VIRGILIO M DYCOCO (NPI# 1528137403) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528137403 |
| Entity Type | Individual |
| Full Name | VIRGILIO M DYCOCO |
| Credential | MD |
| Practice Address |
217 S Locust St Pana Medical Group LLC Pana IL 62557-9998 |
| Mailing Address |
217 S Locust St Pana IL 62557-9998 |
| Practice Telephone | 2175622143 |
| Practice Fax Number | 2175622251 |
| Mailing Telephone | 2175622143 |
| Mailing Fax Number | 2175622251 |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BCBS HEALTH PLAN | 1115581 | 01 | |
| 3RD PARTY ADMIN HEALTH LI | 119043 | 01 |
| Street Address |
217 S LOCUST ST PANA MEDICAL GROUP LLC |
| City | PANA |
| State | IL |
| Zip Code | 62557-9998 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013086982 | Pana Community Hospital Association | Family Medicine | 217 S Locust St, Pana, IL 62557-9998 | 2006-11-07 |
| 1760940860 | Pana Community Hospital Association | Clinic/Center | 217 S Locust St, Pana, IL 62557-1689 | 2019-03-07 |
| 1134671233 | Tabitha Litz | Nurse Practitioner | 217 S Locust St, Pana, IL 62557-1605 | 2016-10-25 |
| 1982159182 | Pana Medical Group | Clinic/Center | 217 S Locust St, Pana, IL 62557-1605 | 2016-08-18 |
| 1396059325 | Coleen Karen Rakers | Nurse Practitioner | 217 S Locust St, Pana, IL 62557-1689 | 2010-08-02 |
| 1598837999 | Gloria G Dycoco | Internal Medicine | 217 S Locust St, Pana Medical Group LLC, Pana, IL 62557-9998 | 2006-11-14 |
| 1851460737 | Ernesto Norona Fabi | General Practice | 217 S Locust St, Pana Medical Group LLC, Pana, IL 62557-9998 | 2006-11-07 |
| 1437228319 | Deogracias F Quizon | Family Medicine | 217 S Locust St, Pana Medical Group LLC, Pana, IL 62557 | 2006-11-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033567805 | Joni Marie Lidy | Speech-Language Pathologist | 1000 E. 6th Street, Pana, IL 62557 | 2016-06-01 |
| 1750538237 | Nancy L. Simpson | Physical Therapy Assistant | 100 E 6th St. Rd., Pana, IL 62557 | 2008-08-26 |
| 1306093661 | Maiden Louise Axalan Bacolod | Physical Therapist | 900 S Chestnut, Prairie Rose Healthcare Center, Pana, IL 62557 | 2008-08-19 |
| 1922128123 | Randall Dean Floyd | Dentist | 9 South State Street, Pana, IL 62557 | 2007-03-30 |
| 1114056363 | Laurie Cunnington | Family Medicine | 101 East Ninth St, Pana, IL 62557 | 2007-03-05 |
| 1871688390 | Donald Metzger | Pharmacist | 28 East Second, Pana, IL 62557 | 2006-10-03 |
| 1851486377 | John A Metzger | Pharmacist | 28 East Second Street, Pana, IL 62557 | 2006-10-03 |
| 1235225236 | Pana Community Hospital Association | Clinic/Center | 101 E 9th St, Suite 105, Pana, IL 62557 | 2006-10-05 |
| 1245437797 | Hickory Estates of Pana LLC | Assisted Living Facility | 101 N Hickory St, Pana, IL 62557-1040 | 2007-06-28 |
| 1235280058 | Alan Douglas Cyrus | Chiropractor | 103 W Washington St, Pana, IL 62557-1144 | 2007-01-16 |
| Find all providers in zip 62557 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851460737 | Ernesto Norona Fabi | General Practice | 217 S Locust St, Pana Medical Group LLC, Pana, IL 62557-9998 | 2006-11-07 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.