| Siu Center For Family Medicine | |
|
520 N 4th St Springfield IL 62702-5238 | |
| (217) 757-8100 | |
| (217) 747-1351 |
| Full Name | Siu Center For Family Medicine |
|---|---|
| Speciality | Clinic/Center |
| Location | 520 N 4th St, Springfield, Illinois |
| Authorized Official Name and Position | Janet R Albers (CEO) |
| Authorized Official Contact | 2177578100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Siu Center For Family Medicine Po Box 19639 Springfield IL 62794-9639 Ph: (217) 545-8000 | Siu Center For Family Medicine 520 N 4th St Springfield IL 62702-5238 Ph: (217) 757-8100 |
| NPI Number | 1396097960 |
|---|---|
| Provider Enumeration Date | 10/08/2012 |
| Last Update Date | 01/24/2023 |
| Medicare PECOS PAC ID | 4486667888 |
|---|---|
| Medicare Enrollment ID | O20130424001019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396097960 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (Illinois) | Primary |
| Provider Name | Harald Lausen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396878674 PECOS PAC ID: 2668371733 Enrollment ID: I20040115000232 |
| Provider Name | Raymond S Bland |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881653103 PECOS PAC ID: 3678475894 Enrollment ID: I20040127000139 |
| 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 | Philip Dean Pan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548248180 PECOS PAC ID: 9830083393 Enrollment ID: I20040214000103 |
| Provider Name | Scott Wright |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447258181 PECOS PAC ID: 3577453596 Enrollment ID: I20040316000150 |
| Provider Name | Mouhamad H Bakir |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1154319994 PECOS PAC ID: 1456345438 Enrollment ID: I20040413000278 |
| Provider Name | Charles R Ellington |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407833130 PECOS PAC ID: 9032108907 Enrollment ID: I20040507000350 |
| Provider Name | Pamela Kay Hunter-reach |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942208988 PECOS PAC ID: 8921083023 Enrollment ID: I20040622001594 |
| Provider Name | Tracy A Aldridge |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154310027 PECOS PAC ID: 7214900869 Enrollment ID: I20040813000007 |
| Provider Name | Sondra S Hoover |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538368568 PECOS PAC ID: 3779552781 Enrollment ID: I20040927001091 |
| Provider Name | Michael L Brewer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588774756 PECOS PAC ID: 7113988056 Enrollment ID: I20041022001189 |
| Provider Name | Paula Scheetz Mackrides |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316924087 PECOS PAC ID: 8426010554 Enrollment ID: I20041101000989 |
| Provider Name | Salvador Sanchez Zuniga |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982799086 PECOS PAC ID: 4587628268 Enrollment ID: I20041112000568 |
| Provider Name | Thomas W Moll |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053459503 PECOS PAC ID: 1557317419 Enrollment ID: I20050324000233 |
| Provider Name | Jennifer C Hammonds |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346200805 PECOS PAC ID: 9931146263 Enrollment ID: I20050408000406 |
| Provider Name | James Milton Daniels |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750368452 PECOS PAC ID: 9032159264 Enrollment ID: I20050506000667 |
| Provider Name | Cesar Sobremonte Arguelles |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518944248 PECOS PAC ID: 7012944036 Enrollment ID: I20050721000434 |
| Provider Name | Timothi J Beth |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629083431 PECOS PAC ID: 2264462084 Enrollment ID: I20050822000063 |
| Provider Name | Steven R Ginos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740298942 PECOS PAC ID: 1456344126 Enrollment ID: I20050822000078 |
| Provider Name | Crystal L Perry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689682528 PECOS PAC ID: 8325078140 Enrollment ID: I20050822000089 |
| Provider Name | Ronald St Hill |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316032147 PECOS PAC ID: 0648201822 Enrollment ID: I20050826000852 |
| Provider Name | Joseph Lane |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548485873 PECOS PAC ID: 6103848841 Enrollment ID: I20051222000316 |
| Provider Name | Scott Kenneth Schonewolf |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114996204 PECOS PAC ID: 6002882560 Enrollment ID: I20060126000776 |
