| Pcc Community Wellness Center | |
|
14 Lake St Oak Park IL 60302-2606 | |
| (708) 383-0113 | |
| (708) 383-1378 |
| Full Name | Pcc Community Wellness Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 14 Lake St, Oak Park, Illinois |
| Authorized Official Name and Position | Robert J Urso (PRESIDENT CEO) |
| Authorized Official Contact | 7083839786 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pcc Community Wellness Center 14 Lake St Oak Park IL 60302-2606 Ph: (708) 383-0113 | Pcc Community Wellness Center 14 Lake St Oak Park IL 60302-2606 Ph: (708) 383-0113 |
| NPI Number | 1871516799 |
|---|---|
| Provider Enumeration Date | 07/25/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 1557270139 |
|---|---|
| Medicare Enrollment ID | O20040206000415 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871516799 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Bertha A Lopez |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1578582979 PECOS PAC ID: 0446152961 Enrollment ID: I20040124000251 |
| Provider Name | Roberto Levi-d'ancona |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1053394155 PECOS PAC ID: 7416850730 Enrollment ID: I20040202000518 |
| Provider Name | Katherine Lynch |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821038720 PECOS PAC ID: 8325935091 Enrollment ID: I20040228000212 |
| Provider Name | Alexander M Wu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871533778 PECOS PAC ID: 6709773310 Enrollment ID: I20040228000524 |
| Provider Name | Paul Luning |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851356414 PECOS PAC ID: 9537056940 Enrollment ID: I20040301001161 |
| Provider Name | Leah Louise Suarez-abraham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003095258 PECOS PAC ID: 2961480694 Enrollment ID: I20040709000738 |
| Provider Name | Mark Amdur |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346277274 PECOS PAC ID: 2062490303 Enrollment ID: I20040712001475 |
| Provider Name | Kenneth L Bray |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1740295161 PECOS PAC ID: 5890752307 Enrollment ID: I20041216000478 |
| Provider Name | Cecelia B Bacom |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1932141637 PECOS PAC ID: 1355389842 Enrollment ID: I20050425000870 |
| Provider Name | Blanca M Baldoceda |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871533703 PECOS PAC ID: 0941240873 Enrollment ID: I20050510000483 |
| Provider Name | Julia E Eckersley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639116528 PECOS PAC ID: 3274574207 Enrollment ID: I20050519000385 |
| Provider Name | Tuwanda Williamson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629018528 PECOS PAC ID: 6608817630 Enrollment ID: I20050519000424 |
| Provider Name | Karole A Lakota Treese |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952365488 PECOS PAC ID: 8729029616 Enrollment ID: I20050520000660 |
| Provider Name | Natasha E Diaz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659300408 PECOS PAC ID: 6305812892 Enrollment ID: I20050906000142 |
| Provider Name | Lisa M Kozinski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871575233 PECOS PAC ID: 2365476959 Enrollment ID: I20050922001048 |
| Provider Name | Charles T Yingling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205843331 PECOS PAC ID: 0042239527 Enrollment ID: I20051114000923 |
| Provider Name | Katrina R Cordero |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386747822 PECOS PAC ID: 4385663483 Enrollment ID: I20051117000826 |
| Provider Name | Audrey J Stillerman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013029644 PECOS PAC ID: 3375558794 Enrollment ID: I20060207000215 |
| Provider Name | Maureen E Ruder |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1548384092 PECOS PAC ID: 7416051305 Enrollment ID: I20070403000123 |
| Provider Name | Lorna G Davis |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1720097538 PECOS PAC ID: 2365549615 Enrollment ID: I20070521000412 |
| Provider Name | Jill Hawkes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467560847 PECOS PAC ID: 6608977616 Enrollment ID: I20070720000457 |
| Provider Name | Martha J Glynn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922113430 PECOS PAC ID: 5597856450 Enrollment ID: I20070807000192 |
| Provider Name | Antoinette B Lullo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346453412 PECOS PAC ID: 0547355075 Enrollment ID: I20070928000401 |
| Provider Name | Tamajah M Jordan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093931198 PECOS PAC ID: 1951401256 Enrollment ID: I20070928000474 |
| Provider Name | Danielle Kraessig |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1306962121 PECOS PAC ID: 8820178528 Enrollment ID: I20080108000317 |
