Mary A Depaz (NPI# 1700846664, PAC ID# 3577477710) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is RADIATION ONCOLOGY.
| Nation Provider ID (NPI) | 1700846664 |
| PAC ID by PECOS | 3577477710 |
| Professional Enrollment ID | I20110118001224 |
| Full Name | Mary A Depaz |
| Organization Legal Name | CANCER CARE SPECIALISTS OF CENTRAL ILLINOIS, S.C. |
| Address |
1990 E Lakeshore Dr Decatur IL 62521-3811 |
| Phone Number | 2174642900 |
| Gender | F |
| Medical School | RUSH MEDICAL COLLEGE OF RUSH UNIVERSITY |
| Graduation Year | 1995 |
| Primary Specialty | RADIATION ONCOLOGY |
| Secondary Specialties | INTERNAL MEDICINE |
| Group Practice PAC ID | 5991619116 |
| Number of Group Practice Members | 23 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 140135 | DECATUR MEMORIAL HOSPITAL |
| 140166 | ST MARYS HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1990 E Lakeshore Dr, Decatur, IL 62521-3811 | 2174642900 | CANCER CARE SPECIALISTS OF CENTRAL ILLINOIS, S.C. |
| 210 W Mckinley Ave, Suite 2, Decatur, IL 62526-5858 | 2178764700 | CANCER CARE SPECIALISTS OF CENTRAL ILLINOIS, S.C. |
| Organization Legal Name | CANCER CARE SPECIALISTS OF CENTRAL ILLINOIS, S.C. |
| Physicians | 24 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jennifer Nicole Born | Nurse Practitioner | Cancer Care Specialists of Central Illinois, S.c. | 905 Medical Park Dr, Effingham, IL 62401-2190 |
| Nicole S Soper | Nurse Practitioner | Cancer Care Specialists of Central Illinois, S.c. | 210 W Mckinley Ave, Suite 2, Decatur, IL 62526-5858 |
| Sebastien Simon Kairouz | Medical Oncology | Cancer Care Specialists of Central Illinois, S.c. | 1990 E Lakeshore Dr, Decatur, IL 62521-3811 |
| Thomas Howard Tarter | Urology | Cancer Care Specialists of Central Illinois, S.c. | 210 W Mckinley Ave, Suite 1, Decatur, IL 62526-5858 |
| Benjamin T Esparaz | Hematology/oncology | Cancer Care Specialists of Central Illinois, S.c. | 210 W Mckinley Ave, Suite 1, Decatur, IL 62526-5858 |
| Mark Andrew Walshauser | Hematology/oncology | Cancer Care Specialists of Central Illinois, S.c. | 210 W Mckinley Ave, Suite 2, Decatur, IL 62526-5858 |
| Mario R Velasco Jr. | Hematology/oncology | Cancer Care Specialists of Central Illinois, S.c. | 210 W Mckinley Ave, Suite 2, Decatur, IL 62526-5858 |
| Kristi Marie Toennies | Nurse Practitioner | Cancer Care Specialists of Central Illinois, S.c. | 1050 M L King Dr, Suite 2, Centralia, IL 62801-3060 |
| Casey Ellis Duncan | Radiation Oncology | Cancer Care Specialists of Central Illinois, S.c. | 1000 Health Ctr Dr, Mattoon, IL 61938-9253 |
| Gibran Hamid Mahmud | Hematology/oncology | Cancer Care Specialists of Central Illinois, S.c. | 1050 M L King Dr, Suite 2, Centralia, IL 62801-3060 |
| Street Address |
1990 E LAKESHORE DR |
| City | DECATUR |
| State | IL |
| Zip | 62521-3811 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sebastien Simon Kairouz | Medical Oncology | Cancer Care Specialists of Central Illinois, S.c. | 1990 E Lakeshore Dr, Decatur, IL 62521-3811 |
| Evelena Patrice Ontiveros | Hematology/oncology | Cancer Care Specialists of Central Illinois, S.c. | 1990 E Lakeshore Dr, Decatur, IL 62521-3811 |
| Renata C Moore | Radiation Oncology | Cancer Care Specialists of Central Illinois, S.c. | 1990 E Lakeshore Dr, Decatur, IL 62521-3811 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Patricia L Miller | Nurse Practitioner | Decatur Memorial Hospital | 4455 Us Route 36 E, Decatur, IL 62521 |
| Dana M Ray | Family Medicine | Community Health Improvement Center | 1221 E Condit St, Decatur, IL 62521-1405 |
| Charles Bedford Jr. | Optometry | 1270 S Jasper St, Decatur, IL 62521-3531 | |
| Michael J Karasis | Urology | Siu Physicians and Surgeons Inc | 1750 E Lake Shore Dr, Suite 120, Decatur, IL 62521-3803 |
| Nicholas Nasry Tadros | Urology | Siu Physicians and Surgeons Inc | 1750 E Lake Shore Dr, Suite Ll2, Decatur, IL 62521-3803 |
| Bradley Fields Schwartz | Urology | Siu Physicians and Surgeons Inc | 1750 E Lake Shore Dr, Suite 120, Decatur, IL 62521-3803 |
| Naeemuddin Jatoi | Internal Medicine | Hshs Medical Group Inc | 1750 E Lake Shore Dr, Suite 100, Decatur, IL 62521-3803 |
| Carrie Ann West | Nurse Practitioner | Siu Physicians and Surgeons Inc | 1750 E Lake Shore Dr, Suite 120, Decatur, IL 62521-3803 |
| Bavikatte Shivakumar | Gastroenterology | Hshs Medical Group Inc | 1750 E Lake Shore Dr, Decatur, IL 62521-3803 |
| Virginia Ann Kerwin | Registered Dietitian Or Nutrition Professional | Hshs Medical Group Inc | 1750 E Lake Shore Dr, Suite 300, Decatur, IL 62521-3806 |
| Find all physicians in zip 62521 | |||
| City | DECATUR |
| Zip Code | 62521 |
| Specialty | RADIATION ONCOLOGY |
| City + Specialty | DECATUR + 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.