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1003006701 0 228 E LAKE ST ADDISON IL 601012889 20 1003006701 0 Physicians Anesthesia Services 20 1003006701 0 Physicians Healthy Kids Services 20 1003006701 0 Physicians Optical Supplies 20 1003006701 0 Physicians Physician Services 20 1003006701 0 Physicians Physicians Psychiatric Services 00 1003007170 0 DANCIU SORIN 2008245 9999999 B 10 1003007170 0 29373 NETWORK PL CHICAGO IL 606733039 20 1003007170 0 Physicians Anesthesia Services 20 1003007170 0 Physicians Healthy Kids Services 20 1003007170 0 Physicians Optical Supplies 20 1003007170 0 Physicians Physician Services 00 1003007345 0 HARLOW MICHAEL 2016328 9999999 B 10 1003007345 0 2704 NE INDEPENDENCE AVE LEES SUMMIT MO 640642323 20 1003007345 0 Physicians Anesthesia Services 20 1003007345 0 Physicians Healthy Kids Services 20 1003007345 0 Physicians Optical Supplies 20 1003007345 0 Physicians Physician Services 20 1003007345 0 Physicians Physicians Psychiatric Services 00 1003010059 0 PARDO ANDREA C. 2015182 9999999 B 10 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1003011800 0 Physicians Physician Services 00 1003011826 0 POLES BILUS 2007244 9999999 B 10 1003011826 0 305 E RAND RD ARLINGTON HEIGH IL 600043103 20 1003011826 0 Dentists Dental Services 20 1003011826 0 Dentists Physician Services 00 1003011941 0 JUNG EDWARD 2018048 9999999 B 10 1003011941 0 10400 SOUTHWEST HWY CHICAGO RIDGE IL 604151367 20 1003011941 0 Physicians Anesthesia Services 20 1003011941 0 Physicians Healthy Kids Services 20 1003011941 0 Physicians Optical Supplies 20 1003011941 0 Physicians Physician Services 00 1003011966 0 KALLSNICK AARON 2007191 9999999 B 10 1003011966 0 265 BROOKVIEW CENTRE WAY STE 4 KNOXVILLE TN 379194052 20 1003011966 0 Physicians Anesthesia Services 20 1003011966 0 Physicians Healthy Kids Services 20 1003011966 0 Physicians Optical Supplies 20 1003011966 0 Physicians Physician Services 00 1003012444 0 PICEL ANDREW C 2018317 9999999 B 10 1003012444 0 FILE 57326 LOS ANGELES CA 900740001 20 1003012444 0 Physicians Anesthesia Services 20 1003012444 0 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KHAJA ASLAM 2007228 9999999 B 10 1003014457 0 5777 DEPT CAROL STREAM IL 601228942 20 1003014457 0 Physicians Anesthesia Services 20 1003014457 0 Physicians Healthy Kids Services 20 1003014457 0 Physicians Optical Supplies 20 1003014457 0 Physicians Physician Services 00 1003015116 0 CHHABRA DARSHIKA 2010258 9999999 B 10 1003015116 0 100 S GRAND AVE E FL 1 SPRINGFIELD IL 627621000 20 1003015116 0 Physicians Anesthesia Services 20 1003015116 0 Physicians Healthy Kids Services 20 1003015116 0 Physicians Optical Supplies 20 1003015116 0 Physicians Physician Services 00 1003015207 0 SWANEY ROBERT 2023011 9999999 B 10 1003015207 0 250 W 96TH ST # 520 INDIANAPOLIS IN 462601316 20 1003015207 0 Physicians Anesthesia Services 20 1003015207 0 Physicians Fluoride varnish 20 1003015207 0 Physicians Healthy Kids Services 20 1003015207 0 Physicians Optical Supplies 20 1003015207 0 Physicians Physician Services 00 1003015447 0 PARNHAM RYAN E 2008061 9999999 B 10 1003015447 0 1420 W PIONEER PKWY PEORIA 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9999999 B 10 1003020496 0 2704 NE INDEPENDENCE AVE LEES SUMMIT MO 640642323 20 1003020496 0 Physicians Anesthesia Services 20 1003020496 0 Physicians Healthy Kids Services 20 1003020496 0 Physicians Optical Supplies 20 1003020496 0 Physicians Physician Services 20 1003020496 0 Physicians Physicians Psychiatric Services 00 1003021916 0 LARVA JEREMY J 2017314 9999999 B 10 1003021916 0 680 N LAKE SHORE DR STE 1000 SUITE# 1000 CHICAGO IL 606118709 20 1003021916 0 Physician Assistant Only Fluoride varnish 20 1003021916 0 Physician Assistant Only Healthy Kids Services 20 1003021916 0 Physician Assistant Only Physician Services 00 1003022237 0 LEE SANGIL 2016211 9999999 B 10 1003022237 0 200 HAWKINS DR IOWA CITY IA 522421009 20 1003022237 0 Physicians Anesthesia Services 20 1003022237 0 Physicians Fluoride