| Macoupin County Public Health Department | |
|
109 E Maple St Gillespie IL 62033-1473 | |
| (217) 839-1526 | |
| (217) 839-1538 |
| Full Name | Macoupin County Public Health Department |
|---|---|
| Speciality | Clinic/Center |
| Location | 109 E Maple St, Gillespie, Illinois |
| Authorized Official Name and Position | Christy Blank (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 2179302283 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Macoupin County Public Health Department 205 Oakland Ave Carlinville IL 62626-1921 Ph: (217) 839-7820 | Macoupin County Public Health Department 109 E Maple St Gillespie IL 62033-1473 Ph: (217) 839-1526 |
| NPI Number | 1538444906 |
|---|---|
| Provider Enumeration Date | 10/18/2011 |
| Last Update Date | 06/27/2023 |
| Medicare PECOS PAC ID | 1557377850 |
|---|---|
| Medicare Enrollment ID | O20060223000446 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538444906 | NPI | - | NPPES |
| 141154 | Other | IL | NGS MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 007 (Illinois) | Primary |
| Provider Name | Miguel A Paniagua |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699856443 PECOS PAC ID: 4183514979 Enrollment ID: I20040319001104 |
| Provider Name | August Adams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992803985 PECOS PAC ID: 6406832450 Enrollment ID: I20040629000746 |
| Provider Name | Arif Habib |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215912977 PECOS PAC ID: 8426065939 Enrollment ID: I20060308000427 |
| Provider Name | Martin Repetto |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881634228 PECOS PAC ID: 9537136569 Enrollment ID: I20071026000741 |
| Provider Name | Julia Terese Ruckman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356599971 PECOS PAC ID: 3779644786 Enrollment ID: I20081209000829 |
| Provider Name | Kristin Buller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982982534 PECOS PAC ID: 6204092448 Enrollment ID: I20120716000557 |
| Provider Name | Mia M Galioto |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225011307 PECOS PAC ID: 8527963560 Enrollment ID: I20140804000642 |
| Provider Name | Joellen Juenger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578970505 PECOS PAC ID: 9436371911 Enrollment ID: I20141118001389 |
| Provider Name | George A Ferguson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861879355 PECOS PAC ID: 9133423270 Enrollment ID: I20160210000121 |
| Provider Name | Samantha Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447789169 PECOS PAC ID: 9638442049 Enrollment ID: I20171106001293 |
| Provider Name | Sandra L Cania |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316441868 PECOS PAC ID: 2264795368 Enrollment ID: I20180423002255 |
| Provider Name | Melinda S Edwards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578065413 PECOS PAC ID: 4385908391 Enrollment ID: I20180427000703 |
| Provider Name | Kate Elizabeth Traum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952887416 PECOS PAC ID: 5294089751 Enrollment ID: I20181120000021 |
| Provider Name | Campbell H Walters |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1891249652 PECOS PAC ID: 3678818358 Enrollment ID: I20181227002402 |
| Provider Name | Amanda Marie Vogel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790249449 PECOS PAC ID: 1355682741 Enrollment ID: I20190412000182 |
| Provider Name | Celeste Mary Govero Yann |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710457007 PECOS PAC ID: 4486995669 Enrollment ID: I20190417000174 |
| Provider Name | Gaurav Sharma |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1518450782 PECOS PAC ID: 0244568285 Enrollment ID: I20190828003337 |
| Provider Name | Michel Mikheil |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1609420819 PECOS PAC ID: 1355775222 Enrollment ID: I20191231000950 |
| Provider Name | Praveen Kumar Gonuguntla Kamma |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1104479724 PECOS PAC ID: 2264859313 Enrollment ID: I20200903001177 |
| Provider Name | Teerthesh Jain |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1366072936 PECOS PAC ID: 9830517374 Enrollment ID: I20200915001612 |
| Provider Name | Kathy J Shafer |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1750499729 PECOS PAC ID: 3971898461 Enrollment ID: I20201007002362 |
| Provider Name | Sherri Lindgren |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124611256 PECOS PAC ID: 5597172387 Enrollment ID: I20210323000983 |
| Provider Name | Dov Rapoport |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376971176 PECOS PAC ID: 3072421999 Enrollment ID: I20210615000417 |
| Provider Name | Lakshmi Sajja |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1669062402 PECOS PAC ID: 6305249822 Enrollment ID: I20210721002856 |
| Provider Name | Rachel Jean Hudson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366054058 PECOS PAC ID: 3870997893 Enrollment ID: I20210812000684 |
| Provider Name | Parth Desai |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1952916355 PECOS PAC ID: 6204233067 Enrollment ID: I20210921001610 |
| Provider Name | Lawrence Elliott Liston |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1568616886 PECOS PAC ID: 4385032838 Enrollment ID: I20211102002263 |
| Provider Name | Maithilee A Jani |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1174289128 PECOS PAC ID: 1254721962 Enrollment ID: I20211210001173 |
| Provider Name | Steven Boente |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1700967031 PECOS PAC ID: 4880905496 Enrollment ID: I20220201001742 |
| Provider Name | Jaclyn Louise Barnhouse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811513526 PECOS PAC ID: 4789082983 Enrollment ID: I20220210000631 |
| Provider Name | Zuzana Jackevicius Killam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306584917 PECOS PAC ID: 2264811645 Enrollment ID: I20220614003052 |
| Provider Name | Cody James Palmer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932799673 PECOS PAC ID: 7113301326 Enrollment ID: I20220907000282 |
| Provider Name | Michael Robert Wattles |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1093956534 PECOS PAC ID: 8820453319 Enrollment ID: I20230505002343 |
| Provider Name | Nathalee Soto-gonzalez |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1588948228 PECOS PAC ID: 4486003373 Enrollment ID: I20231218003719 |
| Provider Name | Ellyn E Busker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194244178 PECOS PAC ID: 9931559465 Enrollment ID: I20231227000114 |
| Provider Name | Daniel Lanctot |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477025203 PECOS PAC ID: 6709237571 Enrollment ID: I20240105000524 |
Macoupin County Recovery Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 118 W Chestnut St, Gillespie, IL 62033 Phone: 217-839-4200 Fax: 217-839-7207 | |
Gillespie Family Practice Ctr Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 715 Broadway St, Gillespie, IL 62033 Phone: 217-839-4491 Fax: 217-839-2689 | |
Integrative Medical Solutions Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 124 N Macoupin St, Gillespie, IL 62033 Phone: 217-839-3040 | |
Carlinville Area Hospital Association Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 807 Broadway St, Gillespie, IL 62033 Phone: 217-854-3900 Fax: 217-839-1313 | |
Neuropathy Center Of Gillespie Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 124 N Macoupin St, Gillespie, IL 62033 Phone: 217-839-3040 | |
Staten Family Practice Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 500 W Virginia Ave, Gillespie, IL 62033 Phone: 217-851-5270 |