| Heartland Rural Healthcare, Llc | |
|
3331 W Deyoung St Marion IL 62959-5896 | |
| (618) 998-7000 | |
| Not Available |
| Full Name | Heartland Rural Healthcare, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 3331 W Deyoung St, Marion, Illinois |
| Authorized Official Name and Position | Laura J Fey (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 6152213641 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Heartland Rural Healthcare, Llc 1573 Mallory Ln Ste 200 Brentwood TN 37027-2895 Ph: (615) 221-1400 | Heartland Rural Healthcare, Llc 3331 W Deyoung St Marion IL 62959-5896 Ph: (618) 998-7000 |
| NPI Number | 1275166134 |
|---|---|
| Provider Enumeration Date | 02/19/2020 |
| Last Update Date | 02/19/2020 |
| Medicare PECOS PAC ID | 3072513043 |
|---|---|
| Medicare Enrollment ID | O20061226000075 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275166134 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Dennis M Hurford |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1497708259 PECOS PAC ID: 5294633376 Enrollment ID: I20031229000145 |
| Provider Name | Rodney L Miller |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1750382396 PECOS PAC ID: 2860393428 Enrollment ID: I20040116000250 |
| Provider Name | Akhtar Khursheed Siddiqui |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1124097951 PECOS PAC ID: 4183519150 Enrollment ID: I20040218000757 |
| Provider Name | Jeffrey Arendell |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1386668218 PECOS PAC ID: 4082503867 Enrollment ID: I20040311000187 |
| 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 | Wendell Walton Becton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649237504 PECOS PAC ID: 2567451552 Enrollment ID: I20040506000705 |
| Provider Name | Cesar Munoz |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1710979208 PECOS PAC ID: 8325023195 Enrollment ID: I20040624000245 |
| Provider Name | Gustavo Vonderlancken |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1881683282 PECOS PAC ID: 8123004603 Enrollment ID: I20040625000460 |
| Provider Name | Sujatha A Rao |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1356420368 PECOS PAC ID: 7214900513 Enrollment ID: I20041004000602 |
| Provider Name | Gary M Reagan |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1417909060 PECOS PAC ID: 9133188121 Enrollment ID: I20041006000192 |
| Provider Name | Scott A Wong |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1275604498 PECOS PAC ID: 5991767055 Enrollment ID: I20041101000430 |
| Provider Name | Paul Jerome Scherer |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1881679181 PECOS PAC ID: 7315914439 Enrollment ID: I20041104001175 |
| Provider Name | Peter J Anderson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1548245848 PECOS PAC ID: 8123095247 Enrollment ID: I20041108000385 |
| Provider Name | Craig A Beyer |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1437134731 PECOS PAC ID: 3678540796 Enrollment ID: I20041108000512 |
| Provider Name | Michael K Delaney |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1851394522 PECOS PAC ID: 8224082763 Enrollment ID: I20050308001048 |
| Provider Name | Elizabeth H Eversmann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528051182 PECOS PAC ID: 1759335813 Enrollment ID: I20050310000960 |
| Provider Name | Kevin B Claffey |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1144226085 PECOS PAC ID: 0446203681 Enrollment ID: I20050421000578 |
| Provider Name | Christopher Leonard Vulin |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1801870126 PECOS PAC ID: 2668411356 Enrollment ID: I20050502001229 |
| Provider Name | Suzanne Mary Burge |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467456798 PECOS PAC ID: 7416991096 Enrollment ID: I20050615000197 |
| Provider Name | Runda A El Khatib |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245281831 PECOS PAC ID: 4284661562 Enrollment ID: I20050719000262 |
| Provider Name | Amy L Rohlfing |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1255335188 PECOS PAC ID: 3779511258 Enrollment ID: I20050727000618 |
| Provider Name | Raza S Hamdani |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1144207218 PECOS PAC ID: 7416920731 Enrollment ID: I20050818000499 |
| Provider Name | Robert Lawrence Hatchett |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1336210624 PECOS PAC ID: 3678479508 Enrollment ID: I20051227000080 |
