| Heartland Healthcare | |
|
2044 Madison Ave Suite 15 Granite City IL 62040-4641 | |
| (618) 798-8652 | |
| (618) 798-8116 |
| Full Name | Heartland Healthcare |
|---|---|
| Speciality | Internal Medicine |
| Location | 2044 Madison Ave, Granite City, Illinois |
| Authorized Official Name and Position | Laura J Fey (SR. DIRECTOR PHYSICIAN REV CYCLE) |
| Authorized Official Contact | 6152213641 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Heartland Healthcare 1573 Mallory Ln Ste 100 Brentwood TN 37027-2895 Ph: (152) 221-1400 | Heartland Healthcare 2044 Madison Ave Suite 15 Granite City IL 62040-4641 Ph: (618) 798-8652 |
| NPI Number | 1073567483 |
|---|---|
| Provider Enumeration Date | 05/20/2006 |
| Last Update Date | 07/07/2023 |
| Medicare PECOS PAC ID | 3274594643 |
|---|---|
| Medicare Enrollment ID | O20041020000505 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073567483 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Jeffrey Arendell |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1386668218 PECOS PAC ID: 4082503867 Enrollment ID: I20040311000187 |
| Provider Name | Diane M Schwind |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104854470 PECOS PAC ID: 3971598327 Enrollment ID: I20040416000175 |
| Provider Name | Benedict Painter |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1154314839 PECOS PAC ID: 6305831769 Enrollment ID: I20040419001147 |
| Provider Name | Lawrence T Harmon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275526956 PECOS PAC ID: 8224023684 Enrollment ID: I20040419001235 |
| Provider Name | Rajinder Kumar Mahay |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669490421 PECOS PAC ID: 8820050487 Enrollment ID: I20061020000148 |
| Provider Name | Murtuza H Bahrainwala |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871590679 PECOS PAC ID: 8628032695 Enrollment ID: I20070613000043 |
| Provider Name | Elizabeth P Mincy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922233576 PECOS PAC ID: 4981729480 Enrollment ID: I20100920001135 |
| Provider Name | Carol Candler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770942716 PECOS PAC ID: 0446557136 Enrollment ID: I20160323001819 |
| Provider Name | Melanie L Banal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770986010 PECOS PAC ID: 2567684012 Enrollment ID: I20160506001023 |
| Provider Name | Laurie Hopper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255853081 PECOS PAC ID: 8123394590 Enrollment ID: I20171030003433 |
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