| Tabatha Selina Wells, MD | |
|
4007 Yucan Dr, Springfield, IL 62711-6459 | |
| (773) 988-3103 | |
| (217) 771-1844 |
| Full Name | Tabatha Selina Wells |
|---|---|
| Gender | Female |
| Speciality | Family Medicine |
| Location | 4007 Yucan Dr, Springfield, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992933923 | NPI | - | NPPES |
| 036129167 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 036-129167 (Illinois) | Primary |
| Entity Name | The Board Of Trustees Of The University Of Illinois |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1386863819 PECOS PAC ID: 3072422716 Enrollment ID: O20031112000158 |
| 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 |
|---|---|
| Tabatha Selina Wells, MD 4007 Yucan Dr, Springfield, IL 62711-6459 Ph: () - | Tabatha Selina Wells, MD 4007 Yucan Dr, Springfield, IL 62711-6459 Ph: (773) 988-3103 |
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 | |
Mrs. Lacey Dively Moy, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 3220 Atlanta St, Springfield, IL 62707 Phone: 217-588-7400 Fax: 217-588-7439 | |
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 |