| Tara Shutt, APN | |
|
100 E Us Highway 36, Atwood, IL 61913-7233 | |
| (217) 578-3814 | |
| (217) 578-3100 |
| Full Name | Tara Shutt |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 100 E Us Highway 36, Atwood, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528621265 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363L00000X | Nurse Practitioner | 209019113 (Illinois) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 209019113 (Illinois) | Primary |
| Entity Name | Kirby Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1386635373 PECOS PAC ID: 6901791144 Enrollment ID: O20050801000320 |
| 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 |
|---|---|
| Tara Shutt, APN 1000 Medical Center Dr, Monticello, IL 61856-2116 Ph: (217) 762-6241 | Tara Shutt, APN 100 E Us Highway 36, Atwood, IL 61913-7233 Ph: (217) 578-3814 |
Jamey L. Witmer, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 100 E Us Highway 36, Atwood, IL 61913 Phone: 217-578-3814 Fax: 217-578-3100 | |
Mrs. Danielle M Pare, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 100 E Us Highway 36, Atwood, IL 61913 Phone: 217-578-3814 Fax: 217-578-3100 |