| Touchette Regional Hospital Inc | |
|
5900 Bond Ave Cahokia Heights IL 62207-2326 | |
| (618) 332-5212 | |
| Not Available |
| Full Name | Touchette Regional Hospital Inc |
|---|---|
| Speciality | Emergency Medicine |
| Location | 5900 Bond Ave, Cahokia Heights, Illinois |
| Authorized Official Name and Position | Brad Goacher (PRESIDENT) |
| Authorized Official Contact | 6183323060 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Touchette Regional Hospital Inc 5900 Bond Ave Cahokia Heights IL 62207-2326 Ph: (618) 332-3060 | Touchette Regional Hospital Inc 5900 Bond Ave Cahokia Heights IL 62207-2326 Ph: (618) 332-5212 |
| NPI Number | 1922019926 |
|---|---|
| Provider Enumeration Date | 08/11/2006 |
| Last Update Date | 02/05/2025 |
| Medicare PECOS PAC ID | 7416843370 |
|---|---|
| Medicare Enrollment ID | O20040226000538 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922019926 | NPI | - | NPPES |
| 500853304 | Medicaid | IL |
| Provider Name | Jacob C Marshall |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922081249 PECOS PAC ID: 9931096526 Enrollment ID: I20040228000434 |
| Provider Name | Zaki H Chowdhury |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1366456022 PECOS PAC ID: 1456345669 Enrollment ID: I20040412000753 |
| Provider Name | Syed K Hussain |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205813714 PECOS PAC ID: 2466358429 Enrollment ID: I20040419000279 |
| Provider Name | Bassam M Albarcha |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821184193 PECOS PAC ID: 6002802253 Enrollment ID: I20040422001046 |
| Provider Name | Wallace M Anderson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1578510913 PECOS PAC ID: 9638068976 Enrollment ID: I20040429000122 |
| Provider Name | Debabrata Ray |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1699861583 PECOS PAC ID: 5799774691 Enrollment ID: I20040506001576 |
| Provider Name | Robert Nordstrom |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1639112113 PECOS PAC ID: 3870584527 Enrollment ID: I20040520001244 |
| Provider Name | Prashanth C Shekar |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1346295847 PECOS PAC ID: 1052399664 Enrollment ID: I20040710000037 |
| Provider Name | Robert Prophete |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1376547802 PECOS PAC ID: 1456264027 Enrollment ID: I20040916000101 |
| Provider Name | Malaz Safi |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1447446489 PECOS PAC ID: 7618939513 Enrollment ID: I20041103000126 |
| Provider Name | Semone Michelle West |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750475109 PECOS PAC ID: 1759332596 Enrollment ID: I20050209000293 |
| Provider Name | David P Lebeau |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1982707857 PECOS PAC ID: 6406895507 Enrollment ID: I20050428000240 |
| Provider Name | Rachelle Leach |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1922023936 PECOS PAC ID: 7113966912 Enrollment ID: I20050502000311 |
| Provider Name | James W Farn |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1124070156 PECOS PAC ID: 4486694536 Enrollment ID: I20050509000215 |
| Provider Name | Robert W Mecker |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1316074727 PECOS PAC ID: 9638069966 Enrollment ID: I20050513000816 |
| Provider Name | Narsimha R Muddasani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548366263 PECOS PAC ID: 2860465697 Enrollment ID: I20050928000176 |
| Provider Name | Joseph T Basler |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1063525160 PECOS PAC ID: 2163457219 Enrollment ID: I20050928000498 |
| Provider Name | Dean Ross Collette |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1437262540 PECOS PAC ID: 3476588534 Enrollment ID: I20050928000549 |
| Provider Name | Theodore J Gleason |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1295848216 PECOS PAC ID: 8729013891 Enrollment ID: I20050928000679 |
| Provider Name | Anton J Johnson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1215040209 PECOS PAC ID: 6901831908 Enrollment ID: I20050928000961 |
| Provider Name | Scott D Long |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1679686679 PECOS PAC ID: 7012942022 Enrollment ID: I20050928001047 |
| Provider Name | Joel E Tennenhouse |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1528171436 PECOS PAC ID: 6305871344 Enrollment ID: I20050928001289 |
