| Stone Ridge Medical Group Sc | |
|
306 46th Ave East Moline IL 61244-4281 | |
| (309) 796-2329 | |
| (309) 796-1146 |
| Full Name | Stone Ridge Medical Group Sc |
|---|---|
| Speciality | Family Medicine |
| Location | 306 46th Ave, East Moline, Illinois |
| Authorized Official Name and Position | James Petre (PRESIDENT) |
| Authorized Official Contact | 3097962329 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stone Ridge Medical Group Sc 306 46th Ave East Moline IL 61244-4281 Ph: (309) 796-2329 | Stone Ridge Medical Group Sc 306 46th Ave East Moline IL 61244-4281 Ph: (309) 796-2329 |
| NPI Number | 1306097894 |
|---|---|
| Provider Enumeration Date | 10/02/2008 |
| Last Update Date | 10/02/2008 |
| Medicare PECOS PAC ID | 8729142534 |
|---|---|
| Medicare Enrollment ID | O20090122000564 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306097894 | NPI | - | NPPES |
| Provider Name | James E Petre |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619973989 PECOS PAC ID: 2668477290 Enrollment ID: I20061003000456 |
| Provider Name | Sharon J Jones Burtlow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497203376 PECOS PAC ID: 8921386178 Enrollment ID: I20161024001117 |
| Provider Name | Jennifer Hook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033662044 PECOS PAC ID: 8729367008 Enrollment ID: I20161109000047 |
| Provider Name | Michele Renee Moritz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710492582 PECOS PAC ID: 1557621323 Enrollment ID: I20180216001105 |
| Provider Name | Nicholas Ryan Petre |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699269308 PECOS PAC ID: 6709136625 Enrollment ID: I20210726000217 |
| Provider Name | Jennifer Wilkinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710647870 PECOS PAC ID: 1850784976 Enrollment ID: I20220211001379 |
Genesis Health Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 306 46th Ave, East Moline, IL 61244 Phone: 309-792-2329 Fax: 309-792-1146 | |
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Tri-county Alcohol And Drug Services Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 926 15th Ave, East Moline, IL 61244 Phone: 309-752-9740 Fax: 309-752-9744 | |
Community Health Care, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 708 15th Ave, East Moline, IL 61244 Phone: 563-327-2015 Fax: 563-327-2045 | |
Nancy J Short Md Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4360 Kennedy Dr, Suite 1, East Moline, IL 61244 Phone: 309-792-6090 Fax: 309-792-6097 | |
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