| Provider Name | Peter White |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1659313823 PECOS PAC ID: 3072518653 Enrollment ID: I20061004000116 |
| Provider Name | Lauri Fick Lopp |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831189539 PECOS PAC ID: 9133160351 Enrollment ID: I20061026000401 |
| Provider Name | Anne S Daly |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1053373498 PECOS PAC ID: 6204834971 Enrollment ID: I20061114000232 |
| Provider Name | Jessie A Junker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205828084 PECOS PAC ID: 8022016690 Enrollment ID: I20061114000333 |
| Provider Name | Mary R Hoffman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316984057 PECOS PAC ID: 1850357526 Enrollment ID: I20061116000374 |
| Provider Name | Melissa S Schleder |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1609959402 PECOS PAC ID: 1759380744 Enrollment ID: I20061221000172 |
| Provider Name | Rajagopal V Sreedhar |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1821211970 PECOS PAC ID: 1759489313 Enrollment ID: I20070605000284 |
| Provider Name | Nichole Joy Mirocha |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457573388 PECOS PAC ID: 7113028622 Enrollment ID: I20070727000765 |
| Provider Name | Andrew Joseph Yochum |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568682649 PECOS PAC ID: 7315048766 Enrollment ID: I20070730000153 |
| Provider Name | Leanne M Novar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720274012 PECOS PAC ID: 6507952181 Enrollment ID: I20071011000614 |
| Provider Name | Rachel Lynn Rahman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568425353 PECOS PAC ID: 0749377372 Enrollment ID: I20071030000241 |
| Provider Name | Nadine C Lamond |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1235114661 PECOS PAC ID: 7810084456 Enrollment ID: I20071030000354 |
| Provider Name | Mary Iftner Dobbins |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235186297 PECOS PAC ID: 6305829391 Enrollment ID: I20071109000030 |
| Provider Name | Airn A Etherton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114115920 PECOS PAC ID: 4789772914 Enrollment ID: I20071121000284 |
| Provider Name | David B Graham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386759264 PECOS PAC ID: 1850374109 Enrollment ID: I20080305000101 |
| Provider Name | Jerry L Goddard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295711240 PECOS PAC ID: 9436259058 Enrollment ID: I20080326000046 |
| Provider Name | Helen L Moose |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1013906460 PECOS PAC ID: 2466539374 Enrollment ID: I20080402000607 |
| Provider Name | Babu R Eladasari |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356393300 PECOS PAC ID: 6901971779 Enrollment ID: I20080814000120 |
| Provider Name | Paul Anthony Hibbert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093961468 PECOS PAC ID: 3870655491 Enrollment ID: I20081216000392 |
| Provider Name | Brian J Reach |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104824598 PECOS PAC ID: 6709938152 Enrollment ID: I20090715000316 |
| Provider Name | Stacy S Melton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760410211 PECOS PAC ID: 7911047519 Enrollment ID: I20091211000419 |
| Provider Name | Gayle Joanne Jennings |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1669705679 PECOS PAC ID: 2769523323 Enrollment ID: I20100105000654 |
| Provider Name | Gary Michael Rull |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154306017 PECOS PAC ID: 5698817468 Enrollment ID: I20100118000185 |
| Provider Name | Debra Marie Phillips |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467439075 PECOS PAC ID: 3375686710 Enrollment ID: I20100206000230 |
| Provider Name | Cynthia Gee Thomas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447249875 PECOS PAC ID: 5294862132 Enrollment ID: I20100423000576 |
| Provider Name | David Howard Decker |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063490043 PECOS PAC ID: 6709913650 Enrollment ID: I20100423000633 |
| Provider Name | Sara Beth Malone |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386976298 PECOS PAC ID: 0547397135 Enrollment ID: I20100430000458 |
| Provider Name | Christopher Louis Gleason |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649269887 PECOS PAC ID: 1456481282 Enrollment ID: I20100604000782 |
