Jerrold C Willis (NPI# 1467407072, PAC ID# 8921086539) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DIAGNOSTIC RADIOLOGY.
| Nation Provider ID (NPI) | 1467407072 |
| PAC ID by PECOS | 8921086539 |
| Professional Enrollment ID | I20040709001419 |
| Full Name | Jerrold C Willis |
| Organization Legal Name | MID AMERICA RADIOLOGY SC |
| Address |
200 Health Care Dr Greenville IL 62246-1154 |
| Phone Number | 6186641230 |
| Gender | M |
| Credential | MD |
| Medical School | SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1977 |
| Primary Specialty | DIAGNOSTIC RADIOLOGY |
| Secondary Specialties | INTERVENTIONAL RADIOLOGY, NUCLEAR MEDICINE |
| Group Practice PAC ID | 5294797353 |
| Number of Group Practice Members | 10 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 140046 | SSM HEALTH - GOOD SAMARITAN HOSPITAL |
| 140034 | SSM HEALTH ST MARY'S HOSPITAL -CENTRALIA |
| 141336 | ST JOSEPH'S HOSPITAL |
| 141345 | SALEM TOWNSHIP HOSPITAL |
| 140137 | GREENVILLE REGIONAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 400 N Pleasant Ave, Centralia, IL 62801-3056 | 6184368000 | MID AMERICA RADIOLOGY SC |
| 200 Health Care Dr, Greenville, IL 62246-1154 | 6186641230 | MID AMERICA RADIOLOGY SC |
| 12866 Troxler Ave, Highland, IL 62249-2806 | 6186547421 | MID AMERICA RADIOLOGY SC |
| 1 Good Samaritan Way, Mount Vernon, IL 62864-2402 | 6188994600 | MID AMERICA RADIOLOGY SC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| MIPS_EC_145_overall | Radiology: Exposure Dose or Time Reported for Procedures Using Fluoroscopy | 100% | |
| MIPS_EC_195_overall | Radiology: Stenosis Measurement in Carotid Imaging Reports | 100% | |
| MIPS_EC_225_overall | Radiology: Reminder System for Screening Mammograms | 100% | |
| MIPS_EC_436_overall | Radiation Consideration for Adult CT: Utilization of Dose Lowering Techniques | 100% |
| Organization Legal Name | MID AMERICA RADIOLOGY SC |
| Physicians | 11 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Patrick J Bennett | Diagnostic Radiology | Mid America Radiology Sc | 400 N Pleasant Ave, Centralia, IL 62801-3056 |
| Neetin C Patel | Diagnostic Radiology | Mid America Radiology Sc | 400 N Pleasant Ave, Centralia, IL 62801-3056 |
| Miguel Gelman | Diagnostic Radiology | Mid America Radiology Sc | 400 N Pleasant Ave, Centralia, IL 62801-3056 |
| John R Willis | Diagnostic Radiology | Mid America Radiology Sc | 200 Health Care Dr, Greenville, IL 62246-1154 |
| Prashanth C Shekar | Diagnostic Radiology | Mid America Radiology Sc | 200 Health Care Dr, Greenville, IL 62246-1154 |
| Anthony N Sodd | Diagnostic Radiology | Mid America Radiology Sc | 200 Health Care Dr, Greenville, IL 62246-1154 |
| Sanjiv Makhecha | Diagnostic Radiology | Mid America Radiology Sc | 400 N Pleasant Ave, Centralia, IL 62801-3056 |
| Timothy Joseph Carmody | Interventional Radiology | Mid America Radiology Sc | 200 Health Care Dr, Greenville, IL 62246-1154 |
| Clarence R Reilly | Diagnostic Radiology | Mid America Radiology Sc | 400 N Pleasant Ave, Centralia, IL 62801-3056 |
| Kent Smith Quinn | Diagnostic Radiology | Mid America Radiology Sc | 400 N Pleasant Ave, Centralia, IL 62801-3056 |
| Street Address |
200 HEALTH CARE DR |
| City | GREENVILLE |
| State | IL |
| Zip | 62246-1154 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| David J Bitzer | Urology | Hshs Medical Group Inc | 200 Health Care Dr, Greenville, IL 62246-1154 |
| Steven D Donnan | Certified Registered Nurse Anesthetist (crna) | Hshs Holy Family Hospital Inc | 200 Health Care Dr, Greenville, IL 62246-1154 |
| Asim I Elmahboub | Internal Medicine | Cep America-illinois Hospitalists LLP | 200 Health Care Dr, Greenville, IL 62246-1154 |
| John R Willis | Diagnostic Radiology | Mid America Radiology Sc | 200 Health Care Dr, Greenville, IL 62246-1154 |
| Prashanth C Shekar | Diagnostic Radiology | Mid America Radiology Sc | 200 Health Care Dr, Greenville, IL 62246-1154 |
| Gabriel A Gigliotti | Certified Registered Nurse Anesthetist (crna) | Hshs Holy Family Hospital Inc | 200 Health Care Dr, Greenville, IL 62246-1154 |
| Anthony N Sodd | Diagnostic Radiology | Mid America Radiology Sc | 200 Health Care Dr, Greenville, IL 62246-1154 |
| Jamie L Baum | Emergency Medicine | Cepamerica Illinois LLP | 200 Health Care Dr, Greenville, IL 62246-1154 |
| Maaroof Islam | Hospitalist | Cep America-illinois Hospitalists LLP | 200 Health Care Dr, Greenville, IL 62246-1154 |
| Jennifer Helmholt | Nurse Practitioner | Cep America-illinois Hospitalists LLP | 200 Health Care Dr, Greenville, IL 62246-1154 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| James R Goggin | Family Medicine | Fayette County Hospital District | 308 W College Ave, Greenville, IL 62246-1019 |
| Andrew S Goggin | Family Medicine | Fayette County Hospital District | 308 W College Ave, Greenville, IL 62246-1019 |
| Vaughn L Robart | Clinical Social Worker | Jubilee House Outreach | 417 W College Ave, Greenville, IL 62246-1020 |
| Melanie C Schaafsma | Clinical Social Worker | Jubilee House Outreach | 417 W College Ave, Greenville, IL 62246-1020 |
| Lisa L Tindall | Nurse Practitioner | Specialized Wound Management LLC | 200 Healthcare Dr, Edward A Utlaut Mem, Greenville, IL 62246-1154 |
| Christopher Frantz | Emergency Medicine | Cepamerica Illinois LLP | 200 Health Care Dr, Greenville, IL 62246-1154 |
| Timothy Joseph Carmody | Interventional Radiology | Mid America Radiology Sc | 200 Health Care Dr, Greenville, IL 62246-1154 |
| Richard G. Mccollum | Emergency Medicine | Cepamerica Illinois LLP | 200 Health Care Dr, Greenville, IL 62246-1154 |
| Anthony M Newell | Emergency Medicine | Cepamerica Illinois LLP | 200 Health Care Dr, Greenville, IL 62246-1154 |
| Noah Michael Einstein | Emergency Medicine | Cepamerica Illinois LLP | 200 Health Care Dr, Greenville, IL 62246-1154 |
| Find all physicians in zip 62246 | |||
| City | GREENVILLE |
| Zip Code | 62246 |
| Specialty | DIAGNOSTIC RADIOLOGY |
| City + Specialty | GREENVILLE + DIAGNOSTIC RADIOLOGY |
Please comment or provide details below to improve the information on Jerrold C Willis.
| 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.