Maureen Street (NPI# 1093716052, PAC ID# 1557327038) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
Nation Provider ID (NPI) | 1093716052 |
PAC ID by PECOS | 1557327038 |
Professional Enrollment ID | I20041207000122 |
Full Name | Maureen Street |
Organization Legal Name | CRYSTAL LAKE CLINIC PC |
Address |
124 Ames St Elk Rapids MI 49629-9449 |
Phone Number | 2312649060 |
Gender | F |
Credential | MD |
Medical School | MICHIGAN STATE UNIVERSITY COLLEGE OF HUMAN MEDICINE |
Graduation Year | 1994 |
Primary Specialty | FAMILY MEDICINE |
Group Practice PAC ID | 0648259010 |
Number of Group Practice Members | 36 |
Accepts Medicare Assignment | Y |
Claim Control Number (CCN) | Legal Business Name |
---|---|
230097 | MUNSON MEDICAL CENTER |
231301 | KALKASKA MEMORIAL HEALTH CENTER |
Address | Phone | Organization |
---|---|---|
124 Ames St, Elk Rapids, MI 49629-9449 | 2312649060 | CRYSTAL LAKE CLINIC PC |
6170 Us Hwy 31 N, Williamsburg, MI 49690-9306 | 2316425556 | CRYSTAL LAKE CLINIC PC |
Organization Legal Name | CRYSTAL LAKE CLINIC PC |
Physicians | 42 |
Name | Specialty | Organization | Address |
---|---|---|---|
Becky Lynn Porter | Nurse Practitioner | Crystal Lake Clinic PC | 115 E 7th St, Manton, MI 49663-9429 |
Danielle Koch | Nurse Practitioner | Crystal Lake Clinic PC | 6170 Us Hwy 31 N, Williamsburg, MI 49690-9306 |
Emily L Fader | Physician Assistant | Crystal Lake Clinic PC | 6227 Frankfort Hwy, Benzonia, MI 49616-8632 |
Karen Lynn Volas | Nurse Practitioner | Crystal Lake Clinic PC | 1975 Stirling Dr, Interlochen, MI 49643-9264 |
George B Ryckman | Family Medicine | Crystal Lake Clinic PC | 8225 Lake St, Bear Lake, MI 49614-9612 |
Michael F Carroll | Family Medicine | Crystal Lake Clinic PC | 2283 E M, Suite 113, Kingsley, MI 49649-9370 |
Tracy Robinson | Nurse Practitioner | Crystal Lake Clinic PC | 8225 Lake St, Bear Lake, MI 49614-9612 |
Jacob Flynn | Family Medicine | Crystal Lake Clinic PC | 6227 Frankfort Hwy, Benzonia, MI 49616-8632 |
Ryan A Sullivan | Internal Medicine | Crystal Lake Clinic PC | 8225 Lake St, Bear Lake, MI 49614-9612 |
Michelle M Macdonald | Physician Assistant | Crystal Lake Clinic PC | 6227 Frankfort Hwy, Benzonia, MI 49616-8632 |
Street Address |
124 AMES ST |
City | ELK RAPIDS |
State | MI |
Zip | 49629-9449 |
Name | Specialty | Organization | Address |
---|---|---|---|
Kimberly Michelle Marino-brothers | Nurse Practitioner | Crystal Lake Clinic PC | 124 Ames St, Elk Rapids, MI 49629-9449 |
Name | Specialty | Organization | Address |
---|---|---|---|
Jennifer A Shockley | Family Medicine | Elk Rapids Primary Care Plc | 115 Bridge St, Elk Rapids, MI 49629-5110 |
Steven M Pray | Family Medicine | Elk Rapids Primary Care Plc | 115 Bridge St, Elk Rapids, MI 49629-5110 |
Ann Kathryn Kuenker | Family Medicine | Elk Rapids Medical Clinic, P.C. | 516 Bridge St, Elk Rapids, MI 49629-9701 |
Rhonda Lammers | Physical Therapy | Elk Rapids Physical Therapy PC | 128 Ames St, Elk Rapids, MI 49629-9739 |
Patricia Gallo | Physical Therapy | Elk Rapids Physical Therapy PC | 128 Ames St, Elk Rapids, MI 49629-9739 |
Julie Chestnut | Physical Therapy | Elk Rapids Physical Therapy PC | 128 Ames St, Elk Rapids, MI 49629-9739 |
Lucinda Polemitis | Physical Therapy | Elk Rapids Physical Therapy PC | 128 Ames St, Elk Rapids, MI 49629-9739 |
City | ELK RAPIDS |
Zip Code | 49629 |
Specialty | FAMILY MEDICINE |
City + Specialty | ELK RAPIDS + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Maureen Street.
Data Provider | Centers for Medicare & Medicaid Services (CMS) |
Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.