Kimberly J Mitchell, | |
2420 State St, East Saint Louis, IL 62205-2321 | |
(618) 318-8809 | |
(618) 615-4205 |
Full Name | Kimberly J Mitchell |
---|---|
Gender | Female |
Speciality | Nurse Practitioner |
Experience | 8 Years |
Location | 2420 State St, East Saint Louis, 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 |
---|---|---|---|
1700350170 | NPI | - | NPPES |
2019026962 | Other | MO | STATE LICENSE MO |
209.018150 | Other | IL | . |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363L00000X | Nurse Practitioner | 209018150 (Illinois) | Secondary |
363LF0000X | Nurse Practitioner - Family | 209.018150 (Illinois) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Osh-il Physicians Group Llc | 3870877699 | 3 |
Entity Name | Midwest Post Acute Care Pllc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1083012074 PECOS PAC ID: 0143547117 Enrollment ID: O20150401000634 |
Entity Name | Osh-il Physicians Group Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1265977698 PECOS PAC ID: 3870877699 Enrollment ID: O20170222002860 |
Mailing Address | Practice Location Address |
---|---|
Kimberly J Mitchell, Po Box 746096, Atlanta, GA 30374-6096 Ph: (312) 733-9730 | Kimberly J Mitchell, 2420 State St, East Saint Louis, IL 62205-2321 Ph: (618) 318-8809 |
Mrs. Tina Teresa Mond, MSN, APRN, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 100 N 8th St Ste 120, East Saint Louis, IL 62201 Phone: 618-274-9105 Fax: 618-274-9101 | |
Yolanda L Hoag, ACNPC-AG Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2001 State St, East Saint Louis, IL 62205 Phone: 618-271-9191 Fax: 618-271-9617 | |
Stephanie Michelle Tate-patterson, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4901 State St, East Saint Louis, IL 62205 Phone: 618-646-3700 | |
Kayla Ann Pryor, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2001 State St, East Saint Louis, IL 62205 Phone: 618-271-0204 | |
Mrs. Donna Marie Wiley, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2420 State St, East Saint Louis, IL 62205 Phone: 618-318-8809 Fax: 618-615-4205 | |
Ms. Latisha Trenice Stennis, PMHNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 8106 Carol Dr, East Saint Louis, IL 62203 Phone: 618-558-0920 | |
Mrs. Virginia L Behrhorst, BC APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 601 James R Thompson Blvd, Building D 2015, East Saint Louis, IL 62201 Phone: 618-482-6959 Fax: 618-482-8311 |