| Michael R Kovanda, MA | |
|
2323 Windish Dr, Galesburg, IL 61401-9780 | |
| (309) 344-4200 | |
| (309) 344-4281 |
| Full Name | Michael R Kovanda |
|---|---|
| Gender | Male |
| Speciality | Mental Health Counselor |
| Experience | 44 Years |
| Location | 2323 Windish Dr, Galesburg, Illinois |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598897274 | NPI | - | NPPES |
| 180-001042 | Other | IL | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 180-001042 (Illinois) | Secondary |
| 101YP2500X | Counselor - Professional | 180001042 (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Saint Francis Medical Center | Peoria, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Osf Multi-specialty Group | 3678889789 | 2123 |
| Entity Name | OSF Multi-specialty Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1922445527 PECOS PAC ID: 3678889789 Enrollment ID: O20150904000279 |
| Mailing Address | Practice Location Address |
|---|---|
| Michael R Kovanda, MA 2323 Windish Dr, Galesburg, IL 61401-9780 Ph: (309) 344-4200 | Michael R Kovanda, MA 2323 Windish Dr, Galesburg, IL 61401-9780 Ph: (309) 344-4200 |
Bailee Shepherd, LCP Counselor Medicare: Not Enrolled in Medicare Practice Location: 2323 Windish Dr, Galesburg, IL 61401 Phone: 309-344-2323 |
Cheryl Majeske, MHP Counselor Medicare: Not Enrolled in Medicare Practice Location: 2323 Windish Dr, Galesburg, IL 61401 Phone: 309-344-2323 Fax: 309-344-4281 |
Julie Schrader, MA Counselor Medicare: Medicare Enrolled Practice Location: 575 N Kellogg St, Suite 4, Galesburg, IL 61401 Phone: 309-343-0800 |
Julie Safranek, MHP Counselor Medicare: Not Enrolled in Medicare Practice Location: 2323 Windish Dr, Galesburg, IL 61401 Phone: 309-344-2323 Fax: 309-344-4281 |
Brenda Harrell, MHP Counselor Medicare: Not Enrolled in Medicare Practice Location: 2323 Windish Dr, Galesburg, IL 61401 Phone: 309-344-2323 Fax: 309-344-4281 |
Kristin Spiegel, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2323 Windish Dr, Galesburg, IL 61401 Phone: 309-344-2323 Fax: 309-344-4281 |
Gregory W Sall, MSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 2323 Windish Dr, Galesburg, IL 61401 Phone: 309-344-2323 Fax: 309-344-4281 |