| Bradley A Wilson, MD | |
|
301 N 8th St, Springfield, IL 62701-1041 | |
| (217) 544-6464 | |
| Not Available |
| Full Name | Bradley A Wilson |
|---|---|
| Gender | Male |
| Speciality | Surgery |
| Location | 301 N 8th St, Springfield, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528046141 | NPI | - | NPPES |
| 208959 | Other | IL | MEDICARE GRP NUMBER |
| 7470693 | Other | MO | AETNA |
| 207215500 | Medicaid | MO | |
| 718653 | Other | MO | HEALTHLINK |
| CE9335 | Other | IL | RR GROUP |
| 207988 | Other | IL | MEDICARE GRP NUMBER |
| I37919 | Other | MO | MERCY HEALTH PLANS |
| P00396925 | Other | IL | RR MEDICARE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | 036118588 (Illinois) | Primary |
| 208600000X | Surgery | 2005016227 (Missouri) | Secondary |
| Entity Name | Sarah Bush Lincoln Health Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1669564662 PECOS PAC ID: 5092614867 Enrollment ID: O20031231000478 |
| Mailing Address | Practice Location Address |
|---|---|
| Bradley A Wilson, MD 301 N 8th St, Springfield, IL 62701-1041 Ph: () - | Bradley A Wilson, MD 301 N 8th St, Springfield, IL 62701-1041 Ph: (217) 544-6464 |
Dr. Emily Catherine Sturm, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 315 W Carpenter St Fl 2, Springfield, IL 62702 Phone: 217-545-8000 | |
Mark Kuhnke, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 900 N 1st Street, Springfield, IL 62702 Phone: 217-528-7541 Fax: 217-528-7543 | |
Teah Qvavadze, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 747 N Rutledge St Fl 4, Springfield, IL 62702 Phone: 217-545-8000 Fax: 217-545-1622 | |
Dr. Krista Michelle Bonney, MD Surgery Medicare: Medicare Enrolled Practice Location: 701 N 1st St, Springfield, IL 62781 Phone: 217-788-3000 | |
Dr. Melanie Lynne Barnard, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 701 N 1st St Ste D308, Springfield, IL 62702 Phone: 217-545-4401 Fax: 217-545-2586 | |
Dr. Fillip Komornik, MD Surgery Medicare: Medicare Enrolled Practice Location: 701 N 1st St # D346, Springfield, IL 62702 Phone: 217-545-8444 | |
Wendy Lim, Surgery Medicare: Medicare Enrolled Practice Location: 701 N 1st St Ste D308, Springfield, IL 62702 Phone: 217-545-4401 Fax: 217-545-1793 |