| Provider Name | Andrew Joseph Varney |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467437343 PECOS PAC ID: 8224168067 Enrollment ID: I20100604000970 |
| Provider Name | Quincy Oneal Scott |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992781710 PECOS PAC ID: 4587794946 Enrollment ID: I20100610000772 |
| Provider Name | Thomas Harold Miller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912984527 PECOS PAC ID: 0042308173 Enrollment ID: I20100610001001 |
| Provider Name | Amber Jean Barnhart |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215926183 PECOS PAC ID: 9537299896 Enrollment ID: I20100611000755 |
| Provider Name | Sharon Ann Smaga |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689650566 PECOS PAC ID: 6103956461 Enrollment ID: I20100611000868 |
| Provider Name | Kathleen Mary Bottum |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124003025 PECOS PAC ID: 7719017086 Enrollment ID: I20100612000017 |
| Provider Name | Janet Regine Albers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023006913 PECOS PAC ID: 0446382220 Enrollment ID: I20100714000154 |
| Provider Name | Careyana Michelle Brenham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568451946 PECOS PAC ID: 8527190347 Enrollment ID: I20100714000696 |
| Provider Name | Kyaw Thet Naing |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215913181 PECOS PAC ID: 4183756919 Enrollment ID: I20100714000806 |
| Provider Name | Susan Thompson Hingle |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124003124 PECOS PAC ID: 1153453717 Enrollment ID: I20100716000379 |
| Provider Name | Socorro Justiniani Shelton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780905638 PECOS PAC ID: 2860526639 Enrollment ID: I20100816000414 |
| Provider Name | Akshra Verma |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043480304 PECOS PAC ID: 1658405444 Enrollment ID: I20100816000579 |
| Provider Name | Michal Dynda |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578749164 PECOS PAC ID: 0941334452 Enrollment ID: I20100819000807 |
| Provider Name | Timothy Titus Ott |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558463505 PECOS PAC ID: 0345140562 Enrollment ID: I20101019000756 |
| Provider Name | Lanny E Stiles |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508951781 PECOS PAC ID: 1759576549 Enrollment ID: I20101105000728 |
| Provider Name | Mary Kay Schlegl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336112929 PECOS PAC ID: 9436047321 Enrollment ID: I20110209000623 |
| Provider Name | Barbara G Grear |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659559169 PECOS PAC ID: 9537344221 Enrollment ID: I20110422000034 |
| Provider Name | Deedra G Mclain |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770635062 PECOS PAC ID: 9234315029 Enrollment ID: I20110511000733 |
| Provider Name | Mingchen Song |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1659571487 PECOS PAC ID: 3173794682 Enrollment ID: I20110913000783 |
| Provider Name | Alexander M Hrynewych |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1780726430 PECOS PAC ID: 3971774712 Enrollment ID: I20110927000556 |
| Provider Name | William H Dixon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740299759 PECOS PAC ID: 8426024837 Enrollment ID: I20111007000618 |
| Provider Name | Amber Nicole Garwood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437431368 PECOS PAC ID: 8123294634 Enrollment ID: I20120105000239 |
| Provider Name | Jay S Keller |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1790760544 PECOS PAC ID: 9234119538 Enrollment ID: I20120510000335 |
| Provider Name | Stacy Renee Lee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043408313 PECOS PAC ID: 3971765850 Enrollment ID: I20120510000570 |
| Provider Name | Clasina Leslie Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437342433 PECOS PAC ID: 0840456745 Enrollment ID: I20120720000508 |
| Provider Name | Obiora Edward Onwuameze |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386806453 PECOS PAC ID: 5597921379 Enrollment ID: I20120723000877 |
| Provider Name | Tabatha Selina Wells |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992933923 PECOS PAC ID: 0840456133 Enrollment ID: I20120801000446 |
| Provider Name | Sarah K Bockhold |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962768853 PECOS PAC ID: 0446400089 Enrollment ID: I20121017000435 |