varnish 20 1003022237 0 Physicians Healthy Kids Services 20 1003022237 0 Physicians Optical Supplies 20 1003022237 0 Physicians Physician Services 00 1003022591 0 KEMPTON LAURENCE B 2015265 9999999 B 10 1003022591 0 340 W 10TH ST INDIANAPOLIS IN 462023082 20 1003022591 0 Physicians Anesthesia Services 20 1003022591 0 Physicians Healthy Kids Services 20 1003022591 0 Physicians Optical Supplies 20 1003022591 0 Physicians Physician Services 00 1003024175 0 RAPAPORT DIANE 1983213 9999999 B 10 1003024175 0 255 E 5TH ST STE 1050 CINCINNATI OH 452024121 20 1003024175 0 Physicians Anesthesia Services 20 1003024175 0 Physicians Fluoride varnish 20 1003024175 0 Physicians Healthy Kids Services 20 1003024175 0 Physicians Optical Supplies 20 1003024175 0 Physicians Physician Services 00 1003025032 0 EL ABIAD RAMI G 2014337 9999999 B 10 1003025032 0 1500 ASSOCIATES DR DUBUQUE IA 520022201 20 1003025032 0 Physicians Anesthesia Services 20 1003025032 0 Physicians Fluoride varnish 20 1003025032 0 Physicians Healthy Kids Services 20 1003025032 0 Physicians Optical Supplies 20 1003025032 0 Physicians Physician Services 00 1003025438 0 HUSSAIN AYESHA 2007227 9999999 B 10 1003025438 0 2424 W PETERSON AVE CHICAGO IL 606594100 20 1003025438 0 Physicians Anesthesia Services 20 1003025438 0 Physicians Healthy Kids Services 20 1003025438 0 Physicians Optical Supplies 20 1003025438 0 Physicians Physician Services 00 1003025651 0 FAASSE MARK A 2014259 9999999 B 10 1003025651 0 29373 NETWORK PL CHICAGO IL 606733039 20 1003025651 0 Physicians Anesthesia Services 20 1003025651 0 Physicians Healthy Kids Services 20 1003025651 0 Physicians Optical Supplies 20 1003025651 0 Physicians Physician Services 00 1003025917 0 JULIAN GWENDOLYN 2001319 9999999 B 10 1003025917 0 1652 N LOCKWOOD AVE CHICAGO IL 606394306 20 1003025917 0 Speech Therapists Medical Supplies 20 1003025917 0 Speech Therapists Medical equipment/prosthetic devices 20 1003025917 0 Speech Therapists Speech Therapy/Pathology Services 00 1003026501 0 MOALLEM MOHANNAD 2021363 9999999 B 10 1003026501 0 PO BOX 778912 CHICAGO IL 606778912 20 1003026501 0 Physicians Anesthesia Services 20 1003026501 0 Physicians Fluoride varnish 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9999999 B 10 1003035593 0 4714 GETTYSBURG RD MECHANICSBURG PA 170554325 20 1003035593 0 Physical Therapists Medical Supplies 20 1003035593 0 Physical Therapists Medical equipment/prosthetic devices 20 1003035593 0 Physical Therapists Physical Therapy Services 00 1003037169 0 CUDONE LORI 2011178 9999999 B 10 1003037169 0 1000 HEALTH CENTER DR MATTOON IL 619384644 20 1003037169 0 Physicians Anesthesia Services 20 1003037169 0 Physicians Healthy Kids Services 20 1003037169 0 Physicians Optical Supplies 20 1003037169 0 Physicians Physician Services 00 1003037359 0 COLE IAN O 2014213 9999999 B 10 1003037359 0 4535 DRESSLER RD NW CANTON OH 447182545 20 1003037359 0 Physicians Anesthesia Services 20 1003037359 0 Physicians Healthy Kids Services 20 1003037359 0 Physicians Optical Supplies 20 1003037359 0 Physicians Physician Services 00 1003038043 0 DUCKWORTH EDWARD 2007182 9999999 B 10 1003038043 0 190 E BANNOCK ST BOISE ID 837126241 20 1003038043 0 Physicians Anesthesia Services 20 1003038043 0 Physicians Healthy Kids Services 20 1003038043 0 Physicians Optical Supplies 20 1003038043 0 Physicians Physician Services 00 1003038423 0 GURNSEY ZACHARIAH 2009182 9999999 B 10 1003038423 0 PO BOX 19248 SPRINGFIELD IL 627949248 20 1003038423 0 Physicians Anesthesia Services 20 1003038423 0 Physicians Healthy Kids Services 20 1003038423 0 Physicians Optical Supplies 20 1003038423 0 Physicians Physician Services 00 1003038688 0 MLYNARCZYK ELIZABETH 2009194 9999999 B 10 1003038688 0 370 SUMMIT ST # 1 ELGIN IL 601203843 20 1003038688 0 Physicians Anesthesia Services 20 1003038688 0 Physicians Healthy Kids Services 20 1003038688 0 Physicians Optical Supplies 20 1003038688 0 Physicians Physician Services 00 1003038746 0 TAVES ADAM 2012183 9999999 B 10 1003038746 0 