Gene C Wong (NPI# 1689620304, PAC ID# 2264414838) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DIAGNOSTIC RADIOLOGY.
| Nation Provider ID (NPI) | 1689620304 |
| PAC ID by PECOS | 2264414838 |
| Professional Enrollment ID | I20040611000214 |
| Full Name | Gene C Wong |
| Organization Legal Name | BLOOMINGTON RADIOLOGY SC |
| Address |
2200 E Washington St St Josephs Med Ctr Bloomington IL 61701-4364 |
| Phone Number | 4173474456 |
| Gender | M |
| Credential | MD |
| Graduation Year | 1985 |
| Primary Specialty | DIAGNOSTIC RADIOLOGY |
| Group Practice PAC ID | 5092797621 |
| Number of Group Practice Members | 13 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 140162 | ST JOSEPH MEDICAL CENTER |
| 140127 | ADVOCATE BROMENN MEDICAL CENTER |
| 141309 | ADVOCATE EUREKA HOSPITAL |
| 141303 | WARNER HOSPITAL AND HEALTH SERVICES |
| Address | Phone | Organization |
|---|---|---|
| 2200 E Washington St, St Josephs Med Ctr, Bloomington, IL 61701-4364 | 4173474456 | BLOOMINGTON RADIOLOGY SC |
| 2200 Fort Jesse Rd, Normal, IL 61761-6289 | BLOOMINGTON RADIOLOGY SC |
| Organization Legal Name | BLOOMINGTON RADIOLOGY SC |
| Physicians | 4 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kiran Sekhar | Diagnostic Radiology | Bloomington Radiology Sc | 2200 Fort Jesse Rd, Suite 280, Normal, IL 61761-6289 |
| William L Ray | Diagnostic Radiology | Bloomington Radiology Sc | 2200 E Washington St, St Josephs Med Ctr, Bloomington, IL 61701-4364 |
| Davender Bhardwaj | Diagnostic Radiology | Bloomington Radiology Sc | 2200 E Washington St, St Josephs Med Ctr, Bloomington, IL 61701-4364 |
| Street Address |
2200 E WASHINGTON ST ST JOSEPHS MED CTR |
| City | BLOOMINGTON |
| State | IL |
| Zip | 61701-4364 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Walter Knoll | Anesthesiology | Mclean County Anesthesiology, Ltd. | 2200 E Washington St, Bloomington, IL 61701-4364 |
| Eno A Nsima-obot | Emergency Medicine | Osf Multi-specialty Group | 2200 E Washington St, Palliative Care, Bloomington, IL 61701-4364 |
| Jason W Brian | Certified Registered Nurse Anesthetist (crna) | Mclean County Anesthesiology, Ltd. | 2200 E Washington St, Bloomington, IL 61701-4364 |
| Sumaya A Al Rawi | Pathology | Bloomington Medical Laboratory Physicians Sc | 2200 E Washington St, Bloomington, IL 61701-4364 |
| Julie R Heisel-wolter | Certified Registered Nurse Anesthetist (crna) | Mclean County Anesthesiology, Ltd. | 2200 E Washington St, Bloomington, IL 61701-4364 |
| Adrienne Y Williams | Anesthesiology | Mclean County Anesthesiology, Ltd. | 2200 E Washington St, Bloomington, IL 61701-4364 |
| Gregory R Dubois | Certified Registered Nurse Anesthetist (crna) | Mclean County Anesthesiology, Ltd. | 2200 E Washington St, Bloomington, IL 61701-4364 |
| William L Ray | Diagnostic Radiology | Bloomington Radiology Sc | 2200 E Washington St, St Josephs Med Ctr, Bloomington, IL 61701-4364 |
| John C Han | Anesthesiology | Mclean County Anesthesiology, Ltd. | 2200 E Washington St, Bloomington, IL 61701-4364 |
| Lawrence J Kohaus | Pathology | Bloomington Medical Laboratory Physicians Sc | 2200 E Washington St, Bloomington, IL 61701-4364 |
| Find all physicians in the same address | |||
| 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 |
| Tracy Pacini | Nurse Practitioner | Chestnut Health Systems, Inc. | 1003 Martin Luther King Dr, Bloomington, IL 61701-1429 |
| Dean Ryan Mccullough | Clinical Social Worker | 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 |
| Find all physicians in zip 61701 | |||
| City | BLOOMINGTON |
| Zip Code | 61701 |
| Specialty | DIAGNOSTIC RADIOLOGY |
| City + Specialty | BLOOMINGTON + DIAGNOSTIC RADIOLOGY |
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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.