| Provider Name | Ashish Moonat |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1063670362 PECOS PAC ID: 6901051168 Enrollment ID: I20130220000096 |
| Provider Name | Manjula V Burri |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1619172228 PECOS PAC ID: 1658311873 Enrollment ID: I20130302000020 |
| Provider Name | Bonnie J Landwehr |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477897312 PECOS PAC ID: 3779729215 Enrollment ID: I20130429000396 |
| Provider Name | Justin Parker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730490111 PECOS PAC ID: 4688813595 Enrollment ID: I20130625000187 |
| Provider Name | Jodie D Vanmeter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972769719 PECOS PAC ID: 1254571045 Enrollment ID: I20130627000487 |
| Provider Name | Jill A Stoops |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407908015 PECOS PAC ID: 1052555695 Enrollment ID: I20130920000169 |
| Provider Name | Dawn Michelle Porter |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336222306 PECOS PAC ID: 8729011903 Enrollment ID: I20131226000272 |
| Provider Name | Wendi R Wills El-amin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033239496 PECOS PAC ID: 0840244331 Enrollment ID: I20140314000595 |
| Provider Name | Rebecca Sharpe-whitaker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205254810 PECOS PAC ID: 7810110400 Enrollment ID: I20140529001435 |
| Provider Name | Mukul Bhattarai |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1013204262 PECOS PAC ID: 9830314335 Enrollment ID: I20140625001005 |
| Provider Name | Seleena Meher Shrestha |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902043334 PECOS PAC ID: 1759508955 Enrollment ID: I20140812001834 |
| Provider Name | Bejoy John |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619285442 PECOS PAC ID: 4587881313 Enrollment ID: I20140819000231 |
| Provider Name | Rexanne Lagare Caga-anan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386933877 PECOS PAC ID: 5496973943 Enrollment ID: I20140826001327 |
| Provider Name | Norah F Baker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407144819 PECOS PAC ID: 2264672245 Enrollment ID: I20140916002480 |
| Provider Name | Audra L Trump |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780076901 PECOS PAC ID: 7416274733 Enrollment ID: I20150326000440 |
| Provider Name | Christopher James Hanson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447514971 PECOS PAC ID: 3072751734 Enrollment ID: I20150327002475 |
| Provider Name | Doreen A Wilmert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457730046 PECOS PAC ID: 9537480991 Enrollment ID: I20150610001859 |
| Provider Name | Jennifer Lynn Rimar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467858514 PECOS PAC ID: 4486975737 Enrollment ID: I20150611001840 |
| Provider Name | Schuyler Whitney Stone |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750645263 PECOS PAC ID: 8921249418 Enrollment ID: I20150625001456 |
| Provider Name | Johnny C Tenegra |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134483936 PECOS PAC ID: 6204077001 Enrollment ID: I20150902000958 |
| Provider Name | Carrie S Tucker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194039289 PECOS PAC ID: 8022319078 Enrollment ID: I20151216000148 |
| Provider Name | Thomas E Youngberg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922473479 PECOS PAC ID: 4284938895 Enrollment ID: I20160202001034 |
| Provider Name | Orlinda B Speckhart |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326400581 PECOS PAC ID: 3072804137 Enrollment ID: I20160620002338 |
| Provider Name | Virginia Ann Kerwin |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1023160728 PECOS PAC ID: 2668764291 Enrollment ID: I20160630000237 |
| Provider Name | Amit Sapra |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144532573 PECOS PAC ID: 4688817745 Enrollment ID: I20160729000204 |
| Provider Name | Dae Hyoun Jeong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265729818 PECOS PAC ID: 6103066048 Enrollment ID: I20160808000706 |
| Provider Name | Ankit Sharma |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346561883 PECOS PAC ID: 6901042829 Enrollment ID: I20160827000043 |
| Provider Name | Abhishek Kalidas Kulkarni |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1437399391 PECOS PAC ID: 0446418990 Enrollment ID: I20160830001370 |
| Provider Name | Megha Bharat Manek |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841446473 PECOS PAC ID: 4385812007 Enrollment ID: I20160831001535 |
