| Teah Qvavadze, MD | |
|
747 N Rutledge St Fl 4, Springfield, IL 62702-6700 | |
| (217) 545-8000 | |
| (217) 545-1622 |
| Full Name | Teah Qvavadze |
|---|---|
| Gender | Female |
| Speciality | Vascular Surgery |
| Experience | 20 Years |
| Location | 747 N Rutledge St Fl 4, 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 |
|---|---|---|---|
| 1033523501 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | MT207459 (Pennsylvania) | Secondary |
| 208600000X | Surgery | 036.166578 (Illinois) | Secondary |
| 2086S0129X | Surgery - Vascular Surgery | 036.166578 (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Memorial Medical Center | Springfield, IL | Hospital |
| Decatur Memorial Hospital | Decatur, IL | Hospital |
| St Johns Hospital | Springfield, IL | Hospital |
| Mc Donough District Hospital | Macomb, IL | Hospital |
| Pana Community Hospital | Pana, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Siu Physicians And Surgeons Inc | 2365352820 | 316 |
| Entity Name | SIU Physicians & Surgeons Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558385989 PECOS PAC ID: 2365352820 Enrollment ID: O20031222000769 |
| Entity Name | Kirby Medical Center |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1730179847 PECOS PAC ID: 6901791144 Enrollment ID: O20050419000531 |
| Entity Name | Kirby Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1386635373 PECOS PAC ID: 6901791144 Enrollment ID: O20050801000320 |
| Mailing Address | Practice Location Address |
|---|---|
| Teah Qvavadze, MD Po Box 19639, Springfield, IL 62794-9639 Ph: (217) 545-8000 | Teah Qvavadze, MD 747 N Rutledge St Fl 4, Springfield, IL 62702-6700 Ph: (217) 545-8000 |
Dr. Emily Catherine Sturm, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 315 W Carpenter St Fl 2, Springfield, IL 62702 Phone: 217-545-8000 |
Mark Kuhnke, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 900 N 1st Street, Springfield, IL 62702 Phone: 217-528-7541 Fax: 217-528-7543 |
Dr. Melanie Lynne Barnard, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 701 N 1st St Ste D308, Springfield, IL 62702 Phone: 217-545-4401 Fax: 217-545-2586 |
Dr. Fillip Komornik, MD Surgery Medicare: Medicare Enrolled Practice Location: 701 N 1st St # D346, Springfield, IL 62702 Phone: 217-545-8444 |
Dr. Rodrigue Fontem, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 701 N 1st St Ste D327, Springfield, IL 62702 Phone: 217-545-8856 Fax: 217-545-7762 |
Syed Omar Anwar-hashmi, MD Surgery Medicare: Medicare Enrolled Practice Location: 701 N 1st St Ste D308, Springfield, IL 62702 Phone: 217-545-4401 |
Dr. Samantha Wallis Elizabeth Knight, MD Surgery Medicare: May Accept Medicare Assignments Practice Location: 400 N 9th St, Springfield, IL 62702 Phone: 217-545-8000 Fax: 217-545-6041 |