Stuart G Hickerson (NPI# 1073629374, PAC ID# 3476645607) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is EMERGENCY MEDICINE.
| Nation Provider ID (NPI) | 1073629374 |
| PAC ID by PECOS | 3476645607 |
| Professional Enrollment ID | I20070817000373 |
| Full Name | Stuart G Hickerson |
| Organization Legal Name | EPSS PEORIA LLC |
| Address |
5409 N Knoxville Ave Peoria IL 61414-5069 |
| Phone Number | 3096911083 |
| Gender | M |
| Medical School | UNIVERSITY OF ILLINOIS AT CHICAGO HEALTH SCIENCE CENTER |
| Graduation Year | 1989 |
| Primary Specialty | EMERGENCY MEDICINE |
| Group Practice PAC ID | 1850587007 |
| Number of Group Practice Members | 10 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 140013 | PROCTOR HOSPITAL |
| 141325 | OSF SAINT LUKES MEDICAL CENTER |
| 140089 | MC DONOUGH DISTRICT HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 5409 N Knoxville Ave, Peoria, IL 61414-5069 | 3096911083 | EPSS PEORIA LLC |
| Organization Legal Name | EPSS PEORIA LLC |
| Physicians | 16 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Krystal L Crecelius | Nurse Practitioner | Epss Peoria LLC | 5409 N Knoxville Ave, Peoria, IL 61414-5069 |
| Chelsea M Krejci | Nurse Practitioner | Epss Peoria LLC | 5409 N Knoxville Ave, Peoria, IL 61414-5069 |
| Marcus S Teng | Emergency Medicine | Epss Peoria LLC | 5409 N Knoxville Ave, Peoria, IL 61414-5069 |
| Manisha Patel | Emergency Medicine | Epss Peoria LLC | 5409 N Knoxville Ave, Peoria, IL 61414-5069 |
| Melissa L Jones | Nurse Practitioner | Epss Peoria LLC | 5409 N Knoxville Ave, Peoria, IL 61414-5069 |
| Kathryn A Craig | Emergency Medicine | Epss Peoria LLC | 5409 N Knoxville Ave, Peoria, IL 61414-5069 |
| Michael R. Johnson | Emergency Medicine | Epss Peoria LLC | 5409 N Knoxville Ave, Peoria, IL 61414-5069 |
| Jennifer S Roberts | Emergency Medicine | Epss Peoria LLC | 5409 N Knoxville Ave, Peoria, IL 61414-5069 |
| Aimee Parrott | Nurse Practitioner | Epss Peoria LLC | 5409 N Knoxville Ave, Peoria, IL 61414-5069 |
| Kelly L Cox | Emergency Medicine | Epss Peoria LLC | 5409 N Knoxville Ave, Peoria, IL 61414-5069 |
| Street Address |
5409 N KNOXVILLE AVE |
| City | PEORIA |
| State | IL |
| Zip | 61414-5069 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Krystal L Crecelius | Nurse Practitioner | Epss Peoria LLC | 5409 N Knoxville Ave, Peoria, IL 61414-5069 |
| Chelsea M Krejci | Nurse Practitioner | Epss Peoria LLC | 5409 N Knoxville Ave, Peoria, IL 61414-5069 |
| Marcus S Teng | Emergency Medicine | Epss Peoria LLC | 5409 N Knoxville Ave, Peoria, IL 61414-5069 |
| Manisha Patel | Emergency Medicine | Epss Peoria LLC | 5409 N Knoxville Ave, Peoria, IL 61414-5069 |
| Melissa L Jones | Nurse Practitioner | Epss Peoria LLC | 5409 N Knoxville Ave, Peoria, IL 61414-5069 |
| Kathryn A Craig | Emergency Medicine | Epss Peoria LLC | 5409 N Knoxville Ave, Peoria, IL 61414-5069 |
| Michael R. Johnson | Emergency Medicine | Epss Peoria LLC | 5409 N Knoxville Ave, Peoria, IL 61414-5069 |
| Katherine A Kasper | Pathology | Peoria Tazewell Pathology Group, S.c. | 5409 N Knoxville Ave, Peoria, IL 61614-5069 |
| Brandy R Pownell | Pathology | Peoria Tazewell Pathology Group, S.c. | 5409 N Knoxville Ave, Peoria, IL 61614-5069 |
| Jennifer S Roberts | Emergency Medicine | Epss Peoria LLC | 5409 N Knoxville Ave, Peoria, IL 61414-5069 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Aimee Parrott | Nurse Practitioner | Epss Peoria LLC | 5409 N Knoxville Ave, Peoria, IL 61414-5069 |
| Kelly L Cox | Emergency Medicine | Epss Peoria LLC | 5409 N Knoxville Ave, Peoria, IL 61414-5069 |
| Nakayla J Gallegos | Emergency Medicine | Epss Peoria LLC | 5409 N Knoxville Ave, Peoria, IL 61414-5069 |
| Ashley N Huff | Emergency Medicine | Epss Peoria LLC | 5409 N Knoxville Ave, Peoria, IL 61414-5069 |
| Cassie J Stone | Nurse Practitioner | Epss Peoria LLC | 5409 N Knoxville Ave, Peoria, IL 61414-5069 |
| Charles L Boursier | Emergency Medicine | Epss Peoria LLC | 5409 N Knoxville Ave, Peoria, IL 61414-5069 |
| Ute C Prohaska | Emergency Medicine | Epss Peoria LLC | 5409 N Knoxville Ave, Peoria, IL 61414-5069 |
| City | PEORIA |
| Zip Code | 61414 |
| Specialty | EMERGENCY MEDICINE |
| City + Specialty | PEORIA + EMERGENCY MEDICINE |
Please comment or provide details below to improve the information on Stuart G Hickerson.
| 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.