| David T Cross, | |
|
134 W Adams St, Morton, IL 61550-1802 | |
| (217) 528-7541 | |
| (309) 676-6545 |
| Full Name | David T Cross |
|---|---|
| Gender | Male |
| Speciality | Pediatrics |
| Location | 134 W Adams St, Morton, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831301282 | NPI | - | NPPES |
| 036118871 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 036118871 (Illinois) | Primary |
| 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 |
|---|---|
| David T Cross, Po Box 19248, Springfield, IL 62794-9248 Ph: (217) 528-7541 | David T Cross, 134 W Adams St, Morton, IL 61550-1802 Ph: (217) 528-7541 |
Matthew Knight, Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 435 Maxine Dr, Morton, IL 61550 Phone: 309-263-2424 Fax: 309-684-2255 | |
Dr. Rebecca Anne Sierra, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 435 Maxine Dr, Suites 3 And 4, Morton, IL 61550 Phone: 309-263-2424 Fax: 309-284-2255 | |
Donald Baker, Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 435 Maxine Dr, Morton, IL 61550 Phone: 309-263-2424 Fax: 309-284-2255 | |
Ronald Luce, Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 435 Maxine Dr, Morton, IL 61550 Phone: 309-263-2424 Fax: 309-284-2255 |