| Dr Gretchen L Kopec, MD | |
|
530 Ne Glen Oak Ave, Peoria, IL 61637-1003 | |
| (309) 624-0615 | |
| Not Available |
| Full Name | Dr Gretchen L Kopec |
|---|---|
| Gender | Female |
| Speciality | Pediatrics - Neonatal-perinatal Medicine |
| Location | 530 Ne Glen Oak Ave, Peoria, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063856342 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2080N0001X | Pediatrics - Neonatal-perinatal Medicine | 036.148113 (Illinois) | Primary |
| Entity Name | The Board of Trustees of the University of Illinois |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1386863819 PECOS PAC ID: 3072422716 Enrollment ID: O20031112000158 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Gretchen L Kopec, MD 3113 Falcon Pt, Springfield, IL 62711-7865 Ph: (217) 553-7424 | Dr Gretchen L Kopec, MD 530 Ne Glen Oak Ave, Peoria, IL 61637-1003 Ph: (309) 624-0615 |
Thomas James Mcmorrow, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637 Phone: 309-655-2553 Fax: 309-655-2602 |
Jessica Ford-davis, D.O. Pediatrics Medicare: Medicare Enrolled Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637 Phone: 309-655-2274 |
Kelsey Elizabeth Grimes, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637 Phone: 309-655-2000 |
Dr. Jacquelyn Flor, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637 Phone: 309-655-7171 |
Mrs. Valeria Claudia Benavides Lopez, M.D., M.P.H. Pediatrics Medicare: Medicare Enrolled Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637 Phone: 309-624-3313 |
Dr. Patrick Joseph Rizzuto Iii, M.D. Pediatrics Medicare: May Accept Medicare Assignments Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637 Phone: 309-671-3000 |
Joyce Wise, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 507 E Armstrong, Regional Development Center, Peoria, IL 61603 Phone: 309-681-6960 |