| Provider Name | Annette R Payot |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1376730366 PECOS PAC ID: 2365520988 Enrollment ID: I20080423000332 |
| Provider Name | Alisha T Thomas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609074657 PECOS PAC ID: 8820163298 Enrollment ID: I20080819000789 |
| Provider Name | Martha F Halsey-lyda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184838567 PECOS PAC ID: 7911067699 Enrollment ID: I20081126000013 |
| Provider Name | Jennifer L Rossato |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487814265 PECOS PAC ID: 0941361224 Enrollment ID: I20081204000742 |
| Provider Name | Sarah M Carreon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538367586 PECOS PAC ID: 4789746462 Enrollment ID: I20081215000727 |
| Provider Name | Sherif A Milik |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427251792 PECOS PAC ID: 6002979192 Enrollment ID: I20090115000625 |
| Provider Name | Umang Sharma |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952475436 PECOS PAC ID: 3577645894 Enrollment ID: I20090204000185 |
| Provider Name | Christine M Swartz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114052297 PECOS PAC ID: 2668538372 Enrollment ID: I20090304000729 |
| Provider Name | Mary-kay Ayers |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1760552582 PECOS PAC ID: 1951455344 Enrollment ID: I20090819000759 |
| Provider Name | Kathleen E Mcdonough |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700086709 PECOS PAC ID: 8820144728 Enrollment ID: I20090917000516 |
| Provider Name | Brooke A Turnock |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1811153570 PECOS PAC ID: 5890832612 Enrollment ID: I20091028000253 |
| Provider Name | Courtney K Suh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528266566 PECOS PAC ID: 0648318030 Enrollment ID: I20091104000564 |
| Provider Name | Mahnaz J Ali |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376734202 PECOS PAC ID: 1850434481 Enrollment ID: I20100204000723 |
| Provider Name | Sabina Wong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932307980 PECOS PAC ID: 7012044654 Enrollment ID: I20100429001024 |
| Provider Name | Rebecca C Dehoek |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437357563 PECOS PAC ID: 1557555174 Enrollment ID: I20101027001445 |
| Provider Name | Tilak Joshi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730364522 PECOS PAC ID: 3577757137 Enrollment ID: I20101028000358 |
| Provider Name | Yolanda Cardenas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073511143 PECOS PAC ID: 4183810013 Enrollment ID: I20101118000139 |
| Provider Name | Margot T Ocampo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760520464 PECOS PAC ID: 4789868506 Enrollment ID: I20110401000746 |
| Provider Name | David S Kim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821159948 PECOS PAC ID: 5395828040 Enrollment ID: I20110411000813 |
| Provider Name | Maureen M Milota |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790076495 PECOS PAC ID: 8527236678 Enrollment ID: I20110718000160 |
| Provider Name | Kevin Koo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699936393 PECOS PAC ID: 9537338686 Enrollment ID: I20110808000448 |
| Provider Name | Tamayo Kawai |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1093977530 PECOS PAC ID: 1254502412 Enrollment ID: I20110919000759 |
| Provider Name | Christabelle Andrea Cabanilla |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447412366 PECOS PAC ID: 7214108471 Enrollment ID: I20110919000795 |
| Provider Name | Emily Lovaasen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144481847 PECOS PAC ID: 0941474415 Enrollment ID: I20111118000078 |
| Provider Name | Chidinma Osineme |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699941930 PECOS PAC ID: 0345415725 Enrollment ID: I20111213000939 |
| Provider Name | Jacara Kelley Muhammad |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689802282 PECOS PAC ID: 2062663560 Enrollment ID: I20121109000351 |
| Provider Name | Zachary P Lamaster |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265667810 PECOS PAC ID: 1557514809 Enrollment ID: I20130116000572 |
| Provider Name | Aaron D Costerisan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396975736 PECOS PAC ID: 5496932030 Enrollment ID: I20130117000034 |
| Provider Name | Katherine Herold |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1215283197 PECOS PAC ID: 6709030141 Enrollment ID: I20130212000076 |
| Provider Name | Kelly E Ellis |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1962705103 PECOS PAC ID: 7719123330 Enrollment ID: I20130425000671 |
