| Mr Paul S Havrilka Iii, APRN, FNP-C | |
|
208 E 3rd St, Centralia, IL 62801-3902 | |
| (618) 244-4800 | |
| (618) 532-3128 |
| Full Name | Mr Paul S Havrilka Iii |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner |
| Experience | 13 Years |
| Location | 208 E 3rd St, Centralia, 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 |
|---|---|---|---|
| 1801071543 | NPI | - | NPPES |
| 1134582018 | Medicaid | IL |
| Facility Name | Location | Facility Type |
|---|---|---|
| Ssm Health St Mary's Hospital -centralia | Centralia, IL | Hospital |
| Ssm Health - Good Samaritan Hospital | Mount vernon, IL | Hospital |
| Crossroads Community Hospital | Mount vernon, IL | Hospital |
| Hamilton Memorial Hospital | Mcleansboro, IL | Hospital |
| Salem Township Hospital | Salem, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Asbery And Associates Ob Gyn Llc | 6507993136 | 11 |
| Entity Name | Physician Services Corporation Of Southern Illinois Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1831101807 PECOS PAC ID: 9234022567 Enrollment ID: O20040304000583 |
| Entity Name | Asbery And Associates Ob Gyn Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1033440722 PECOS PAC ID: 6507993136 Enrollment ID: O20100429000968 |
| Entity Name | Midwest Emergency Centralia Campus Associates, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1396034245 PECOS PAC ID: 2163672650 Enrollment ID: O20121018000074 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Paul S Havrilka Iii, APRN, FNP-C 8 Cusumano Professional Plaza Dr, Mount Vernon, IL 62864-6736 Ph: (618) 244-4800 | Mr Paul S Havrilka Iii, APRN, FNP-C 208 E 3rd St, Centralia, IL 62801-3902 Ph: (618) 244-4800 |
Mr. Dale D Pearce, APRN, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1535 W Mccord St, Centralia, IL 62801 Phone: 618-533-1811 | |
Alexis Wernsman, APN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1052 Ml King Drive, Suite 2, Centralia, IL 62801 Phone: 618-436-5410 Fax: 618-436-8063 | |
Abbey Dempsey, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1307 E Mccord St, Centralia, IL 62801 Phone: 618-899-9200 Fax: 618-899-9206 | |
Mrs. Amber Lynn Wennerstrom, DNP, PMHNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 444 N Pleasant Ave, Centralia, IL 62801 Phone: 618-436-5665 | |
Ms. Jessica Lynn Chapman, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1535 W Mccord St, Centralia, IL 62801 Phone: 618-532-1811 | |
Andrea Marie Johnson, PMHNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 444 N Pleasant Ave, Centralia, IL 62801 Phone: 618-436-5665 Fax: 618-436-8042 | |
Stacy D Menees, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 432 N Pleasant Ave, Centralia, IL 62801 Phone: 618-436-8300 |