| Dr James D Ausfahl, MD | |
|
1120 E War Memorial Dr, Peoria Heights, IL 61616-7757 | |
| (309) 685-0100 | |
| (309) 685-0172 |
| Full Name | Dr James D Ausfahl |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 1120 E War Memorial Dr, Peoria Heights, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518058619 | NPI | - | NPPES |
| L06046 | Other | IL | PIN NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 036059777 (Illinois) | Primary |
| Entity Name | Tazwood Mental Health Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1083671127 PECOS PAC ID: 1850291741 Enrollment ID: O20040108000963 |
| Entity Name | Proctor Health Systems |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1134173917 PECOS PAC ID: 3476440173 Enrollment ID: O20040227000906 |
| Entity Name | Human Service Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1881630689 PECOS PAC ID: 6901896968 Enrollment ID: O20040513000449 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr James D Ausfahl, MD 1120 E War Memorial Dr, Peoria Heights, IL 61616-7757 Ph: (309) 685-0100 | Dr James D Ausfahl, MD 1120 E War Memorial Dr, Peoria Heights, IL 61616-7757 Ph: (309) 685-0100 |
Dr. Jumuna Patel, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1120 E War Memorial Dr, Peoria Heights, IL 61616 Phone: 309-685-0100 Fax: 309-685-0172 | |
Dr. Mark Montefolka, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1120 E War Memorial Dr, Peoria Heights, IL 61616 Phone: 309-685-0100 Fax: 309-685-0172 | |
Dr. Ioan Mosoiu, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1120 E War Memorial Dr, Peoria Heights, IL 61616 Phone: 309-685-0100 Fax: 309-685-0172 |