| Provider Name | Martha A Sommers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972849891 PECOS PAC ID: 7113164567 Enrollment ID: I20130502000507 |
| Provider Name | Mary Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508127051 PECOS PAC ID: 3678713484 Enrollment ID: I20130627000785 |
| Provider Name | Jeanine C Shah |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518287812 PECOS PAC ID: 1254565245 Enrollment ID: I20131007000092 |
| Provider Name | Elizabeth A Dowell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154419661 PECOS PAC ID: 4486888161 Enrollment ID: I20131011001114 |
| Provider Name | Whitney A Henderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669710984 PECOS PAC ID: 5092949719 Enrollment ID: I20131014000679 |
| Provider Name | Dina V Zissimopoulos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922376888 PECOS PAC ID: 3274768171 Enrollment ID: I20131031000639 |
| Provider Name | Ellen B Barton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336367036 PECOS PAC ID: 2668607342 Enrollment ID: I20131105001434 |
| Provider Name | Gwendolyn Haywood |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053447326 PECOS PAC ID: 5294961652 Enrollment ID: I20131114000080 |
| Provider Name | Kyle E Geissler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972739647 PECOS PAC ID: 5294975090 Enrollment ID: I20131119000213 |
| Provider Name | Katherine M Wehrmann |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1407288442 PECOS PAC ID: 2264669332 Enrollment ID: I20131217000271 |
| Provider Name | Jill N Degen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811292717 PECOS PAC ID: 2264660521 Enrollment ID: I20140113000171 |
| Provider Name | Graham A Phelps |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114358033 PECOS PAC ID: 1850520503 Enrollment ID: I20140129001635 |
| Provider Name | Emanuel Favela |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952614893 PECOS PAC ID: 6709015290 Enrollment ID: I20140203001020 |
| Provider Name | Lakieta Edwards Glass |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053739813 PECOS PAC ID: 7719100304 Enrollment ID: I20140529001481 |
| Provider Name | Amanda Brooks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659786465 PECOS PAC ID: 9436375151 Enrollment ID: I20140731002861 |
| Provider Name | John Franco |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861788994 PECOS PAC ID: 6406072123 Enrollment ID: I20140731002974 |
| Provider Name | Saifuddin Talib |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205266947 PECOS PAC ID: 5698994200 Enrollment ID: I20140915000248 |
| Provider Name | Gitanjali Sivasubramaniam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326334103 PECOS PAC ID: 4880813146 Enrollment ID: I20140918000774 |
| Provider Name | Erika Maite Montoya |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386934008 PECOS PAC ID: 5294954319 Enrollment ID: I20140922001940 |
| Provider Name | Leslie Sanchez |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1508282302 PECOS PAC ID: 4981824612 Enrollment ID: I20141001001672 |
| Provider Name | Donald P Reese |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053632406 PECOS PAC ID: 6709019615 Enrollment ID: I20141110000849 |
| Provider Name | Marta H Sciubisz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922394808 PECOS PAC ID: 9739402637 Enrollment ID: I20141230000401 |
| Provider Name | Jennifer Jaume |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1417350612 PECOS PAC ID: 3476878026 Enrollment ID: I20150203000362 |
| Provider Name | Sara Miranda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841690328 PECOS PAC ID: 9032434212 Enrollment ID: I20150210001784 |
| Provider Name | Mary Rigoni |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1306247010 PECOS PAC ID: 5193040392 Enrollment ID: I20150210002506 |
| Provider Name | Jacqueline Rincon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710387618 PECOS PAC ID: 2365767571 Enrollment ID: I20150211000334 |
| Provider Name | Bernie Aguilar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902207004 PECOS PAC ID: 8729304878 Enrollment ID: I20150306001968 |
| Provider Name | Krysten Rollins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821494154 PECOS PAC ID: 1254658511 Enrollment ID: I20150325001088 |
| Provider Name | Amrit K Rao |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699116186 PECOS PAC ID: 3072831189 Enrollment ID: I20150421000315 |
| Provider Name | Kim Mccoy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568858223 PECOS PAC ID: 7214248673 Enrollment ID: I20150625002163 |