| Provider Name | Ronald Wheeler |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1053328831 PECOS PAC ID: 3375567860 Enrollment ID: I20060124000252 |
| Provider Name | Frank M Eaton |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1962419614 PECOS PAC ID: 4082609854 Enrollment ID: I20060406000465 |
| Provider Name | Jacques Papazian |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1366491193 PECOS PAC ID: 5496768574 Enrollment ID: I20060801000147 |
| Provider Name | Alan S Harad |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1679579510 PECOS PAC ID: 7416951074 Enrollment ID: I20060913000230 |
| Provider Name | Rajinder Kumar Mahay |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669490421 PECOS PAC ID: 8820050487 Enrollment ID: I20061020000148 |
| Provider Name | Jeffery S Deacon |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1104919075 PECOS PAC ID: 3274504832 Enrollment ID: I20061221000132 |
| Provider Name | David J Lane |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1164472155 PECOS PAC ID: 7618978479 Enrollment ID: I20070122000148 |
| Provider Name | Anthony C Vacca |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497797401 PECOS PAC ID: 3173628864 Enrollment ID: I20070425000560 |
| Provider Name | Terri L Braddock-hartman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477637551 PECOS PAC ID: 5092811091 Enrollment ID: I20070508000700 |
| Provider Name | Murtuza H Bahrainwala |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871590679 PECOS PAC ID: 8628032695 Enrollment ID: I20070613000043 |
| Provider Name | John E Lindsay |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1245444819 PECOS PAC ID: 8921108895 Enrollment ID: I20070706000040 |
| Provider Name | William R Reilly |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1205846516 PECOS PAC ID: 2567418171 Enrollment ID: I20070921000819 |
| Provider Name | Travis L Bullock |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1699810507 PECOS PAC ID: 8325144272 Enrollment ID: I20080115000058 |
| Provider Name | Eric S Graham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720120462 PECOS PAC ID: 2365502838 Enrollment ID: I20081114000138 |
| Provider Name | Andrew Robert Johnson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1164418943 PECOS PAC ID: 0749370195 Enrollment ID: I20081208000491 |
| Provider Name | Jeffrey B Mcintosh |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1790754075 PECOS PAC ID: 9830277037 Enrollment ID: I20090114000531 |
| Provider Name | Bonnie Carol Clark Kutscher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962507087 PECOS PAC ID: 1759447048 Enrollment ID: I20090312000118 |
| Provider Name | Jack D Keller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467636605 PECOS PAC ID: 1951457803 Enrollment ID: I20090918000247 |
| Provider Name | Tracy M Hasler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336230499 PECOS PAC ID: 8921160003 Enrollment ID: I20091210000266 |
| Provider Name | Sharma Saith |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1225013683 PECOS PAC ID: 9335051077 Enrollment ID: I20100127000252 |
| Provider Name | Jeffrey A Parres |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1619951027 PECOS PAC ID: 3678460169 Enrollment ID: I20100629000801 |
| Provider Name | Demetrios A Katsikas |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1457335762 PECOS PAC ID: 1153229612 Enrollment ID: I20100629000829 |
| Provider Name | Richard L Morgan |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1972607604 PECOS PAC ID: 8123003860 Enrollment ID: I20100722000755 |
| Provider Name | Elizabeth P Mincy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922233576 PECOS PAC ID: 4981729480 Enrollment ID: I20100920001135 |
| Provider Name | Melissa L Kalaher |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629161765 PECOS PAC ID: 2567588056 Enrollment ID: I20100921001259 |
| Provider Name | Elizabeth R Williams |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1790802429 PECOS PAC ID: 8325199888 Enrollment ID: I20101014001466 |
| Provider Name | Brad C White |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1205810512 PECOS PAC ID: 8325935810 Enrollment ID: I20101214000940 |
| Provider Name | Courtney Shands |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1902880362 PECOS PAC ID: 1850288341 Enrollment ID: I20110104000799 |
