| Macoupin County Public Health Department | |
|
109 E Maple St Gillespie IL 62033-1473 | |
| (217) 839-1526 | |
| (217) 839-1538 |
| Full Name | Macoupin County Public Health Department |
|---|---|
| Speciality | Clinic/Center |
| Location | 109 E Maple St, Gillespie, Illinois |
| Authorized Official Name and Position | Christy Blank (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 2179302283 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Macoupin County Public Health Department 205 Oakland Ave Carlinville IL 62626-1921 Ph: (217) 839-7820 | Macoupin County Public Health Department 109 E Maple St Gillespie IL 62033-1473 Ph: (217) 839-1526 |
| NPI Number | 1538444906 |
|---|---|
| Provider Enumeration Date | 10/18/2011 |
| Last Update Date | 06/27/2023 |
| Medicare PECOS PAC ID | 1557377850 |
|---|---|
| Medicare Enrollment ID | O20060223000446 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538444906 | NPI | - | NPPES |
| 141154 | Other | IL | NGS MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 007 (Illinois) | Primary |
| Provider Name | August Adams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992803985 PECOS PAC ID: 6406832450 Enrollment ID: I20040629000746 |
| Provider Name | Martin Repetto |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881634228 PECOS PAC ID: 9537136569 Enrollment ID: I20071026000741 |
| Provider Name | Julia Terese Ruckman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356599971 PECOS PAC ID: 3779644786 Enrollment ID: I20081209000829 |
| Provider Name | Rosemary L Staten |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376809525 PECOS PAC ID: 1951564210 Enrollment ID: I20120523000703 |
| Provider Name | Kristin Buller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982982534 PECOS PAC ID: 6204092448 Enrollment ID: I20120716000557 |
| Provider Name | Samantha Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447789169 PECOS PAC ID: 9638442049 Enrollment ID: I20171106001293 |
| Provider Name | Sandra L Cania |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316441868 PECOS PAC ID: 2264795368 Enrollment ID: I20180423002255 |
| Provider Name | Amanda Marie Vogel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790249449 PECOS PAC ID: 1355682741 Enrollment ID: I20190412000182 |
| Provider Name | Kathy J Shafer |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1750499729 PECOS PAC ID: 3971898461 Enrollment ID: I20201007002362 |
| Provider Name | Colleen E Cash |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1528677119 PECOS PAC ID: 6406266113 Enrollment ID: I20210409002107 |
| Provider Name | Katherine Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194282343 PECOS PAC ID: 1052711298 Enrollment ID: I20210610000142 |
| Provider Name | Lakshmi Sajja |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1669062402 PECOS PAC ID: 6305249822 Enrollment ID: I20210721002856 |
| Provider Name | Parth Desai |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1952916355 PECOS PAC ID: 6204233067 Enrollment ID: I20210921001610 |
| Provider Name | Steven Boente |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1700967031 PECOS PAC ID: 4880905496 Enrollment ID: I20220201001742 |
| Provider Name | Ashley D Greenwalt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306590088 PECOS PAC ID: 0143615898 Enrollment ID: I20220316003325 |
| Provider Name | Zuzana Jackevicius Killam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306584917 PECOS PAC ID: 2264811645 Enrollment ID: I20220614003052 |
| Provider Name | Michael Robert Wattles |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1093956534 PECOS PAC ID: 8820453319 Enrollment ID: I20230505002343 |
| Provider Name | Carissa Van Den Berk-clark |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609625136 PECOS PAC ID: 5496290165 Enrollment ID: I20240717003770 |
| Provider Name | Ashley Renee Brown |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1114601051 PECOS PAC ID: 7214477389 Enrollment ID: I20240904003902 |
| Provider Name | Ronald K Howard |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1871110734 PECOS PAC ID: 5496288706 Enrollment ID: I20241024004277 |
Macoupin County Public Health Department Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 118 W Chestnut St, Gillespie, IL 62033 Phone: 217-839-4200 Fax: 217-839-7207 | |
Macoupin Family Practice Center, Llp Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 715 Broadway St, Gillespie, IL 62033 Phone: 217-839-4491 Fax: 217-839-2689 | |
Integrative Medical Solutions Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 124 N Macoupin St, Gillespie, IL 62033 Phone: 217-839-3040 | |
Carlinville Area Hospital Association Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 807 Broadway St, Gillespie, IL 62033 Phone: 217-854-3900 Fax: 217-839-1313 | |
Neuropathy Center Of Gillespie Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 124 N Macoupin St, Gillespie, IL 62033 Phone: 217-839-3040 | |
Staten Family Practice Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 500 W Virginia Ave, Gillespie, IL 62033 Phone: 217-851-5270 | |
Macoupin County Public Health Department Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 109 E Maple St, Gillespie, IL 62033 Phone: 217-839-4110 Fax: 217-839-4105 |