| Visiting Doctors Network Inc. | |
|
618 W Jackson St Morton IL 61550-1536 | |
| (309) 291-0479 | |
| (309) 291-0932 |
| Full Name | Visiting Doctors Network Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 618 W Jackson St, Morton, Illinois |
| Authorized Official Name and Position | Araceli Lear (OFFICE MANAGER) |
| Authorized Official Contact | 3092910479 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Visiting Doctors Network Inc. 618 W Jackson St Morton IL 61550-1536 Ph: (309) 291-0479 | Visiting Doctors Network Inc. 618 W Jackson St Morton IL 61550-1536 Ph: (309) 291-0479 |
| NPI Number | 1942722368 |
|---|---|
| Provider Enumeration Date | 07/07/2017 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 1153696927 |
|---|---|
| Medicare Enrollment ID | O20171004000803 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942722368 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0000X | Family Medicine - Adolescent Medicine | 036078962 (Illinois) | Primary |
| 261Q00000X | Clinic/center | 036078962 (Illinois) | Secondary |
| Provider Name | Gail Williamson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376597732 PECOS PAC ID: 3173677143 Enrollment ID: I20090811000440 |
| Provider Name | Faye Yetton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003218116 PECOS PAC ID: 8628343407 Enrollment ID: I20171004001089 |
| Provider Name | Toufic S Khairallah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427546688 PECOS PAC ID: 0345584439 Enrollment ID: I20190425000169 |
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