MRS. MARY WUNDERLICH (NPI# 1477856979) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477856979 |
| Entity Type | Individual |
| Full Name | MRS. MARY WUNDERLICH |
| Credential | PA-C |
| Practice Address |
1650 State St Chester IL 62233-1001 |
| Practice Telephone | 6188264152 |
| Practice Fax Number | 6188264210 |
| Mailing Telephone | 6188264152 |
| Mailing Fax Number | 6188264210 |
| Enumeration Date | 2010-12-06 |
| Last Update Date | 2010-12-06 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
085-000332 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1650 STATE ST |
| City | CHESTER |
| State | IL |
| Zip Code | 62233-1001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972775856 | Allan L Liefer Md | Surgery | 1650 State St, Chester, IL 62233-1001 | 2008-03-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164840740 | Malorie K Morris | Dentist | 9449 Mill Creek Road, Chester, IL 62233 | 2014-04-01 |
| 1366655268 | Adam Matthew Gibbs | Chiropractor | 423 W Holmes St, Chester, IL 62233 | 2007-05-07 |
| 1982816625 | Jodi Beth Buskohl Southern Il Chiropractic Clinic | Chiropractor | 2447 State St., Chester, IL 62233 | 2007-05-04 |
| 1881806008 | Human Service Center | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3298 Dawnview Road, Chester, IL 62233 | 2007-05-03 |
| 1356563563 | Human Service Center of Southern Metro East | Clinic/Center | 115 East Stacey Street, Chester, IL 62233 | 2007-05-03 |
| 1902951536 | Southern Illinois Eye Care, PC | Optometrist | 425 W. Holmes, Chester, IL 62233 | 2007-01-24 |
| 1235117417 | Chester Clinic Professional Corp | Clinic/Center | 2319 Old Plank Rd, Chester, IL 62233 | 2006-01-06 |
| 1881951648 | Sara Elizabeth Chandler | Nurse Practitioner | 1315 Lehmen Drive, Chester, IL 62233 | 2012-04-18 |
| 1245323260 | Eve B Hoover | Physician Assistant | 2319 Old Plank Rd, Chester Clinic PC, Chester, IL 62233 | 2006-10-02 |
| 1154387850 | Brett A Prywitch | Radiology | 1900 State St, Chester Memorial Hospital, Chester, IL 62233 | 2006-04-22 |
| Find all providers in zip 62233 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699230219 | Christina Simpson Baumert | Physician Assistant | 30 Medical Center Blvd Ste 202, Chester, PA 19013-3956 | 2019-02-07 |
| 1790774297 | Jaime Pedraza | Physician Assistant | 30 Medical Center Blvd Bldg 1, Chester, PA 19013-3955 | 2005-10-18 |
| 1609497981 | Jessica Hyman | Physician Assistant | 1 Medical Center Blvd, Chester, PA 19013-3995 | 2020-04-28 |
| 1548724107 | Katherine Belliveau | Physician Assistant | 1 Medical Center Blvd, Chester, PA 19013-3902 | 2019-01-29 |
| 1972015154 | Dane Alexander Darnell | Physician Assistant | 1 Medical Center Blvd, Chester, PA 19013-3902 | 2017-10-28 |
| 1558782623 | Shannon Austin Jabs | Physician Assistant | 1716 E Hundred Rd, Suite 102, Chester, VA 23836-3301 | 2013-12-17 |
| 1629330782 | April Chaundra Nellie Foust-ward | Physician Assistant | 1714 E Hundred Rd, Suite 104, Chester, VA 23836-3310 | 2012-06-13 |
| 1013209360 | Jessica Elizabeth Mathieson | Physician Assistant | 30 Medical Center Blvd, Pob #1 - Suite 305, Chester, PA 19013-3955 | 2011-05-04 |
| 1790917888 | Danielle Marie Dinorscia | Physician Assistant | 1 Medical Center Blvd, Chester, PA 19013-3902 | 2009-08-21 |
| 1295907988 | Joan Marie Formiglia | Physician Assistant | 1 E Beacon Light Ln, Chester, PA 19013-4433 | 2008-04-02 |
| Find all providers in CHESTER | ||||
Please comment or provide details below to improve the information on MRS. MARY WUNDERLICH.
| 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.