| Lois Marlene Dishman-cooper, MPAS, PA-C | |
|
929 Stacey Burk Dr, Flora, IL 62839-3241 | |
| (618) 662-2131 | |
| (618) 662-3077 |
| Full Name | Lois Marlene Dishman-cooper |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant - Medical |
| Location | 929 Stacey Burk Dr, Flora, Illinois |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851476238 | NPI | - | NPPES |
| 00004500 | Other | FL | PA PRESCRIBER NUMBER |
| PA9101866 | Other | FL | PA LICENSE NUMBER |
| 085-002930 | Other | IL | LICENSE NUMBER |
| 291816100 | Medicaid | FL | |
| MED-PAC-LIC-26883 | Other | MT | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AM0700X | Physician Assistant - Medical | 085-002930 (Illinois) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Lois Marlene Dishman-cooper, MPAS, PA-C 929 Stacey Burk Dr, Flora, IL 62839-3241 Ph: (618) 662-2131 | Lois Marlene Dishman-cooper, MPAS, PA-C 929 Stacey Burk Dr, Flora, IL 62839-3241 Ph: (618) 662-2131 |
Mrs. Kristina Marie Snell, RMA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 201 E N Avenue, Clay Medical Center, Flora, IL 62839 Phone: 618-662-8386 Fax: 618-662-4338 |