Luis C Devenecia Jr. (NPI# 1750495792, PAC ID# 2062306194) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1750495792 |
| PAC ID by PECOS | 2062306194 |
| Professional Enrollment ID | I20050120000433 |
| Full Name | Luis C Devenecia Jr. |
| Organization Legal Name | SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC. |
| Address |
1200 N E St Olney IL 62450-2432 |
| Phone Number | 6183955222 |
| Gender | M |
| Credential | MD |
| Graduation Year | 1990 |
| Primary Specialty | INTERNAL MEDICINE |
| Group Practice PAC ID | 1456256874 |
| Number of Group Practice Members | 77 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 140147 | RICHLAND MEMORIAL HOSPITAL |
| 141311 | FAIRFIELD MEMORIAL HOSPITAL 1 |
| 141351 | CLAY COUNTY HOSPITAL |
| 141344 | LAWRENCE COUNTY MEMORIAL HOSPITAL |
| 141343 | CRAWFORD MEMORIAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1200 N E St, Olney, IL 62450-2432 | 6183955222 | SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC. |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % |
| Organization Legal Name | SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC. |
| Physicians | 75 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Noah M Cooperstein | Family Medicine | Southern Illinois Healthcare Foundation, Inc. | 3 Saint Elizabeth Blvd, Suite 4000, O Fallon, IL 62269-1099 |
| James Webb Cole Iii | Psychiatry | Southern Illinois Healthcare Foundation, Inc. | 1200 N E St, Olney, IL 62450-2432 |
| James Howard Hobby | Obstetrics/gynecology | Southern Illinois Healthcare Foundation, Inc. | 7210 W Main St, Belleville, IL 62223-3038 |
| Christa L Metzelaars | Nurse Practitioner | Southern Illinois Healthcare Foundation, Inc. | 700 Broadway Ave E, Suite 39, Mattoon, IL 61938-4662 |
| Shelley D Reichling | Nurse Practitioner | Southern Illinois Healthcare Foundation, Inc. | 824 Locust St, Red Bud, IL 62278-1209 |
| Chester B Nay | Physician Assistant | Southern Illinois Healthcare Foundation, Inc. | 302 N Mill St, Greenup, IL 62428-1062 |
| Amy L Mclean | Nurse Practitioner | Southern Illinois Healthcare Foundation, Inc. | 1275 Hawthorn Rd, Salem, IL 62881-1028 |
| Susan K Reynolds | Family Medicine | Southern Illinois Healthcare Foundation, Inc. | 1215 Vandalia St, Collinsville, IL 62234-4060 |
| Alfred Johnson | Family Medicine | Southern Illinois Healthcare Foundation, Inc. | 2001 State St, East Saint Louis, IL 62205-1803 |
| Nanthini Suthan | Internal Medicine | Southern Illinois Healthcare Foundation, Inc. | 2 Terminal Dr, Suite 8, East Alton, IL 62024-2294 |
| Street Address |
1200 N E ST |
| City | OLNEY |
| State | IL |
| Zip | 62450-2432 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| James Webb Cole Iii | Psychiatry | Southern Illinois Healthcare Foundation, Inc. | 1200 N E St, Olney, IL 62450-2432 |
| Mary M Waller | Urology | Richland Memorial Hospital Inc | 1200 N E St, Olney, IL 62450-2432 |
| William R Padgett | Obstetrics/gynecology | Southern Illinois Healthcare Foundation, Inc. | 1200 N E St, Olney, IL 62450-2432 |
| Rise C Hatten | Obstetrics/gynecology | Southern Illinois Healthcare Foundation, Inc. | 1200 N E St, Olney, IL 62450-2432 |
| Debra Waggle | Nurse Practitioner | Richland Memorial Hospital Inc | 1200 N E St, Olney, IL 62450-2432 |
| Stephen E Reid Jr. | General Surgery | Richland Memorial Hospital Inc | 1200 N E St, Olney, IL 62450-2432 |
| Benjamin E Johnson | General Surgery | Richland Memorial Hospital Inc | 1200 N E St, Olney, IL 62450-2432 |
| Kylie Lynn Garbe | Nurse Practitioner | Southern Illinois Healthcare Foundation, Inc. | 1200 N E St, Olney, IL 62450-2432 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Joshua C Feddes | Chiropractic | 200 N W St, Olney, IL 62450-1108 | |
| Tara Beth Mckinney | Chiropractic | 200 N W St, Olney, IL 62450-1108 | |
| Gary Roe Street | Chiropractic | 400 S W St, Olney, IL 62450-1217 | |
| Ronald J Greenberg | Chiropractic | 731 S W St, Olney, IL 62450-1309 | |
| Jack Anthony Cole | Psychologist, Clinical | 302 S Kitchell Ave E, Olney, IL 62450-1500 | |
| Amanda J Schlick | Chiropractic | 600 W Main St, Olney, IL 62450-1542 | |
| Nathan A Stevens | Chiropractic | 600 W Main St, Stevens Chiropractic Clinic, Olney, IL 62450-1542 | |
| Deanna Fields | Nurse Practitioner | 117 N Boone St, Olney, IL 62450-2109 | |
| Daniel J Brown | Optometry | Optometric Eyecare Inc. | 303 E Main St, Olney, IL 62450-2117 |
| Clark E Deshon | Optometry | Optometric Eyecare Inc. | 303 E Main St, Olney, IL 62450-2117 |
| Find all physicians in zip 62450 | |||
| City | OLNEY |
| Zip Code | 62450 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | OLNEY + INTERNAL MEDICINE |
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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.