| Bryan J Kellenberger, MD | |
|
400 Saint Johns Dr, Sherman, IL 62684-9779 | |
| (217) 528-7541 | |
| (217) 525-0044 |
| Full Name | Bryan J Kellenberger |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 16 Years |
| Location | 400 Saint Johns Dr, Sherman, 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 |
|---|---|---|---|
| 1275733073 | NPI | - | NPPES |
| 036125353 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 036125353 (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Enhabit Home Health | Springfield, IL | Home health agency |
| Hshs Home Care Illinois | Effingham, IL | Home health agency |
| Memorial Home Services | Springfield, IL | Home health agency |
| Memorial Medical Center | Springfield, IL | Hospital |
| St Johns Hospital | Springfield, IL | Hospital |
| Abraham Lincoln Memorial Hospital | Lincoln, IL | Hospital |
| Villa Health Care East | Sherman, IL | Nursing home |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Springfield Clinic, Llp | 0547166076 | 678 |
| Entity Name | Springfield Clinic, LLP |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1780638478 PECOS PAC ID: 0547166076 Enrollment ID: O20040331000826 |
| Mailing Address | Practice Location Address |
|---|---|
| Bryan J Kellenberger, MD 1025 S 6th St, Springfield, IL 62703-2403 Ph: (217) 528-7541 | Bryan J Kellenberger, MD 400 Saint Johns Dr, Sherman, IL 62684-9779 Ph: (217) 528-7541 |
Leticia A. Drapiza, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 400 St. John's Drive, Sherman, IL 62684 Phone: 217-525-4150 |