| Roger Maillefer, MD | |
|
1850 Gateway Dr, Sycamore, IL 60178-3192 | |
| (815) 758-8671 | |
| Not Available |
| Full Name | Roger Maillefer |
|---|---|
| Gender | Male |
| Speciality | General Surgery |
| Experience | 32 Years |
| Location | 1850 Gateway Dr, Sycamore, 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 |
|---|---|---|---|
| 1558373696 | NPI | - | NPPES |
| 036098042 | Medicaid | IL | |
| 040142 | Other | IL | HEALTH ALLIANCE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | 4301503936 (Michigan) | Primary |
| 208600000X | Surgery | 036-098042 (Illinois) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Charlevoix Area Hospital | Charlevoix, MI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Munson Healthcare Charlevoix Hospital | 4284528035 | 43 |
| Entity Name | Munson Healthcare Charlevoix Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1629154307 PECOS PAC ID: 4284528035 Enrollment ID: O20071011000237 |
| Mailing Address | Practice Location Address |
|---|---|
| Roger Maillefer, MD 14695 Park Ave, Ste A, Charlevoix, MI 49720-1920 Ph: (815) 758-8671 | Roger Maillefer, MD 1850 Gateway Dr, Sycamore, IL 60178-3192 Ph: (815) 758-8671 |
Stephen Goldman, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 1850 Gateway Dr, Sycamore, IL 60178 Phone: 815-758-8671 | |
Jack Wagoner, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 1850 Gateway Dr, Sycamore, IL 60178 Phone: 815-758-8671 Fax: 815-758-5610 | |
Nitzet Velez, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 1850 Gateway Dr, Sycamore, IL 60178 Phone: 815-758-8671 |