| Nicole Dalton, PA | |
|
241 W Weaver Rd, Suite 145b, Forsyth, IL 62535-9762 | |
| (217) 794-5472 | |
| (217) 794-5458 |
| Full Name | Nicole Dalton |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Experience | 25 Years |
| Location | 241 W Weaver Rd, Forsyth, 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 |
|---|---|---|---|
| 1326109992 | NPI | - | NPPES |
| 833120 | Other | MEDICARE GROUP # | |
| P00807365 | Other | RR INDIVIDUAL # | |
| CA2264 | Other | RR GROUP # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 085-001647 (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| St Joseph Medical Center | Bloomington, IL | Hospital |
| Warner Hospital And Health Services | Clinton, IL | Hospital |
| Saint James Hospital | Pontiac, IL | Hospital |
| Decatur Memorial Hospital | Decatur, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Saint James Hospital | 0648187252 | 58 |
| Mailing Address | Practice Location Address |
|---|---|
| Nicole Dalton, PA 2300 N Edward St, Decatur, IL 62526-4163 Ph: (217) 876-2868 | Nicole Dalton, PA 241 W Weaver Rd, Suite 145b, Forsyth, IL 62535-9762 Ph: (217) 794-5472 |
Ms. Sunni Leigh Delahunty, P.A.-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 241 W Weaver Rd, Suite 145c, Forsyth, IL 62535 Phone: 217-876-5200 Fax: 217-876-5206 | |
Mr. Casey Christopher Vercruysse, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 845 S Route 51, Forsyth, IL 62535 Phone: 217-872-0953 |