| Dr Matthew Taylor Hefty, MD | |
|
215 E 1st St Ste 316, Dixon, IL 61021-3190 | |
| (815) 285-5842 | |
| (815) 285-5845 |
| Full Name | Dr Matthew Taylor Hefty |
|---|---|
| Gender | Male |
| Speciality | General Surgery |
| Experience | 16 Years |
| Location | 215 E 1st St Ste 316, Dixon, 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 |
|---|---|---|---|
| 1154633618 | NPI | - | NPPES |
| F400525521 | Other | IL | MEDICARE PTAN |
| 4301096886 | Other | MI | EDUCATIONAL LIMITED LICENSE |
| 376897 | Other | IL | HEALTH ALLIANCE PROVIDER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | 036147642 (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Katherine Shaw Bethea Hospital | Dixon, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Osf Multi-specialty Group | 3678889789 | 1848 |
| 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 | Katherine Shaw Bethea Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1427043546 PECOS PAC ID: 2264480037 Enrollment ID: O20081218000029 |
| 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 Matthew Taylor Hefty, MD 215 E 1st St Ste 316, Dixon, IL 61021-3190 Ph: (815) 285-5842 | Dr Matthew Taylor Hefty, MD 215 E 1st St Ste 316, Dixon, IL 61021-3190 Ph: (815) 285-5842 |
David Joseph Powers, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 215 E 1st St Ste 315, Dixon, IL 61021 Phone: 815-288-1035 Fax: 815-284-0584 | |
John Strom, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 403 E 1st St, Dixon, IL 61021 Phone: 815-285-5600 Fax: 815-285-5602 | |
Dr. Osmaan Abbas Khawaja, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 215 E 1st St, Suite 105, Dixon, IL 61021 Phone: 815-285-5842 Fax: 815-285-5845 |