| Terrill Applewhite,m.d. | |
|
475 Brown Blvd Ste 103 Bourbonnais IL 60914 | |
| (815) 937-7962 | |
| (815) 936-8650 |
| Full Name | Terrill Applewhite,m.d. |
|---|---|
| Speciality | Internal Medicine |
| Location | 475 Brown Blvd, Bourbonnais, Illinois |
| Authorized Official Name and Position | Terrill Applewhite (OWNER) |
| Authorized Official Contact | 8159377962 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Terrill Applewhite,m.d. 475 Brown Blvd Ste 103 Bourbonnais IL 60914 Ph: (815) 937-7962 | Terrill Applewhite,m.d. 475 Brown Blvd Ste 103 Bourbonnais IL 60914 Ph: (815) 937-7962 |
| NPI Number | 1629152574 |
|---|---|
| Provider Enumeration Date | 10/25/2006 |
| Last Update Date | 08/17/2021 |
| Medicare PECOS PAC ID | 4284634155 |
|---|---|
| Medicare Enrollment ID | O20061228000338 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629152574 | NPI | - | NPPES |
| 0136104924 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 036104924 (Illinois) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Jovita C Anyanwu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629136551 PECOS PAC ID: 1456349422 Enrollment ID: I20040506000467 |
| Provider Name | Terrill Applewhite |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205910114 PECOS PAC ID: 5496702193 Enrollment ID: I20050405000775 |
| Provider Name | Suresh K Didwania |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093777880 PECOS PAC ID: 8527099795 Enrollment ID: I20050912001262 |
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Nepomuceno Family Practice Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 475 Brown Blvd Ste 106, Bourbonnais, IL 60914 Phone: 815-937-8786 | |
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Keith A. Moss, M.d., Sc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 300 Riverside Dr, Suite 2400, Bourbonnais, IL 60914 Phone: 815-935-2784 Fax: 815-935-5687 | |
Sarat Yalamanchili, Md, Sc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1521 N Convent St Ste 101, Bourbonnais, IL 60914 Phone: 815-937-4500 Fax: 815-937-4777 | |
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