| Jay S Keller, MD | |
|
611 W Park St, Urbana, IL 61801-2529 | |
| (217) 383-3140 | |
| (217) 383-4966 |
| Full Name | Jay S Keller |
|---|---|
| Gender | Male |
| Speciality | Obstetrics/gynecology |
| Experience | 37 Years |
| Location | 611 W Park St, Urbana, 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 |
|---|---|---|---|
| 1790760544 | NPI | - | NPPES |
| 036130109 | Medicaid | IL | |
| 510I160042 | Other | AL | MEDICARE PTAN |
| D835 | Other | AL | MEDICARE GROUP PIN |
| 1912966847 | Other | AL | MEDICAID BILLING |
| 101902 | Medicaid | AL | |
| 51548375 | Other | AL | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207V00000X | Obstetrics & Gynecology | 16383 (Alabama) | Secondary |
| 207V00000X | Obstetrics & Gynecology | 036130109 (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| The Carle Foundation Hospital | Urbana, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Hoopeston Community Memorial Hospital | 3577456037 | 120 |
| Carle Health Care Incorporated | 3577515774 | 912 |
| 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 | Community Health Improvement Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1467784090 PECOS PAC ID: 4385625342 Enrollment ID: O20040526000316 |
| Entity Name | Carle Health Care Incorporated |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1154653947 PECOS PAC ID: 3577515774 Enrollment ID: O20100513000829 |
| Entity Name | Board Of Trustees Of Southern Illinois University |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1396097960 PECOS PAC ID: 4486667888 Enrollment ID: O20130424001019 |
| Mailing Address | Practice Location Address |
|---|---|
| Jay S Keller, MD 611 W Park St, Fapc, Urbana, IL 61801 Ph: () - | Jay S Keller, MD 611 W Park St, Urbana, IL 61801-2529 Ph: (217) 383-3140 |
Dr. Ronald E Kimball, MD Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: 509 W University Ave, Urbana, IL 61801 Phone: 217-383-6636 Fax: 217-383-3466 | |
Rebecca A Wagner, MD Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: 611 W. Park St., Ob/gyn, Urbana, IL 61801 Phone: 217-383-3140 Fax: 217-383-4966 | |
Karima M Shmila, MD Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 611 W. Park St, Fapc, Urbana, IL 61801 Phone: 217-383-3311 | |
Ismail Olusayo Oshogwemoh, D.O. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 611 W Park St, Urbana, IL 61801 Phone: 217-383-3140 Fax: 217-383-4966 | |
Mrs. Tovah Ann Buikema, D.O. Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 611 W. Park St., Maternal-fetal Medicine, Urbana, IL 61801 Phone: 217-383-4930 Fax: 217-383-4014 | |
Anna L Schmitz, MD Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 611 W. Park St., Sc4, Urbana, IL 61801 Phone: 217-383-3140 Fax: 217-383-4966 | |
Dr. Jamie Lynn Fulfer, MD Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 602 W. University Avenue, Ob/gyn, Urbana, IL 61801 Phone: 217-383-3140 Fax: 217-383-4966 |