| Provider Name | Claudia M Vandiver |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245542117 PECOS PAC ID: 0345553434 Enrollment ID: I20150717002617 |
| Provider Name | Beata Janton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538556162 PECOS PAC ID: 7618280371 Enrollment ID: I20150723008985 |
| Provider Name | Yvette Gross |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558623041 PECOS PAC ID: 9032368600 Enrollment ID: I20150917001298 |
| Provider Name | Morgan Madison |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265708069 PECOS PAC ID: 1951618388 Enrollment ID: I20150917002230 |
| Provider Name | Elizabeth A Redican |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154615797 PECOS PAC ID: 4183854987 Enrollment ID: I20150917002303 |
| Provider Name | Colleen V Loo-gross |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427314426 PECOS PAC ID: 7618284969 Enrollment ID: I20150918000095 |
| Provider Name | Joseph Angel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760743363 PECOS PAC ID: 2365759594 Enrollment ID: I20150921000207 |
| Provider Name | Gina Rogers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609248608 PECOS PAC ID: 6901116052 Enrollment ID: I20151102002844 |
| Provider Name | Steven D Smrha |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588928907 PECOS PAC ID: 0042443707 Enrollment ID: I20151104002125 |
| Provider Name | Abiah A Grant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720488760 PECOS PAC ID: 5395068043 Enrollment ID: I20151201000414 |
| Provider Name | Kristen Richter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033588736 PECOS PAC ID: 2062713944 Enrollment ID: I20151217002706 |
| Provider Name | Inger Anthony |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871769752 PECOS PAC ID: 5294036844 Enrollment ID: I20151223001861 |
| Provider Name | Rachel Zurek |
|---|---|
| Provider Type | Practitioner - Other (non-physician) |
| Provider Identifiers | NPI Number: 1720405871 PECOS PAC ID: 8224331970 Enrollment ID: I20160129001455 |
| Provider Name | Gina Marcin |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1205261682 PECOS PAC ID: 9335443001 Enrollment ID: I20160201002512 |
| Provider Name | Ryan Tuscher |
|---|---|
| Provider Type | Practitioner - Other (non-physician) |
| Provider Identifiers | NPI Number: 1851520720 PECOS PAC ID: 1153625553 Enrollment ID: I20160204002360 |
| Provider Name | Maureen Marquez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235500877 PECOS PAC ID: 1153625124 Enrollment ID: I20160211001773 |
| Provider Name | Daniel Murphy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922328624 PECOS PAC ID: 6901100759 Enrollment ID: I20160215002217 |
| Provider Name | Douglas R Gregg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376908301 PECOS PAC ID: 6901102763 Enrollment ID: I20160304001569 |
| Provider Name | Gigi C Frye |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831537760 PECOS PAC ID: 1355647405 Enrollment ID: I20160315002959 |
| Provider Name | Anna G Weinberg Kliner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508230475 PECOS PAC ID: 7517264567 Enrollment ID: I20160318001264 |
| Provider Name | Manal Yasin |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1811320799 PECOS PAC ID: 7810296738 Enrollment ID: I20160427002248 |
| Provider Name | Tera Martin |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1265733349 PECOS PAC ID: 7315236510 Enrollment ID: I20160511001088 |
| Provider Name | Yesenia Arce |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811334626 PECOS PAC ID: 4486887866 Enrollment ID: I20160606002404 |
| Provider Name | Haley Swanson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740418474 PECOS PAC ID: 0840580684 Enrollment ID: I20160607000251 |
| Provider Name | Jerome Pietrusiak |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679793913 PECOS PAC ID: 5799078499 Enrollment ID: I20160718001800 |
| Provider Name | Jessica Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679831937 PECOS PAC ID: 9739198664 Enrollment ID: I20160722000574 |
| Provider Name | Justine Parker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386986420 PECOS PAC ID: 7517257165 Enrollment ID: I20160722000814 |
| Provider Name | Charity E Lehn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306189881 PECOS PAC ID: 8325348253 Enrollment ID: I20160725003110 |
| Provider Name | Tia J Dorn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285074740 PECOS PAC ID: 5294968988 Enrollment ID: I20160804001996 |
| Provider Name | Jessica M Lenth |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437381050 PECOS PAC ID: 2860786415 Enrollment ID: I20160804002374 |
