| Dr Glen B Smith, MD | |
|
1505 Eastland Dr, Suite 210, Bloomington, IL 61701-7906 | |
| (309) 662-5506 | |
| (309) 662-5443 |
| Full Name | Dr Glen B Smith |
|---|---|
| Gender | Male |
| Speciality | Thoracic Surgery |
| Experience | 40 Years |
| Location | 1505 Eastland Dr, Bloomington, 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 |
|---|---|---|---|
| 1326031105 | NPI | - | NPPES |
| 008131 | Other | IL | HEALTH ALLIANCE PROVIDER |
| 205477201 | Medicaid | MO | |
| 37773 | Other | PHCS | |
| 37893 | Other | TRICARE | |
| 228074 | Other | HEALTHLINK | |
| 036075454000 | Other | OSF HEALTH PLANS | |
| 05732036 | Other | IL | BLUE SHIELD GROUP NUMBER |
| 233989 | Other | PERSONAL CARE | |
| 1955270 | Other | UNITED HEALTHCARE | |
| IL0102 | Other | JOHN DEERE HEALTH PLAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208G00000X | Thoracic Surgery (cardiothoracic Vascular Surgery) | 036075454 (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| St Joseph Medical Center | Bloomington, IL | Hospital |
| Saint James Hospital | Pontiac, IL | Hospital |
| Ottawa Regional Hospital Dba Osf Saint Elizabeth Mdl Ctr | Ottawa, IL | Hospital |
| Saint Francis Medical Center | Peoria, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Osf Multi-specialty Group | 3678889789 | 1848 |
| Entity Name | Osf Multi-specialty Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1922445527 PECOS PAC ID: 3678889789 Enrollment ID: O20150904000279 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Glen B Smith, MD 1505 Eastland Dr, Suite 210, Bloomington, IL 61701-7906 Ph: (309) 662-5506 | Dr Glen B Smith, MD 1505 Eastland Dr, Suite 210, Bloomington, IL 61701-7906 Ph: (309) 662-5506 |
Dr. Jesse L Vanle, M.D. Thoracic Surgery (Cardiothoracic Vascular Surgery) Medicare: Accepting Medicare Assignments Practice Location: 1505 Eastland Dr, Suite 210, Bloomington, IL 61701 Phone: 309-662-5506 Fax: 309-662-5443 |