Matthew David Johnson (NPI# 1881824647, PAC ID# 8921231408) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OTOLARYNGOLOGY.
| Nation Provider ID (NPI) | 1881824647 |
| PAC ID by PECOS | 8921231408 |
| Professional Enrollment ID | I20151123000521 |
| Full Name | Matthew David Johnson |
| Organization Legal Name | SIU PHYSICIANS AND SURGEONS INC |
| Address |
751 N Rutledge St Springfield IL 62702-4968 |
| Phone Number | 2175458000 |
| Gender | M |
| Medical School | UNIVERSITY OF WISCONSIN MEDICAL SCHOOL |
| Graduation Year | 2009 |
| Primary Specialty | OTOLARYNGOLOGY |
| Group Practice PAC ID | 2365352820 |
| Number of Group Practice Members | 236 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 140148 | MEMORIAL MEDICAL CENTER |
| 140053 | ST JOHNS HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 751 N Rutledge St, Springfield, IL 62702-4968 | 2175458000 | SIU PHYSICIANS AND SURGEONS INC |
| Organization Legal Name | SIU PHYSICIANS AND SURGEONS INC |
| Physicians | 259 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Amanda M Clouser | Nurse Practitioner | Siu Physicians and Surgeons Inc | 315 W Carpenter St, Springfield, IL 62702-4901 |
| Kristina Epplin Sondgeroth | Obstetrics/gynecology | Siu Physicians and Surgeons Inc | 400 N 9th St, 3rd Floor Clinic B, Springfield, IL 62702-5310 |
| Evans M Mutua | Nurse Practitioner | Siu Physicians and Surgeons Inc | 720 N Bond St, Springfield, IL 62702-4952 |
| Lori A Bland | Nurse Practitioner | Siu Physicians and Surgeons Inc | 102 W Kenwood Ave, Lowr Level, Decatur, IL 62526-4368 |
| Carmen A Orellana Martinez | Psychiatry | Siu Physicians and Surgeons Inc | 319 E Madison St, Fl 3, Springfield, IL 62701-1035 |
| Basar Cenik | Psychiatry | Siu Physicians and Surgeons Inc | 901 W Jefferson St, Springfield, IL 62702-4833 |
| Henry Olugbenga Adekola | Obstetrics/gynecology | Siu Physicians and Surgeons Inc | 415 N 9th St, Springfield, IL 62702-5303 |
| Momin Saulat Siddique | Cardiovascular Disease (cardiology) | Siu Physicians and Surgeons Inc | 340 W Miller St, Springfield, IL 62702-4928 |
| Kaylie A Caswell | Nurse Practitioner | Siu Physicians and Surgeons Inc | 1100 E Lincolnshire Blvd, Suite 200, Springfield, IL 62703-5950 |
| Lorie Ann Sporrer | Nurse Practitioner | Siu Physicians and Surgeons Inc | 301 N 8th St, Springfield, IL 62701-1041 |
| Street Address |
751 N RUTLEDGE ST |
| City | SPRINGFIELD |
| State | IL |
| Zip | 62702-4968 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Robert Marc Abrams | Obstetrics/gynecology | Siu Physicians and Surgeons Inc | 751 N Rutledge St, Springfield, IL 62702-4968 |
| Zachariah Gurnsey | Internal Medicine | Siu Physicians and Surgeons Inc | 751 N Rutledge St, Springfield, IL 62702-4968 |
| Nathalie Emma Marie Foray | Pulmonary Disease | Siu Physicians and Surgeons Inc | 751 N Rutledge St, Springfield, IL 62702-4968 |
| Ryan Mccarty | Internal Medicine | Siu Physicians and Surgeons Inc | 751 N Rutledge St, Springfield, IL 62702-4968 |
| Lucinda Sue Buescher | Dermatology | Siu Physicians and Surgeons Inc | 751 N Rutledge St, Springfield, IL 62702-4968 |
| Abdullah Alsawaf | Neurology | Siu Physicians and Surgeons Inc | 751 N Rutledge St, Springfield, IL 62702-4968 |
| Abdul Monem Swied | Gastroenterology | Siu Physicians and Surgeons Inc | 751 N Rutledge St, Springfield, IL 62702-4968 |
| James Manning Gilchrist | Neurology | Siu Physicians and Surgeons Inc | 751 N Rutledge St, Springfield, IL 62702-4968 |
| Elizabeth Ramsey Unal | Obstetrics/gynecology | Siu Physicians and Surgeons Inc | 751 N Rutledge St, Springfield, IL 62702-4968 |
| Stacy Renee Lee | Clinical Social Worker | Siu Physicians and Surgeons Inc | 751 N Rutledge St, Springfield, IL 62702-4968 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Douglas P Speck | Chiropractic | 405 E Sangamon Ave, Springfield, IL 62702-1762 | |
| Ryan T Durocher | Chiropractic | 1244 E Sangamon Ave, Springfield, IL 62702-1854 | |
| Dana K Oliver | Chiropractic | Lincoln Chiropractic Clinic PC | 1244 E Sangamon Ave, Springfield, IL 62702-1854 |
| Casey Steven Sitko | Chiropractic | 205 N Grand W Ave, Springfield, IL 62702-2550 | |
| Steven M Sitko | Chiropractic | 205 N Grand Ave W, Springfield, IL 62702-2550 | |
| John L Miller | Chiropractic | The Wellness Center S.c. | 203 N Grand Ave W, Springfield, IL 62702-2550 |
| Cody Derek Needham | Chiropractic | 205 N Grand Ave W, Springfield, IL 62702-2550 | |
| Kyle James Sitko | Chiropractic | 205 N Grand Ave W, Springfield, IL 62702-2550 | |
| Scott P Blomberg | Optometry | Springfield Vision Care Associates Ltd | 121 N Grand Ave W, Springfield, IL 62702-2562 |
| Andrew T Clark | Optometry | Springfield Vision Care Associates Ltd | 121 N Grand Ave W, Springfield, IL 62702-2562 |
| Find all physicians in zip 62702 | |||
| City | SPRINGFIELD |
| Zip Code | 62702 |
| Specialty | OTOLARYNGOLOGY |
| City + Specialty | SPRINGFIELD + OTOLARYNGOLOGY |
Please comment or provide details below to improve the information on Matthew David Johnson.
| 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.