Wade Larry Thorstad (NPI# 1356367668, PAC ID# 1355371295) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is RADIATION ONCOLOGY.
| Nation Provider ID (NPI) | 1356367668 |
| PAC ID by PECOS | 1355371295 |
| Professional Enrollment ID | I20050819000427 |
| Full Name | Wade Larry Thorstad |
| Organization Legal Name | WASHINGTON UNIVERSITY PHYSICIANS IN ILLINOIS INC |
| Address |
6 Memorial Dr Bldg C Alton IL 62002-6751 |
| Phone Number | 6184337979 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF TEXAS MEDICAL SCHOOL AT HOUSTON |
| Graduation Year | 1991 |
| Primary Specialty | RADIATION ONCOLOGY |
| Group Practice PAC ID | 4789945163 |
| Number of Group Practice Members | 45 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 260032 | BARNES JEWISH HOSPITAL |
| 140002 | ALTON MEMORIAL HOSPITAL |
| 260162 | BARNES-JEWISH WEST COUNTY HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 6 Memorial Dr, Bldg C, Alton, IL 62002-6751 | 6184337979 | WASHINGTON UNIVERSITY PHYSICIANS IN ILLINOIS INC |
| 4921 Parkview Pl Lower Lvl - Ctr for Advanced, Medicine Dept of Radiation Oncology, Saint Louis, MO 63110-1032 | 3143629715 | WASHINGTON UNIVERSITY |
| 5225 Mid America Plz, Saint Louis, MO 63129-0002 | 3142861911 | WASHINGTON UNIVERSITY |
| Organization Legal Name | WASHINGTON UNIVERSITY PHYSICIANS IN ILLINOIS INC |
| Physicians | 19 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Nishant Poddar | Medical Oncology | Washington University Physicians In Illinois Inc | 8 Sunset Hills Professional Ctr, Suite 100, Edwardsville, IL 62025-3760 |
| Stephanie M Perkins | Radiation Oncology | Washington University Physicians In Illinois Inc | 6 Memorial Dr, Bldg C, Alton, IL 62002-6751 |
| John L Visconti | Hematology/oncology | Washington University Physicians In Illinois Inc | 4000 N Illinois Ln, Suite C, Swansea, IL 62226-1969 |
| Michelle V Jacob | Nurse Practitioner | Washington University Physicians In Illinois Inc | 4000 N Illinois Ln, Swansea, IL 62226-1969 |
| Alfred O Greco | Medical Oncology | Washington University Physicians In Illinois Inc | 4000 N Illinois Ln, Suite C, Swansea, IL 62226-1969 |
| James M Close | Critical Care (intensivists) | Washington University Physicians In Illinois Inc | 4000 N Illinois Ln, Swansea, IL 62226-1969 |
| Lawrence Osei | Critical Care (intensivists) | Washington University Physicians In Illinois Inc | 4500 Memorial Dr, Belleville, IL 62226-5360 |
| Alexis A Mcallister | Nurse Practitioner | Washington University Physicians In Illinois Inc | 1414 Cross St, Suite 140, Shiloh, IL 62269-2988 |
| Eric M Yeager | Nurse Practitioner | Washington University Physicians In Illinois Inc | 4000 N Illinois Ln, Swansea, IL 62226-1969 |
| John Matthew Felder Iii | Plastic and Reconstructive Surgery | Washington University Physicians In Illinois Inc | 1 Memorial Dr, Alton, IL 62002-6722 |
| Street Address |
6 MEMORIAL DR BLDG C |
| City | ALTON |
| State | IL |
| Zip | 62002-6751 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Stephanie M Perkins | Radiation Oncology | Washington University Physicians In Illinois Inc | 6 Memorial Dr, Bldg C, Alton, IL 62002-6751 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Christina J Levi | Optometry | Nu-crown, LLC | 406 E Broadway, Alton, IL 62002-2417 |
| Chih Jen Wang | Optometry | Nu-crown, LLC | 406 E Broadway, Alton, IL 62002-2417 |
| Elaina Ward | Clinical Social Worker | Centerstone of Illinois Inc | 2615 Edwards St, Alton, IL 62002-3915 |
| Carol Worthington | Clinical Social Worker | Centerstone of Illinois Inc | 2615 Edwards St, Alton, IL 62002-3915 |
| Donna J Boone | Addiction Medicine | Centerstone of Illinois Inc | 2615 Edwards St, Alton, IL 62002-3915 |
| Jennifer Gerlach | Clinical Social Worker | Centerstone of Illinois Inc | 2615 Edwards St, Alton, IL 62002-3915 |
| Olivia M Winters | Nurse Practitioner | Centerstone of Illinois Inc | 2615 Edwards St, Alton, IL 62002-3915 |
| Sarah Viliocco | Clinical Social Worker | Centerstone of Illinois Inc | 2615 Edwards St, Alton, IL 62002-3915 |
| Rebecca Ashworth-rhein | Clinical Social Worker | Centerstone of Illinois Inc | 2615 Edwards St, Alton, IL 62002-3915 |
| Brittany L Mccrady | Clinical Social Worker | Centerstone of Illinois Inc | 2615 Edwards St, Alton, IL 62002-3915 |
| Find all physicians in zip 62002 | |||
| City | ALTON |
| Zip Code | 62002 |
| Specialty | RADIATION ONCOLOGY |
| City + Specialty | ALTON + RADIATION ONCOLOGY |
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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.