| Mrs Lacey Dively Moy, MD | |
|
3220 Atlanta St, Springfield, IL 62707-8801 | |
| (217) 588-7400 | |
| (217) 588-7439 |
| Full Name | Mrs Lacey Dively Moy |
|---|---|
| Gender | Female |
| Speciality | Family Practice |
| Experience | 17 Years |
| Location | 3220 Atlanta St, Springfield, 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 |
|---|---|---|---|
| 1013144021 | NPI | - | NPPES |
| 036.129248 | Other | IL | MD LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 036129248 (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Memorial Medical Center | Springfield, IL | Hospital |
| St Johns Hospital | Springfield, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Memorial Physician Services | 9032005681 | 155 |
| Entity Name | Memorial Physician Services |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1417922964 PECOS PAC ID: 9032005681 Enrollment ID: O20040223000454 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Lacey Dively Moy, MD 3220 Atlanta St, Springfield, IL 62707-8801 Ph: (217) 588-7400 | Mrs Lacey Dively Moy, MD 3220 Atlanta St, Springfield, IL 62707-8801 Ph: (217) 588-7400 |
Dr. Kaitlin Delaney Henry, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2200 Wabash Ave, Springfield, IL 62704 Phone: 217-528-7541 | |
Kathryn D Viotto, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 3132 Old Jacksonville Rd Ste 110, Springfield, IL 62704 Phone: 217-588-2600 Fax: 217-862-0904 | |
Mark T. Mckay, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2200 Wabash Ave, Springfield, IL 62704 Phone: 217-528-7541 | |
Dr. Hari Iyengar, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 520 N 4th St, Springfield, IL 62702 Phone: 217-757-8100 | |
Dr. Jamie Wallman, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 319 E Madison St Ste 1f, Springfield, IL 62701 Phone: 217-545-8000 | |
Janet R Albers, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 520 N 4th St, Springfield, IL 62702 Phone: 217-545-8000 Fax: 217-757-8161 |