Diane L Destefano (NPI# 1063797314, PAC ID# 2264606995) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1063797314 |
| PAC ID by PECOS | 2264606995 |
| Professional Enrollment ID | I20130328000349 |
| Full Name | Diane L Destefano |
| Organization Legal Name | WABASH GENERAL HOSPITAL DISTRICT |
| Address |
610 N Court St Grayville IL 62844-1002 |
| Phone Number | 6183757101 |
| Gender | F |
| Graduation Year | 2011 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 8022908185 |
| Number of Group Practice Members | 25 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 141327 | WABASH GENERAL HOSPITAL 1 |
| Address | Phone | Organization |
|---|---|---|
| 610 N Court St, Grayville, IL 62844-1002 | 6183757101 | WABASH GENERAL HOSPITAL DISTRICT |
| 1418 College Dr, Mount Carmel, IL 62863-2638 | 6182628621 | WABASH GENERAL HOSPITAL DISTRICT |
| Organization Legal Name | WABASH GENERAL HOSPITAL DISTRICT |
| Physicians | 22 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kristina A Lecrone | Nurse Practitioner | Wabash General Hospital District | 1430 College Dr, Suite B, Mount Carmel, IL 62863-2649 |
| Michael Patrick Cheesman | Physician Assistant | Wabash General Hospital District | 929 Stacey Burk Dr, Flora, IL 62839-3241 |
| Kayla M Wilcox | Physician Assistant | Wabash General Hospital District | 1112 Oak St, Carmi, IL 62821-1344 |
| Jenna L Kintner | Nurse Practitioner | Wabash General Hospital District | 1527 College Dr, Mount Carmel, IL 62863-2615 |
| Justin A Miller | Orthopedic Surgery | Wabash General Hospital District | 26 E Elm St, Albion, IL 62806-1211 |
| Narendra H Anadkat | Hospitalist | Wabash General Hospital District | 1418 College Dr, Mount Carmel, IL 62863-2638 |
| Karsten B Slater | Family Medicine | Wabash General Hospital District | 2200 State St, Lawrenceville, IL 62439-1852 |
| Julko E Fullop | Orthopedic Surgery | Wabash General Hospital District | 2200 State St, Lawrenceville, IL 62439-1852 |
| Alicia Leann Kinsolving | Physician Assistant | Wabash General Hospital District | 1418 College Dr, Mount Carmel, IL 62863-2638 |
| Abdul Badr | General Surgery | Wabash General Hospital District | 1430 College Dr, Suite B, Mount Carmel, IL 62863-2649 |
| Street Address |
610 N COURT ST |
| City | GRAYVILLE |
| State | IL |
| Zip | 62844-1002 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Janie J Tompson | Nurse Practitioner | Wabash General Hospital District | 610 N Court St, Grayville, IL 62844-1002 |
| Ketan C Vyas | Internal Medicine | 610 N Court St, Grayville, IL 62844-1002 |
| City | GRAYVILLE |
| Zip Code | 62844 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | GRAYVILLE + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Diane L Destefano.
| 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.