| Dr Daniel A Liesen, MD | |
|
927 Broadway St, Quincy, IL 62301-2719 | |
| (217) 214-3447 | |
| (217) 214-5819 |
| Full Name | Dr Daniel A Liesen |
|---|---|
| Gender | Male |
| Speciality | General Surgery |
| Experience | 24 Years |
| Location | 927 Broadway St, Quincy, 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 |
|---|---|---|---|
| 1386747731 | NPI | - | NPPES |
| 036115999 | Medicaid | IL | |
| 036115999 | Other | IL | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | 036115999 (Illinois) | Secondary |
| 2086S0127X | Surgery - Trauma Surgery | 036115999 (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Blessing Hospital | Quincy, IL | Hospital |
| Memorial Hospital | Carthage, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Blessing Hospital | 3072422534 | 369 |
| Entity Name | Scheer Surgical Sc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1437333747 PECOS PAC ID: 6800972258 Enrollment ID: O20080325000547 |
| Entity Name | Blessing Hospital |
|---|---|
| Entity Type | Part B Supplier - Hospital Department(s) |
| Entity Identifiers | NPI Number: 1114471737 PECOS PAC ID: 3072422534 Enrollment ID: O20161005001836 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Daniel A Liesen, MD 1005 Broadway St, Quincy, IL 62301-2834 Ph: (217) 214-3447 | Dr Daniel A Liesen, MD 927 Broadway St, Quincy, IL 62301-2719 Ph: (217) 214-3447 |
Timothy S Smith, DO Surgery Medicare: Accepting Medicare Assignments Practice Location: 1025 Maine St, Quincy, IL 62301 Phone: 217-222-6550 | |
Harry E Wilkins Iii, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 1025 Maine St, Quincy, IL 62301 Phone: 217-222-6550 | |
Pierre S Charles, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 1025 Maine St, Quincy, IL 62301 Phone: 217-222-6550 | |
Alan R Nichols, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 1017 Abbey Rdg, Quincy, IL 62305 Phone: 217-222-6222 Fax: 217-222-6222 | |
Dr. Michael Anthony Hart, DO Surgery Medicare: Accepting Medicare Assignments Practice Location: 927 Broadway St Ste 231, Quincy, IL 62301 Phone: 217-223-8400 | |
Todd H Petty, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 1025 Maine St, Quincy, IL 62301 Phone: 217-222-6550 |