GLEN E DUST (NPI# 1477555738) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477555738 |
| Entity Type | Individual |
| Full Name | GLEN E DUST |
| Credential | M.D. |
| Practice Address |
2 W Adams St Sullivan IL 61951-1943 |
| Practice Telephone | 2177287353 |
| Practice Fax Number | 2177282580 |
| Mailing Telephone | 2177287353 |
| Mailing Fax Number | 2177282580 |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2019-04-04 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 036068658 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 0360686581 | 05 | |
| IL | PALMETTO | 080027217 | 01 |
| IL | BCBS OF ILLINOIS | 0007000023 | 01 |
| IL | HEALTHLINK | 182358 | 01 |
| Street Address |
2 W ADAMS ST |
| City | SULLIVAN |
| State | IL |
| Zip Code | 61951-1943 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255826814 | Hayley Yoder | Family Medicine | 2 W Adams St, Sullivan, IL 61951-1943 | 2018-06-26 |
| 1376545509 | Faisal Bukhari | Internal Medicine | 2 W Adams St, Sullivan, IL 61951-1943 | 2005-06-01 |
| 1578565701 | Dennis D Costerisan | Family Medicine | 2 W Adams St, Sullivan, IL 61951-1943 | 2005-06-01 |
| 1801898085 | Joya Ryan | Nurse Practitioner | 2 W Adams St, Sullivan, IL 61951-1943 | 2005-06-01 |
| 1932101193 | Esther Johnson | Nurse Practitioner | 2 W Adams St, Sullivan, IL 61951-1943 | 2005-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497104558 | Laura Ellis | Speech-Language Pathologist | 1 Masonic Way, Sullivan, IL 61951 | 2016-06-09 |
| 1134561665 | Murray Chiropractic and Acupuncture, LLC | Chiropractor | 221 N Anderson St, Sullivan, IL 61951-1001 | 2013-07-25 |
| 1427450220 | Harley Chiropractic, LLC | Chiropractor | 221 N Anderson St, Sullivan, IL 61951-1001 | 2014-09-23 |
| 1104822568 | Patricia E Carr | Nurse Practitioner | 1220 W Jackson St, Sullivan, IL 61951-1032 | 2005-06-21 |
| 1396789590 | Healthcom, Inc | Emergency Response System Companies | 1600 W Jackson St, Sullivan, IL 61951-1066 | 2006-06-16 |
| 1598275646 | Janice Althoff | Speech-Language Pathologist | 910 N Graham St, Sullivan, IL 61951-1114 | 2017-10-03 |
| 1134639289 | Anne Margaret Osthoff | Speech-Language Pathologist | 910 N Graham St, Sullivan, IL 61951-1114 | 2017-10-03 |
| 1891857447 | William Earl Alwerdt | Dentist | 110 N Hamilton St, Sullivan, IL 61951-1405 | 2006-12-13 |
| 1548511819 | Cindi L Reed | Pharmacist | 17 N Hamilton St, Sullivan, IL 61951-1452 | 2012-09-27 |
| 1306466263 | Reed Pharmacies, LLC | Family Medicine | 17 N Hamilton St, Sullivan, IL 61951-1452 | 2020-04-21 |
| Find all providers in zip 61951 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568628915 | Barbara Ann Reed | Family Medicine | 2186 N Hospital Blvd Ste 2, Sullivan, IN 47882-7654 | 2008-08-05 |
| 1922295815 | Patients First Health Care LLC | Family Medicine | 102 Grande Ctr, Sullivan, MO 63080-1266 | 2007-09-25 |
| 1548337942 | Premier Health Center, L.L.C. | Family Medicine | 102 Progress Pkwy, Sullivan, MO 63080-2359 | 2006-11-29 |
| 1578633194 | Mary Ann Chavez | Family Medicine | 1120 N Section St, Sullivan Medical Clinic, Sullivan, IN 47882-9200 | 2006-11-09 |
| 1912924630 | Medical Income Management Corp | Family Medicine | 101 W Jefferson St, Sullivan, IL 61951-1914 | 2006-07-17 |
| 1457393712 | Matthew J Tiefenbrunn | Family Medicine | 1326 S Service Rd W Ste 10, Sullivan, MO 63080-2306 | 2006-06-12 |
| 1811973944 | Yasuo Ishida | Family Medicine | 102 Progress Pkwy # A, Sullivan, MO 63080-2359 | 2005-12-20 |
| 1952304123 | Carl F. Conwell | Family Medicine | 2229 Mary Sherman Dr, Sullivan, IN 47882-7633 | 2005-05-23 |
| 1497363303 | Sullivan County Community Hospital | Family Medicine | 2186 N Hospital Blvd Ste 2, Sullivan, IN 47882-7654 | 2020-07-16 |
| 1306466263 | Reed Pharmacies, LLC | Family Medicine | 17 N Hamilton St, Sullivan, IL 61951-1452 | 2020-04-21 |
| Find all providers in SULLIVAN | ||||
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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.