| Community Health Systems, Inc. | |
|
74 Eclipse Ctr Beloit WI 53511-3550 | |
| (608) 361-0311 | |
| (608) 361-6131 |
| Full Name | Community Health Systems, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 74 Eclipse Ctr, Beloit, Wisconsin |
| Authorized Official Name and Position | Julie A. Sprecher (CEO) |
| Authorized Official Contact | 6083610311 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Health Systems, Inc. 74 Eclipse Ctr Beloit WI 53511-3550 Ph: (608) 361-0311 | Community Health Systems, Inc. 74 Eclipse Ctr Beloit WI 53511-3550 Ph: (608) 361-0311 |
| NPI Number | 1750390670 |
|---|---|
| Provider Enumeration Date | 08/07/2006 |
| Last Update Date | 10/14/2021 |
| Medicare PECOS PAC ID | 3678565116 |
|---|---|
| Medicare Enrollment ID | O20040402000368 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750390670 | NPI | - | NPPES |
| 32956700 | Medicaid | WI | |
| 000054100 | Other | WI | MEDICARE PART A |
| 42216400 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Robert M Sage |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1871523316 PECOS PAC ID: 8224939236 Enrollment ID: I20081111000327 |
| Provider Name | Jennifer Leigh Weidner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750438651 PECOS PAC ID: 3072867357 Enrollment ID: I20181127000733 |
| Provider Name | Monica Reu |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255974705 PECOS PAC ID: 5698192508 Enrollment ID: I20200824001955 |
| Provider Name | Mary Pintarro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689310179 PECOS PAC ID: 2769861541 Enrollment ID: I20220624001529 |
| Provider Name | Caitlyn Socha |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518689439 PECOS PAC ID: 0143691626 Enrollment ID: I20230119002319 |
| Provider Name | Denise Druck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336534791 PECOS PAC ID: 2860790052 Enrollment ID: I20230213000378 |
| Provider Name | Debora Lea Humphrey |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699161166 PECOS PAC ID: 0840638342 Enrollment ID: I20240403001116 |
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