Dean Ryan Mccullough (NPI# 1194014670, PAC ID# 1658632658) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is CLINICAL SOCIAL WORKER.
| Nation Provider ID (NPI) | 1194014670 |
| PAC ID by PECOS | 1658632658 |
| Professional Enrollment ID | I20180308002029 |
| Full Name | Dean Ryan Mccullough |
| Organization Legal Name | CHESTNUT HEALTH SYSTEMS, INC. |
| Address |
1003 Martin Luther King Dr Bloomington IL 61701-1429 |
| Phone Number | 3095571400 |
| Gender | M |
| Graduation Year | 2009 |
| Primary Specialty | CLINICAL SOCIAL WORKER |
| Group Practice PAC ID | 1052393063 |
| Number of Group Practice Members | 19 |
| Accepts Medicare Assignment | M |
| Address | Phone | Organization |
|---|---|---|
| 1003 Martin Luther King Dr, Bloomington, IL 61701-1429 | 3095571400 | CHESTNUT HEALTH SYSTEMS, INC. |
| Organization Legal Name | CHESTNUT HEALTH SYSTEMS, INC. |
| Physicians | 20 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Tracy Pacini | Nurse Practitioner | Chestnut Health Systems, Inc. | 1003 Martin Luther King Dr, Bloomington, IL 61701-1429 |
| Charles Joseph Franke | Clinical Social Worker | Chestnut Health Systems, Inc. | 2148 Vadalabene Dr, Maryville, IL 62062-5632 |
| Rebecca Merchiori | Nurse Practitioner | Chestnut Health Systems, Inc. | 12 N 64th St, Belleville, IL 62223-3809 |
| Ella N Wilson | Nurse Practitioner | Chestnut Health Systems, Inc. | 50 Northgate Industrial Dr, Granite City, IL 62040-6805 |
| Veronica M Powers | Nurse Practitioner | Chestnut Health Systems, Inc. | 50 Northgate Industrial Dr, Granite City, IL 62040-6805 |
| Jessica Ann Newby | Nurse Practitioner | Chestnut Health Systems, Inc. | 50 Northgate Industrial Dr, Granite City, IL 62040-6805 |
| James W Tarasuik Jr. | Nurse Practitioner | Chestnut Health Systems, Inc. | 1003 Martin Luther King Dr, Bloomington, IL 61701-1429 |
| Terri R Smith | Clinical Social Worker | Chestnut Health Systems, Inc. | 50 Northgate Industrial Dr, Granite City, IL 62040-6805 |
| Jenia Rochelle Heavens | Nurse Practitioner | Chestnut Health Systems, Inc. | 1003 Martin Luther King Dr, Bloomington, IL 61701-1429 |
| Janel Latrice Townsend | Nurse Practitioner | Chestnut Health Systems, Inc. | 50 Northgate Industrial Dr, Granite City, IL 62040-6805 |
| Street Address |
1003 MARTIN LUTHER KING DR |
| City | BLOOMINGTON |
| State | IL |
| Zip | 61701-1429 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Tracy Pacini | Nurse Practitioner | Chestnut Health Systems, Inc. | 1003 Martin Luther King Dr, Bloomington, IL 61701-1429 |
| James W Tarasuik Jr. | Nurse Practitioner | Chestnut Health Systems, Inc. | 1003 Martin Luther King Dr, Bloomington, IL 61701-1429 |
| Jenia Rochelle Heavens | Nurse Practitioner | Chestnut Health Systems, Inc. | 1003 Martin Luther King Dr, Bloomington, IL 61701-1429 |
| Paula C Miller | Nurse Practitioner | Chestnut Health Systems, Inc. | 1003 Martin Luther King Dr, Bloomington, IL 61701-1429 |
| Nancy G Duffy | Clinical Social Worker | Chestnut Health Systems, Inc. | 1003 Martin Luther King Dr, Bloomington, IL 61701-1429 |
| Todd S Smith | Clinical Social Worker | Chestnut Health Systems, Inc. | 1003 Martin Luther King Dr, Bloomington, IL 61701-1429 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Anthony J Buecker | Emergency Medicine | St. Joseph Medical Center | 2200 W Washington St, Bloomington, IL 61701 |
| Ryan E Newberger | Emergency Medicine | St. Joseph Medical Center | 2200 W Washington St, Bloomington, IL 61701 |
| Kayla S Olesky | Emergency Medicine | St. Joseph Medical Center | 2200 W Washington St, Bloomington, IL 61701 |
| Alex R Yuan | Emergency Medicine | St. Joseph Medical Center | 2200 W Washington St, Bloomington, IL 61701 |
| Ryan Edward Hazlehurst | Optometry | Gailey Eye Clinic, Ltd | 1008 N Main St, Bloomington, IL 61701-1784 |
| Sarah Christine Sturgill | Optometry | Gailey Eye Clinic, Ltd | 1008 N Main St, Bloomington, IL 61701-1784 |
| Angela M Oberreiter | Optometry | Gailey Eye Clinic, Ltd | 1008 N Main St, Bloomington, IL 61701-1784 |
| Erik K Kooba | Anesthesiology | Anesthesia Pain Services LLC | 1008 N Main St, Bloomington, IL 61701-1784 |
| Ara D Aprahamian | Ophthalmology | Gailey Eye Clinic, Ltd | 1008 N Main St, Bloomington, IL 61701-1784 |
| Robert M Lee | Ophthalmology | Gailey Eye Clinic, Ltd | 1008 N Main St, Bloomington, IL 61701-1784 |
| Find all physicians in zip 61701 | |||
| City | BLOOMINGTON |
| Zip Code | 61701 |
| Specialty | CLINICAL SOCIAL WORKER |
| City + Specialty | BLOOMINGTON + CLINICAL SOCIAL WORKER |
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| 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.