| Provider Name | Matthew Spellman |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1205810520 PECOS PAC ID: 3274545843 Enrollment ID: I20110105000708 |
| Provider Name | Danielle Bogue |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295062537 PECOS PAC ID: 2466632930 Enrollment ID: I20110216000107 |
| Provider Name | Tamer Aiti |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1801043864 PECOS PAC ID: 8123283074 Enrollment ID: I20120627000735 |
| Provider Name | Victor Mwansa |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1811194244 PECOS PAC ID: 1254587116 Enrollment ID: I20120808000389 |
| Provider Name | Michelle Deane Mc Lain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104102474 PECOS PAC ID: 2668619271 Enrollment ID: I20130517000511 |
| Provider Name | Randy Balmforth |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1366642738 PECOS PAC ID: 0244480739 Enrollment ID: I20130626000577 |
| Provider Name | Richard H. Hsu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679521827 PECOS PAC ID: 9335331974 Enrollment ID: I20130711000472 |
| Provider Name | James Rybak |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1801042700 PECOS PAC ID: 6103068564 Enrollment ID: I20130814000394 |
| Provider Name | Nicole Kennedy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780902486 PECOS PAC ID: 4183893431 Enrollment ID: I20131009000357 |
| Provider Name | Etai Goldenberg |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1669663605 PECOS PAC ID: 6901055854 Enrollment ID: I20131108000881 |
| Provider Name | Billie L Vincent |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639508039 PECOS PAC ID: 7911134812 Enrollment ID: I20131223000806 |
| Provider Name | Angela K Schloer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992971535 PECOS PAC ID: 9335379445 Enrollment ID: I20140310001911 |
| Provider Name | Khawaja Rahman |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1508865239 PECOS PAC ID: 7214980218 Enrollment ID: I20140602002095 |
| Provider Name | Delora Brooks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659622330 PECOS PAC ID: 9537311808 Enrollment ID: I20141103001224 |
| Provider Name | Vivek K Manchanda |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1083729941 PECOS PAC ID: 6002998069 Enrollment ID: I20150108002163 |
| Provider Name | Abagail M Summers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902297435 PECOS PAC ID: 3375869241 Enrollment ID: I20150312000378 |
| Provider Name | Khalid Naseer |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1851341366 PECOS PAC ID: 9335177047 Enrollment ID: I20150630001727 |
| Provider Name | Rita Mukerji |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1023218807 PECOS PAC ID: 6305961673 Enrollment ID: I20150831002407 |
| Provider Name | Erin Alcazar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457698607 PECOS PAC ID: 8921243940 Enrollment ID: I20160205002483 |
| Provider Name | Amit Wasudeo Bhandarkar |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1962711937 PECOS PAC ID: 3678753720 Enrollment ID: I20160412001675 |
| Provider Name | Robin Dailey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265893051 PECOS PAC ID: 5890084321 Enrollment ID: I20160523001042 |
| Provider Name | Michelle A Cunningham |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1437597846 PECOS PAC ID: 0941506257 Enrollment ID: I20160705002189 |
| Provider Name | Gregory Dalencourt |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1013185842 PECOS PAC ID: 5698853919 Enrollment ID: I20160831002792 |
| Provider Name | Gautam Datta |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568688414 PECOS PAC ID: 6406957851 Enrollment ID: I20160901000093 |
| Provider Name | Uwais B Zaid |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1366777856 PECOS PAC ID: 8426280546 Enrollment ID: I20161007000746 |
| Provider Name | Charmaine E Edwards |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1972586253 PECOS PAC ID: 1557451234 Enrollment ID: I20161110001707 |
| Provider Name | Amy Dodd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952754798 PECOS PAC ID: 6901180645 Enrollment ID: I20170224001895 |
| Provider Name | Robert Bell |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1851371082 PECOS PAC ID: 8820124803 Enrollment ID: I20170405001369 |
| Provider Name | Brittney Voyda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053846816 PECOS PAC ID: 1658648506 Enrollment ID: I20170524000713 |
