| Evangeline De Sagun, MD | |
|
1221 S Gear Ave, West Burlington, IA 52655-1679 | |
| (319) 768-1000 | |
| Not Available |
| Full Name | Evangeline De Sagun |
|---|---|
| Gender | Female |
| Speciality | Pathology |
| Experience | 39 Years |
| Location | 1221 S Gear Ave, West Burlington, Iowa |
| 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 |
|---|---|---|---|
| 1356446322 | NPI | - | NPPES |
| 32913278 | Other | CHAMPUS | |
| P00047449 | Other | RAILROAD MEDICARE | |
| 009847 | Other | HEALTH ALLIANCE | |
| 1922250 | Other | IL | BCBS IL |
| 036097387 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207ZP0102X | Pathology - Anatomic Pathology & Clinical Pathology | 036097387 (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Great River Medical Center | West burlington, IA | Hospital |
| Henry County Health Center | Mount pleasant, IA | Hospital |
| University Of Iowa Hospital & Clinics | Iowa city, IA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Southeast Iowa Regional Medical Center Inc | 3870496417 | 281 |
| Henry County Health Center Inc | 9638570740 | 59 |
| Entity Name | Southeast Iowa Regional Medical Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1164433884 PECOS PAC ID: 3870496417 Enrollment ID: O20040130000139 |
| Entity Name | Henry County Health Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1871177477 PECOS PAC ID: 9638570740 Enrollment ID: O20210701003616 |
| Mailing Address | Practice Location Address |
|---|---|
| Evangeline De Sagun, MD 1221 S Gear Ave, West Burlington, IA 52655-1679 Ph: () - | Evangeline De Sagun, MD 1221 S Gear Ave, West Burlington, IA 52655-1679 Ph: (319) 768-1000 |
Jonathan W Snow, M.D. Pathology Medicare: Not Enrolled in Medicare Practice Location: 1221 S Gear Ave, West Burlington, IA 52655 Phone: 319-768-1000 Fax: 319-233-0722 |