| Community Health Improvement Center Health Dept Satellite | |
|
1221 East Condit Street Decatur IL 62521 | |
| (217) 423-6988 | |
| Not Available |
| Full Name | Community Health Improvement Center Health Dept Satellite |
|---|---|
| Speciality | Clinic/Center |
| Location | 1221 East Condit Street, Decatur, Illinois |
| Authorized Official Name and Position | Tanya Andricks (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2178779117 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Health Improvement Center Health Dept Satellite 2905 North Main Street Decatur IL 62526 Ph: (217) 877-9117 | Community Health Improvement Center Health Dept Satellite 1221 East Condit Street Decatur IL 62521 Ph: (217) 423-6988 |
| NPI Number | 1467784090 |
|---|---|
| Provider Enumeration Date | 02/08/2010 |
| Last Update Date | 03/24/2014 |
| Medicare PECOS PAC ID | 4385625342 |
|---|---|
| Medicare Enrollment ID | O20040526000316 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467784090 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Tricia L Scerba |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1467534065 PECOS PAC ID: 7618960683 Enrollment ID: I20040406000377 |
| Provider Name | Debra Babich |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1649215757 PECOS PAC ID: 0840288833 Enrollment ID: I20040506000613 |
| Provider Name | Corinne Kohler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053386250 PECOS PAC ID: 8022098169 Enrollment ID: I20040721000302 |
| Provider Name | Vineeta Chandra |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1356316541 PECOS PAC ID: 9931163029 Enrollment ID: I20041118000132 |
| Provider Name | Ida Kay Hess |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831264639 PECOS PAC ID: 6406883180 Enrollment ID: I20050725000658 |
| Provider Name | David A Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942292412 PECOS PAC ID: 9335164938 Enrollment ID: I20051012001097 |
| Provider Name | Dana M Ray |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225051071 PECOS PAC ID: 9335146653 Enrollment ID: I20061031000041 |
| Provider Name | Dennis Costerisan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578565701 PECOS PAC ID: 8123104544 Enrollment ID: I20100619000116 |
| Provider Name | Manisha C Shah |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1306154984 PECOS PAC ID: 6103011374 Enrollment ID: I20101112000979 |
| Provider Name | Allison M Raiha |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1447568605 PECOS PAC ID: 7416143755 Enrollment ID: I20101129000190 |
| Provider Name | Margaret M Thomson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1033177183 PECOS PAC ID: 8325222151 Enrollment ID: I20110401000869 |
| Provider Name | Jay S Keller |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1790760544 PECOS PAC ID: 9234119538 Enrollment ID: I20120510000335 |
| Provider Name | Charmaine L Robertson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235484510 PECOS PAC ID: 8022253996 Enrollment ID: I20130325000314 |
| Provider Name | Pierre M Johnson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1659531903 PECOS PAC ID: 8527201565 Enrollment ID: I20130823000693 |
| Provider Name | Debra L Lowrance |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1174869408 PECOS PAC ID: 8729221478 Enrollment ID: I20130827000899 |
| Provider Name | Sarah E Winter |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1316258056 PECOS PAC ID: 4587881958 Enrollment ID: I20140807001851 |
| Provider Name | Chinelo C Echeazu |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1922319839 PECOS PAC ID: 0749407161 Enrollment ID: I20140808000591 |
| Provider Name | Aashima Bansal |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1316262892 PECOS PAC ID: 7012158017 Enrollment ID: I20141118002170 |
| Provider Name | Anne L Hocking |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225415664 PECOS PAC ID: 8921315565 Enrollment ID: I20150915002438 |
| Provider Name | Kristen L Hufford |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1831574987 PECOS PAC ID: 7517268105 Enrollment ID: I20151228000815 |
| Provider Name | Angela L King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528434222 PECOS PAC ID: 3577860857 Enrollment ID: I20160331001657 |
| Provider Name | Erin Scott Payne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609242080 PECOS PAC ID: 8527366079 Enrollment ID: I20160415001569 |
| Provider Name | Erin Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811364391 PECOS PAC ID: 9234398033 Enrollment ID: I20160420002235 |
| Provider Name | Sara Abercrombie |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1215398128 PECOS PAC ID: 7517257561 Enrollment ID: I20160602001602 |
| Provider Name | Elizabeth A Shuff |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1457705063 PECOS PAC ID: 0648568352 Enrollment ID: I20161013000016 |
| Provider Name | Dima Alfakara |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295175529 PECOS PAC ID: 2567685274 Enrollment ID: I20170301002694 |
| Provider Name | Sandra L Yockey |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1427132190 PECOS PAC ID: 2466738232 Enrollment ID: I20170410001236 |
| Provider Name | Julie Brasel |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1093268583 PECOS PAC ID: 5395000517 Enrollment ID: I20180517001351 |
| Provider Name | Lindsay Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083193858 PECOS PAC ID: 3870845605 Enrollment ID: I20181005002457 |
| Provider Name | Stephanie Kanitsch |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1659787893 PECOS PAC ID: 6406108125 Enrollment ID: I20181008003160 |
| Provider Name | Song Ok Kang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366927741 PECOS PAC ID: 4587083829 Enrollment ID: I20201006001118 |
| Provider Name | Nakita Dorez Cook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710496021 PECOS PAC ID: 6103232863 Enrollment ID: I20210304002170 |
| Provider Name | Jessica Kraemer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659041432 PECOS PAC ID: 5193115582 Enrollment ID: I20211129000684 |
| Provider Name | Lubna Fatima Qasim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891408068 PECOS PAC ID: 9234587155 Enrollment ID: I20231201002494 |
Heritage Behavioral Health Center Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 151 N Main St, Decatur, IL 62523 Phone: 217-362-6262 Fax: 217-362-6290 | |
Veteran's Administration Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3035 E Mound Rd, Decatur, IL 62526 Phone: 217-875-2670 Fax: 217-875-2689 | |
Oasis Day Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 243 West Cerro Gordo Street, Decatur, IL 62526 Phone: 217-422-3940 | |
Vsr Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 180 W Imboden Dr, Decatur, IL 62521 Phone: 715-207-1134 | |
Heritage Behavioral Health Center Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 243 W Cerro Gordo St, Decatur, IL 62522 Phone: 217-422-3940 | |
Planned Parenthood Of Illinois Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3021 N Oakland Ave, Decatur, IL 62526 Phone: 217-877-6474 Fax: 217-877-9452 | |
Gowdar & Gowdawr Md Sc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 741 W Pershing Rd, Decatur, IL 62526 Phone: 217-876-7200 Fax: 217-876-7233 |