Physician Services Of Mch | |
1401 East 12th Street Mendota IL 61342-9216 | |
(815) 539-7461 | |
(815) 538-5516 |
Full Name | Physician Services Of Mch |
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Speciality | Family Medicine |
Location | 1401 East 12th Street, Mendota, Illinois |
Authorized Official Name and Position | Robert C. Sehring (CEO, OSF HEALTHCARE SYSTEM) |
Authorized Official Contact | 3066552850 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Physician Services Of Mch 124 Sw Adams St Peoria IL 61602-1320 Ph: (093) 655-2850 | Physician Services Of Mch 1401 East 12th Street Mendota IL 61342-9216 Ph: (815) 539-7461 |
NPI Number | 1407872997 |
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Provider Enumeration Date | 07/15/2006 |
Last Update Date | 03/18/2024 |
Medicare PECOS PAC ID | 2264335777 |
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Medicare Enrollment ID | O20040131000102 |
Identifier | Type | State | Issuer |
---|---|---|---|
1407872997 | NPI | - | NPPES |
CI2549 | Other | RAILROAD MEDICARE |
Provider Name | David C Hulsey |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1316992969 PECOS PAC ID: 8426955667 Enrollment ID: I20031216000809 |
Provider Name | Jane L Kotecki |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1760451793 PECOS PAC ID: 4789578774 Enrollment ID: I20040211000152 |
Provider Name | Serge Golber |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1861464992 PECOS PAC ID: 5294637740 Enrollment ID: I20040313000408 |
Provider Name | Dana C Perry |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1265434658 PECOS PAC ID: 3870484629 Enrollment ID: I20040322001834 |
Provider Name | Troy S Cutler |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1639108020 PECOS PAC ID: 7012902232 Enrollment ID: I20040417000140 |
Provider Name | Mark A Meeker |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1225139058 PECOS PAC ID: 8123013604 Enrollment ID: I20040421000528 |
Provider Name | Damian W Grivetti |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1518970847 PECOS PAC ID: 4789672114 Enrollment ID: I20040504001455 |
Provider Name | Gueorgui S Gueorguiev |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1356336952 PECOS PAC ID: 4981694064 Enrollment ID: I20040512001483 |
Provider Name | Robert G Vottero |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1902832025 PECOS PAC ID: 1153303201 Enrollment ID: I20040603000187 |
Provider Name | Michael G Saad |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1831191261 PECOS PAC ID: 3577537349 Enrollment ID: I20040826000023 |
Provider Name | Scott M Guth |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1568422962 PECOS PAC ID: 1850367434 Enrollment ID: I20040903001161 |
Provider Name | Jasmine N Bhurgri |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1821046186 PECOS PAC ID: 1254306723 Enrollment ID: I20041015000070 |
Provider Name | Kara Oprian Fess |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1700843950 PECOS PAC ID: 7113976283 Enrollment ID: I20050117000129 |
Provider Name | Sherine F Hanna |
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Provider Type | Practitioner - Anesthesiology |
Provider Identifiers | NPI Number: 1003886417 PECOS PAC ID: 6002867512 Enrollment ID: I20050202000250 |
Provider Name | Raul V Guerrero |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1053307660 PECOS PAC ID: 3274573951 Enrollment ID: I20050512000275 |
Provider Name | Brian S Curtis |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1730272964 PECOS PAC ID: 2365478609 Enrollment ID: I20050708000808 |
Provider Name | James R Hubler |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1861428492 PECOS PAC ID: 8527095264 Enrollment ID: I20050725000372 |
Provider Name | James T Brown |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1699704122 PECOS PAC ID: 2668409368 Enrollment ID: I20050725000835 |
Provider Name | Brian R Pope |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1275533820 PECOS PAC ID: 1355372889 Enrollment ID: I20050824001135 |
Provider Name | Leonardo Lopez |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1376643007 PECOS PAC ID: 7810928280 Enrollment ID: I20050825000273 |
Provider Name | Shaista A Malik |
---|---|
Provider Type | Practitioner - Anesthesiology |
Provider Identifiers | NPI Number: 1407965585 PECOS PAC ID: 8820002405 Enrollment ID: I20060202000855 |
Provider Name | Robert W Morrow |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1295747137 PECOS PAC ID: 8820005275 Enrollment ID: I20060310000050 |
Provider Name | Amy M Matheis Soliman |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1376566539 PECOS PAC ID: 8325042500 Enrollment ID: I20060830000290 |
Provider Name | Christopher M Herman |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1588734842 PECOS PAC ID: 1658370119 Enrollment ID: I20061211000187 |
