| Abraham Lincoln Memorial Hospital | |
|
200 Stahlhut Dr Lincoln IL 62656-5066 | |
| (217) 732-2161 | |
| (217) 735-3526 |
| Full Name | Abraham Lincoln Memorial Hospital |
|---|---|
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 200 Stahlhut Dr, Lincoln, Illinois |
| Authorized Official Name and Position | Heidi C Maltimore (MANAGER) |
| Authorized Official Contact | 2175886405 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Abraham Lincoln Memorial Hospital Po Box 3428 Springfield IL 62708-3428 Ph: (217) 588-2624 | Abraham Lincoln Memorial Hospital 200 Stahlhut Dr Lincoln IL 62656-5066 Ph: (217) 732-2161 |
| NPI Number | 1558586180 |
|---|---|
| Provider Enumeration Date | 04/17/2007 |
| Last Update Date | 03/10/2021 |
| Certification Date | 03/10/2021 |
| Medicare PECOS PAC ID | 9436040573 |
|---|---|
| Medicare Enrollment ID | O20101123001008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558586180 | NPI | - | NPPES |
| F100606037 | Other | IL | MEDICARE |
| Provider Name | Christopher E Wottowa |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1922195718 PECOS PAC ID: 2860471752 Enrollment ID: I20040715000038 |
| Provider Name | Alyssa L Tusek |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1730175894 PECOS PAC ID: 4587602891 Enrollment ID: I20050418001291 |
| Provider Name | Matthew L Johnston |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1780628677 PECOS PAC ID: 6800798331 Enrollment ID: I20060131000174 |
| Provider Name | Shelley Daigh |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1093978892 PECOS PAC ID: 4587732821 Enrollment ID: I20081014000246 |
| Provider Name | Ted R Clark |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1497914741 PECOS PAC ID: 7618020975 Enrollment ID: I20090804000267 |
| Provider Name | Jessica L Alwerdt |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1669706057 PECOS PAC ID: 6800934100 Enrollment ID: I20091106000109 |
| Provider Name | Brett M Jones |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1659583755 PECOS PAC ID: 2567501992 Enrollment ID: I20091125000026 |
| Provider Name | Katherine D Anderson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1679772511 PECOS PAC ID: 6709912256 Enrollment ID: I20100413000049 |
| Provider Name | Ann R Larson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1013249879 PECOS PAC ID: 3971632829 Enrollment ID: I20100602000517 |
| Provider Name | Sarah B Stambaugh |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1730128687 PECOS PAC ID: 6709042799 Enrollment ID: I20120718000900 |
| Provider Name | Eric M High |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1629299599 PECOS PAC ID: 4789831355 Enrollment ID: I20120904000770 |
| Provider Name | Gina Marie Palazzolo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891049276 PECOS PAC ID: 4587817564 Enrollment ID: I20131030001280 |
| Provider Name | Kelsey Jo Clark |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1518381896 PECOS PAC ID: 5890927123 Enrollment ID: I20140421000000 |
| Provider Name | Sumesh S Jain |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1043507999 PECOS PAC ID: 2668611534 Enrollment ID: I20140505001153 |
| Provider Name | Nathaniel S Gregoire |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1477956811 PECOS PAC ID: 0840412383 Enrollment ID: I20141117001516 |
| Provider Name | Jerel Watson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1760747406 PECOS PAC ID: 6507005303 Enrollment ID: I20150406002139 |
| Provider Name | Matthew E Albrecht |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1174887384 PECOS PAC ID: 7618116518 Enrollment ID: I20150408000401 |
| Provider Name | Brent D Riva |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1902265754 PECOS PAC ID: 3072818293 Enrollment ID: I20160226000211 |
| Provider Name | Emily a Jones Robson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1144680620 PECOS PAC ID: 1850698911 Enrollment ID: I20160405000735 |
| Provider Name | Kimberley a Knuuti |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710438320 PECOS PAC ID: 1355629932 Enrollment ID: I20161102001479 |
| Provider Name | Brooke L Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235686759 PECOS PAC ID: 5092093526 Enrollment ID: I20161103000368 |
| Provider Name | Joseph Bulinski |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1972014488 PECOS PAC ID: 5092072710 Enrollment ID: I20171205000196 |
| Provider Name | Matthew K Woodruff |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1235648221 PECOS PAC ID: 0244599645 Enrollment ID: I20180110001264 |
| Provider Name | Kelli a Levek |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1992187934 PECOS PAC ID: 3577876416 Enrollment ID: I20180724000902 |
