| Gayana Wanniarachchi, | |
|
215 E 1st St Ste 111, Dixon, IL 61021-3198 | |
| (815) 345-5677 | |
| Not Available |
| Full Name | Gayana Wanniarachchi |
|---|---|
| Gender | Female |
| Speciality | Podiatrist - Foot & Ankle Surgery |
| Location | 215 E 1st St Ste 111, Dixon, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003540220 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | 135.001170 (Illinois) | Primary |
| Provider Name | Ksb Medical Group Inc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1073592119 PECOS PAC ID: 7911890009 Enrollment ID: O20040203000860 |
| Provider Name | Katherine Shaw Bethea Hospital |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1427043546 PECOS PAC ID: 2264480037 Enrollment ID: O20081218000029 |
| Mailing Address | Practice Location Address |
|---|---|
| Gayana Wanniarachchi, 215 E 1st St Ste 111, Dixon, IL 61021-3198 Ph: () - | Gayana Wanniarachchi, 215 E 1st St Ste 111, Dixon, IL 61021-3198 Ph: (815) 345-5677 |
Kyle Swanson, Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 215 E 1st St, Suite 310, Dixon, IL 61021 Phone: 515-210-9777 Fax: 815-285-5699 | |
Cara Lee Fontana, DPM Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 215 E 1st St Ste 111, Dixon, IL 61021 Phone: 815-285-5801 | |
Brandon R. Gumbiner, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 215 E 1st St Ste 310, Dixon, IL 61021 Phone: 815-285-5801 Fax: 815-285-5699 | |
Dr. Michael J Wessels, DPM Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 215 E 1st St, Ste 306, Dixon, IL 61021 Phone: 815-285-5801 Fax: 815-285-5699 | |
Steven Yeschek, Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 215 E 1st St, Dixon, IL 61021 Phone: 815-285-5698 | |
Dr. James J Dukelow, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 716 N Galena Ave, Dixon, IL 61021 Phone: 815-284-2023 Fax: 630-897-6851 |