Provider Name | Joseph Boyle |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1356427785 PECOS PAC ID: 5890794861 Enrollment ID: I20061221000014 |
Provider Name | Mete Korkmaz |
---|---|
Provider Type | Practitioner - Medical Oncology |
Provider Identifiers | NPI Number: 1902833999 PECOS PAC ID: 7517967508 Enrollment ID: I20061221000232 |
Provider Name | Niko I Keys |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1881783793 PECOS PAC ID: 9436159266 Enrollment ID: I20070102000027 |
Provider Name | Ricardo J Calderon |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1194886226 PECOS PAC ID: 4284684077 Enrollment ID: I20070411000271 |
Provider Name | Kelly L Cox |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1518182906 PECOS PAC ID: 3779471768 Enrollment ID: I20071126000332 |
Provider Name | Dimitrios T Mougolias |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1053520700 PECOS PAC ID: 3375632748 Enrollment ID: I20071228000405 |
Provider Name | Joan Marie Luckey |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1881767762 PECOS PAC ID: 7113004391 Enrollment ID: I20080411000656 |
Provider Name | Louis R Lukancic |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1326153651 PECOS PAC ID: 0648332783 Enrollment ID: I20081223000635 |
Provider Name | Michael S Morrow |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1013920420 PECOS PAC ID: 2365504412 Enrollment ID: I20081223000651 |
Provider Name | Shawn E Bailey |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1447363585 PECOS PAC ID: 2365530219 Enrollment ID: I20090625000330 |
Provider Name | Eric Kivisto |
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Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1447257316 PECOS PAC ID: 8820155963 Enrollment ID: I20090917000544 |
Provider Name | Fazal A Khan |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1669430567 PECOS PAC ID: 2163564980 Enrollment ID: I20100116000161 |
Provider Name | Michelle Lynn Vasquez |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1164629531 PECOS PAC ID: 2365567328 Enrollment ID: I20100914000609 |
Provider Name | Shylendra B Sreenivasappa |
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Provider Type | Practitioner - Medical Oncology |
Provider Identifiers | NPI Number: 1972706604 PECOS PAC ID: 3476740242 Enrollment ID: I20101206000580 |
Provider Name | Debra M Herz |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1275842650 PECOS PAC ID: 6608057740 Enrollment ID: I20110223000496 |
Provider Name | Rahul R Sampat |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1790937092 PECOS PAC ID: 4981886983 Enrollment ID: I20110312000081 |
Provider Name | Christopher B Beach |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1649245564 PECOS PAC ID: 7113187170 Enrollment ID: I20120328000823 |
Provider Name | Katherine R Riva Foster |
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Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1073869475 PECOS PAC ID: 1951554856 Enrollment ID: I20121228000336 |
Provider Name | Karen L Eggers |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1073806048 PECOS PAC ID: 6800037722 Enrollment ID: I20130718000482 |
Provider Name | Christine E Hermosillo |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1962838862 PECOS PAC ID: 7911134770 Enrollment ID: I20131226001054 |
Provider Name | Jennifer A Berkley |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1295088391 PECOS PAC ID: 2062641723 Enrollment ID: I20140129001866 |
Provider Name | Andrew J Zidow |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1700141009 PECOS PAC ID: 6608196860 Enrollment ID: I20150908000188 |
Provider Name | Bharat N Raju |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1720217581 PECOS PAC ID: 9830346477 Enrollment ID: I20150910000175 |
Provider Name | Jennifer M Kelsey |
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Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
Provider Identifiers | NPI Number: 1861860058 PECOS PAC ID: 6507166766 Enrollment ID: I20151120000349 |
Provider Name | Joy R Preciado |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1306216098 PECOS PAC ID: 1850595992 Enrollment ID: I20160108002309 |
Provider Name | Muhammad Waqar Khattak |
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Provider Type | Practitioner - Nephrology |
Provider Identifiers | NPI Number: 1669648309 PECOS PAC ID: 9739254418 Enrollment ID: I20160115000133 |
Provider Name | Alicia M Szafranski |
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Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1912361361 PECOS PAC ID: 2769773449 Enrollment ID: I20160628001172 |
Provider Name | Traci L Keyster |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1255684072 PECOS PAC ID: 2567754716 Enrollment ID: I20160707002099 |
Provider Name | Stacy A Piller |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1508319914 PECOS PAC ID: 8527355783 Enrollment ID: I20161003001309 |
