| Jacob Samuel Witt, MD | |
|
321 Regency Park Ste 100, O Fallon, IL 62269-1887 | |
| (618) 416-7970 | |
| (618) 416-7971 |
| Full Name | Jacob Samuel Witt |
|---|---|
| Gender | Male |
| Speciality | Radiation Oncology |
| Experience | 10 Years |
| Location | 321 Regency Park Ste 100, O Fallon, 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 |
|---|---|---|---|
| 1891157871 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0001X | Radiology - Radiation Oncology | 036150707 (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Hshs St Elizabeth's Hospital | O fallon, IL | Hospital |
| St Josephs Hospital | Breese, IL | Hospital |
| Hshs Holy Family Hospital Inc | Greenville, IL | Hospital |
| St Joseph's Hospital | Highland, IL | Hospital |
| Ssm Health St Mary's Hospital -centralia | Centralia, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Cancer Care Specialists Of Central Illinois Sc | 5991619116 | 31 |
| Entity Name | Rockford Health Physicians |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043242886 PECOS PAC ID: 2567374036 Enrollment ID: O20031103000584 |
| Entity Name | Cancer Care Specialists Of Central Illinois Sc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1871580142 PECOS PAC ID: 5991619116 Enrollment ID: O20031113000022 |
| Mailing Address | Practice Location Address |
|---|---|
| Jacob Samuel Witt, MD Po Box 25228, Decatur, IL 62525-5228 Ph: (217) 329-3232 | Jacob Samuel Witt, MD 321 Regency Park Ste 100, O Fallon, IL 62269-1887 Ph: (618) 416-7970 |
Kris Kahler, Radiology Medicare: Not Enrolled in Medicare Practice Location: 1 Saint Elizabeth Blvd, O Fallon, IL 62269 Phone: 618-234-2120 | |
Camille M. Williams, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 321 Regency Park, O Fallon, IL 62269 Phone: 314-377-3833 |