| Adrienne Schupbach, MD | |
|
3024 E Empire St Ste E&f, Bloomington, IL 61704-5402 | |
| (309) 451-3376 | |
| Not Available |
| Full Name | Adrienne Schupbach |
|---|---|
| Gender | Female |
| Speciality | Dermatology |
| Experience | 16 Years |
| Location | 3024 E Empire St Ste E&f, Bloomington, 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 |
|---|---|---|---|
| 1740415777 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207N00000X | Dermatology | 036.131823 (Illinois) | Secondary |
| 207N00000X | Dermatology | 2022005842 (Missouri) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Dermatology And Skin Cancer Center | 2668821919 | 4 |
| Dermatology And Mohs Surgery Skin Cancer Center | 8527447945 | 8 |
| Cenla Dermatology | 0446679161 | 4 |
| Entity Name | Dermatology And Skin Cancer Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093596652 PECOS PAC ID: 2668821919 Enrollment ID: O20231212001130 |
| Mailing Address | Practice Location Address |
|---|---|
| Adrienne Schupbach, MD 110 Business Park Dr Ste C, Branson, MO 65616-7449 Ph: (417) 336-0033 | Adrienne Schupbach, MD 3024 E Empire St Ste E&f, Bloomington, IL 61704-5402 Ph: (309) 451-3376 |
Michael Thomas Ginnetti, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1015 S Mercer Ave Ste Gf7, Bloomington, IL 61701 Phone: 309-660-8442 | |
Kent S. Taulbee, M.D. Dermatology Medicare: Not Enrolled in Medicare Practice Location: 2418 E Lincoln St, Bloomington, IL 61701 Phone: 309-663-6386 Fax: 309-662-7622 | |
Mr. Rajagopala Swaminathan, MD Dermatology Medicare: Medicare Enrolled Practice Location: 3024 E Empire St Ste Eandf, Bloomington, IL 61704 Phone: 309-451-3376 Fax: 309-452-3376 | |
Joanne M Larow, DO Dermatology Medicare: Accepting Medicare Assignments Practice Location: 3302 Gerig Dr Ste 100, Bloomington, IL 61704 Phone: 309-533-7070 Fax: 855-710-6552 | |
Mr. Thomas Richard Brander, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1404 Eastland Drive, Suite 204, Bloomington, IL 61701 Phone: 309-662-8813 Fax: 309-662-6835 | |
Mr. James Richard Seehafer, MD Dermatology Medicare: Not Enrolled in Medicare Practice Location: 1404 Eastland Drive, Suite 204, Bloomington, IL 61701 Phone: 309-662-8813 Fax: 309-662-6835 | |
Mrs. Lucy Nelson Wisdom, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1404 Eastland Drive, Suite 204, Bloomington, IL 61701 Phone: 309-662-8813 Fax: 309-662-6835 |