DR. ANTHONY C VACCA (NPI# 1497797401) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497797401 |
| Entity Type | Individual |
| Full Name | DR. ANTHONY C VACCA |
| Credential | D.O. |
| Practice Address |
1 Good Samaritan Way Mount Vernon IL 62864-2402 |
| Practice Telephone | 6188994600 |
| Practice Fax Number | 6188994768 |
| Mailing Telephone | 6188994600 |
| Mailing Fax Number | 6188994768 |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2014-03-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 036105971 | IL | Allopathic & Osteopathic Physicians |
| N | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
036105971 | IL | Allopathic & Osteopathic Physicians |
| Y | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
036105971 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BCBS | 04132005 | 01 |
| IL | HEALTHLINK | 264630 | 01 |
| IL | MEDICARE RAILROAD | 290014938 | 01 |
| IL | 036105971 | 05 | |
| IL | HEALTH ALLIANCE | 081851 | 01 |
| Street Address |
1 GOOD SAMARITAN WAY |
| City | MOUNT VERNON |
| State | IL |
| Zip Code | 62864-2402 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083609184 | Kent S Quinn | Radiology | 1 Good Samaritan Way, Attn Radiology Dept, Mount Vernon, IL 62864-2402 | 2005-09-14 |
| 1407470206 | Brittany L Jerger | Registered Nurse | 1 Good Samaritan Way, Mount Vernon, IL 62864-2402 | 2020-06-08 |
| 1407418619 | Annie Rae Lowery | Registered Nurse | 1 Good Samaritan Way, Mount Vernon, IL 62864-2402 | 2019-07-08 |
| 1366951436 | Roxanna Elise Stevens | Nurse Practitioner | 1 Good Samaritan Way, Mount Vernon, IL 62864-2402 | 2017-09-21 |
| 1871022095 | Mathavi Sahadevan | Internal Medicine | 1 Good Samaritan Way, Mount Vernon, IL 62864-2402 | 2017-06-09 |
| 1326589680 | Amber Dawn Willis | Nurse Practitioner | 1 Good Samaritan Way, Mount Vernon, IL 62864-2402 | 2017-03-19 |
| 1194269597 | Good Samaritan Regional Health Center | Anesthesiology | 1 Good Samaritan Way, Mount Vernon, IL 62864-2402 | 2016-12-05 |
| 1710439112 | Nicole Michelle Boyd | Nurse Practitioner | 1 Good Samaritan Way, Mount Vernon, IL 62864-2402 | 2016-11-01 |
| 1588115810 | Cristina Myers | Nurse Practitioner | 1 Good Samaritan Way, Mount Vernon, IL 62864-2402 | 2016-10-21 |
| 1144771692 | Misty Dawn Wernsman | Nurse Practitioner | 1 Good Samaritan Way, Mount Vernon, IL 62864-2402 | 2016-10-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619438892 | Melissa Pryer | Dietitian, Registered | 2020 Broadway, Suite 1, Mt. Vernon, IL 62864 | 2019-03-28 |
| 1487145454 | Chiropractic Wellness Center of Mt Vernon, LLC. | Chiropractor | 1009 S 42nd St Ste 5, Mount Vernon, IL 62864 | 2018-05-24 |
| 1851889208 | Kimberly Tate | Counselor | 4110 North Water Place, Mt. Vernon, IL 62864 | 2018-05-01 |
| 1871907790 | University Hematology Oncology Inc | Specialist | #11 Cusumano Professional Plaza, Mount Vernon, IL 62864 | 2014-06-18 |
| 1457771677 | Dynamic Counseling and Consultation Services | Social Worker | 3600 S Water Tower Pl, Mt Vernon, IL 62864 | 2014-04-27 |
| 1619239431 | Judith C Morgan | Counselor | 16338 N Illinois Hwy 37, Mount Vernon, IL 62864 | 2012-06-08 |
| 1073888624 | James Brian Verges | Counselor | 16338 N. Illinois Hwy 37, Mount Vernon, IL 62864 | 2012-03-15 |
| 1720352271 | Lucinda M. Holdren | Counselor | 16338 North Illinois Highway 37, Mount Vernon, IL 62864 | 2012-03-01 |
| 1780978627 | Jamie M Orange | Physical Therapy Assistant | 19958 Fairfield Rd, Mt. Vernon, IL 62864 | 2011-06-08 |
| 1780978791 | Wendy Marie Claytor | Speech-Language Pathologist | 600 E Il Hwy 15, Mount Vernon, IL 62864 | 2011-06-07 |
| Find all providers in zip 62864 | ||||
| Taxonomy Code | 207RP1001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Pulmonary Disease |
| An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780807594 | Southern Illinois Acute Care Consultants,ltd | Internal Medicine | 4106 South Water Tower Place, Mount Vernon, IL 62864-6544 | 2007-04-10 |
| 1396026506 | Abdulmonam Ahmad Abulgasem Ali | Internal Medicine | 4106 S Water Tower Pl, Mount Vernon, IL 62864-6544 | 2011-08-31 |
| 1790725307 | Chirag Dave | Internal Medicine | 209 Crossroads Pl, Suite 110, Mount Vernon, IL 62864-6545 | 2006-06-08 |
| 1386623999 | Laurie A Mooney | Internal Medicine | 1330 Coshocton Ave, Mount Vernon, OH 43050-1440 | 2006-01-11 |
| 1497741482 | Robert L Coffey | Internal Medicine | 1400 E Kincaid St, Mount Vernon, WA 98274-4127 | 2005-09-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720636202 | Pulmonary Associates Ltd | Internal Medicine | 71 W 156th St Ste 203, Harvey, IL 60426-4262 | 2019-08-28 |
| 1336516467 | Hesham A. Hassaballa, Md, Ltd | Internal Medicine | 109 Symonds Dr Unit 684, Hinsdale, IL 60522-7304 | 2015-08-24 |
| 1497141394 | Pulmonary and Critical Care Solutions, LLC | Internal Medicine | 6116 N 2200 East Rd, Downs, IL 61736-9459 | 2015-04-08 |
| 1558771220 | Christopher Charles Sutton | Internal Medicine | 3 Saint Elizabeth Blvd, O Fallon, IL 62269-1281 | 2014-05-05 |
| 1861835985 | Christie Ann Brillante | Internal Medicine | 1801 W. Taylor, Suite 3c, Chicago, IL 60612-4795 | 2013-04-08 |
| 1992050850 | Thomas Christopher Draghi | Internal Medicine | 155 Linden Ave, Oak Park, IL 60302-2610 | 2012-07-17 |
| 1144586041 | Robert T Zeck | Internal Medicine | 13141 Lake Mary Dr, Plainfield, IL 60585-2650 | 2012-04-04 |
| 1508160359 | Aziz Rahman Md Facp PC | Internal Medicine | 1050 Martin Luther King Dr, Ste 109, Centralia, IL 62801 | 2011-01-07 |
| 1811211774 | Vitalcare Medical Sc | Internal Medicine | 1146 S Waukegan Rd, Waukegan, IL 60085-6731 | 2010-03-22 |
| 1508095605 | Farhan Zaidi | Internal Medicine | 444 N Northwest Hwy Ste 206, Park Ridge, IL 60068 | 2009-07-09 |
| Find all providers with the same taxonomy | ||||
| City | MOUNT VERNON |
| Zip Code | 62864 |
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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.