Amanda Sides, LPN is a
Licensed Practical Nurse based in Sullivan, Illinois. Amanda Sides is licensed to practice in Illinois (license number 043114801) and her current practice location is
Moultrie County Counseling Center, 12 W Harrison Street, Sullivan, Illinois. She can be reached at her office (for appointments etc.) via phone at
(217) 728-4358.
NPI number for Amanda Sides is 1255168738 and her current mailing address is Moultrie County Counseling Center, 12 W Harrison Street, Sullivan, Illinois. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1255168738.
Provider's Profile
| Full Name | Amanda Sides |
|---|
| Gender | Female |
|---|
| Speciality | Licensed Practical Nurse |
|---|
| Location | Moultrie County Counseling Center, Sullivan, Illinois |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1255168738
- Provider Enumeration Date: 09/18/2024
- Last Update Date: 09/18/2024
Medical Identifiers
Medical identifiers for Amanda Sides such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1255168738 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 164W00000X | Licensed Practical Nurse | 043114801 (Illinois) | Primary |
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. Amanda Sides is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Amanda Sides, LPN Moultrie County Counseling Center, 12 W Harrison Street, Sullivan, IL 61951 Ph: (217) 728-4358 | Amanda Sides, LPN Moultrie County Counseling Center, 12 W Harrison Street, Sullivan, IL 61951 Ph: (217) 728-4358 |
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