| Preferred Family Healthcare, Inc. | |
|
418 S 36th St Quincy IL 62301-5924 | |
| (217) 224-6300 | |
| (217) 224-4329 |
| Full Name | Preferred Family Healthcare, Inc. |
|---|---|
| Speciality | Substance Abuse Rehabilitation Facility |
| Location | 418 S 36th St, Quincy, Illinois |
| Authorized Official Name and Position | Mark Conover (CHIEF REVENUE OFFICER) |
| Authorized Official Contact | 6606651962 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Preferred Family Healthcare, Inc. 1601 Old South River Rd Saint Charles MO 63303-4120 Ph: () - | Preferred Family Healthcare, Inc. 418 S 36th St Quincy IL 62301-5924 Ph: (217) 224-6300 |
| NPI Number | 1114099421 |
|---|---|
| Provider Enumeration Date | 11/14/2006 |
| Last Update Date | 06/10/2022 |
| Certification Date | 06/10/2022 |
| Medicare PECOS PAC ID | 0244256246 |
|---|---|
| Medicare Enrollment ID | O20151124002928 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114099421 | NPI | - | NPPES |
| Provider Name | Anil Gupta |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912961558 PECOS PAC ID: 9335032028 Enrollment ID: I20040205001080 |
| Provider Name | Tonya N Stamper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811144413 PECOS PAC ID: 7618030230 Enrollment ID: I20120302000604 |
| Provider Name | Heather Anne Mahsman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952968141 PECOS PAC ID: 1456680552 Enrollment ID: I20210427001658 |
| Provider Name | Katarzyna Derlukiewicz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033378708 PECOS PAC ID: 1153497862 Enrollment ID: I20210504002429 |
| Provider Name | Tabitha Martin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053909572 PECOS PAC ID: 2264834399 Enrollment ID: I20210713001362 |
| Provider Name | John T Sylvara |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881662724 PECOS PAC ID: 4587623830 Enrollment ID: I20210821000398 |
| Provider Name | Joseph L Spalding |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073554085 PECOS PAC ID: 6507910163 Enrollment ID: I20210907002905 |
| Provider Name | Mandy Lee Eisenberg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659931491 PECOS PAC ID: 0941605489 Enrollment ID: I20211025000332 |
| Provider Name | Amy Bue |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326696360 PECOS PAC ID: 2466887518 Enrollment ID: I20220907000147 |
| Provider Name | Chanda Herron |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225463490 PECOS PAC ID: 4880821925 Enrollment ID: I20221213001782 |
| Provider Name | Matthew Wells |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407112204 PECOS PAC ID: 1456515444 Enrollment ID: I20230322000520 |
| Provider Name | Caren Stephine Patton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659903615 PECOS PAC ID: 7911329784 Enrollment ID: I20230322000956 |
| Provider Name | Betty Long |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821331984 PECOS PAC ID: 8921313305 Enrollment ID: I20230424000885 |
| Provider Name | Pamela Barrigar |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134571672 PECOS PAC ID: 5991048290 Enrollment ID: I20230531001667 |
| Provider Name | Destiney Khristine Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659064483 PECOS PAC ID: 1153784673 Enrollment ID: I20230831002081 |
| Provider Name | Jessica Baker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1316467210 PECOS PAC ID: 5890142012 Enrollment ID: I20240108004999 |
| Provider Name | Stacey Samantha Juilfs |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1003342783 PECOS PAC ID: 9234586181 Enrollment ID: I20240110002708 |
| Provider Name | Deanna M Sublette |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1598436271 PECOS PAC ID: 9436501541 Enrollment ID: I20240113000367 |
| Provider Name | Darion D Stephens |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1407484454 PECOS PAC ID: 2769834878 Enrollment ID: I20240113000508 |
| Provider Name | Gregory Michael Lowes |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1720275860 PECOS PAC ID: 3274983945 Enrollment ID: I20240115000671 |
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