone: 815-363-9900 |