| Stacey Waddington, PA-C | |
|
200 S Cedar St, Shelbyville, IL 62565-1838 | |
| (217) 774-4400 | |
| (217) 774-6445 |
| Full Name | Stacey Waddington |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Experience | 18 Years |
| Location | 200 S Cedar St, Shelbyville, 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 |
|---|---|---|---|
| 1154578615 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 085-003283 (Illinois) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Osf Multi-specialty Group | 3678889789 | 2123 |
| Entity Name | SIU Physicians & Surgeons Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558385989 PECOS PAC ID: 2365352820 Enrollment ID: O20031222000769 |
| Entity Name | HSHS Good Shepherd Hospital Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1053348532 PECOS PAC ID: 9335031061 Enrollment ID: O20040327000037 |
| Entity Name | HSHS Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1962644807 PECOS PAC ID: 5092857821 Enrollment ID: O20100116000275 |
| Entity Name | OSF Multi-specialty Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1922445527 PECOS PAC ID: 3678889789 Enrollment ID: O20150904000279 |
| Mailing Address | Practice Location Address |
|---|---|
| Stacey Waddington, PA-C 1025 S 6th St, Springfield, IL 62703-2403 Ph: (217) 528-7541 | Stacey Waddington, PA-C 200 S Cedar St, Shelbyville, IL 62565-1838 Ph: (217) 774-4400 |
Catherine Elizabeth Yutmeyer, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 249 N Morgan St, Shelbyville, IL 62565 Phone: 217-774-2900 Fax: 217-347-2922 |
Kristin Marie Haag, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1215 W Main St, Shelbyville, IL 62565 Phone: 217-774-4305 Fax: 217-774-4306 |
Mr. Gary D Hayden, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1215 W Main St, Shelbyville, IL 62565 Phone: 217-774-4305 Fax: 217-774-4306 |