220 COMPASS POINT DR SAINT CHARLES MO 633014405 20 1003038746 0 Physicians Anesthesia Services 20 1003038746 0 Physicians Healthy Kids Services 20 1003038746 0 Physicians Optical Supplies 20 1003038746 0 Physicians Physician Services 00 1003038803 0 HITCHCOCK ROBYN 2020245 9999999 B 10 1003038803 0 5410 MARYLAND WAY STE 300 SUITE 300 BRENTWOOD TN 370275339 20 1003038803 0 Physicians Anesthesia Services 20 1003038803 0 Physicians Healthy Kids Services 20 1003038803 0 Physicians Optical Supplies 20 1003038803 0 Physicians Physician Services 00 1003039678 0 DOLAN LYNN E 2014322 9999999 B 10 1003039678 0 PO BOX 5081 JANESVILLE WI 535475081 20 1003039678 0 Physicians Anesthesia Services 20 1003039678 0 Physicians Healthy Kids Services 20 1003039678 0 Physicians Optical Supplies 20 1003039678 0 Physicians Physician Services 00 1003039850 0 BRADLEY CATHERINE M 2004272 9999999 B 10 1003039850 0 8822 BROOKFIELD AVE UNIT 310 BROOKFIELD IL 605131794 20 1003039850 0 Speech Therapists Medical Supplies 20 1003039850 0 Speech Therapists Medical equipment/prosthetic devices 20 1003039850 0 Speech Therapists Speech Therapy/Pathology Services 00 1003040106 0 BECK BRYON L 2018128 9999999 B 10 1003040106 0 3015 N BALLAS RD SAINT LOUIS MO 631312329 20 1003040106 0 Physician Assistant Only Fluoride varnish 20 1003040106 0 Physician Assistant Only Healthy Kids Services 20 1003040106 0 Physician Assistant Only Physician Services 00 1003041476 0 LINDGREN KEVIN 2012214 9999999 B 10 1003041476 0 75 REMITTANCE DR DEPT 1611 SUITE 1611 CHICAGO IL 606751611 20 1003041476 0 Physicians Anesthesia Services 20 1003041476 0 Physicians Fluoride varnish 20 1003041476 0 Physicians Healthy Kids Services 20 1003041476 0 Physicians Optical Supplies 20 1003041476 0 Physicians Physician Services 00 1003042920 0 AMADI CHIEMEZIE C 2022181 9999999 B 10 1003042920 0 3621 S STATE ST ANN ARBOR MI 481081633 20 1003042920 0 Physicians Anesthesia Services 20 1003042920 0 Physicians Healthy Kids Services 20 1003042920 0 Physicians Optical Supplies 20 1003042920 0 Physicians Physician Services 00 1003043050 0 WALKER AMANDA 2013213 9999999 B 10 1003043050 0 301 JOHN ST BOX 42 KALAMAZOO MI 490075295 20 1003043050 0 Physicians Anesthesia Services 20 1003043050 0 Physicians Healthy Kids Services 20 1003043050 0 Physicians Optical Supplies 20 1003043050 0 Physicians Physician Services 00 1003043167 0 WANG MARK C 2014182 9999999 B 10 1003043167 0 44000 GARFIELD RD CLINTON TOWNSHI MI 480381125 20 1003043167 0 Physicians Anesthesia Services 20 1003043167 0 Physicians Healthy Kids Services 20 1003043167 0 Physicians Optical Supplies 20 1003043167 0 Physicians Physician Services 00 1003043837 0 MEYER BENJAMIN 2021235 9999999 B 10 1003043837 0 PO BOX 208807 DALLAS TX 753208807 20 1003043837 0 Physicians Anesthesia Services 20 1003043837 0 Physicians Healthy Kids Services 20 1003043837 0 Physicians Optical Supplies 20 1003043837 0 Physicians Physician Services 00 1003044082 0 GARCIA GANDY 2009180 9999999 B 10 1003044082 0 9118 OGDEN AVE STE B BROOKFIELD IL 605131974 20 1003044082 0 Dentists Dental Services 20 1003044082 0 Dentists Physician Services 00 1003044280 0 MITTAL NUPUR 2015244 9999999 B 10 1003044280 0 225 E CHICAGO AVE # 118 CHICAGO IL 606112991 20 1003044280 0 Physicians Anesthesia Services 20 1003044280 0 Physicians Fluoride varnish 20 1003044280 0 Physicians Healthy Kids Services 20 1003044280 0 Physicians Optical Supplies 20 1003044280 0 Physicians Physician Services 00 1003044520 0 BRUCE SIDNEY 2020294 9999999 B 10 1003044520 0 250 N SHADELAND AVE INDIANAPOLIS IN 462194959 20 1003044520 0 Physicians Anesthesia Services 20 1003044520 0 Physicians Healthy Kids Services 20 1003044520 0 Physicians Optical Supplies 20 1003044520 0 Physicians Physician Services 00 1003044751 0 SYAMAL MAUSUMI 2023226 9999999 B 10 1003044751 0 75 REMITTANCE DR DEPT 1611 SUITE 1611 CHICAGO IL 606751611 20 1003044751 0 Physicians Anesthesia Services 20 1003044751 0 Physicians Healthy Kids Services 20 1003044751 0 Physicians