| Mr Jacob Smith, PA-C, ATC | |
|
1111 Trinity Ln Ste 111, Bloomington, IL 61704-8112 | |
| (309) 663-6461 | |
| Not Available |
| Full Name | Mr Jacob Smith |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 3 Years |
| Location | 1111 Trinity Ln Ste 111, Bloomington, Illinois |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548675945 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AM0700X | Physician Assistant - Medical | 085008559 (Illinois) | Secondary |
| 363A00000X | Physician Assistant | 085008559 (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Advocate Bromenn Medical Center | Normal, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Carle West Physician Group Inc | 8921420308 | 254 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Jacob Smith, PA-C, ATC 611 W. Park St., Fapc, Urbana, IL 61801 Ph: () - | Mr Jacob Smith, PA-C, ATC 1111 Trinity Ln Ste 111, Bloomington, IL 61704-8112 Ph: (309) 663-6461 |
Nicholas Ray Von Holten, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1111 Trinity Ln Ste 111, Bloomington, IL 61704 Phone: 309-663-6461 | |
Victoria C Voegel, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 1414 Woodbine Rd, Bloomington, IL 61704 Phone: 309-662-2273 Fax: 309-662-2014 | |
Danielle Beer, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1505 Eastland Dr, Bloomington, IL 61701 Phone: 309-663-2100 Fax: 309-663-8322 | |
Harshal Jani, P.A. Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1701 E College Ave, Bloomington, IL 61704 Phone: 309-664-3000 | |
Mrs. Sara Ann Houk, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 2200 E. Washington St, Bloomington, IL 61701 Phone: 309-662-3311 | |
John Jeffrey Williamson, P.A. Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1701 E College Ave, Bloomington, IL 61704 Phone: 309-664-3422 | |
Mr. Brian A Schrock, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1111 Trinity Ln Ste 111, Bloomington, IL 61704 Phone: 309-663-6461 Fax: 309-663-5711 |