Gregory S Clark (NPI# 1528627833, PAC ID# 8123358199) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA).
| Nation Provider ID (NPI) | 1528627833 |
| PAC ID by PECOS | 8123358199 |
| Professional Enrollment ID | I20190918002030 |
| Full Name | Gregory S Clark |
| Organization Legal Name | ANESTHESIA ASSOCIATES OF SOUTHERN ILLINOIS LLC |
| Address |
3333 W Deyoung St Marion IL 62959-5884 |
| Phone Number | 6188993869 |
| Gender | M |
| Graduation Year | 2019 |
| Primary Specialty | CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) |
| Group Practice PAC ID | 7810251501 |
| Number of Group Practice Members | 20 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 140184 | HEARTLAND REGIONAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 3333 W Deyoung St, Marion, IL 62959-5884 | 6188993869 | ANESTHESIA ASSOCIATES OF SOUTHERN ILLINOIS LLC |
| Organization Legal Name | ANESTHESIA ASSOCIATES OF SOUTHERN ILLINOIS LLC |
| Physicians | 6 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Timothy A Sanders | Certified Registered Nurse Anesthetist (crna) | Anesthesia Associates of Southern Illinois LLC | 8 Doctors Park Rd, Mount Vernon, IL 62864-6224 |
| Danuta Gwarnicka | Anesthesiology | Anesthesia Associates of Southern Illinois LLC | 3333 W Deyoung St, Marion, IL 62959-5884 |
| Vincent C Compton | Certified Registered Nurse Anesthetist (crna) | Anesthesia Associates of Southern Illinois LLC | 8 Doctors Park Rd, Mount Vernon, IL 62864-6224 |
| Don E Bertschi | Certified Registered Nurse Anesthetist (crna) | Anesthesia Associates of Southern Illinois LLC | 8 Doctors Park Rd, Mount Vernon, IL 62864-6224 |
| Samuel P Figueroa | Anesthesiology | Anesthesia Associates of Southern Illinois LLC | 8 Doctors Park Rd, Mount Vernon, IL 62864-6224 |
| Street Address |
3333 W DEYOUNG ST |
| City | MARION |
| State | IL |
| Zip | 62959-5884 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Gladstone A Tucker | Internal Medicine | Memorial Management Inc | 3333 W Deyoung St, Marion, IL 62959-5884 |
| Danuta Gwarnicka | Anesthesiology | Anesthesia Associates of Southern Illinois LLC | 3333 W Deyoung St, Marion, IL 62959-5884 |
| Mustafa Hindi | Hospitalist | Ess of Marion LLC | 3333 W Deyoung St, Marion, IL 62959-5884 |
| Todd L Engdahl | Emergency Medicine | Ess of Marion LLC | 3333 W Deyoung St, Marion, IL 62959-5884 |
| Joseph L Liebenrood | Certified Registered Nurse Anesthetist (crna) | Marion Hospital Corporation | 3333 W Deyoung St, Marion, IL 62959-5884 |
| Randy D Balmforth | Diagnostic Radiology | Midwest Radiological Associates PC | 3333 W Deyoung St, Marion, IL 62959-5884 |
| Michael J Hicks | Qualified Audiologist | Memorial Management Inc | 3333 W Deyoung St, Marion, IL 62959-5884 |
| Terri L Braddock-hartman | Nurse Practitioner | Memorial Management Inc | 3333 W Deyoung St, Marion, IL 62959-5884 |
| Earl Hamilton Rudolph | Internal Medicine | Memorial Management Inc | 3333 W Deyoung St, Marion, IL 62959-5884 |
| Elizabeth R Eggemeyer | Certified Registered Nurse Anesthetist (crna) | Marion Hospital Corporation | 3333 W Deyoung St, Marion, IL 62959-5884 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Justin M White | Chiropractic | 1603 W Kimmel, Marion, IL 62959 | |
| Elizabeth E Lawler | Endocrinology | 1129 N Carbon St, Marion, IL 62959-1068 | |
| Michael P Lawler | Internal Medicine | 1129 N Carbon St, Suite 3, Marion, IL 62959-1068 | |
| James T Lawler | Internal Medicine | 1129 N Carbon St, Marion, IL 62959-1068 | |
| Shirley George | Clinical Social Worker | Centerstone of Illinois Inc | 1307 W Main St, Marion, IL 62959-1139 |
| Aaron M Morehead | Clinical Social Worker | Centerstone of Illinois Inc | 1307 W Main St, Marion, IL 62959-1139 |
| William P Hess Sr. | Podiatry | 1506 W Main St, Marion, IL 62959-1144 | |
| Gary S Karnes | Chiropractic | 1716 W Main, Marion, IL 62959-1148 | |
| Steven C Blandford | Chiropractic | 1716 Main St, Marion, IL 62959-1148 | |
| Mark D Whitehead | Chiropractic | 2103 W Main, Marion, IL 62959-1163 | |
| Find all physicians in zip 62959 | |||
| City | MARION |
| Zip Code | 62959 |
| Specialty | CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) |
| City + Specialty | MARION + CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) |
Please comment or provide details below to improve the information on Gregory S Clark.
| 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.