| Provider Name | Gregory A Gregg |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1568575595 PECOS PAC ID: 1850328931 Enrollment ID: I20050929000073 |
| Provider Name | Syed A Abdulaziz |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1114906005 PECOS PAC ID: 9234152588 Enrollment ID: I20060112000494 |
| Provider Name | Hatim A Mahmood |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1174556583 PECOS PAC ID: 9830112101 Enrollment ID: I20060112000619 |
| Provider Name | Sue J Volarich |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1063462885 PECOS PAC ID: 4082604483 Enrollment ID: I20060522000110 |
| Provider Name | Richard J Hehmann |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1215922067 PECOS PAC ID: 9436155942 Enrollment ID: I20061005000526 |
| Provider Name | Omer M Aker |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1205821543 PECOS PAC ID: 0345348264 Enrollment ID: I20070531000051 |
| Provider Name | Faisal Lala |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205965787 PECOS PAC ID: 9739280231 Enrollment ID: I20070727000684 |
| Provider Name | Christopher Loynd |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003965955 PECOS PAC ID: 9436184538 Enrollment ID: I20070816000175 |
| Provider Name | Randy J Jung |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205917176 PECOS PAC ID: 5193805943 Enrollment ID: I20080107000040 |
| Provider Name | Reginald P Wince |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417129693 PECOS PAC ID: 7618056508 Enrollment ID: I20080502000649 |
| Provider Name | Abdulsalam Jamous |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891778221 PECOS PAC ID: 4587607809 Enrollment ID: I20081103000126 |
| Provider Name | Daniel L Stanton |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1770518706 PECOS PAC ID: 4082618798 Enrollment ID: I20090216000407 |
| Provider Name | Daniel J Schwarze |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1740262625 PECOS PAC ID: 4688603947 Enrollment ID: I20090311000495 |
| Provider Name | David L Kee |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1992772289 PECOS PAC ID: 4587737044 Enrollment ID: I20090603000528 |
| Provider Name | Daniel R Keys |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1477756203 PECOS PAC ID: 5597830950 Enrollment ID: I20090618000767 |
| Provider Name | Simon V Bekker |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558400358 PECOS PAC ID: 3173676954 Enrollment ID: I20090727000199 |
| Provider Name | Kelly J Medlin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083859821 PECOS PAC ID: 7214083120 Enrollment ID: I20090917000599 |
| Provider Name | Leslie Ann Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962647149 PECOS PAC ID: 0143368498 Enrollment ID: I20091106000510 |
| Provider Name | Curtis Settlemoir |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1487875910 PECOS PAC ID: 2961533831 Enrollment ID: I20100622000438 |
| Provider Name | Vincent J Zata |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1184820334 PECOS PAC ID: 0547310245 Enrollment ID: I20100728000690 |
| Provider Name | Susan T Rauckman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669642260 PECOS PAC ID: 3274727375 Enrollment ID: I20101103000117 |
| Provider Name | Deepa A Cyriac |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1467785352 PECOS PAC ID: 2466647458 Enrollment ID: I20101116001071 |
| Provider Name | Christopher V Johnson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205975448 PECOS PAC ID: 3870780588 Enrollment ID: I20101207001123 |
| Provider Name | Nadeem Ahmed |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1376546804 PECOS PAC ID: 9032029848 Enrollment ID: I20110210000486 |
| Provider Name | Elizabeth Kraus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831495845 PECOS PAC ID: 2769666833 Enrollment ID: I20110414000160 |
| Provider Name | Susan G Drabing |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326345141 PECOS PAC ID: 3870779200 Enrollment ID: I20110518000757 |
| Provider Name | Kelechi J N Loynd |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720104888 PECOS PAC ID: 9335308246 Enrollment ID: I20120313000619 |
| Provider Name | James A Fernandez |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1528037280 PECOS PAC ID: 0446256838 Enrollment ID: I20120530000356 |
