| Dr Vicken S Chalian, MD | |
|
1401 Eastland Dr, Suite B, Bloomington, IL 61701-3514 | |
| (309) 663-9424 | |
| (309) 663-6350 |
| Full Name | Dr Vicken S Chalian |
|---|---|
| Gender | Male |
| Speciality | Urology |
| Experience | 30 Years |
| Location | 1401 Eastland Dr, Bloomington, 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 |
|---|---|---|---|
| 1871529594 | NPI | - | NPPES |
| 0723870001 | Other | IL | DME PROVIDER NUMBER |
| 5732045 | Other | IL | BC BS PROVIDER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208800000X | Urology | (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Central Dupage Hospital | Winfield, IL | Hospital |
| Advocate Bromenn Medical Center | Normal, IL | Hospital |
| St Joseph Medical Center | Bloomington, IL | Hospital |
| Saint James Hospital | Pontiac, IL | Hospital |
| Advocate Eureka Hospital | Eureka, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Premier Medical Group, Llc | 5991989477 | 10 |
| Entity Name | Premier Medical Group, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1942501978 PECOS PAC ID: 5991989477 Enrollment ID: O20110407000129 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Vicken S Chalian, MD 1401 Eastland Dr, Suite B, Bloomington, IL 61701-3514 Ph: (309) 663-9424 | Dr Vicken S Chalian, MD 1401 Eastland Dr, Suite B, Bloomington, IL 61701-3514 Ph: (309) 663-9424 |
Dr. Benjamin J Leak, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 1401 Eastland Dr, Suite B, Bloomington, IL 61701 Phone: 309-663-9424 Fax: 309-663-6350 | |
Dr. Mariano Villalon Tolentino Jr., M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 2502 E Empire St, Bloomington, IL 61704 Phone: 309-661-3380 Fax: 309-661-3318 | |
Dr. Scott Christopher Morgan, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 2502 E Empire St, Bloomington, IL 61704 Phone: 309-661-3380 Fax: 309-661-3318 | |
Dr. Thomas B Kulb, M.D., Urology Medicare: Not Enrolled in Medicare Practice Location: 1401 Eastland Dr, Suite B, Bloomington, IL 61701 Phone: 309-663-9424 Fax: 309-663-6350 |