| Paul A Siebert, MD | |
|
1001 Main St, Suite 300, Peoria, IL 61606-1907 | |
| (309) 495-0200 | |
| (309) 353-4380 |
| Full Name | Paul A Siebert |
|---|---|
| Gender | Male |
| Speciality | General Surgery |
| Experience | 35 Years |
| Location | 1001 Main St, Peoria, 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 |
|---|---|---|---|
| 1154337236 | NPI | - | NPPES |
| 036090618 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208G00000X | Thoracic Surgery (cardiothoracic Vascular Surgery) | 036090618 (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Carle Home Care | Champaign, IL | Home health agency |
| Pekin Memorial Hospital | Pekin, IL | Hospital |
| Methodist Medical Center Of Illinois | Peoria, IL | Hospital |
| Saint Francis Medical Center | Peoria, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Pekin Prohealth Inc | 1951214576 | 8 |
| Entity Name | Pekin Prohealth Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1932150299 PECOS PAC ID: 1951214576 Enrollment ID: O20031110000647 |
| Entity Name | Methodist Medical Center Of Illinois |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1982656575 PECOS PAC ID: 1355259714 Enrollment ID: O20031126000494 |
| Entity Name | Siebert Moazzam P C |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1396780292 PECOS PAC ID: 2567511876 Enrollment ID: O20090515000361 |
| Mailing Address | Practice Location Address |
|---|---|
| Paul A Siebert, MD 600 S 13th St, Ste M, Pekin, IL 61554-4936 Ph: (309) 353-0765 | Paul A Siebert, MD 1001 Main St, Suite 300, Peoria, IL 61606-1907 Ph: (309) 495-0200 |
Dr. James Bertram Williams, M.D. Thoracic Surgery (Cardiothoracic Vascular Surgery) Medicare: Medicare Enrolled Practice Location: 2420 W Nebraska Ave, Peoria, IL 61604 Phone: 309-680-5000 Fax: 309-680-1002 | |
Dr. Mark D Plunkett, MD Thoracic Surgery (Cardiothoracic Vascular Surgery) Medicare: Medicare Enrolled Practice Location: 420 Ne Glen Oak Ave Ste 301, Suite 301, Peoria, IL 61603 Phone: 309-655-3453 Fax: 309-624-3852 |