| Provider Name | Michelle C Kronmiller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871052522 PECOS PAC ID: 4981946423 Enrollment ID: I20190502000012 |
| Provider Name | Timothy Samuel Denney |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1336705482 PECOS PAC ID: 7911233168 Enrollment ID: I20190725000601 |
| Provider Name | Tiffany N Renfro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285279612 PECOS PAC ID: 0042643603 Enrollment ID: I20191212001273 |
| Provider Name | Aaron M Golitko |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1881122844 PECOS PAC ID: 8022388404 Enrollment ID: I20200325000140 |
| Provider Name | Kenneth Guillotte |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1649709668 PECOS PAC ID: 4880964295 Enrollment ID: I20200408003055 |
| Provider Name | Brandon W Koser |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1245751254 PECOS PAC ID: 8729337050 Enrollment ID: I20200417002187 |
| Provider Name | Allison E Mayfield |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1780099747 PECOS PAC ID: 7113211707 Enrollment ID: I20200603001100 |
| Provider Name | Katy Jo Northcutt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609343128 PECOS PAC ID: 1355763939 Enrollment ID: I20200629001040 |
| Provider Name | Mary Ann Seagle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316552524 PECOS PAC ID: 3072923838 Enrollment ID: I20201105001531 |
| Provider Name | Jase Camp |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1932691292 PECOS PAC ID: 4981951233 Enrollment ID: I20210609002900 |
| Provider Name | Nida Naeem Khan Feller |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1366937575 PECOS PAC ID: 6800143678 Enrollment ID: I20210802001994 |
| Provider Name | Brittany Nicole Campbell |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1962024109 PECOS PAC ID: 8022414192 Enrollment ID: I20210915001684 |
| Provider Name | Maia D. Scharf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447822705 PECOS PAC ID: 8820487259 Enrollment ID: I20211105000500 |
| Provider Name | Alexis C Gazda |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1043874761 PECOS PAC ID: 8224360722 Enrollment ID: I20220203000766 |
| Provider Name | Sadie Marie Sawyer |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1184347072 PECOS PAC ID: 5799151098 Enrollment ID: I20221011001926 |
| Provider Name | Joshua Stein |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1710347075 PECOS PAC ID: 7012200819 Enrollment ID: I20230522002158 |
| Provider Name | Evan Jenkins |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1225650773 PECOS PAC ID: 4880018407 Enrollment ID: I20230721000643 |
| Provider Name | Kyley J Wyss |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1225534027 PECOS PAC ID: 1052675279 Enrollment ID: I20240627001886 |
| Provider Name | Jessica Maerz |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1295268001 PECOS PAC ID: 3870866213 Enrollment ID: I20240813000959 |
| Provider Name | Jennifer L Scott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558077602 PECOS PAC ID: 1153852215 Enrollment ID: I20241001001796 |
| Provider Name | Jacob Bayley Sholl |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1629814348 PECOS PAC ID: 0345772695 Enrollment ID: I20241011002567 |
| Provider Name | Michelle Alexandria Boyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225851793 PECOS PAC ID: 9638606718 Enrollment ID: I20241231003390 |
| Provider Name | Samuel Susko |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1235923145 PECOS PAC ID: 8123531001 Enrollment ID: I20250702003859 |
| Provider Name | Meaghan D Mendoza |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1396484051 PECOS PAC ID: 0941681225 Enrollment ID: I20250717000290 |
Family Medical Center of Lincoln, LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 515 N College St, Lincoln, IL 62656 Phone: 217-732-9681 Fax: 217-735-6527 |
Family Medical Center-lincoln Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 515 N College St, Lincoln, IL 62656 Phone: 217-732-9681 Fax: 217-735-6527 |
Mark Canty MD, Ltd Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 N Postville Dr, Lincoln, IL 62656 Phone: 309-258-7822 |
Memorial Physician Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 515 N College St, Lincoln, IL 62656 Phone: 217-732-9681 Fax: 217-735-6527 |
Lincoln Rural Health Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 100 Stahlhut Dr, Lincoln, IL 62656 Phone: 217-735-9555 |
Memorial Physician Services Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 515 N College St, Lincoln, IL 62656 Phone: 217-732-9681 Fax: 217-735-6527 |