| Family Healthcare Clinic | |
|
201 Bailey Lane Benton IL 62812-0000 | |
| (618) 439-3161 | |
| (618) 439-4049 |
| Full Name | Family Healthcare Clinic |
|---|---|
| Speciality | Internal Medicine |
| Location | 201 Bailey Lane, Benton, Illinois |
| Authorized Official Name and Position | Rikki Bonthron (CFO) |
| Authorized Official Contact | 6184393161 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Healthcare Clinic 201 Bailey Lane Benton IL 62812-0000 Ph: (618) 439-3161 | Family Healthcare Clinic 201 Bailey Lane Benton IL 62812-0000 Ph: (618) 439-3161 |
| NPI Number | 1255369427 |
|---|---|
| Provider Enumeration Date | 06/28/2006 |
| Last Update Date | 02/25/2019 |
| Medicare PECOS PAC ID | 4082516042 |
|---|---|
| Medicare Enrollment ID | O20040121001102 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255369427 | NPI | - | NPPES |
| Provider Name | Rodney L Miller |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1750382396 PECOS PAC ID: 2860393428 Enrollment ID: I20040116000250 |
| Provider Name | Jason L Dorris |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1558391367 PECOS PAC ID: 9830188408 Enrollment ID: I20040510000148 |
| Provider Name | Ronald J Johnson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679571897 PECOS PAC ID: 5496736027 Enrollment ID: I20040528000206 |
| Provider Name | Richard Rethorst |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770530024 PECOS PAC ID: 4789670852 Enrollment ID: I20040818001267 |
| Provider Name | John D Hartman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851399976 PECOS PAC ID: 6204803034 Enrollment ID: I20050129000005 |
| Provider Name | Gemilo V Resaba |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760427199 PECOS PAC ID: 1153361100 Enrollment ID: I20050509000971 |
| Provider Name | Cesar E Coello |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1003997560 PECOS PAC ID: 5698716488 Enrollment ID: I20050523000328 |
| Provider Name | Patrick L Riley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730133505 PECOS PAC ID: 8325059413 Enrollment ID: I20060607000018 |
| Provider Name | Frederick J Pfalzgraf |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1659385581 PECOS PAC ID: 9032116868 Enrollment ID: I20061108000526 |
| Provider Name | Raed Al-dallow |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1164572095 PECOS PAC ID: 4688675903 Enrollment ID: I20070129000474 |
| Provider Name | Mark Kiplagat Rotich |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659393601 PECOS PAC ID: 3971694100 Enrollment ID: I20070802000294 |
| Provider Name | Ferdinand F Salvacion |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1710958640 PECOS PAC ID: 3870640063 Enrollment ID: I20090403000293 |
| Provider Name | Melinda B Moore |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1508003849 PECOS PAC ID: 2668528902 Enrollment ID: I20090928000737 |
| Provider Name | Heather D Rice |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1700976131 PECOS PAC ID: 6709889017 Enrollment ID: I20110105000135 |
| Provider Name | Aziz U Rahman |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1275540015 PECOS PAC ID: 2365602190 Enrollment ID: I20120402000042 |
| Provider Name | Jeanne E Holdren |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497860811 PECOS PAC ID: 7315161593 Enrollment ID: I20140609001296 |
| Provider Name | Othniel S Doolittle |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386965499 PECOS PAC ID: 1456576552 Enrollment ID: I20140703001136 |
| Provider Name | Kayla L Kimmel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063810463 PECOS PAC ID: 5193045326 Enrollment ID: I20150528002750 |
| Provider Name | Anand K Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326302910 PECOS PAC ID: 6103130810 Enrollment ID: I20150807014480 |
| Provider Name | Katlyn E Carrier |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1215483193 PECOS PAC ID: 1456631746 Enrollment ID: I20161202000036 |
| Provider Name | Jayna L Cowsert |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1871043414 PECOS PAC ID: 3375825490 Enrollment ID: I20170126000325 |
| Provider Name | Darla J Allan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215184635 PECOS PAC ID: 7911068747 Enrollment ID: I20180524001286 |
