Alfred Johnson (NPI# 1144316431, PAC ID# 7719169341) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1144316431 |
| PAC ID by PECOS | 7719169341 |
| Professional Enrollment ID | I20110303000235 |
| Full Name | Alfred Johnson |
| Organization Legal Name | SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC. |
| Address |
2001 State St East Saint Louis IL 62205-1803 |
| Phone Number | 6182719191 |
| Gender | M |
| Medical School | UNIVERSITY OF MISSISSIPPI SCHOOL OF MEDICINE |
| Graduation Year | 1984 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 1456256874 |
| Number of Group Practice Members | 77 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 141346 | FAYETTE COUNTY HOSPITAL |
| 140077 | TOUCHETTE REGIONAL HOSPITAL INC |
| 140187 | HSHS ST ELIZABETH'S HOSPITAL |
| 140125 | GATEWAY REGIONAL MEDICAL CENTER |
| 140185 | MEMORIAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 2001 State St, East Saint Louis, IL 62205-1803 | 6182719191 | SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC. |
| 1510 Sunset Dr, Vandalia, IL 62471-3228 | 6182833144 | SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC. |
| 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 |
| Nanthini Suthan | Internal Medicine | Southern Illinois Healthcare Foundation, Inc. | 2 Terminal Dr, Suite 8, East Alton, IL 62024-2294 |
| Theodore Ross | Internal Medicine | Southern Illinois Healthcare Foundation, Inc. | 6000 Bond Ave, Centreville, IL 62207-2328 |
| Street Address |
2001 STATE ST |
| City | EAST SAINT LOUIS |
| State | IL |
| Zip | 62205-1803 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Miguel H Granger | Family Medicine | Southern Illinois Healthcare Foundation, Inc. | 2001 State St, East Saint Louis, IL 62205-1803 |
| Natascha Jeffries | Nurse Practitioner | Southern Illinois Healthcare Foundation, Inc. | 2001 State St, East Saint Louis, IL 62205-1803 |
| Verna J Porter | Obstetrics/gynecology | Southern Illinois Healthcare Foundation, Inc. | 2001 State St, East Saint Louis, IL 62205-1803 |
| Dolores J Gunn | Family Medicine | Southern Illinois Healthcare Foundation, Inc. | 2001 State St, East Saint Louis, IL 62205-1803 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Howard Franklin Jackson | Podiatry | 4601 State St, Suite 310, East Saint Louis, IL 62205-1359 | |
| Bernice L Collins | Psychologist, Clinical | 605 Vogel Place, East St Louis, IL 62205-2132 | |
| James Jay White | Chiropractic | Kaesberg Chiropractic Clinic PC | 3131 State St, East Saint Louis, IL 62205-2203 |
| Kendra P Kaesberg | Chiropractic | Kaesberg Chiropractic Clinic PC | 3131 State St, East Saint Louis, IL 62205-2203 |
| City | EAST SAINT LOUIS |
| Zip Code | 62205 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | EAST SAINT LOUIS + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Alfred Johnson.
| 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.