| Dr Sandra Lynn Ettema, MD, PHD | |
|
1005 Health Center Dr Ste 201, Mattoon, IL 61938-4653 | |
| (217) 258-2409 | |
| (217) 258-2323 |
| Full Name | Dr Sandra Lynn Ettema |
|---|---|
| Gender | Female |
| Speciality | Otolaryngology |
| Experience | 23 Years |
| Location | 1005 Health Center Dr Ste 201, Mattoon, 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 |
|---|---|---|---|
| 1760577902 | NPI | - | NPPES |
| 036118460 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Y00000X | Otolaryngology | 036.118460 (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Sarah Bush Lincoln Health Center | Mattoon, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Sarah Bush Lincoln Health Center | 5092614867 | 359 |
| Entity Name | Siu Physicians & Surgeons Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558385989 PECOS PAC ID: 2365352820 Enrollment ID: O20031222000769 |
| Entity Name | Sarah Bush Lincoln Health Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1669564662 PECOS PAC ID: 5092614867 Enrollment ID: O20031231000478 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Sandra Lynn Ettema, MD, PHD Po Box 372, Mattoon, IL 61938-0372 Ph: () - | Dr Sandra Lynn Ettema, MD, PHD 1005 Health Center Dr Ste 201, Mattoon, IL 61938-4653 Ph: (217) 258-2409 |
Lori Cudone, M.D. Otolaryngology Medicare: Medicare Enrolled Practice Location: 1005 Health Center Dr Ste 201, Mattoon, IL 61938 Phone: 217-258-2409 Fax: 217-258-2323 | |
Dr. Mary Elizabeth Gorman, M.D. Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 1005 Health Center Dr Ste 201, Mattoon, IL 61938 Phone: 217-258-2409 Fax: 217-258-2323 | |
Michael Smith, M.D. Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 1005 Health Center Dr Ste 201, Mattoon, IL 61938 Phone: 217-258-2409 Fax: 217-258-2323 | |
Dr. Harry Robert Borovik, M.D. Otolaryngology Medicare: Medicare Enrolled Practice Location: 1000 Health Center Dr Ste 401, Mattoon, IL 61938 Phone: 217-258-2409 Fax: 217-258-2323 |