UPPER CERVICAL CARE OF ALTON LLC (NPI# 1073880423) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073880423 |
| Entity Type | Organization |
| Organization Name | UPPER CERVICAL CARE OF ALTON LLC |
| Practice Address |
3 Professional Dr Suite B Alton IL 62002-5067 |
| Practice Telephone | 6184657177 |
| Mailing Telephone | 6184657177 |
| Enumeration Date | 2011-11-29 |
| Last Update Date | 2011-11-29 |
| Authorized Official Name | WYNNDEL BUENGER (MANAGER) |
| Authorized Official Telephone | 6184657177 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | PIASA PAIN CENTER LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QH0100X |
Clinic/Center Specialization: Health Service |
038008971 | IL | Ambulatory Health Care Facilities |
| Street Address |
3 PROFESSIONAL DR SUITE B |
| City | ALTON |
| State | IL |
| Zip Code | 62002-5067 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689677254 | Gerald A Wankum | Ophthalmology | 3 Professional Dr, Alton, IL 62002-5067 | 2005-05-27 |
| 1578014957 | Anesthesia Services Associates, Pllc | Durable Medical Equipment & Medical Supplies | 3 Professional Dr, Alton, IL 62002-5067 | 2016-10-20 |
| 1144676719 | Anesthesia Services Associates Pllc | Anesthesiology | 3 Professional Dr, Suite B, Alton, IL 62002-5067 | 2016-05-12 |
| 1528445319 | Allison Chancellor | Anesthesiology | 3 Professional Dr, Suite B, Alton, IL 62002-5067 | 2015-04-30 |
| 1578605994 | Imaging Center of Alton, LLC | Clinic/Center | 3 Professional Dr, Suite A, Alton, IL 62002-5067 | 2007-02-13 |
| 1063524718 | Paul A Heischmidt | Nurse Anesthetist, Certified Registered | 3 Professional Dr, Ste B, Alton, IL 62002 | 2006-08-31 |
| 1366550352 | Thomas B Brummett | Anesthesiology | 3 Professional Dr, Ste B, Alton, IL 62002 | 2006-08-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285272807 | Jersey Community Hospital | Obstetrics & Gynecology | #2 Memorial Drive, Suite 203, Alton, IL 62002 | 2019-12-13 |
| 1912540659 | Kelsi N Harre | Community Health Worker | 2603 N. Rogers Ave., Alton, IL 62002 | 2019-10-25 |
| 1841848322 | Destiny L Miller | Technician | 3429 Meridocia St, Alton, IL 62002 | 2019-08-28 |
| 1942854633 | Jessica Leigh Jump | Speech-Language Pathologist | 453 Bluff Street, Alton, IL 62002 | 2019-07-30 |
| 1194380741 | Vasiliki Kytridou | Dentist | 2800 College Avenue Southern Il University School of De, Building 285, Alton, IL 62002 | 2019-05-08 |
| 1982125910 | Amy Nicole Spalding | Social Worker | 1123 Harrison St, Alton, IL 62002 | 2017-06-29 |
| 1962856310 | Patricia Gregory | Social Worker | 5090 Humbert Rd, Alton, IL 62002 | 2016-04-21 |
| 1447612510 | Alanna Lynn Mcnelly | Chiropractor | 219 Piasa St, Suite 200, Alton, IL 62002 | 2016-03-28 |
| 1174983050 | Roberta's Lovely Ladies Boutique | Mastectomy Fitter | 603 W. Delmar, Alton, IL 62002 | 2016-03-04 |
| 1184081556 | Darcy Graham | Nurse Practitioner | 4 Memorial Dr # 210, Alton, IL 62002 | 2016-01-15 |
| Find all providers in zip 62002 | ||||
| Taxonomy Code | 261QH0100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Health Service |
| Definition to come... |
| Notes: [7/1/2006: modified title] |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.