Provider Name | David J Kawior |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1326453093 PECOS PAC ID: 3476857715 Enrollment ID: I20170227001657 |
Provider Name | Hallie A Konieczki |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1619425204 PECOS PAC ID: 0749564078 Enrollment ID: I20170303001488 |
Provider Name | Shahmohammed F Parves |
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Provider Type | Practitioner - Anesthesiology |
Provider Identifiers | NPI Number: 1538394838 PECOS PAC ID: 8123269255 Enrollment ID: I20170907001935 |
Provider Name | Anastasia Figura |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1023455680 PECOS PAC ID: 7416251814 Enrollment ID: I20170921000464 |
Provider Name | Anju D Patel |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1407260110 PECOS PAC ID: 2860618048 Enrollment ID: I20170926002315 |
Provider Name | Grant Michael Reed |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1215354246 PECOS PAC ID: 2365750973 Enrollment ID: I20171012001968 |
Provider Name | Britnae L Lewis |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1922524578 PECOS PAC ID: 8628335718 Enrollment ID: I20171128000808 |
Provider Name | Elizabeth L Stuart |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1669983789 PECOS PAC ID: 9931467933 Enrollment ID: I20171221000145 |
Provider Name | Austin D Martin |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1730560822 PECOS PAC ID: 2163739541 Enrollment ID: I20180629001614 |
Provider Name | Carrie B Finley |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1427531615 PECOS PAC ID: 8628320975 Enrollment ID: I20181015001561 |
Provider Name | Alisha N Jackson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1487197745 PECOS PAC ID: 2567715519 Enrollment ID: I20181022002454 |
Provider Name | Cynthia Salazar |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1477010031 PECOS PAC ID: 2264774157 Enrollment ID: I20190424002015 |
Provider Name | Keith J Christensen |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1255844189 PECOS PAC ID: 9133552466 Enrollment ID: I20191127001370 |
Provider Name | Taylor Anne Vipond |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1528603057 PECOS PAC ID: 4082049358 Enrollment ID: I20200114002094 |
Provider Name | Janie Clary |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1053912188 PECOS PAC ID: 7416360458 Enrollment ID: I20210111003071 |
Provider Name | Susan J Olsen |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1508491663 PECOS PAC ID: 8527472661 Enrollment ID: I20210201000392 |
Provider Name | Connor Joseph Kristof |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1912495383 PECOS PAC ID: 7113277815 Enrollment ID: I20210611002460 |
Provider Name | Marcela R Lemus |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1962175562 PECOS PAC ID: 5294131041 Enrollment ID: I20210902002559 |
Provider Name | Candace R Ramirez |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1053087767 PECOS PAC ID: 9537567391 Enrollment ID: I20211007003068 |
Provider Name | Maritza Yesenia Estrada-o'brien |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1184187767 PECOS PAC ID: 9234522079 Enrollment ID: I20220131001759 |
Provider Name | Tiffany Ann Shinnick |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1003388463 PECOS PAC ID: 3678960689 Enrollment ID: I20220421001520 |
Provider Name | Brooke A Yucus |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1619617602 PECOS PAC ID: 5092198150 Enrollment ID: I20220825002652 |
Provider Name | Melissa E Ramirez |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1043943830 PECOS PAC ID: 1254703887 Enrollment ID: I20230208002099 |
Provider Name | Amy Gail Corsolini |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1992407738 PECOS PAC ID: 9638538093 Enrollment ID: I20230703000184 |
Provider Name | Bridget A Pratt |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1427741933 PECOS PAC ID: 6901266659 Enrollment ID: I20230713001900 |
Osf Promptcare Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1401 E 12th St Ste 400, Mendota, IL 61342 Phone: 815-538-7200 | |
Community Health Partnership Of Illinois Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1009 Main St, Mendota, IL 61342 Phone: 815-539-6124 Fax: 815-539-9015 | |
Osf Medical Group-washington Street Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1401 Washington Street, Mendota, IL 61342 Phone: 815-538-1825 | |
Associated Physicians, Sc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1405 E 12th St, Suite 300, Mendota, IL 61342 Phone: 815-539-3141 Fax: 815-487-4901 | |
Dr. Megan's Healthcare Ministries Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1201 Meriden St, Mendota, IL 61342 Phone: 815-539-3739 Fax: 815-539-3753 | |
Osf Saint Paul Medical Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1405 E 12th St, Mendota, IL 61342 Phone: 815-539-7461 |