| Provider Name | Katharine L Patel |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1316390909 PECOS PAC ID: 8325336381 Enrollment ID: I20161007000763 |
| Provider Name | Jennifer K Rose |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942640438 PECOS PAC ID: 0244456259 Enrollment ID: I20161017002269 |
| Provider Name | Andrea L Peters |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902356835 PECOS PAC ID: 4183903594 Enrollment ID: I20161107002322 |
| Provider Name | Michael E Connolly |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538110960 PECOS PAC ID: 7719913391 Enrollment ID: I20170105000490 |
| Provider Name | Molly J Hardwick |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881012847 PECOS PAC ID: 6406131523 Enrollment ID: I20170331001457 |
| Provider Name | Shawn A Holcomb |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487854998 PECOS PAC ID: 3375698996 Enrollment ID: I20170713003520 |
| Provider Name | Jacob Aloysius Varney |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972910172 PECOS PAC ID: 0941427983 Enrollment ID: I20170714000304 |
| Provider Name | Peter Daniel Miller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427459957 PECOS PAC ID: 0244450211 Enrollment ID: I20170823001897 |
| Provider Name | Zachary J Shipp |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275976094 PECOS PAC ID: 9537384300 Enrollment ID: I20170831002536 |
| Provider Name | Kyle Marc Kovski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881147379 PECOS PAC ID: 8224301817 Enrollment ID: I20170901001395 |
| Provider Name | Supriya Gupta |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639588163 PECOS PAC ID: 1850616681 Enrollment ID: I20171024000938 |
| Provider Name | Anmol N Tolani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326482688 PECOS PAC ID: 0042515991 Enrollment ID: I20171211001031 |
| Provider Name | Andrew John Hossler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710392428 PECOS PAC ID: 6901021799 Enrollment ID: I20171212000827 |
| Provider Name | Rebecca A Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366942450 PECOS PAC ID: 0143583831 Enrollment ID: I20180411000289 |
| Provider Name | Hannah J. Bettis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922596568 PECOS PAC ID: 6608131537 Enrollment ID: I20180524002262 |
| Provider Name | Basar Cenik |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013350446 PECOS PAC ID: 8123383528 Enrollment ID: I20180606002340 |
| Provider Name | Deandra Bockhold |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003219593 PECOS PAC ID: 9739435835 Enrollment ID: I20180703000860 |
| Provider Name | Tara L Brinkoetter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669639050 PECOS PAC ID: 4587912803 Enrollment ID: I20180802002611 |
| Provider Name | Carmen Orellana Martinez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205191988 PECOS PAC ID: 8527206648 Enrollment ID: I20180818000026 |
| Provider Name | Kathleen Elizabeth Bautista |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063836104 PECOS PAC ID: 2365791332 Enrollment ID: I20180823003625 |
| Provider Name | Lori A Bland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043790306 PECOS PAC ID: 2365794922 Enrollment ID: I20181009001818 |
| Provider Name | Rebecca Michelle Howard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346721990 PECOS PAC ID: 3173875754 Enrollment ID: I20181009002894 |
| Provider Name | Kelly Eileen Crooks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073925723 PECOS PAC ID: 2668743097 Enrollment ID: I20181015003502 |
| Provider Name | Misty Dawn Spencer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538644646 PECOS PAC ID: 5597000653 Enrollment ID: I20181218000497 |
| Provider Name | Bette Ann Macintosh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215996483 PECOS PAC ID: 9830435155 Enrollment ID: I20190108001424 |
| Provider Name | John Junhaeng Lee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336374297 PECOS PAC ID: 0547417081 Enrollment ID: I20190318001580 |
| Provider Name | Waiz Abdul Wasey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649653916 PECOS PAC ID: 9830403468 Enrollment ID: I20190612001457 |
| Provider Name | Megan T Ault |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851757306 PECOS PAC ID: 2466757455 Enrollment ID: I20190618002784 |
