| Gcp Illinois, Pllc | |
|
1251 College Ave Alton IL 62002-6735 | |
| (314) 925-0903 | |
| (314) 764-2279 |
| Full Name | Gcp Illinois, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1251 College Ave, Alton, Illinois |
| Authorized Official Name and Position | Mae Lin (OFFICE MANAGER) |
| Authorized Official Contact | 3149250903 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gcp Illinois, Pllc Po Box 14713 Belfast ME 04915-4042 Ph: (314) 925-0903 | Gcp Illinois, Pllc 1251 College Ave Alton IL 62002-6735 Ph: (314) 925-0903 |
| NPI Number | 1366050007 |
|---|---|
| Provider Enumeration Date | 07/20/2020 |
| Last Update Date | 12/16/2020 |
| Medicare PECOS PAC ID | 1557687803 |
|---|---|
| Medicare Enrollment ID | O20200908001358 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366050007 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| Provider Name | Michelle Vandorn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093817355 PECOS PAC ID: 5597731273 Enrollment ID: I20040903000319 |
| Provider Name | Anne Leslie Kramer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326441478 PECOS PAC ID: 0345564787 Enrollment ID: I20150113002191 |
| Provider Name | Katherine A Burnley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013397967 PECOS PAC ID: 0749598829 Enrollment ID: I20151009001910 |
| Provider Name | Walter Lin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952481913 PECOS PAC ID: 9931425295 Enrollment ID: I20201205000160 |
| Provider Name | Mary E Maloney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710592175 PECOS PAC ID: 6608285234 Enrollment ID: I20210511001054 |
Family Physicians Of Alton Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 230 Regional Dr, Alton, IL 62002 Phone: 618-465-7080 Fax: 618-465-7080 | |
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Cep America - Illinois Hospitalists, Llp Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1 Saint Anthonys Way, Alton, IL 62002 Phone: 618-465-2571 | |
Cep America - Illinois Snf, Llp Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3523 Wickenhauser Ave, Alton, IL 62002 Phone: 618-465-8887 | |
E J Aragona Md Ltd Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 108 Northport Dr, Alton, IL 62002 Phone: 618-466-6177 Fax: 618-466-6388 | |
Central Alton Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2615 Edwards St, Alton, IL 62002 Phone: 618-462-4342 Fax: 618-462-5334 | |
Cep America - Illinois Snf, Llp Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3490 Humbert Rd, Alton, IL 62002 Phone: 618-465-2626 |