Kenneth Wayne Birge (NPI# 1194896720, PAC ID# 5799816708) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1194896720 |
| PAC ID by PECOS | 5799816708 |
| Professional Enrollment ID | I20100707000547 |
| Full Name | Kenneth Wayne Birge |
| Organization Legal Name | SUMMIT FAMILY MEDICAL CENTER |
| Address |
902 N Hershey Rd Bloomington IL 61704-3730 |
| Phone Number | 3096626880 |
| Gender | M |
| Graduation Year | 1986 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 6406755917 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 140242 | CENTRAL DUPAGE HOSPITAL |
| 140127 | ADVOCATE BROMENN MEDICAL CENTER |
| 140162 | ST JOSEPH MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 902 N Hershey Rd, Bloomington, IL 61704-3730 | 3096626880 | SUMMIT FAMILY MEDICAL CENTER |
| Organization Legal Name | SUMMIT FAMILY MEDICAL CENTER |
| Physicians | 2 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Elizabeth Devlin | Nurse Practitioner | Summit Family Medical Center | 902 N Hershey Rd, Bloomington, IL 61704-3730 |
| Street Address |
902 N HERSHEY RD |
| City | BLOOMINGTON |
| State | IL |
| Zip | 61704-3730 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Elizabeth Devlin | Nurse Practitioner | Summit Family Medical Center | 902 N Hershey Rd, Bloomington, IL 61704-3730 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Leah C Swanson | Clinical Social Worker | Elliott Counseling Services LLC | 209 S Prospect, Suite 1, Bloomington, IL 61704 |
| Cheri Miller | Psychologist, Clinical | Advocate Health and Hospitals Corporation | 303 N Hershey, Suite 2c, Bloomington, IL 61704 |
| Dennis M Brtva | Optometry | Central Illinois Family Eyecare LLC | 2109 N Veterans Pkwy, Suite 2, Bloomington, IL 61704-0910 |
| Christopher James Wetzler | Optometry | Central Illinois Family Eyecare LLC | 2109 N Veterans Pkwy, Suite 2, Bloomington, IL 61704-0910 |
| Ashley Elizabeth Foster | Optometry | Central Illinois Family Eyecare LLC | 2109 N Veterans Pkwy, Suite 2, Bloomington, IL 61704-0910 |
| Preston Langdon Smith | Optometry | Central Illinois Family Eyecare LLC | 2109 N Veterans Pkwy, Suite 2, Bloomington, IL 61704-0910 |
| Kristine C Winkler | Nurse Practitioner | Encounter Telehealth LLC | 11 Harbor Pointe Ct, Bloomington, IL 61704-1409 |
| Robert J Hermann | Chiropractic | 2415 E Washington St F, Bloomington, IL 61704-1609 | |
| Robert D Brown | Chiropractic | 2422 E Washington St, Suite 202, Bloomington, IL 61704-1611 | |
| Julie R Dostal | Registered Dietitian Or Nutrition Professional | 2412 E Washington St, Suite 1b, Bloomington, IL 61704-1613 | |
| Find all physicians in zip 61704 | |||
| City | BLOOMINGTON |
| Zip Code | 61704 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | BLOOMINGTON + 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.