Gerald A Wankum (NPI# 1689677254, PAC ID# 2365407244) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OPHTHALMOLOGY.
| Nation Provider ID (NPI) | 1689677254 |
| PAC ID by PECOS | 2365407244 |
| Professional Enrollment ID | I20041120000193 |
| Full Name | Gerald A Wankum |
| Organization Legal Name | SUREVISION EYE CENTERS MIDWEST LLC |
| Address |
1 Professional Dr Suite 260 Alton IL 62002-5068 |
| Phone Number | 6184652020 |
| Gender | M |
| Credential | MD |
| Medical School | SAINT LOUIS UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1976 |
| Primary Specialty | OPHTHALMOLOGY |
| Group Practice PAC ID | 1850297904 |
| Number of Group Practice Members | 5 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 1 Professional Dr, Suite 260, Alton, IL 62002-5068 | 6184652020 | SUREVISION EYE CENTERS MIDWEST LLC |
| 7934 N Lindbergh Blvd, A, Hazelwood, MO 63042-3521 | 3149212020 | SUREVISION EYE CENTERS MIDWEST LLC |
| Organization Legal Name | SUREVISION EYE CENTERS MIDWEST LLC |
| Physicians | 5 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ashley M Deese | Optometry | Surevision Eye Centers Midwest LLC | 7934 N Lindbergh Blvd, A, Hazelwood, MO 63042-3521 |
| Lawrence A Gans | Ophthalmology | Surevision Eye Centers Midwest LLC | 1 Professional Dr, Suite 260, Alton, IL 62002-5068 |
| Eric R Ricker | Optometry | Surevision Eye Centers Midwest LLC | 7934 N Lindbergh Blvd, A, Hazelwood, MO 63042-3521 |
| Jason Michael Newman | Ophthalmology | Surevision Eye Centers Midwest LLC | 7934 N Lindbergh Blvd, A, Hazelwood, MO 63042-3521 |
| Street Address |
1 PROFESSIONAL DR SUITE 260 |
| City | ALTON |
| State | IL |
| Zip | 62002-5068 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| William R Bartley | Internal Medicine | Alton Memorial Physician Billing Services LLC | 1 Professional Dr, Suite 220, Alton, IL 62002-5068 |
| Tariq L Quadri | Internal Medicine | Alton Memorial Physician Billing Services LLC | 1 Professional Dr, Suite 220, Alton, IL 62002-5068 |
| Melissa Rae Mitchell | Nurse Practitioner | Alton Memorial Physician Billing Services LLC | 1 Professional Dr, Suite 150, Alton, IL 62002-5070 |
| Lawrence A Gans | Ophthalmology | Surevision Eye Centers Midwest LLC | 1 Professional Dr, Suite 260, Alton, IL 62002-5068 |
| Erik C Stabell | Internal Medicine | Alton Memorial Physician Billing Services LLC | 1 Professional Dr, Suite 220, Alton, IL 62002-5068 |
| Kristen M Stabell | Internal Medicine | Alton Memorial Physician Billing Services LLC | 1 Professional Dr, Suite 220, Alton, IL 62002-5068 |
| Rachel E Durham | Obstetrics/gynecology | Alton Memorial Physician Billing Services LLC | 1 Professional Dr, Suite 150, Alton, IL 62002-5070 |
| Randall J Rogalsky | Orthopedic Surgery | Alton Memorial Physician Billing Services LLC | 1 Professional Dr, Suite 120, Alton, IL 62002-5068 |
| Debra L Rieger | Nurse Practitioner | Alton Memorial Physician Billing Services LLC | 1 Professional Dr, Suite 220, Alton, IL 62002-5068 |
| Matthew Anthony Thomas | Ophthalmology | Retina Consultants, Ltd | 1 Professional Dr, Suite 260, Alton, IL 62002-5068 |
| Find all physicians in the same address | |||
| 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 | OPHTHALMOLOGY |
| City + Specialty | ALTON + OPHTHALMOLOGY |
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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.