Kelly Deboer (NPI# 1023070257, PAC ID# 2961402102) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1023070257 |
| PAC ID by PECOS | 2961402102 |
| Professional Enrollment ID | I20120127000154 |
| Full Name | Kelly Deboer |
| Organization Legal Name | ILLINOIS VALLEY COMMUNITY HOSPITAL |
| Address |
310 Walnut St Peru IL 61354-1946 |
| Phone Number | 8157803855 |
| Gender | F |
| Credential | MD |
| Medical School | UNIVERSITY OF CINCINNATI COLLEGE OF MEDICINE |
| Graduation Year | 1996 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 1759274442 |
| Number of Group Practice Members | 39 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 140234 | ILLINOIS VALLEY COMMUNITY HOSPITAL |
| 140110 | OTTAWA REGIONAL HOSPITAL DBA OSF SAINT ELIZABETH MDL CTR |
| 140143 | ST MARGARETS HOSPITAL |
| 140067 | OSF SAINT FRANCIS MEDICAL CENTER |
| 141310 | OSF SAINT PAUL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 310 Walnut St, Peru, IL 61354-1946 | 8157803855 | ILLINOIS VALLEY COMMUNITY HOSPITAL |
| 925 W St, Peru, IL 61354-2757 | ILLINOIS VALLEY COMMUNITY HOSPITAL |
| Organization Legal Name | ILLINOIS VALLEY COMMUNITY HOSPITAL |
| Physicians | 50 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ilan D Bornstein | Obstetrics/gynecology | Illinois Valley Community Hospital | 925 W St, Peru, IL 61354-2757 |
| David Patrick O Donnell | Family Medicine | Illinois Valley Community Hospital | 520 W Walnut St, Oglesby, IL 61348-1400 |
| Ricardo J Calderon | Family Medicine | Illinois Valley Community Hospital | 128 Bucklin St, La Salle, IL 61301-2389 |
| Lucille I Damasauskas | Emergency Medicine | Illinois Valley Community Hospital | 310 Walnut St, Peru, IL 61354-1946 |
| Mark A Fernandez | Internal Medicine | Illinois Valley Community Hospital | 920 W St, Peru, IL 61354-2763 |
| Upendra K Sinha | Orthopedic Surgery | Illinois Valley Community Hospital | 501 Oakley Ave, Streator, IL 61364-1002 |
| Daniel E Obrien | Emergency Medicine | Illinois Valley Community Hospital | 925 W St, Peru, IL 61354-2757 |
| Dana M Hoffman | Certified Nurse Midwife (cnm) | Illinois Valley Community Hospital | 920 W St, Peru, IL 61354-2763 |
| Saamer M Siddiqi | Hospitalist | Illinois Valley Community Hospital | 925 W St, Peru, IL 61354-2757 |
| Maher N Younes | Otolaryngology | Illinois Valley Community Hospital | 925 W St, Peru, IL 61354-2757 |
| Street Address |
310 WALNUT ST |
| City | PERU |
| State | IL |
| Zip | 61354-1946 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lucille I Damasauskas | Emergency Medicine | Illinois Valley Community Hospital | 310 Walnut St, Peru, IL 61354-1946 |
| Jennifer Olesen | Nurse Practitioner | Illinois Valley Community Hospital | 310 Walnut St, Peru, IL 61354-1946 |
| Jonnelle D Smith | Physician Assistant | Illinois Valley Community Hospital | 310 Walnut St, Peru, IL 61354-1946 |
| John T Kuzma | Physician Assistant | Illinois Valley Community Hospital | 310 Walnut St, Peru, IL 61354-1946 |
| Rahul Sampat | Family Medicine | Illinois Valley Community Hospital | 310 Walnut St, Peru, IL 61354-1946 |
| Britnae L Lewis | Nurse Practitioner | Illinois Valley Community Hospital | 310 Walnut St, Peru, IL 61354-1946 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Dotun I Oyedijo | Radiation Oncology | 4391 Venture Dr, Peru, IL 61354-1018 | |
| Joseph B Jackson | Optometry | Jak Enterprises Inc | 3323 Frontage Rd, Peru, IL 61354-1101 |
| David J Coynik | Dermatology | David J Coynik, Md,pc | 4413 Progress Blvd, Peru, IL 61354-1109 |
| Dale R Chilson | Otolaryngology | St. Margarets Hospital | 4040 Progress Blvd, Peru, IL 61354-1124 |
| Katrina Mcquilkin | Chiropractic | 3815 Progress Blvd, Suite C, Peru, IL 61354-1188 | |
| Bulent Mamikoglu | Otolaryngology | 4231 Progress Blvd, Suite 2, Peru, IL 61354-1193 | |
| Rakesh K Garg | Neurology | 4231 Progress Blvd, Peru, IL 61354-1193 | |
| Angela Benavides | Neurology | St. Margarets Hospital | 1400 Midtown Plaza, Peru, IL 61354-1269 |
| Lacey M Strack | Physician Assistant | St. Margarets Hospital | 1650 Midtown Rd, Peru, IL 61354-1274 |
| Rachel L Colby | Physician Assistant | St. Margarets Hospital | 1650 Midtown Rd, Peru, IL 61354-1274 |
| Find all physicians in zip 61354 | |||
| City | PERU |
| Zip Code | 61354 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | PERU + FAMILY MEDICINE |
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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.