| Abiodun Sangoseni, MD | |
|
17 Ginger Creek Mdws, Glen Carbon, IL 62034-3508 | |
| (800) 968-6866 | |
| Not Available |
| Full Name | Abiodun Sangoseni |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine |
| Experience | 40 Years |
| Location | 17 Ginger Creek Mdws, Glen Carbon, Illinois |
| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194710483 | NPI | - | NPPES |
| 196690 | Other | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Crossroads Community Hospital | Mount vernon, IL | Hospital |
| Memorial Hospital | Chester, IL | Hospital |
| Gateway Regional Medical Center | Granite city, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Memorial Hospital | 5294649372 | 31 |
| Ahs Il Medical Group Llc | 5496111676 | 48 |
| Entity Name | Integritas Emergency Physician Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1790128817 PECOS PAC ID: 7113167446 Enrollment ID: O20130710000760 |
| Entity Name | Ahs Il Medical Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1659098101 PECOS PAC ID: 5496111676 Enrollment ID: O20230512001300 |
| Mailing Address | Practice Location Address |
|---|---|
| Abiodun Sangoseni, MD Po Box 66971, Dept Le, Saint Louis, MO 63166-6971 Ph: (800) 968-6866 | Abiodun Sangoseni, MD 17 Ginger Creek Mdws, Glen Carbon, IL 62034-3508 Ph: (800) 968-6866 |
Candyce Frey, Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 220 Evergreen Ln Unit A, Glen Carbon, IL 62034 Phone: 618-655-0333 |