Kelly A Bushur, CP PHD | |
400 S Lewis Ln, Carbondale, IL 62901-3547 | |
(618) 519-9900 | |
(618) 529-1384 |
Full Name | Kelly A Bushur |
---|---|
Gender | Female |
Speciality | Clinical Psychologist |
Experience | 28 Years |
Location | 400 S Lewis Ln, Carbondale, Illinois |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1629248406 | NPI | - | NPPES |
370966854006 | Medicaid | IL | |
370966854015 | Medicaid | IL | |
370966854002 | Medicaid | IL | |
370966854024 | Medicaid | IL | |
370966854005 | Medicaid | IL | |
640701 | Other | IL | MEDICARE GROUP ID |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC0700X | Psychologist - Clinical | 071005772 (Illinois) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
St. Louis Behavioral Medicine Institute Inc | 3173428638 | 44 |
Entity Name | St. Louis Behavioral Medicine Institute Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1487732335 PECOS PAC ID: 3173428638 Enrollment ID: O20031223000497 |
Mailing Address | Practice Location Address |
---|---|
Kelly A Bushur, CP PHD Po Box 577, Carterville, IL 62918-0577 Ph: (618) 985-8221 | Kelly A Bushur, CP PHD 400 S Lewis Ln, Carbondale, IL 62901-3547 Ph: (618) 519-9900 |
Jacqueline N Buck, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 3200 Fishback Rd, Carbondale, IL 62901 Phone: 618-457-1111 Fax: 618-351-1419 | |
Christian Hope Gillespie, PHD, LCP Psychologist Medicare: Not Enrolled in Medicare Practice Location: 810 N Wall St, Carbondale, IL 62901 Phone: 310-270-5878 | |
Dr. Matthew Eric Denis, PH.D. Psychologist Medicare: Accepting Medicare Assignments Practice Location: 3412 S Illinois Ave, Carbondale, IL 62903 Phone: 618-457-4488 Fax: 618-457-8844 | |
Sylvia Lane, PSYD, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 810 N Wall St, Carbondale, IL 62901 Phone: 773-551-7536 | |
Dr. Jeffrey Saunders Kellogg, PSY.D Psychologist Medicare: Accepting Medicare Assignments Practice Location: 3412 S Illinois Ave, Carbondale, IL 62903 Phone: 618-457-4488 Fax: 618-457-8844 | |
Aireal Dee Weber, M.A. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 2311 S Illinois Ave, Carbondale, IL 62903 Phone: 618-457-6703 Fax: 618-529-4563 | |
Dr. Warren Thomas Bush, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 374 E Grand Ave, Carbondale, IL 62901 Phone: 618-453-5371 |