| Antonio Rodriguez, | |
|
800 E Locust St, Olney, IL 62450-2553 | |
| (618) 395-7340 | |
| Not Available |
| Full Name | Antonio Rodriguez |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | 800 E Locust St, Olney, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114024155 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 036065824 (Illinois) | Primary |
| Entity Name | Crossroads Emergency Physicians Llp |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1023033982 PECOS PAC ID: 3072419712 Enrollment ID: O20031211000854 |
| Entity Name | Lawrence County Memorial Hospital |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1881643401 PECOS PAC ID: 7517144249 Enrollment ID: O20110607000309 |
| 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 |
| Mailing Address | Practice Location Address |
|---|---|
| Antonio Rodriguez, 303 Nw 11th St, Fairfield, IL 62837-1203 Ph: (618) 842-2611 | Antonio Rodriguez, 800 E Locust St, Olney, IL 62450-2553 Ph: (618) 395-7340 |
Alyssa Suzanne Lewandowski, D.O Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 800 E Locust St, Olney, IL 62450 Phone: 618-395-7340 | |
Dirk Rosenberg, Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 800 E Locust St, Olney, IL 62450 Phone: 618-395-7340 |