Otis G Allen (NPI# 1306847900, PAC ID# 0840453411) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PLASTIC AND RECONSTRUCTIVE SURGERY.
| Nation Provider ID (NPI) | 1306847900 |
| PAC ID by PECOS | 0840453411 |
| Professional Enrollment ID | I20120517000387 |
| Full Name | Otis G Allen |
| Address |
1215 Holiday Dr Bloomington IL 61704-2214 |
| Gender | M |
| Graduation Year | 1977 |
| Primary Specialty | PLASTIC AND RECONSTRUCTIVE SURGERY |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 140162 | ST JOSEPH MEDICAL CENTER |
| 140127 | ADVOCATE BROMENN MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 1215 Holiday Dr, Bloomington, IL 61704-2214 |
| Street Address |
1215 HOLIDAY DR |
| City | BLOOMINGTON |
| State | IL |
| Zip | 61704-2214 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Leah C Swanson | Clinical Social Worker | Elliott Counseling Services LLC | 209 S Prospect, Suite 1, Bloomington, IL 61704 |
| Cheri Miller | Psychologist, Clinical | Advocate Health and Hospitals Corporation | 303 N Hershey, Suite 2c, Bloomington, IL 61704 |
| Dennis M Brtva | Optometry | Central Illinois Family Eyecare LLC | 2109 N Veterans Pkwy, Suite 2, Bloomington, IL 61704-0910 |
| Christopher James Wetzler | Optometry | Central Illinois Family Eyecare LLC | 2109 N Veterans Pkwy, Suite 2, Bloomington, IL 61704-0910 |
| Ashley Elizabeth Foster | Optometry | Central Illinois Family Eyecare LLC | 2109 N Veterans Pkwy, Suite 2, Bloomington, IL 61704-0910 |
| Preston Langdon Smith | Optometry | Central Illinois Family Eyecare LLC | 2109 N Veterans Pkwy, Suite 2, Bloomington, IL 61704-0910 |
| Kristine C Winkler | Nurse Practitioner | Encounter Telehealth LLC | 11 Harbor Pointe Ct, Bloomington, IL 61704-1409 |
| Robert J Hermann | Chiropractic | 2415 E Washington St F, Bloomington, IL 61704-1609 | |
| Robert D Brown | Chiropractic | 2422 E Washington St, Suite 202, Bloomington, IL 61704-1611 | |
| Julie R Dostal | Registered Dietitian Or Nutrition Professional | 2412 E Washington St, Suite 1b, Bloomington, IL 61704-1613 | |
| Find all physicians in zip 61704 | |||
| City | BLOOMINGTON |
| Zip Code | 61704 |
| Specialty | PLASTIC AND RECONSTRUCTIVE SURGERY |
| City + Specialty | BLOOMINGTON + PLASTIC AND RECONSTRUCTIVE 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.