| Provider Name | Naveen C Saini |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1619163433 PECOS PAC ID: 1355528753 Enrollment ID: I20121011000800 |
| Provider Name | Charles Allen Smittkamp |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1942492475 PECOS PAC ID: 9335387182 Enrollment ID: I20130618000840 |
| Provider Name | Clarence R Reilly |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1669453338 PECOS PAC ID: 8022003839 Enrollment ID: I20130624000639 |
| Provider Name | Paul Joseph Pace |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1528222437 PECOS PAC ID: 8022251990 Enrollment ID: I20130823001155 |
| Provider Name | Franklin W Harry |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1881972982 PECOS PAC ID: 9335394782 Enrollment ID: I20141108000241 |
| Provider Name | Rebecca Merchiori |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588068464 PECOS PAC ID: 1254655020 Enrollment ID: I20150127001109 |
| Provider Name | Shawn A Mayer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1346495546 PECOS PAC ID: 8325282767 Enrollment ID: I20150603000559 |
| Provider Name | Minesh Suresh Patel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1811131089 PECOS PAC ID: 8123243623 Enrollment ID: I20150728005286 |
| Provider Name | Saquib Khawar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477701084 PECOS PAC ID: 5698912699 Enrollment ID: I20150819006474 |
| Provider Name | Kara A Huegen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306207139 PECOS PAC ID: 6709183809 Enrollment ID: I20160404001276 |
| Provider Name | Samuel Hutson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1487941092 PECOS PAC ID: 6406145358 Enrollment ID: I20160516001406 |
| Provider Name | Olivia Jo Ludwig |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1326240102 PECOS PAC ID: 2163580705 Enrollment ID: I20170302000632 |
| Provider Name | David Thomas Downs |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1942564869 PECOS PAC ID: 3577860048 Enrollment ID: I20171116002438 |
| Provider Name | Mikasa L Crawford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316486160 PECOS PAC ID: 2365729399 Enrollment ID: I20180123001193 |
| Provider Name | Kavita K Erickson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1932205077 PECOS PAC ID: 3375501323 Enrollment ID: I20180207000512 |
| Provider Name | Jay Wigboldy |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1487636569 PECOS PAC ID: 1850335225 Enrollment ID: I20180403000750 |
| Provider Name | Matthew S Abell |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1568726826 PECOS PAC ID: 4587968235 Enrollment ID: I20180813000699 |
| Provider Name | Douglas K Basso |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1295191112 PECOS PAC ID: 4981956349 Enrollment ID: I20181012000327 |
| Provider Name | Brandy R Whetstone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487132387 PECOS PAC ID: 8224381413 Enrollment ID: I20181106001133 |
| Provider Name | Terence E Wade |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1023290681 PECOS PAC ID: 6406100627 Enrollment ID: I20181107000000 |
| Provider Name | Robyn L Haithcock |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1497751994 PECOS PAC ID: 0547266496 Enrollment ID: I20181211000364 |
| Provider Name | Melvin B Saltzman |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1124025416 PECOS PAC ID: 7719983667 Enrollment ID: I20181211000684 |
| Provider Name | Joseph M Ojile |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003895236 PECOS PAC ID: 1850297383 Enrollment ID: I20190322000063 |
| Provider Name | Charles E Scheer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346333192 PECOS PAC ID: 2163480369 Enrollment ID: I20190619000130 |
| Provider Name | Ronald V Hublall |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1740329242 PECOS PAC ID: 5890776207 Enrollment ID: I20190912000788 |
| Provider Name | Brittany D Varney |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1881001089 PECOS PAC ID: 7517184336 Enrollment ID: I20200612000683 |
| Provider Name | Rosewell Valentino Mackey |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1407246663 PECOS PAC ID: 3476898909 Enrollment ID: I20200716003725 |