| Provider Name | Matthew Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093055402 PECOS PAC ID: 3870732126 Enrollment ID: I20170606001632 |
| Provider Name | Emily M Cottrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295262459 PECOS PAC ID: 5193093946 Enrollment ID: I20170620000286 |
| Provider Name | Ziya Baghmanli |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1699068767 PECOS PAC ID: 4688978240 Enrollment ID: I20170627001916 |
| Provider Name | Sergio Casillas Berumen |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1437470762 PECOS PAC ID: 9234389115 Enrollment ID: I20171004003560 |
| Provider Name | Laurie Hopper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255853081 PECOS PAC ID: 8123394590 Enrollment ID: I20171030003433 |
| Provider Name | Amy M Quertermous |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265943591 PECOS PAC ID: 3779840848 Enrollment ID: I20171127003339 |
| Provider Name | Yazan Abu Qwaider |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1356377816 PECOS PAC ID: 4587699707 Enrollment ID: I20171205001361 |
| Provider Name | Rhonda Raye Heatherly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073048120 PECOS PAC ID: 3274892344 Enrollment ID: I20180117002389 |
| Provider Name | Jacob Colman Blakeman |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1760749261 PECOS PAC ID: 1052613122 Enrollment ID: I20180220000537 |
| Provider Name | Peter J Mulhern |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1417932005 PECOS PAC ID: 6800843640 Enrollment ID: I20180313000836 |
| Provider Name | Megan Wood |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407052996 PECOS PAC ID: 0244495521 Enrollment ID: I20180420002056 |
| Provider Name | Gregory B Auffenberg |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1396977328 PECOS PAC ID: 0941513402 Enrollment ID: I20180717000433 |
| Provider Name | Naomasa Hase |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1841610961 PECOS PAC ID: 5496053464 Enrollment ID: I20180802003821 |
| Provider Name | Jacob Ark |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1891053716 PECOS PAC ID: 3870896715 Enrollment ID: I20180806001223 |
| Provider Name | Nicholas Kyle Shockley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649766288 PECOS PAC ID: 8123370509 Enrollment ID: I20181012000980 |
| Provider Name | Seth Strope |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1427109248 PECOS PAC ID: 9638271794 Enrollment ID: I20181120002351 |
| Provider Name | Dietra Leigh Angelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902371313 PECOS PAC ID: 9931356276 Enrollment ID: I20190130001729 |
| Provider Name | Melissa K Odle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225308406 PECOS PAC ID: 1850630617 Enrollment ID: I20190222001403 |
| Provider Name | Margret De Guzman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1477852028 PECOS PAC ID: 6103047543 Enrollment ID: I20190510000846 |
| Provider Name | Ashley M Berneking |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437615044 PECOS PAC ID: 3779824362 Enrollment ID: I20190515002269 |
| Provider Name | Rachel M Bailey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427511757 PECOS PAC ID: 7911230909 Enrollment ID: I20190606000127 |
| Provider Name | Louis A Aliperti |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1861810350 PECOS PAC ID: 5193022614 Enrollment ID: I20190730003012 |
| Provider Name | William A Critchlow |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1700296621 PECOS PAC ID: 5698994119 Enrollment ID: I20190802000297 |
| Provider Name | Kristen James |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1770977100 PECOS PAC ID: 6406183664 Enrollment ID: I20190809002203 |
| Provider Name | Amar Nath Mukerji |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1750624045 PECOS PAC ID: 7214264175 Enrollment ID: I20190815000119 |
| Provider Name | Barry N Rosenblum |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1750318341 PECOS PAC ID: 8729987789 Enrollment ID: I20190905003215 |
| Provider Name | Wendy Devonne Frazier |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629332127 PECOS PAC ID: 6709118615 Enrollment ID: I20191025002173 |
| Provider Name | Tracy Adele Caswell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407407885 PECOS PAC ID: 4880027010 Enrollment ID: I20191202002738 |