Optical Supplies 20 1003044751 0 Physicians Physician Services 00 1003045063 0 BECKER NILS 2023152 9999999 B 10 1003045063 0 6240 SHILOH RD ALPHARETTA GA 300058347 20 1003045063 0 Physicians Anesthesia Services 20 1003045063 0 Physicians Healthy Kids Services 20 1003045063 0 Physicians Optical Supplies 20 1003045063 0 Physicians Physician Services 00 1003045071 0 LONG TIMOTHY 2012209 9999999 B 10 1003045071 0 1860 PAYSPHERE CIR CHICAGO IL 606740018 20 1003045071 0 Physicians Anesthesia Services 20 1003045071 0 Physicians Fluoride varnish 20 1003045071 0 Physicians Healthy Kids Services 20 1003045071 0 Physicians Optical Supplies 20 1003045071 0 Physicians Physician Services 00 1003045097 0 KIM ELIJAH 2017243 9999999 B 10 1003045097 0 PO BOX 19248 SPRINGFIELD IL 627949248 20 1003045097 0 Physicians Anesthesia Services 20 1003045097 0 Physicians Healthy Kids Services 20 1003045097 0 Physicians Optical Supplies 20 1003045097 0 Physicians Physician Services 00 1003045337 0 PONSER JONATHAN 2016001 9999999 B 10 1003045337 0 PO BOX 3428 SPRINGFIELD IL 627083428 20 1003045337 0 Other behavior health professional Licensed Clinical Professional Counselor 00 1003045428 0 BASTAWROUS MOANIS K 2022090 9999999 B 10 1003045428 0 4500 COLLEGE AVE ALTON IL 620025012 20 1003045428 0 Physicians Anesthesia Services 20 1003045428 0 Physicians Healthy Kids Services 20 1003045428 0 Physicians Optical Supplies 20 1003045428 0 Physicians Physician Services 20 1003045428 0 Physicians Physicians Psychiatric Services 00 1003046228 0 SMITH ALISSA 2009222 9999999 B 10 1003046228 0 PO BOX 3428 SPRINGFIELD IL 627083428 20 1003046228 0 Nurse Practitioners Fluoride varnish 20 1003046228 0 Nurse Practitioners Healthy Kids Services 20 1003046228 0 Nurse Practitioners Nurse Practitioners Services 20 1003046228 0 Nurse Practitioners Physician Services 00 1003047267 0 KENNEDY RAELENE D 2019244 9999999 B 10 1003047267 0 75 REMITTANCE DR DEPT 1611 SUITE 1611 CHICAGO IL 606751611 20 1003047267 0 Physicians Anesthesia Services 20 1003047267 0 Physicians Healthy Kids Services 20 1003047267 0 Physicians Optical Supplies 20 1003047267 0 Physicians Physician Services 00 1003047820 0 MAHON MELISSA M 2019311 9999999 B 10 1003047820 0 1600 MORGAN ST KEOKUK IA 526323456 20 1003047820 0 Nurse Practitioners Anesthesia Services 20 1003047820 0 Nurse Practitioners Nurse Practitioners Services 20 1003047820 0 Nurse Practitioners Physician Services 00 1003047929 0 ETMINAN SODABEH 2009182 9999999 B 10 1003047929 0 1220 S WOOD ST CHICAGO IL 606081202 20 1003047929 0 Dentists Dental Services 20 1003047929 0 Dentists Physician Services 00 1003048000 0 MCCARRON DANIELLE 2012092 9999999 B 10 1003048000 0 5342 S ARCHER AVE CHICAGO IL 606324949 20 1003048000 0 Dentists Dental Services 20 1003048000 0 Dentists Physician Services 00 1003048745 0 GREWAL PUNEET 2012296 9999999 B 10 1003048745 0 8496 SOLUTIONS CTR CHICAGO IL 606778004 20 1003048745 0 Physicians Anesthesia Services 20 1003048745 0 Physicians Healthy Kids Services 20 1003048745 0 Physicians Optical Supplies 20 1003048745 0 Physicians Physician Services 00 1003048802 0 KARIMA FITZGERALD 2019270 9999999 B 10 1003048802 0 PO BOX 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O'MORCHOE KATHRYN 2020128 9999999 B 10 1003135765 0 PO BOX 14909 MINNEAPOLIS MN 554140909 20 1003135765 0 Physician Assistant Only Fluoride varnish 20 1003135765 0 Physician Assistant Only Healthy Kids Services 20 1003135765 0 Physician Assistant Only Physician Services 00 1003135864 0 BURCHAM ELAINE L 2014139 9999999 B 10 1003135864 0 429 S 6TH ST VINCENNES IN 475911022 20 1003135864 0 Nurse Practitioners Fluoride varnish 20 1003135864 0 Nurse Practitioners Healthy Kids Services 20 1003135864 0 Nurse Practitioners Nurse Practitioners Services 20 1003135864 0 Nurse Practitioners Physician Services 00 1003136151 0 GRABOSCH SHANNON 2018182 9999999 B 10 1003136151 0 1145 CORPORATE LAKE DR SAINT LOUIS MO 631322907 20 1003136151 0 Physicians Anesthesia Services 20 1003136151 