| Laurel Kietzman, MD | |
|
2500 W Reynolds St, Pontiac, IL 61764-9774 | |
| (815) 842-2828 | |
| Not Available |
| Full Name | Laurel Kietzman |
|---|---|
| Gender | Female |
| Speciality | Emergency Medicine |
| Experience | 40 Years |
| Location | 2500 W Reynolds St, Pontiac, Illinois |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336331222 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 036119129 (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Methodist Medical Center Of Illinois | Peoria, IL | Hospital |
| Presence St Marys Hospital | Kankakee, IL | Hospital |
| Presence Mercy Medical Center | Aurora, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Methodist Medical Center Of Illinois | 1355259714 | 283 |
| Cepamerica Illinois Llp | 3274793633 | 449 |
| Entity Name | Methodist Medical Center Of Illinois |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1982656575 PECOS PAC ID: 1355259714 Enrollment ID: O20031126000494 |
| Entity Name | Trinity Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1568414134 PECOS PAC ID: 2264337518 Enrollment ID: O20031203000016 |
| Entity Name | Cgh Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1902854623 PECOS PAC ID: 6103723267 Enrollment ID: O20031217000054 |
| Entity Name | Valley Emergency Care Management Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1841395092 PECOS PAC ID: 1850387713 Enrollment ID: O20040424000146 |
| Entity Name | Cepamerica Illinois Llp |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1912283110 PECOS PAC ID: 3274793633 Enrollment ID: O20120322000587 |
| 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 |
| Entity Name | Methodist Medical Center Of Illinois |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1265966048 PECOS PAC ID: 1355259714 Enrollment ID: O20170828003194 |
| Mailing Address | Practice Location Address |
|---|---|
| Laurel Kietzman, MD 2500 W Reynolds St, Pontiac, IL 61764-9774 Ph: (815) 842-2828 | Laurel Kietzman, MD 2500 W Reynolds St, Pontiac, IL 61764-9774 Ph: (815) 842-2828 |
Richard Ruff, D.O. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 2500 W Reynolds St, Pontiac, IL 61764 Phone: 708-383-6200 | |
John Rinker, DO Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1515 W Reynolds St, Pontiac, IL 61764 Phone: 815-842-3381 Fax: 815-842-2861 | |
Kenneth Velez, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 1306 N Ann St, Pontiac, IL 61764 Phone: 815-842-3429 | |
Kristina L Morgan, D.O. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 2500 W Reynolds St, Pontiac, IL 61764 Phone: 815-842-2828 | |
Dr. Vanessa L Pitts, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 2500 W Reynolds St, Pontiac, IL 61764 Phone: 815-842-2828 | |
Daniel Butterbach, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 2500 W Reynolds St, Pontiac, IL 61764 Phone: 708-783-9100 |