| Provider Name | Jenny Kim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073710794 PECOS PAC ID: 6608160874 Enrollment ID: I20160810002449 |
| Provider Name | Jacqueline Michelle Allen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275979965 PECOS PAC ID: 8921394941 Enrollment ID: I20160831000009 |
| Provider Name | Sveva V Brown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467895854 PECOS PAC ID: 1658590187 Enrollment ID: I20160831001278 |
| Provider Name | Andrew L Eastman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972846475 PECOS PAC ID: 0648592014 Enrollment ID: I20160901000158 |
| Provider Name | Maura Stefko |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497075600 PECOS PAC ID: 4789835166 Enrollment ID: I20160912002279 |
| Provider Name | Krzysztof Garbarz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548718216 PECOS PAC ID: 4486942539 Enrollment ID: I20161005002520 |
| Provider Name | Nicole Kurian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679956247 PECOS PAC ID: 7315235066 Enrollment ID: I20161012000755 |
| Provider Name | Ricardo Aguinaga |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215187661 PECOS PAC ID: 0749568475 Enrollment ID: I20161031001242 |
| Provider Name | Fernando Velasquez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386195535 PECOS PAC ID: 5193003861 Enrollment ID: I20161031002474 |
| Provider Name | Jenna Pederson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063966158 PECOS PAC ID: 4880973742 Enrollment ID: I20161116001996 |
| Provider Name | Lizbeth Rodriguez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578976205 PECOS PAC ID: 1850671207 Enrollment ID: I20161201000843 |
| Provider Name | Patricia Martin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366855090 PECOS PAC ID: 7517247968 Enrollment ID: I20161201001088 |
| Provider Name | Daniel Hawthorne |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871906594 PECOS PAC ID: 3173803467 Enrollment ID: I20161202000085 |
| Provider Name | Damaris Velazquez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003277500 PECOS PAC ID: 6800177726 Enrollment ID: I20170106001059 |
| Provider Name | Ericka Sanders |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265871834 PECOS PAC ID: 4688956881 Enrollment ID: I20170124001092 |
| Provider Name | Frank Rodell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598933830 PECOS PAC ID: 6305986530 Enrollment ID: I20170310001001 |
| Provider Name | Kimberly Finnegan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134661366 PECOS PAC ID: 7416224498 Enrollment ID: I20170523000325 |
| Provider Name | Sarah Kristin Grebasch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437553013 PECOS PAC ID: 1759650989 Enrollment ID: I20170703001216 |
| Provider Name | Kellilynn Bosak |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205363421 PECOS PAC ID: 8729357892 Enrollment ID: I20170705001212 |
| Provider Name | Jeffrey Rosenblatt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508283722 PECOS PAC ID: 7618248691 Enrollment ID: I20170809003145 |
| Provider Name | Jiyeon Jeon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902223050 PECOS PAC ID: 6002199734 Enrollment ID: I20170809003480 |
| Provider Name | Aisha T Wright |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184038002 PECOS PAC ID: 2668794280 Enrollment ID: I20170815004635 |
| Provider Name | Colleen Weseloh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962820100 PECOS PAC ID: 1456653393 Enrollment ID: I20170817003103 |
| Provider Name | Funmi Adeleke |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1588701452 PECOS PAC ID: 2466724851 Enrollment ID: I20170818003136 |
| Provider Name | Melissa Beally |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1306281480 PECOS PAC ID: 9234410911 Enrollment ID: I20170829004078 |
| Provider Name | Moshini Sivasubramaniam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720491467 PECOS PAC ID: 9537432919 Enrollment ID: I20170906003506 |
| Provider Name | Thomas Kim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407083488 PECOS PAC ID: 3971759838 Enrollment ID: I20170916000038 |
| Provider Name | Kimberly Zoellick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104344431 PECOS PAC ID: 5294009387 Enrollment ID: I20170928002171 |
| Provider Name | Michael Kelly |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1265888655 PECOS PAC ID: 7416222476 Enrollment ID: I20171002002564 |
| Provider Name | Sweta Shah |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1093070435 PECOS PAC ID: 4587930235 Enrollment ID: I20171024002435 |
