Susan Provow, MD is a medicare enrolled "Family Medicine" physician in Rock Falls, Illinois. Her current practice location is
100 W 1st St, Rock Falls, Illinois. You can reach out to her office (for appointments etc.) via phone at
(815) 625-4790.
Susan Provow is licensed to practice in Illinois (license number ) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1861580128.
Physician's Profile
| Full Name | Susan Provow |
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| Gender | Female |
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| Speciality | Family Medicine |
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| Location | 100 W 1st St, Rock Falls, Illinois |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1861580128
- Provider Enumeration Date: 10/11/2006
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 5890803928
- Enrollment ID: I20101019000956
Medical Identifiers
Medical identifiers for Susan Provow such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1861580128 | NPI | - | NPPES |
| 9815737 | Other | IL | BLUE CROSS BLUE SHIELD |
| 011542 | Other | IL | HEALTH ALLIANCE MEDICAL |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 207Q00000X | Family Medicine | (Illinois) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Susan Provow allows following entities to bill medicare on her behalf.
| Entity Name | Cgh Medical Center |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1902854623 PECOS PAC ID: 6103723267 Enrollment ID: O20031217000054 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Susan Provow is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Susan Provow, MD 101 E Miller Rd, Sterling, IL 61081-1252 Ph: (815) 625-4790 | Susan Provow, MD 100 W 1st St, Rock Falls, IL 61071-1269 Ph: (815) 625-4790 |
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