Jessica L Secor (NPI# 1164700183, PAC ID# 8022231802) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is VASCULAR SURGERY.
| Nation Provider ID (NPI) | 1164700183 |
| PAC ID by PECOS | 8022231802 |
| Professional Enrollment ID | I20160623001451 |
| Full Name | Jessica L Secor |
| Organization Legal Name | METHODIST MEDICAL CENTER OF ILLINOIS |
| Address |
112 Crescent Ave Peoria IL 61611-3257 |
| Phone Number | 3096724670 |
| Gender | F |
| Medical School | WRIGHT STATE UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 2011 |
| Primary Specialty | VASCULAR SURGERY |
| Group Practice PAC ID | 1355259714 |
| Number of Group Practice Members | 203 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 140209 | METHODIST MEDICAL CENTER OF ILLINOIS |
| 140001 | GRAHAM HOSPITAL ASSOCIATION |
| 140013 | PROCTOR HOSPITAL |
| 140067 | OSF SAINT FRANCIS MEDICAL CENTER |
| 140120 | PEKIN MEMORIAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 180 S Main St, Canton, IL 61520-2608 | 3096470201 | GRAHAM HOSPITAL ASSOCIATION |
| 1001 W Main St 3rd Floor, Peoria, IL 61606-1277 | 3094950200 | PEORIA SURGICAL GROUP, LTD. |
| 112 Crescent Ave, Peoria, IL 61611-3257 | 3096724670 | METHODIST MEDICAL CENTER OF ILLINOIS |
| 221 Ne Glen Oak, Peoria, IL 61636 | 3096725522 | METHODIST MEDICAL CENTER OF ILLINOIS |
| Organization Legal Name | METHODIST MEDICAL CENTER OF ILLINOIS |
| Physicians | 227 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kari M Hoffman | Nurse Practitioner | Methodist Medical Center of Illinois | 815 Main St A, Peoria, IL 61602-1080 |
| Alanna M Trettin | Physician Assistant | Methodist Medical Center of Illinois | 815 Main St, A, Peoria, IL 61602-1080 |
| Cheryl Herrmann | Certified Clinical Nurse Specialist (cns) | Methodist Medical Center of Illinois | 112 Necrescent Ave, Peoria, IL 61606-1901 |
| Lionel J Malebranche | Cardiovascular Disease (cardiology) | Methodist Medical Center of Illinois | 112 Ne Crescent Ave, Mmg Cardiology, Peoria, IL 61606-1901 |
| Melanie L Andrews | Family Medicine | Methodist Medical Center of Illinois | 221 Ne Glen Oak, Peoria, IL 61636-0001 |
| Anne M Look | Nurse Practitioner | Methodist Medical Center of Illinois | 112 Crescent Ave, Peoria, IL 61611-3257 |
| John K Kula | Anesthesiology | Methodist Medical Center of Illinois | 221 Neglen Oak Ave, Peoria, IL 61636-0001 |
| Nicholas L Warnecke | Physician Assistant | Methodist Medical Center of Illinois | 1800 Broadway St, Pekin, IL 61554-3822 |
| Melissa S Terhark | Certified Registered Nurse Anesthetist (crna) | Methodist Medical Center of Illinois | 221 Ne Glen Oak Ave, Peoria, IL 61636-0001 |
| Robert B Adams | Family Practice | Methodist Medical Center of Illinois | 200 River Rd, East Peoria, IL 61611-2095 |
| Street Address |
112 CRESCENT AVE |
| City | PEORIA |
| State | IL |
| Zip | 61611-3257 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Anne M Look | Nurse Practitioner | Methodist Medical Center of Illinois | 112 Crescent Ave, Peoria, IL 61611-3257 |
| Adel F Mina | Cardiovascular Disease (cardiology) | Methodist Medical Center of Illinois | 112 Crescent Ave, Peoria, IL 61611-3257 |
| Walter S Reid | Pulmonary Disease | Methodist Medical Center of Illinois | 112 Crescent Ave, Peoria, IL 61611-3257 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Dustin Brown | Physical Therapy | Accelerated Rehabilitation Centers Ltd | 123 W Spring Creek Rd, East Peoria, IL 61611-1346 |
| Catherine J Kilbourn | Clinical Social Worker | 2500 N Main St, Suite 2b, East Peoria, IL 61611-1780 | |
| Nancy S Egger | Clinical Social Worker | 2500 N Main St, Suite 2b, East Peoria, IL 61611-1780 | |
| Cameron Taylor | Diagnostic Radiology | Central Illinois Radiological Associates Ltd | 111 Oakwood Rd, East Peoria, IL 61611-1853 |
| James W Farn | Diagnostic Radiology | Central Illinois Radiological Associates Ltd | 111 Oakwood Rd, East Peoria, IL 61611-1853 |
| Merle A Piacenti | Diagnostic Radiology | Central Illinois Radiological Associates Ltd | 111 Oakwood Rd, East Peoria, IL 61611-1853 |
| Tyler M Flessner | Diagnostic Radiology | Central Illinois Radiological Associates Ltd | 111 Oakwood Rd, East Peoria, IL 61611-1853 |
| Stephen W Goth | Diagnostic Radiology | Central Illinois Radiological Associates Ltd | 111 Oakwood Rd, East Peoria, IL 61611-1853 |
| Mary E Mccrate | Diagnostic Radiology | Central Illinois Radiological Associates Ltd | 111 Oakwood Rd, East Peoria, IL 61611-1853 |
| Steven P Lukancic | Diagnostic Radiology | Central Illinois Radiological Associates Ltd | 111 Oakwood Rd, East Peoria, IL 61611-1853 |
| Find all physicians in zip 61611 | |||
| City | PEORIA |
| Zip Code | 61611 |
| Specialty | VASCULAR SURGERY |
| City + Specialty | PEORIA + VASCULAR SURGERY |
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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.