| Provider Name | Arindam Chakrabarty |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063896819 PECOS PAC ID: 6800190687 Enrollment ID: I20190701000145 |
| Provider Name | Eukesh Ranjit |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497138457 PECOS PAC ID: 1456657808 Enrollment ID: I20190711000839 |
| Provider Name | Kalyan Kandra |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437533098 PECOS PAC ID: 0042526220 Enrollment ID: I20190712001505 |
| Provider Name | Curtis Johnston |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871943308 PECOS PAC ID: 6800188764 Enrollment ID: I20190716003569 |
| Provider Name | Nathalie Emma Marie Foray |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1013356930 PECOS PAC ID: 3375785769 Enrollment ID: I20190805001809 |
| Provider Name | Cynthia D Saylors |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205490380 PECOS PAC ID: 4082753090 Enrollment ID: I20190808003308 |
| Provider Name | Ashley Nicole Howard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841649662 PECOS PAC ID: 9638461593 Enrollment ID: I20190814000368 |
| Provider Name | Andrew Corkery |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104277607 PECOS PAC ID: 0143516286 Enrollment ID: I20190815000236 |
| Provider Name | Jordan Sestak Bruce |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1528440724 PECOS PAC ID: 8921311986 Enrollment ID: I20190916000291 |
| Provider Name | Camille Dunkley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720493455 PECOS PAC ID: 0345570651 Enrollment ID: I20190930003229 |
| Provider Name | Daphne Kuehl |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1063054898 PECOS PAC ID: 4688906704 Enrollment ID: I20191023000041 |
| Provider Name | Ryan Mccarty |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013368646 PECOS PAC ID: 2264729375 Enrollment ID: I20191114000140 |
| Provider Name | Kalyan Chakravarthy Potu |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1861834897 PECOS PAC ID: 8527297704 Enrollment ID: I20191213001345 |
| Provider Name | Harini Rathinamanickam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871722116 PECOS PAC ID: 3072829159 Enrollment ID: I20200123002974 |
| Provider Name | Dana R Knox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285273144 PECOS PAC ID: 4284060708 Enrollment ID: I20200131001901 |
| Provider Name | Charlyn Fargo Ware |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1174934269 PECOS PAC ID: 7416384284 Enrollment ID: I20200218000769 |
| Provider Name | Mohsin Salih |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1326488594 PECOS PAC ID: 3274835020 Enrollment ID: I20200227001123 |
| Provider Name | Mark W Graves |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285702308 PECOS PAC ID: 3870668874 Enrollment ID: I20200228001722 |
| Provider Name | Sarah Beth Jarman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679105308 PECOS PAC ID: 9537597398 Enrollment ID: I20200310002736 |
| Provider Name | Benjamin Bukey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598294696 PECOS PAC ID: 3173892684 Enrollment ID: I20200401003076 |
| Provider Name | Anshul Pandey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902288988 PECOS PAC ID: 6103177399 Enrollment ID: I20200505001268 |
| Provider Name | Ethan Patrick Berg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831629401 PECOS PAC ID: 9234409699 Enrollment ID: I20200513000959 |
| Provider Name | Priyanka Bhandari |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417305277 PECOS PAC ID: 5698067551 Enrollment ID: I20200527001280 |
| Provider Name | Amanda Graham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578112363 PECOS PAC ID: 4688097413 Enrollment ID: I20200713000162 |
| Provider Name | Sonaina Imtiaz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376959510 PECOS PAC ID: 8820216427 Enrollment ID: I20200714000332 |
| Provider Name | Hannah Jacobs |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972133452 PECOS PAC ID: 1254754823 Enrollment ID: I20200715001098 |
| Provider Name | Nicole Tenegra |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992234504 PECOS PAC ID: 1254601503 Enrollment ID: I20200721002179 |
| Provider Name | Shruti Hegde |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1295143725 PECOS PAC ID: 7618268566 Enrollment ID: I20200723001326 |