0 Physicians Healthy Kids Services 20 1003136151 0 Physicians Optical Supplies 20 1003136151 0 Physicians Physician Services 00 1003136276 0 HENRY KAITLIN 2013335 9999999 B 10 1003136276 0 PO BOX 19248 SPRINGFIELD IL 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1003158254 0 Physicians Fluoride varnish 20 1003158254 0 Physicians Healthy Kids Services 20 1003158254 0 Physicians Optical Supplies 20 1003158254 0 Physicians Physician Services 00 1003158403 0 SHIRANI LIZA A DAFCHAHI 2017248 9999999 B 10 1003158403 0 1305 WALT WHITMAN RD STE 300 MELVILLE NY 117474300 20 1003158403 0 Physicians Anesthesia Services 20 1003158403 0 Physicians Healthy Kids Services 20 1003158403 0 Physicians Optical Supplies 20 1003158403 0 Physicians Physician Services 00 1003159021 0 DAWSON MATTHEW N 2022021 9999999 B 10 1003159021 0 355 E ERIE ST CHICAGO IL 606113167 20 1003159021 0 Physicians Anesthesia Services 20 1003159021 0 Physicians Healthy Kids Services 20 1003159021 0 Physicians Optical Supplies 20 1003159021 0 Physicians Physician Services 00 1003159153 0 KOMINSKY MATTHEW S 2019248 9999999 B 10 1003159153 0 680 N LAKE SHORE DR STE 1000 SUITE# 1000 CHICAGO IL 606118709 20 1003159153 0 Physicians Anesthesia Services 20 1003159153 0 Physicians Healthy Kids 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1003161993 0 Physicians Physician Services 00 1003162249 0 AZIZ ZAINAB 2017339 9999999 B 10 1003162249 0 47 CLOCK TOWER PLZ ELGIN IL 601207800 20 1003162249 0 Dentists Dental Services 20 1003162249 0 Dentists Physician Services 00 1003162520 0 SHEPHERD DANIELLE B 2015044 9999999 B 10 1003162520 0 8496 SOLUTIONS CTR CHICAGO IL 606778004 20 1003162520 0 Clinical Social Worker Social work service 00 1003163148 0 YOHANNAN JOE V 2015196 9999999 B 10 1003163148 0 318 MAXWELL RD STE 500 ALPHARETTA GA 300092064 20 1003163148 0 Physicians Anesthesia Services 20 1003163148 0 Physicians Fluoride varnish 20 1003163148 0 Physicians Healthy Kids Services 20 1003163148 0 Physicians Optical Supplies 20 1003163148 0 Physicians Physician Services 00 1003163197 0 HERRON MICHELE 2014098 9999999 H 10 1003163197 0 614 N CARPENTER ST SPRINGFIELD IL 62702 20 1003163197 0 Other behavior health professional Other Behavioral Health Services 00 1003163403 0 RAHRIG MATTHEW S 2019001 9999999 B 10 1003163403 0 851 E 5TH ST STE 226 WASHINGTON MO 630903129 20 1003163403 0 Physicians Anesthesia Services 20 1003163403 0 Physicians Healthy Kids Services 20 1003163403 0 Physicians Optical Supplies 20 1003163403 0 Physicians Physician Services 00 1003163676 0 MCCLURE JACQUELINE R 2012001 9999999 B 10 1003163676 0 275 S UNIVERSITY ST 211 RACHEL COOPER CAMPUS BOX 4 NORMAL IL 617904720 20 1003163676 0 Speech Therapists Medical Supplies 20 1003163676 0 Speech Therapists Medical equipment/prosthetic devices 20 1003163676 0 Speech Therapists Speech Therapy/Pathology Services 00 1003164443 0 BUDDHADEV PAKHADI H 2022068 9999999 B 10 1003164443 0 680 N LAKE SHORE DR STE 1000 SUITE# 1000 CHICAGO IL 606118709 20 1003164443 0 Physicians Anesthesia Services 20 1003164443 0 Physicians Fluoride varnish 20 1003164443 0 Physicians Healthy Kids Services 20 1003164443 0 Physicians Optical Supplies 20 1003164443 0 Physicians Physician Services 00 1003164617 0 HAJOSTEK MELISSA K 2016004 9999999 B 10 1003164617 0 124 SW ADAMS 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20 1003189333 0 Physical Therapists Medical Supplies 20 1003189333 0 Physical Therapists Medical equipment/prosthetic devices 20 1003189333 0 Physical Therapists Physical Therapy Services 00 1003190711 0 SYED RAFEEL 2016203 9999999 B 10 1003190711 0 PO BOX 3877 JOLIET IL 604343877 20 1003190711 0 Physicians Anesthesia Services 20 1003190711 0 Physicians Fluoride varnish 20 1003190711 0 Physicians Healthy Kids Services 20 1003190711 0 Physicians Optical Supplies 20 1003190711 0 Physicians Physician Services 00 1003194093 0 BHATIA RUCHI 2017182 9999999 B 10 1003194093 0 PO BOX 60352 660 SOUTH EUCLID AVENUE SAINT LOUIS MO 631600352 20 