| Brady W Iba, DO | |
|
1802 S Mattis Ave, Champaign, IL 61821-5923 | |
| (217) 365-2855 | |
| Not Available |
| Full Name | Brady W Iba |
|---|---|
| Gender | Male |
| Speciality | Psychiatry |
| Experience | 4 Years |
| Location | 1802 S Mattis Ave, Champaign, Illinois |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043894132 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 8368 (Oklahoma) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 036179155 (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Ssm Health St Anthony Hospital - Midwest | Midwest city, OK | Hospital |
| Ssm Health St Anthony Hospital - Oklahoma City | Oklahoma city, OK | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Saints Medical Group, Llc | 7012914898 | 430 |
| Oklahoma Mental Health Council | 3173514387 | 69 |
| Entity Name | Oklahoma Mental Health Council |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1275574907 PECOS PAC ID: 3173514387 Enrollment ID: O20040518001034 |
| Entity Name | Saints Medical Group, LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1437195922 PECOS PAC ID: 7012914898 Enrollment ID: O20061109000189 |
| Mailing Address | Practice Location Address |
|---|---|
| Brady W Iba, DO 611 W Park St, Urbana, IL 61801-2529 Ph: Not Available | Brady W Iba, DO 1802 S Mattis Ave, Champaign, IL 61821-5923 Ph: (217) 365-2855 |
Mrs. Archana Chopra, M.D Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 1210 Lancaster Dr, # C, Champaign, IL 61821 Phone: 217-398-4443 Fax: 217-398-4926 |
Dr. Rayal Gorrepati, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 206 N Randolph St, 2nd Floor Office 246, Champaign, IL 61820 Phone: 833-251-8255 Fax: 888-815-3583 |
Dr. Michael A Moreno, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 1802 S Mattis Ave, Champaign, IL 61821 Phone: 217-383-1850 Fax: 217-383-3439 |
Dr. Sarita Sharma, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 206 N Randolph St Ste 2, Champaign, IL 61820 Phone: 833-351-8255 |
Lawrence Richards, M.D. Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 714 S Lynn St, Champaign, IL 61820 Phone: 217-398-3084 |
John P Beck, M.D. Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 1813 W. Kirby Avenue, Pschiatry/psychology, Champaign, IL 61821 Phone: 217-383-1850 Fax: 217-383-3439 |
Karelis Sierra-cintron, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 206 N. Randolph St. 2nd Floor, Champaign, IL 61820 Phone: 917-634-5311 |