| Gavin O'neil, LISW, LCSW | |
|
1450 N County Road 2050 E, Carthage, IL 62321-3551 | |
| (217) 357-2173 | |
| Not Available |
| Full Name | Gavin O'neil |
|---|---|
| Gender | Male |
| Speciality | Social Worker - Clinical |
| Location | 1450 N County Road 2050 E, Carthage, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669152336 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 098983 (Iowa) | Secondary |
| 1041C0700X | Social Worker - Clinical | 149025797 (Illinois) | Primary |
| Entity Name | Memorial Hospital Association |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1730139031 PECOS PAC ID: 0244134682 Enrollment ID: O20031126000246 |
| Mailing Address | Practice Location Address |
|---|---|
| Gavin O'neil, LISW, LCSW 1450 N County Road 2050 E, Carthage, IL 62321-3551 Ph: (217) 357-2173 | Gavin O'neil, LISW, LCSW 1450 N County Road 2050 E, Carthage, IL 62321-3551 Ph: (217) 357-2173 |
Tammey Gilbert, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 403 S Adams St, Suite 239, Carthage, IL 62321 Phone: 217-357-0617 Fax: 217-357-0615 | |
Debra J Hertenstein, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 921 N County Road 1900 E, Carthage, IL 62321 Phone: 217-357-1290 |