1003194093 0 Physicians Anesthesia Services 20 1003194093 0 Physicians Fluoride varnish 20 1003194093 0 Physicians Healthy Kids Services 20 1003194093 0 Physicians Optical Supplies 20 1003194093 0 Physicians Physician Services 00 1003194549 0 RAMOS JUAN C 2023067 9999999 B 10 1003194549 0 615 S NEW BALLAS RD SAINT LOUIS MO 631418221 20 1003194549 0 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Assistant Only Healthy Kids Services 20 1003430596 0 Physician Assistant Only Physician Services 00 1003431073 0 BRADBURY MACY 2022053 9999999 B 10 1003431073 0 5121 MARYLAND WAY STE 300 BRENTWOOD TN 370277516 20 1003431073 0 Physician Assistant Only Fluoride varnish 20 1003431073 0 Physician Assistant Only Healthy Kids Services 20 1003431073 0 Physician Assistant Only Physician Services 00 1003431420 0 DYER ERIN L 2020240 9999999 B 10 1003431420 0 PO BOX 60352 660 SOUTH EUCLID AVENUE SAINT LOUIS MO 631600352 20 1003431420 0 Physicians Anesthesia Services 20 1003431420 0 Physicians Fluoride varnish 20 1003431420 0 Physicians Healthy Kids Services 20 1003431420 0 Physicians Optical Supplies 20 1003431420 0 Physicians Physician Services 00 1003432576 0 DIEHL JESSICA 2022326 9999999 B 10 1003432576 0 PO BOX 781076 DETROIT MI 482781076 20 1003432576 0 Nurse Practitioners Healthy Kids Services 20 1003432576 0 Nurse Practitioners Nurse Practitioners Services 20 1003432576 0 Nurse Practitioners Physician Services 00 1003432600 0 PATEL PAYAL 2020299 9999999 B 10 1003432600 0 1 BARNES JEWISH HOSPITAL PLZ SAINT LOUIS MO 631101003 20 1003432600 0 Physicians Anesthesia Services 20 1003432600 0 Physicians Fluoride varnish 20 1003432600 0 Physicians Healthy Kids Services 20 1003432600 0 Physicians Optical Supplies 20 1003432600 0 Physicians Physician Services 00 1003433715 0 PEDERSEN BREANNE 2020196 9999999 B 10 1003433715 0 265 STONEGATE RD STE 102 ALGONQUIN IL 601025614 20 1003433715 0 Other behavior health professional Other Behavioral Health Services 00 1003434291 0 KIMBRELL MADISON 2023073 9999999 B 10 1003434291 0 7951 E MAPLEWOOD AVE STE 118 GREENWOOD VILLA CO 801114724 20 1003434291 0 Clinical Social Worker Social work service 00 1003436031 0 CARLTON ANNE LEWIS 2020196 9999999 B 10 1003436031 0 150 HARVESTER DR STE 300 BURR RIDGE IL 605275965 20 1003436031 0 Physicians Anesthesia Services 20 1003436031 0 Physicians Fluoride varnish 20 1003436031 0 Physicians Healthy Kids Services 20 1003436031 0 Physicians Optical Supplies 20 1003436031 0 Physicians Physician Services 00 1003436163 0 ANDERSON DERRIUS JARRETT 2020182 9999999 B 10 1003436163 0 150 HARVESTER DR STE 300 BURR RIDGE IL 605275965 20 1003436163 0 Physicians Anesthesia Services 20 1003436163 0 Physicians Healthy Kids Services 20 1003436163 0 Physicians Optical Supplies 20 1003436163 0 Physicians Physician Services 00 1003436742 0 FAHNESTOCK ANNE 2020120 9999999 B 10 1003436742 0 611 W PARK ST URBANA IL 618012529 20 1003436742 0 Physical Therapists Medical Supplies 20 1003436742 0 Physical Therapists Medical equipment/prosthetic devices 20 1003436742 0 Physical Therapists Physical Therapy Services 00 1003437161 0 PATTON SAMANTHA 2023279 9999999 B 10 1003437161 0 1500 S DOUGLAS RD STE 230 CORAL GABLES FL 331344108 20 1003437161 0 Other behavior health professional RBT Services 00 1003437260 0 GUPTA SONALI 2020188 9999999 B 10 1003437260 0 1700 W VAN BUREN ST STE 161 CHICAGO IL 606123228 20 1003437260 0 Physicians Anesthesia Services 20 1003437260 0 Physicians Healthy Kids Services 20 1003437260 0 Physicians Optical Supplies 20 1003437260 0 Physicians Physician Services 00 1003437443 0 GIBSON KAITLIN MARIE 2020184 9999999 B 10 1003437443 0 1700 W VAN BUREN ST STE 161 CHICAGO IL 606123228 20 1003437443 0 Physicians Anesthesia Services 20 1003437443 0 Physicians Fluoride varnish 20 1003437443 0 Physicians Healthy Kids Services 20 1003437443 0 Physicians Optical Supplies 20 1003437443 0 Physicians Physician Services 00 1003437781 0 REEVERTS KOLTON D 2020128 9999999 B 10 1003437781 0 2547 PLAINFIELD