| Provider Name | Lamya S Mubayed |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1447686415 PECOS PAC ID: 2860619459 Enrollment ID: I20200928002839 |
| Provider Name | Latisha Stennis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154946788 PECOS PAC ID: 5799199626 Enrollment ID: I20210203003130 |
| Provider Name | Liam James Fischer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1528449634 PECOS PAC ID: 0143533307 Enrollment ID: I20210310001317 |
| Provider Name | Daniel M Ryan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1386059400 PECOS PAC ID: 6901027630 Enrollment ID: I20210512002598 |
| Provider Name | Logan K Chastain |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1578945846 PECOS PAC ID: 3274847504 Enrollment ID: I20210521002376 |
| Provider Name | Joseph Huber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477148443 PECOS PAC ID: 0648670968 Enrollment ID: I20210608002349 |
| Provider Name | Vicky Hwang |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1205332194 PECOS PAC ID: 5698021913 Enrollment ID: I20210614002557 |
| Provider Name | Tina A Winter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922676675 PECOS PAC ID: 0941699896 Enrollment ID: I20211115001037 |
| Provider Name | Jeremy Cole Hollingsead |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376000232 PECOS PAC ID: 5597005017 Enrollment ID: I20220314001515 |
| Provider Name | Anthony H. Zych |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1801450101 PECOS PAC ID: 8628301025 Enrollment ID: I20220513001344 |
| Provider Name | Joshua Dwaine Lentz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134781412 PECOS PAC ID: 6103205679 Enrollment ID: I20220614002485 |
| Provider Name | Jordan Kenneth Marshall |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1396188025 PECOS PAC ID: 1658509260 Enrollment ID: I20220711002792 |
| Provider Name | Michael Vanantwerp |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1790349033 PECOS PAC ID: 7113251109 Enrollment ID: I20220822001663 |
| Provider Name | Kelli Jan May |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528793148 PECOS PAC ID: 9436535572 Enrollment ID: I20220927003666 |
| Provider Name | Ignacio Salas |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1548759442 PECOS PAC ID: 4183962434 Enrollment ID: I20221126000097 |
| Provider Name | Brittany N Chrisman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1104323666 PECOS PAC ID: 9739427402 Enrollment ID: I20221201001940 |
| Provider Name | Amanda Batten |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1609260744 PECOS PAC ID: 1456721075 Enrollment ID: I20221222002405 |
| Provider Name | Nicholas A Burke |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1174144364 PECOS PAC ID: 3476974270 Enrollment ID: I20230918004082 |
| Provider Name | Charmayne Gail Cooley |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1720609803 PECOS PAC ID: 1254753676 Enrollment ID: I20231002001576 |
| Provider Name | Nawal Azhari Elbashir |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1912520172 PECOS PAC ID: 1557783149 Enrollment ID: I20231101003104 |
| Provider Name | Rebecca Roelofs Hartog |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1417375791 PECOS PAC ID: 9436378254 Enrollment ID: I20231220001489 |
| Provider Name | Alissa Anne Helm |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1417578626 PECOS PAC ID: 4587085048 Enrollment ID: I20231222000597 |
| Provider Name | Kristopher Andrew Torossian |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1770163099 PECOS PAC ID: 1153720297 Enrollment ID: I20240626003547 |
| Provider Name | Byron Loy |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1043426752 PECOS PAC ID: 1254758394 Enrollment ID: I20240712001512 |
| Provider Name | Magdalene Tikun Teba |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1295315257 PECOS PAC ID: 4284043688 Enrollment ID: I20240712003129 |
| Provider Name | Alissa Struble |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164105490 PECOS PAC ID: 9032657945 Enrollment ID: I20240809002343 |
| Provider Name | Andrew Glatz |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1053496463 PECOS PAC ID: 4587666730 Enrollment ID: I20240925003157 |
| Provider Name | Anthony Hollins |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1689818155 PECOS PAC ID: 0244479871 Enrollment ID: I20250130003298 |