| Provider Name | Megan K Dawson |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1154841815 PECOS PAC ID: 1951668045 Enrollment ID: I20171128001023 |
| Provider Name | Ralph G. Ryan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548254972 PECOS PAC ID: 9739168832 Enrollment ID: I20171130001618 |
| Provider Name | Peter M Chapman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053552497 PECOS PAC ID: 5698035764 Enrollment ID: I20180209001465 |
| Provider Name | Mary Leung |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1710492947 PECOS PAC ID: 6103188818 Enrollment ID: I20180316000996 |
| Provider Name | Anastasia Crihfield |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467831867 PECOS PAC ID: 3870881212 Enrollment ID: I20180725003585 |
| Provider Name | Kyle Bohan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457730855 PECOS PAC ID: 0648528208 Enrollment ID: I20180730003426 |
| Provider Name | Alexander M Neuman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295114668 PECOS PAC ID: 6507114170 Enrollment ID: I20180731000014 |
| Provider Name | Jacob Shaw |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023497344 PECOS PAC ID: 7911213921 Enrollment ID: I20180731002364 |
| Provider Name | Scott Agee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154700938 PECOS PAC ID: 9931420890 Enrollment ID: I20180809000008 |
| Provider Name | Tanen St Clair-brown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487040739 PECOS PAC ID: 5193014488 Enrollment ID: I20180809004724 |
| Provider Name | Veronica Pappas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285047647 PECOS PAC ID: 9032497110 Enrollment ID: I20180810000085 |
| Provider Name | Dillon M Cleary |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225419476 PECOS PAC ID: 8123321320 Enrollment ID: I20180810000818 |
| Provider Name | Emma Kathryn Worringer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154734853 PECOS PAC ID: 8729208574 Enrollment ID: I20181025001528 |
| Provider Name | Megan C Tress |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235612383 PECOS PAC ID: 5597018952 Enrollment ID: I20181101000543 |
| Provider Name | Stephanie M Weller |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1891886164 PECOS PAC ID: 6406858141 Enrollment ID: I20190226003080 |
| Provider Name | Kathleen Escalona |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356805386 PECOS PAC ID: 5991046385 Enrollment ID: I20190412000191 |
| Provider Name | Lauren Harriett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700232733 PECOS PAC ID: 1658614409 Enrollment ID: I20190517000502 |
| Provider Name | Anna Pecyna |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083125033 PECOS PAC ID: 7517200371 Enrollment ID: I20190517000709 |
| Provider Name | Jamika Walton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568900835 PECOS PAC ID: 9032443593 Enrollment ID: I20190703000603 |
| Provider Name | Michelle Behrens |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013574136 PECOS PAC ID: 0547597254 Enrollment ID: I20190802001917 |
| Provider Name | Brittani A Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881045011 PECOS PAC ID: 8820325392 Enrollment ID: I20190806002614 |
| Provider Name | Christine Elaine Schultheiss |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255786430 PECOS PAC ID: 4981931391 Enrollment ID: I20190808000197 |
| Provider Name | Jacob Matthew Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760838965 PECOS PAC ID: 7810289691 Enrollment ID: I20190808000871 |
| Provider Name | Kristen Marie Moser |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003264177 PECOS PAC ID: 7214264654 Enrollment ID: I20190808001134 |
| Provider Name | Aeri J Paek |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366899619 PECOS PAC ID: 6608160163 Enrollment ID: I20190808001481 |
| Provider Name | Michele Alba |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184006397 PECOS PAC ID: 1557626298 Enrollment ID: I20190808001845 |
| Provider Name | Brandi S Alexander |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265896922 PECOS PAC ID: 5395038509 Enrollment ID: I20190812000341 |
| Provider Name | Jeanine Valrie Logan |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1255997375 PECOS PAC ID: 1557699238 Enrollment ID: I20190819002987 |
| Provider Name | Bonnie J Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669829776 PECOS PAC ID: 6204114887 Enrollment ID: I20190904000262 |
| Provider Name | Alvie Bender |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023677051 PECOS PAC ID: 4183953797 Enrollment ID: I20190906002731 |
| Provider Name | Maryam A Diaz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891356721 PECOS PAC ID: 4880924042 Enrollment ID: I20191001002791 |