NAPERVILLE RD NAPERVILLE IL 605648701 20 1003437781 0 Physical Therapists Medical Supplies 20 1003437781 0 Physical Therapists Medical equipment/prosthetic devices 20 1003437781 0 Physical Therapists Physical Therapy Services 00 1003437799 0 WOJACK ALISON 2021333 9999999 B 10 1003437799 0 18221 TORRENCE AVE STE 1B LANSING IL 604382870 20 1003437799 0 Nurse Practitioners Anesthesia Services 20 1003437799 0 Nurse Practitioners Fluoride varnish 20 1003437799 0 Nurse Practitioners Healthy Kids Services 20 1003437799 0 Nurse Practitioners Nurse Practitioners Services 20 1003437799 0 Nurse Practitioners Physician Services 00 1003438813 0 GULERIA SHAN 2020188 9999999 B 10 1003438813 0 75 REMITTANCE DR DEPT 1611 SUITE 1611 CHICAGO IL 606751611 20 1003438813 0 Physicians Anesthesia Services 20 1003438813 0 Physicians Fluoride varnish 20 1003438813 0 Physicians Healthy Kids Services 20 1003438813 0 Physicians Optical Supplies 20 1003438813 0 Physicians Physician Services 00 1003439217 0 KIGHTLY ALLISON F 2021239 9999999 B 10 1003439217 0 1700 E HIGGINS RD STE 600 DES PLAINES IL 600185621 20 1003439217 0 Physician Assistant Only Fluoride varnish 20 1003439217 0 Physician Assistant Only Healthy Kids Services 20 1003439217 0 Physician Assistant Only Physician Services 00 1003440462 0 HARKINS KRISTIN I 2020056 9999999 B 10 1003440462 0 7974 UW HEALTH CT MIDDLETON WI 535625531 20 1003440462 0 Other behavior health professional Healthy Kids Services 20 1003440462 0 Other behavior health professional Nurse Practitioners Services 00 1003440769 0 REFVIK KIRSTEN 2020071 9999999 B 10 1003440769 0 3450 OAKTON ST STE 300 SKOKIE IL 600762951 20 1003440769 0 Clinical Social Worker Social work service 00 1003442039 0 SPILLANE ALISON 2021155 9999999 B 10 1003442039 0 2650 RIDGE AVE # 1223 EVANSTON IL 602011700 20 1003442039 0 Nurse Practitioners Healthy Kids Services 20 1003442039 0 Nurse Practitioners Midwife Services 20 1003442039 0 Nurse Practitioners Nurse Practitioners Services 20 1003442039 0 Nurse Practitioners Physician Services 00 1003442880 0 VICENCIO CANDICE J 2020134 9999999 B 10 1003442880 0 2550 CHARLES ST ROCKFORD IL 611081673 20 1003442880 0 Nurse Practitioners Fluoride varnish 20 1003442880 0 Nurse Practitioners Healthy Kids Services 20 1003442880 0 Nurse Practitioners Nurse Practitioners Services 20 1003442880 0 Nurse 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1003443771 0 Physicians Physician Services 00 1003444266 0 CANEVA ROBERTO 2020169 9999999 B 10 1003444266 0 4440 W 95TH ST OAK LAWN IL 604532600 20 1003444266 0 Podiatrists Podiatric Services 00 1003444290 0 LIU JENNY 2020233 9999999 B 10 1003444290 0 2525 S MICHIGAN AVE CHICAGO IL 606162315 20 1003444290 0 Physicians Anesthesia Services 20 1003444290 0 Physicians Fluoride varnish 20 1003444290 0 Physicians Healthy Kids Services 20 1003444290 0 Physicians Optical Supplies 20 1003444290 0 Physicians Physician Services 00 1003444837 0 BERKA ASHLEY N 2020111 9999999 B 10 1003444837 0 7974 UW HEALTH CT MIDDLETON WI 535625531 20 1003444837 0 Nurse Practitioners Fluoride varnish 20 1003444837 0 Nurse Practitioners Healthy Kids Services 20 1003444837 0 Nurse Practitioners Nurse Practitioners Services 20 1003444837 0 Nurse Practitioners Physician Services 00 1003444894 0 GALLUS SHEA N 2020181 9999999 B 10 1003444894 0 PO BOX 3039 OAK BROOK IL 605223039 20 1003444894 0 Physicians Anesthesia Services 20 1003444894 0 Physicians Fluoride varnish 20 1003444894 0 Physicians Healthy Kids Services 20 1003444894 0 Physicians Optical Supplies 20 1003444894 0 Physicians Physician Services 00 1003444944 0 CHO ELIZABETH 2021214 9999999 B 10 1003444944 0 2160 S 1ST AVE BLDG 201 MAYWOOD IL 601533328 20 1003444944 0 Physicians Anesthesia Services 20 1003444944 0 Physicians Healthy Kids Services 20 1003444944 0 Physicians Optical Supplies 20 1003444944 0 Physicians Physician Services 00 1003445099 0 LAM TIMTIM 2020245 9999999 B 10 1003445099 0 800 E LOCUST ST OLNEY IL 624502553 20 1003445099 0 Nurse Practitioners