| Provider Name | Vadzim Chyzhyk |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1093128720 PECOS PAC ID: 6002129962 Enrollment ID: I20180628000422 |
| Provider Name | Chelsea N Webb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457833592 PECOS PAC ID: 4789936527 Enrollment ID: I20181005002487 |
| Provider Name | Heather Rae Ward |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558839084 PECOS PAC ID: 3274878582 Enrollment ID: I20181214002081 |
| Provider Name | Leslie Ann Hickman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184196883 PECOS PAC ID: 1557601580 Enrollment ID: I20190328002317 |
| Provider Name | Allison Frost |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528622644 PECOS PAC ID: 9032449178 Enrollment ID: I20191002003049 |
| Provider Name | Dawn Marie Stowers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306490438 PECOS PAC ID: 0446581656 Enrollment ID: I20191018000751 |
| Provider Name | Brooke a Hudson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912549965 PECOS PAC ID: 8820421928 Enrollment ID: I20191203002845 |
| Provider Name | Bridget J Ray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588283360 PECOS PAC ID: 8224469069 Enrollment ID: I20200512002336 |
| Provider Name | Mary E Connell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396194403 PECOS PAC ID: 7517259112 Enrollment ID: I20210211001451 |
| Provider Name | Brandon Edwards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245840636 PECOS PAC ID: 8022427921 Enrollment ID: I20210505001722 |
| Provider Name | Joseph Gregory Huber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477148443 PECOS PAC ID: 0648670968 Enrollment ID: I20210608002349 |
| Provider Name | Arslan Mirza |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1073928776 PECOS PAC ID: 7113216169 Enrollment ID: I20210609001244 |
| Provider Name | Danielle Butler |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1730482951 PECOS PAC ID: 4486042223 Enrollment ID: I20211027000859 |
| Provider Name | Garrett William Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821766973 PECOS PAC ID: 9537552609 Enrollment ID: I20220214000766 |
| Provider Name | Rizwan Ahmad Khan |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1902288855 PECOS PAC ID: 6800149949 Enrollment ID: I20220726002626 |
| Provider Name | Joshua C Loyd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598445405 PECOS PAC ID: 5597129049 Enrollment ID: I20230915003113 |
| Provider Name | Jennifer Little |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134679509 PECOS PAC ID: 5799054391 Enrollment ID: I20240304002460 |
| Provider Name | Bryan G Anderson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1760820989 PECOS PAC ID: 9739460718 Enrollment ID: I20240624003284 |
| Provider Name | Ashlyn Peebles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669201091 PECOS PAC ID: 0749721850 Enrollment ID: I20240917001049 |
| Provider Name | Madison Brooke Worthington |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1265278865 PECOS PAC ID: 8022543685 Enrollment ID: I20241120001075 |
| Provider Name | Jennifer N Isom |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1922281054 PECOS PAC ID: 6204343569 Enrollment ID: I20250730002368 |
Family Healthcare Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 201 Bailey Lane, Benton, IL 62812 Phone: 618-439-3161 Fax: 618-439-4049 |
Crossroads Family Medicine of Benton #2 Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 203 Bailey Ln, Benton, IL 62812 Phone: 618-438-3621 Fax: 618-438-3622 |
Franklin Rural Health Clinic I Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 205 Bailey Ln, Benton, IL 62812 Phone: 618-439-3706 Fax: 618-435-2023 |
Rea Clinic Benton Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 206 E Church St Ste B, Benton, IL 62812 Phone: 618-435-9888 Fax: 618-435-9889 |
Benton Mental Health Wellness Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 107 E Smith St Ste B, Benton, IL 62812 Phone: 618-435-9315 Fax: 618-435-9316 |
Deaconess Illinois Clinic Gi and Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 205 Bailey Ln Ste F, Benton, IL 62812 Phone: 618-918-0645 Fax: 618-918-6046 |