| Provider Name | Jonathan Roderick Dutt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497277263 PECOS PAC ID: 8224309950 Enrollment ID: I20200724000787 |
| Provider Name | Amanda Krus-johnston |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255781886 PECOS PAC ID: 9335431295 Enrollment ID: I20200915003567 |
| Provider Name | Omar Zuhair Abdulfattah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205259330 PECOS PAC ID: 1759701675 Enrollment ID: I20201015000033 |
| Provider Name | Jill Marie Zwick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285224998 PECOS PAC ID: 4981010816 Enrollment ID: I20210301002079 |
| Provider Name | Sherri Lindgren |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124611256 PECOS PAC ID: 5597172387 Enrollment ID: I20210323000983 |
| Provider Name | Christopher Love Smyre |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992237762 PECOS PAC ID: 6709122609 Enrollment ID: I20210324002160 |
| Provider Name | Momin Saulat Siddique |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184852089 PECOS PAC ID: 2062727167 Enrollment ID: I20210331000618 |
| Provider Name | Herman Leung |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346770377 PECOS PAC ID: 5597035709 Enrollment ID: I20210331001751 |
| Provider Name | Olivia Ann Delay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033795992 PECOS PAC ID: 4486063534 Enrollment ID: I20210503000854 |
| Provider Name | Suhayb Ranjha |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548754542 PECOS PAC ID: 3476800400 Enrollment ID: I20210525002490 |
| Provider Name | Pooja Sheth-dutt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346735065 PECOS PAC ID: 1557619541 Enrollment ID: I20210608000211 |
| Provider Name | Marvin Merriweather |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861014326 PECOS PAC ID: 6507266863 Enrollment ID: I20210609000190 |
| Provider Name | Dois Charles Ogan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821583964 PECOS PAC ID: 1850648403 Enrollment ID: I20210622002848 |
| Provider Name | Asiya Sumreen Mohammed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689195778 PECOS PAC ID: 0042580383 Enrollment ID: I20210722001630 |
| Provider Name | Jamie Nicole Wallman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013495878 PECOS PAC ID: 3072863893 Enrollment ID: I20210806002229 |
| Provider Name | Sidra Ilyas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801322136 PECOS PAC ID: 5395143770 Enrollment ID: I20211015001007 |
| Provider Name | Tanya Denise Rolfe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144826793 PECOS PAC ID: 9537559000 Enrollment ID: I20211124002004 |
| Provider Name | Amelia Frank |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699114470 PECOS PAC ID: 7214171941 Enrollment ID: I20211222001248 |
| Provider Name | Julia E Rozier |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720565336 PECOS PAC ID: 0648521757 Enrollment ID: I20220201001305 |
| Provider Name | Elizabeth S Carriker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366195331 PECOS PAC ID: 9436542743 Enrollment ID: I20220209002343 |
| Provider Name | Jessica Taylor |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1609354315 PECOS PAC ID: 3173875267 Enrollment ID: I20220404000919 |
| Provider Name | Venkata R Karthik Missula |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1285294041 PECOS PAC ID: 6507190071 Enrollment ID: I20220510000926 |
| Provider Name | Noupama Mirihagalle |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609435395 PECOS PAC ID: 5698000180 Enrollment ID: I20220524002504 |
| Provider Name | Tharani Sundararajan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376102285 PECOS PAC ID: 3678807146 Enrollment ID: I20220602001748 |
| Provider Name | Rucha Haily Dalvi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336692367 PECOS PAC ID: 7315232030 Enrollment ID: I20220621001770 |
| Provider Name | Tomonao Hashimoto |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1164918975 PECOS PAC ID: 2769864727 Enrollment ID: I20220808001281 |
| Provider Name | Tanner Craig Eiben |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710472964 PECOS PAC ID: 5597012393 Enrollment ID: I20220823001483 |
| Provider Name | Ashima Datey Chakrabarty |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669992343 PECOS PAC ID: 5698046688 Enrollment ID: I20220825000255 |