| Provider Name | Lauren K Sidwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720629470 PECOS PAC ID: 7416380407 Enrollment ID: I20191205000698 |
| Provider Name | Angie Catlin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679051486 PECOS PAC ID: 2860737764 Enrollment ID: I20191230000327 |
| Provider Name | Danielle Schnoeker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144871120 PECOS PAC ID: 2264867340 Enrollment ID: I20200117001564 |
| Provider Name | Michelle Schofield |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104874056 PECOS PAC ID: 2062437106 Enrollment ID: I20200313001246 |
| Provider Name | Philip L Mar |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1982999462 PECOS PAC ID: 6507141306 Enrollment ID: I20200318000149 |
| Provider Name | Kenan Sahbaz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285143545 PECOS PAC ID: 4486910114 Enrollment ID: I20200421000145 |
| Provider Name | Neill M Wright |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1770500209 PECOS PAC ID: 8224186432 Enrollment ID: I20200514000715 |
| Provider Name | Asim Qureshi |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1235665811 PECOS PAC ID: 5698197028 Enrollment ID: I20200612000391 |
| Provider Name | Anthony J Courey |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1023138443 PECOS PAC ID: 9931174869 Enrollment ID: I20200619000934 |
| Provider Name | Jeramie L Rosales Rodriguez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205290319 PECOS PAC ID: 0547515124 Enrollment ID: I20200709001348 |
| Provider Name | Megan Nicole Plummer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487271557 PECOS PAC ID: 8729406319 Enrollment ID: I20200914002372 |
| Provider Name | Lisa Lawrence |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720606973 PECOS PAC ID: 6103244520 Enrollment ID: I20200917001311 |
| Provider Name | Lindsay D Gwaltney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194369884 PECOS PAC ID: 4486073889 Enrollment ID: I20201005001918 |
| Provider Name | Carla R. Rogers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417555897 PECOS PAC ID: 3173934692 Enrollment ID: I20201204000154 |
| Provider Name | Joseph Parkhurst |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1205879772 PECOS PAC ID: 5890779292 Enrollment ID: I20210125000557 |
| Provider Name | Lawrence Teruel |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1467405050 PECOS PAC ID: 0749292613 Enrollment ID: I20210213000089 |
| Provider Name | James P Lovinggood |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1558328633 PECOS PAC ID: 5698761138 Enrollment ID: I20210331000830 |
| Provider Name | Steven W Bigg |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1932166162 PECOS PAC ID: 5092766626 Enrollment ID: I20210408001450 |
| Provider Name | Joshua L Gibson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427646496 PECOS PAC ID: 6406265198 Enrollment ID: I20210510002396 |
| Provider Name | Rachel Dulaney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225514722 PECOS PAC ID: 7810306321 Enrollment ID: I20210513002584 |
| Provider Name | Francis Le |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1134236508 PECOS PAC ID: 3476596925 Enrollment ID: I20210517001509 |
| Provider Name | Nelson Yu |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1447297601 PECOS PAC ID: 3779554233 Enrollment ID: I20210518002361 |
| Provider Name | Samantha D Richardson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063039378 PECOS PAC ID: 4587063540 Enrollment ID: I20210524001546 |
| Provider Name | Crystle Kay Laugavitz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386220259 PECOS PAC ID: 5294134672 Enrollment ID: I20210604002678 |
| Provider Name | Charles B Sebunyenzi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427603307 PECOS PAC ID: 8426388612 Enrollment ID: I20210609001134 |
| Provider Name | Natasha D Bancroft |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679153456 PECOS PAC ID: 0143622191 Enrollment ID: I20210713002351 |
| Provider Name | Amber S Bruce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932705050 PECOS PAC ID: 5092118083 Enrollment ID: I20210728003076 |
| Provider Name | Stephen J Johans |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1013273580 PECOS PAC ID: 7012219454 Enrollment ID: I20210820002725 |
