| Ann Luise West, MD | |
|
1310 N Main St, Suite 209, Sandwich, IL 60548-1394 | |
| (815) 786-1967 | |
| (815) 786-1806 |
| Full Name | Ann Luise West |
|---|---|
| Gender | Female |
| Speciality | Obstetrics & Gynecology - Obstetrics |
| Location | 1310 N Main St, Sandwich, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801816277 | NPI | - | NPPES |
| 036072751 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207V00000X | Obstetrics & Gynecology | 2722 (Wisconsin) | Secondary |
| 207VX0000X | Obstetrics & Gynecology - Obstetrics | 036072751 (Illinois) | Primary |
| Entity Name | Bonaventure Medical Foundation Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1588775647 PECOS PAC ID: 7517863178 Enrollment ID: O20031212000374 |
| Entity Name | Obhg Illinois Sc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1700107216 PECOS PAC ID: 7810179702 Enrollment ID: O20110314001065 |
| Mailing Address | Practice Location Address |
|---|---|
| Ann Luise West, MD 1310 N Main St, Suite 209, Sandwich, IL 60548-1394 Ph: (815) 786-1967 | Ann Luise West, MD 1310 N Main St, Suite 209, Sandwich, IL 60548-1394 Ph: (815) 786-1967 |
Jill M Palko, M.D. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 831 Sandhurst Dr, Sandwich, IL 60548 Phone: 815-786-1088 Fax: 815-786-1314 | |
Dr. James N Hawkins, D.O. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 831 Sandhurst Dr, Sandwich, IL 60548 Phone: 815-786-1088 Fax: 815-786-1314 |