| Dr John Gregory Selgestad, MD | |
|
403 E 1st St, Dixon, IL 61021 | |
| (815) 288-5531 | |
| Not Available |
| Full Name | Dr John Gregory Selgestad |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 403 E 1st St, Dixon, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518935014 | NPI | - | NPPES |
| 036-057471 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 036-057471 (Illinois) | Primary |
| Entity Name | Illinois Department Of Human Services |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1003960394 PECOS PAC ID: 9830003920 Enrollment ID: O20031113000414 |
| Entity Name | Ksb Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073592119 PECOS PAC ID: 7911890009 Enrollment ID: O20040203000860 |
| 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 John Gregory Selgestad, MD 102 S Hennepin Ave, Dixon, IL 61021-3083 Ph: (815) 288-7711 | Dr John Gregory Selgestad, MD 403 E 1st St, Dixon, IL 61021 Ph: (815) 288-5531 |
Maitri Mehta, DO Family Medicine Medicare: Medicare Enrolled Practice Location: 102 S Hennepin Ave, Dixon, IL 61021 Phone: 815-285-8520 Fax: 815-285-8903 | |
Kirk Anthony Stewart, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 102 S Hennepin Ave, Dixon, IL 61021 Phone: 815-285-8520 Fax: 815-285-8520 | |
Joyce Johnson, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 102 S Hennepin Ave, Dixon, IL 61021 Phone: 815-285-8520 Fax: 815-285-8903 | |
Jaclyn Pranita Parayao, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 102 S Hennepin Ave, Dixon, IL 61021 Phone: 815-285-8520 Fax: 815-285-8903 | |
Tyler Walsh, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 102 S Hennepin Ave, Dixon, IL 61021 Phone: 815-285-8520 Fax: 815-285-8903 | |
Dr. James Francis Gallant, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 403 E 1st St, Dixon, IL 61021 Phone: 815-285-5552 Fax: 815-285-5865 | |
Dr. Kristine P Pultorak, D.O. Family Medicine Medicare: Medicare Enrolled Practice Location: 403 E 1st St, Dixon, IL 61021 Phone: 815-288-5561 Fax: 815-285-5859 |