| Provider Name | Sarah J Fouke |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1154433712 PECOS PAC ID: 3476551409 Enrollment ID: I20210825001012 |
| Provider Name | Ahmad Abdin |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1487060364 PECOS PAC ID: 6608199070 Enrollment ID: I20210825002978 |
| Provider Name | Karen Sein Ohn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518119536 PECOS PAC ID: 6901864370 Enrollment ID: I20210830002019 |
| Provider Name | Lindsey Sollers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124797535 PECOS PAC ID: 9032516646 Enrollment ID: I20210924000642 |
| Provider Name | Brendan M Fong |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1245670504 PECOS PAC ID: 2860621885 Enrollment ID: I20211005003090 |
| Provider Name | Devin Haub |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952835910 PECOS PAC ID: 7012276967 Enrollment ID: I20211008000682 |
| Provider Name | Sandra Blazek |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942721295 PECOS PAC ID: 8527390392 Enrollment ID: I20211013002312 |
| Provider Name | Mandy E Bettenhausen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295254266 PECOS PAC ID: 5294123212 Enrollment ID: I20211119001208 |
| Provider Name | Michael N Polinsky |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1134183205 PECOS PAC ID: 7810927324 Enrollment ID: I20220209001629 |
| Provider Name | Christina Kay Frymire |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922750785 PECOS PAC ID: 1153716188 Enrollment ID: I20220309002797 |
| Provider Name | Andrew S Youkilis |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1740244813 PECOS PAC ID: 4284664780 Enrollment ID: I20220318000926 |
| Provider Name | Sarah Saller Travers |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1699193748 PECOS PAC ID: 6406258391 Enrollment ID: I20220524000946 |
| Provider Name | Angela Burns |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992339279 PECOS PAC ID: 3971913997 Enrollment ID: I20220609002807 |
| Provider Name | Majdee M Islam |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1447645304 PECOS PAC ID: 5799098562 Enrollment ID: I20220614002293 |
| Provider Name | Kalinda Jo Dunning |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851961635 PECOS PAC ID: 9133502974 Enrollment ID: I20220811002408 |
| Provider Name | Kelly Schelich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427539030 PECOS PAC ID: 3779835368 Enrollment ID: I20220830002702 |
| Provider Name | Jordan M Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700513637 PECOS PAC ID: 8820472111 Enrollment ID: I20220906002211 |
| Provider Name | Heather Diane Alexander |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992439293 PECOS PAC ID: 0840674966 Enrollment ID: I20220908001376 |
| Provider Name | Jennifer L Felchlia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114659703 PECOS PAC ID: 1850776956 Enrollment ID: I20220909001166 |
| Provider Name | David Shiyu Zhu |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1821440751 PECOS PAC ID: 9436441458 Enrollment ID: I20220921003340 |
| Provider Name | Belinda Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275285652 PECOS PAC ID: 7911387725 Enrollment ID: I20221026002848 |
| Provider Name | Kaitlyn Drost |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376267666 PECOS PAC ID: 1759759756 Enrollment ID: I20221123000465 |
Michael P Lawler Md S Corp Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1129 N Carbon St Ste 3, Marion, IL 62959 Phone: 618-967-7660 | |
Dr. James T. Lawler M.d. S.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1129 N Carbon St, Marion, IL 62959 Phone: 618-518-7700 | |
Deaconess Illinois Clinic, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3411 Professional Park Dr, Marion, IL 62959 Phone: 618-969-8630 Fax: 618-969-8639 | |
Southern Spine & Rehab, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1616 W Main St Ste 200, Marion, IL 62959 Phone: 618-772-2999 | |
Marion Rural Health Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1028 N Market St, Marion, IL 62959 Phone: 618-993-8913 Fax: 618-997-2867 | |
Simca Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3331 W Deyoung St, Suite 305, Marion, IL 62959 Phone: 618-998-7000 | |
Deaconess Il Specialty Express 2700 Deyoung Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2700 W Deyoung St Ste F, Marion, IL 62959 Phone: 618-969-8633 Fax: 618-969-8639 |