| Provider Name | Felisa Gutierrez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891340717 PECOS PAC ID: 8729318829 Enrollment ID: I20191002001457 |
| Provider Name | Emily R Schulte |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295264992 PECOS PAC ID: 2769713734 Enrollment ID: I20191007002050 |
| Provider Name | Chandra A Matteson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093360653 PECOS PAC ID: 5799016549 Enrollment ID: I20191009003040 |
| Provider Name | Antonio Wheeler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356980486 PECOS PAC ID: 7416386636 Enrollment ID: I20200408003966 |
| Provider Name | Ruchi M Fitzgerald |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720060072 PECOS PAC ID: 4880791128 Enrollment ID: I20200629001193 |
| Provider Name | Gabrielle Denise Gay |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003337817 PECOS PAC ID: 9335565829 Enrollment ID: I20200814000097 |
| Provider Name | Unnati Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952838179 PECOS PAC ID: 9436577178 Enrollment ID: I20200914000681 |
| Provider Name | Katrina Weimer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083148464 PECOS PAC ID: 7911277751 Enrollment ID: I20200918000230 |
| Provider Name | Lindsey Kurdi Wood |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902336266 PECOS PAC ID: 9638449952 Enrollment ID: I20200918000570 |
| Provider Name | Joelle N Potts |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891225611 PECOS PAC ID: 1052684305 Enrollment ID: I20200921002249 |
| Provider Name | Joanna Marie Curran |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326577057 PECOS PAC ID: 2264842012 Enrollment ID: I20201105000994 |
| Provider Name | Dennis Ea |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114450988 PECOS PAC ID: 9638447964 Enrollment ID: I20201209000609 |
| Provider Name | Jeslyn John Lukose |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992320592 PECOS PAC ID: 1850703943 Enrollment ID: I20201215000009 |
| Provider Name | Katherine Jaynes Getchell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659978179 PECOS PAC ID: 5597177691 Enrollment ID: I20201215000457 |
| Provider Name | Patricia B Billingsley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396389342 PECOS PAC ID: 4486066511 Enrollment ID: I20201215001467 |
| Provider Name | Kathryn Lee Stromdahl |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609305234 PECOS PAC ID: 8527470319 Enrollment ID: I20201221000976 |
| Provider Name | Jennifer Nudo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881215960 PECOS PAC ID: 9739591397 Enrollment ID: I20201224000041 |
| Provider Name | Hannah Polus |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376072009 PECOS PAC ID: 2769755040 Enrollment ID: I20210107001632 |
| Provider Name | Alma Delia Gallegos |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1376145433 PECOS PAC ID: 7113330002 Enrollment ID: I20210114000976 |
| Provider Name | Vanessa Rooney |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508398173 PECOS PAC ID: 5597035808 Enrollment ID: I20210129001145 |
| Provider Name | Andrew Wojda |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376133504 PECOS PAC ID: 4981011244 Enrollment ID: I20210402000335 |
| Provider Name | Matthew Q English |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417546607 PECOS PAC ID: 8527475615 Enrollment ID: I20210408001044 |
| Provider Name | Olivia Nicole Corrado |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1699173856 PECOS PAC ID: 0446569883 Enrollment ID: I20210628002153 |
| Provider Name | Francesco Tani |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851884522 PECOS PAC ID: 5698177525 Enrollment ID: I20210714001719 |
| Provider Name | Andrea Haynes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720585029 PECOS PAC ID: 8527317593 Enrollment ID: I20210714002364 |
| Provider Name | Shayna Friedman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1548764301 PECOS PAC ID: 7416359179 Enrollment ID: I20210719000185 |
| Provider Name | Umar Siddiqui |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1578055984 PECOS PAC ID: 9638572902 Enrollment ID: I20210723001383 |
| Provider Name | Alexis P Hoffkling |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295239697 PECOS PAC ID: 4183035959 Enrollment ID: I20210724000052 |
| Provider Name | Bjai A Rice |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912490954 PECOS PAC ID: 9436552759 Enrollment ID: I20210724000082 |
| Provider Name | Brisa Gulari-jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255851218 PECOS PAC ID: 5991079766 Enrollment ID: I20210924000903 |
