| Dr Gardner Thomas Kenny, MD | |
|
405 W Jackson St, Carbondale, IL 62901-1462 | |
| (618) 549-0721 | |
| (618) 529-0449 |
| Full Name | Dr Gardner Thomas Kenny |
|---|---|
| Gender | Male |
| Speciality | Anesthesiology |
| Experience | 37 Years |
| Location | 405 W Jackson St, Carbondale, 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 |
|---|---|---|---|
| 1851383947 | NPI | - | NPPES |
| 214881 | Other | IL | MULTISPECIALTY GROUP PTAN |
| 036086011 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207L00000X | Anesthesiology | 036086011 (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Southern Illinois Hospital Services Dba Herrin Hospital | Herrin, IL | Hospital |
| Memorial Hospital Of Carbondale | Carbondale, IL | Hospital |
| Harrisburg Medical Center | Harrisburg, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Northstar Anesthesia Of Illinois, Llc | 4688893878 | 318 |
| Entity Name | Southern Illinois Medical Services Nfp |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770656837 PECOS PAC ID: 3678677390 Enrollment ID: O20070404000595 |
| Entity Name | Northstar Anesthesia Of Illinois, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1962822395 PECOS PAC ID: 4688893878 Enrollment ID: O20140922000405 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Gardner Thomas Kenny, MD Po Box 3988, Carbondale, IL 62902-3988 Ph: (618) 457-5200 | Dr Gardner Thomas Kenny, MD 405 W Jackson St, Carbondale, IL 62901-1462 Ph: (618) 549-0721 |
Long Ha Huynh, M.D., PH.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 405 W Jackson St, Carbondale, IL 62901 Phone: 618-549-0721 Fax: 618-529-0449 | |
Dr. Refat Daherdiab Khader, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 405 W Jackson St, Carbondale, IL 62901 Phone: 618-549-0721 Fax: 618-529-0449 | |
Ryan Stock, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 405 W Jackson St, Sih Medical Group Anesthesiology, Carbondale, IL 62903 Phone: 618-457-5111 | |
Dr. Michael Stanley, DO, MS Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 405 W Jackson Street, Dba Sih Medical Group Anesthesiology, Carbondale, IL 62901 Phone: 618-549-0721 Fax: 618-529-0449 | |
Jai P. Singh, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 35 Albany Rd, Suite C, Carbondale, IL 62903 Phone: 618-457-5111 Fax: 618-457-6560 | |
Purnima Sharma, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 405 W Jackson St, Carbondale, IL 62901 Phone: 618-549-0721 Fax: 618-529-0449 | |
Dr. Mark J. Garwin, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 35 Albany Rd, Carbondale, IL 62903 Phone: 888-804-4330 |