| Provider Name | Samantha A Agar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568024867 PECOS PAC ID: 4880929900 Enrollment ID: I20220826002775 |
| Provider Name | Amanda Elizabeth Chahalis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497473037 PECOS PAC ID: 9638554157 Enrollment ID: I20220920003011 |
| Provider Name | Kacie L Dawson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962123646 PECOS PAC ID: 6709262041 Enrollment ID: I20221010002846 |
| Provider Name | Sumi Lisa Miriam Rebeiro |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659809721 PECOS PAC ID: 3375813546 Enrollment ID: I20230324002385 |
| Provider Name | Michael Bernard Neinast |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1770105769 PECOS PAC ID: 5597189050 Enrollment ID: I20230512001722 |
| Provider Name | Neil C Parker |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1912521790 PECOS PAC ID: 9234553785 Enrollment ID: I20230601001251 |
| Provider Name | Ahmad Al Turk |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1841675725 PECOS PAC ID: 7719389238 Enrollment ID: I20230728001045 |
| Provider Name | Deseray Eve Aguirre |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982232385 PECOS PAC ID: 0749656965 Enrollment ID: I20230803000674 |
| Provider Name | Rebekah Dawn Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265117964 PECOS PAC ID: 2567816671 Enrollment ID: I20230922002817 |
| Provider Name | Erin Ashley Shaefer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548044308 PECOS PAC ID: 5193179703 Enrollment ID: I20231002001149 |
| Provider Name | Abigail K Ivancicts |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417731290 PECOS PAC ID: 6002260528 Enrollment ID: I20231002002007 |
| Provider Name | Lindsey Reno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558144980 PECOS PAC ID: 3476907957 Enrollment ID: I20231003000507 |
| Provider Name | Rachel Rice |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427730159 PECOS PAC ID: 8921453531 Enrollment ID: I20231017000284 |
| Provider Name | Cassandra L Eilers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679226930 PECOS PAC ID: 3173979747 Enrollment ID: I20231102002103 |
| Provider Name | Latisha Ann O Neal |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770779969 PECOS PAC ID: 1355798091 Enrollment ID: I20231116003639 |
| Provider Name | Abigail Ryan Bilderback |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1275245300 PECOS PAC ID: 0446609275 Enrollment ID: I20231205003688 |
| Provider Name | Kami Harless |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841533171 PECOS PAC ID: 7719205137 Enrollment ID: I20240122001219 |
| Provider Name | Gwendolyn Scott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700331311 PECOS PAC ID: 0446547202 Enrollment ID: I20240130003023 |
| Provider Name | James Love |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073595310 PECOS PAC ID: 5890722482 Enrollment ID: I20240206004728 |
| Provider Name | Davanna Jo Ayako Reynolds |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326731423 PECOS PAC ID: 1951748706 Enrollment ID: I20240328001663 |
| Provider Name | Kathy D. Swafford |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1871583849 PECOS PAC ID: 8729426978 Enrollment ID: I20240405003117 |
| Provider Name | Nitin Saini |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023682648 PECOS PAC ID: 3577965201 Enrollment ID: I20240522000170 |
Board Of Trustees Of Southern Illinois University Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2833 S Grand Ave E, Springfield, IL 62703 Phone: 221-753-5310 Fax: 217-789-2069 | |
Professional Services Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 701 N 1st St, Springfield, IL 62781 Phone: 217-788-3000 | |
Hshs Medical Group Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3215 Executive Park Dr, Springfield, IL 62703 Phone: 217-523-5406 | |
Michael Bova M D S C Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2524 Farragut Dr, Suite C, Springfield, IL 62704 Phone: 217-726-9346 | |
North Dirksen Medical Associates, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3220 Atlanta St, Springfield, IL 62707 Phone: 217-588-7400 | |
Siu Physicians & Surgeons, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 701 N 1st St, D235, Springfield, IL 62781 Phone: 217-545-7578 Fax: 217-545-1884 | |
B3 Healthcare Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 319 E Madison St Ste 2d, Springfield, IL 62701 Phone: 217-508-5859 |