| Provider Name | Morgan Colleen Beatty |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811488679 PECOS PAC ID: 7113325770 Enrollment ID: I20211012002101 |
| Provider Name | Colleen Elizabeth Mcshane |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1720468721 PECOS PAC ID: 9638473051 Enrollment ID: I20211105001161 |
| Provider Name | Leslie Smebak |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760973515 PECOS PAC ID: 7012306202 Enrollment ID: I20211109002289 |
| Provider Name | Femmily Blake Robison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871096016 PECOS PAC ID: 6204203599 Enrollment ID: I20221028001885 |
| Provider Name | Julene Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780316414 PECOS PAC ID: 4486022399 Enrollment ID: I20221128001634 |
| Provider Name | Denise Padilla |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1235718420 PECOS PAC ID: 2163895756 Enrollment ID: I20230301002268 |
| Provider Name | Kathleen Britten |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1821719147 PECOS PAC ID: 7618340050 Enrollment ID: I20230306000251 |
| Provider Name | Samantha Shay |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467164129 PECOS PAC ID: 1557734993 Enrollment ID: I20230306000516 |
| Provider Name | Devyani Chawla |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1861915969 PECOS PAC ID: 2668846114 Enrollment ID: I20230323001448 |
| Provider Name | Nicole Marie Paprocki |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811458466 PECOS PAC ID: 9931433778 Enrollment ID: I20230329002494 |
| Provider Name | Max Roland Ruben |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073137279 PECOS PAC ID: 4082071287 Enrollment ID: I20230602001394 |
| Provider Name | Stephen Elliot Hawthorne |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376872721 PECOS PAC ID: 1557728607 Enrollment ID: I20230605001485 |
| Provider Name | Kathryn Elizabeth Ryan Nutting |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962026005 PECOS PAC ID: 7618362286 Enrollment ID: I20230703000838 |
| Provider Name | Kiara L Dillard-dorve |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275162190 PECOS PAC ID: 5991189094 Enrollment ID: I20230830004176 |
| Provider Name | Bryce T De Venecia |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1568091924 PECOS PAC ID: 8921429481 Enrollment ID: I20230911001175 |
| Provider Name | Tiffany G Tahata |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1942820337 PECOS PAC ID: 4981067816 Enrollment ID: I20230922001944 |
| Provider Name | Kate Meizlish |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053940924 PECOS PAC ID: 4486060142 Enrollment ID: I20231002003006 |
| Provider Name | Nauramy Aboro |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053853317 PECOS PAC ID: 0840522991 Enrollment ID: I20231013002682 |
| Provider Name | Lucero Garcia |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366986911 PECOS PAC ID: 5890141048 Enrollment ID: I20231025001139 |
| Provider Name | Ana A Toledo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558983627 PECOS PAC ID: 5597188482 Enrollment ID: I20231115001867 |
| Provider Name | Catherine Ives-louter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942755426 PECOS PAC ID: 8123476652 Enrollment ID: I20231122000916 |
| Provider Name | Alison Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871279992 PECOS PAC ID: 8628427531 Enrollment ID: I20231218000145 |
| Provider Name | Kimberly Ann Sammons |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144906926 PECOS PAC ID: 5092153684 Enrollment ID: I20240402000870 |
James Lo M.d., Mary Lo M.d. S.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1140 W Lake St, Suite 402, Oak Park, IL 60301 Phone: 708-848-0330 | |
Diamond Gastroenterology Sc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1010 Lake St Ste 424, Oak Park, IL 60301 Phone: 708-613-4417 | |
Maria Slobodian Md Sc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1 Erie Ct, Suite#7040, Oak Park, IL 60302 Phone: 708-848-5410 Fax: 708-848-6539 | |
Anarkali Internists Sc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1035 N Marion St, Oak Park, IL 60302 Phone: 773-354-7041 | |
Pcc Community Wellness Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 14 W Lake St, Oak Park, IL 60302 Phone: 708-383-0113 Fax: 708-383-9911 | |
Midwest Gi And Hepatology, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 610 S Maple Ave, Suite 2600, Oak Park, IL 60304 Phone: 708-290-1010 | |
Pedios, Ltd. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 260 Chicago Ave, Oak Park, IL 60302 Phone: 708-383-8070 Fax: 708-383-0811 |