Healthy Kids Services 20 1003445099 0 Nurse Practitioners Nurse Practitioners Services 20 1003445099 0 Nurse Practitioners Physician Services 00 1003445222 0 SADEK MICHAEL 2020177 9999999 B 10 1003445222 0 75 REMITTANCE DR DEPT 1296 CHICAGO IL 606751296 20 1003445222 0 Physicians Anesthesia Services 20 1003445222 0 Physicians Fluoride varnish 20 1003445222 0 Physicians Healthy 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RENO AVE OKLAHOMA CITY OK 731279711 20 1003446832 0 Nurse Practitioners Fluoride varnish 20 1003446832 0 Nurse Practitioners Healthy Kids Services 20 1003446832 0 Nurse Practitioners Nurse Practitioners Services 20 1003446832 0 Nurse Practitioners Physician Services 00 1003448978 0 WILLIAMS AARON 2023262 9999999 B 10 1003448978 0 611 W PARK ST URBANA IL 618012529 20 1003448978 0 Physical Therapists Medical Supplies 20 1003448978 0 Physical Therapists Medical equipment/prosthetic devices 20 1003448978 0 Physical Therapists Physical Therapy Services 00 1003450354 0 HARTZELL CHELSEA 2021307 9999999 B 10 1003450354 0 PO BOX 268 FREEPORT IL 610320268 20 1003450354 0 Nurse Practitioners Healthy Kids Services 20 1003450354 0 Nurse Practitioners Nurse Practitioners Services 20 1003450354 0 Nurse Practitioners Physician Services 00 1003451824 0 PEARLMAN JESSICA 2021068 9999999 B 10 1003451824 0 180 HANSEN CT WOOD DALE IL 601911121 20 1003451824 0 Speech Therapists Medical Supplies 20 1003451824 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20556 SPRINGFIELD IL 627080556 20 1003463225 0 Nurse Practitioners Fluoride varnish 20 1003463225 0 Nurse Practitioners Healthy Kids Services 20 1003463225 0 Nurse Practitioners Nurse Practitioners Services 20 1003463225 0 Nurse Practitioners Physician Services 00 1003463381 0 LINCOLN EMILY R 2021082 9999999 B 10 1003463381 0 1 CHILDRENS PL STE 3S-36 SAINT LOUIS MO 631101002 20 1003463381 0 Nurse Practitioners Healthy Kids Services 20 1003463381 0 Nurse Practitioners Nurse Practitioners Services 20 1003463381 0 Nurse Practitioners Physician Services 00 1003465121 0 MOLL DANIESL 2019263 9999999 B 10 1003465121 0 PO BOX 146 WATERLOO IL 622980146 20 1003465121 0 Other behavior health professional Other Behavioral Health Services 00 1003465162 0 RHOADES EMILY 2021025 9999999 B 10 1003465162 0 3051 HOLLIS DR SPRINGFIELD IL 627047452 20 1003465162 0 Nurse Practitioners Fluoride varnish 20 1003465162 0 Nurse Practitioners Healthy Kids Services 20 1003465162 0 Nurse Practitioners Nurse 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1003470469 0 Physicians Anesthesia Services 20 1003470469 0 Physicians Fluoride varnish 20 1003470469 0 Physicians Healthy Kids Services 20 1003470469 0 Physicians Optical Supplies 20 1003470469 0 Physicians Physician Services 00 1003470865 0 BIER TRACY 2021127 9999999 B 10 1003470865 0 PO BOX 1455 DES MOINES IA 503061455 20 1003470865 0 Nurse Practitioners Fluoride varnish 20 1003470865 0 Nurse Practitioners Healthy Kids Services 20 1003470865 0 Nurse Practitioners Nurse Practitioners Services 20 1003470865 0 Nurse Practitioners Physician Services 00 1003470923 0 ANGELL EARLENE M 2021245 9999999 B 10 1003470923 0 4055 VALLEY VIEW LN STE 400 DALLAS TX 752445071 20 1003470923 0 Nurse Practitioners Healthy Kids Services 20 1003470923 0 Nurse Practitioners Nurse Practitioners Services 20 1003470923 0 Nurse Practitioners Physician Services 00 1003471798 0 CHOREN CLAIRE K 2023217 9999999 B 10 1003471798 0 3301 W FOREST HOME AVE MILWAUKEE WI 532152843 20 1003471798 0 Physician Assistant Only 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Psychiatric Services 00 1003473729 0 FORBES MICHAEL R 2019261 9999999 B 10 1003473729 0 1860 PAYSPHERE CIR CHICAGO IL 606740018 20 1003473729 0 Physicians Anesthesia Services 20 1003473729 0 Physicians Fluoride varnish 20 1003473729 0 Physicians Healthy Kids Services 20 1003473729 0 Physicians Optical Supplies 20 1003473729 0 Physicians Physician Services 00 1003474776 0 MUNIR SABA 2019365 9999999 B 10 1003474776 0 1700 W VAN BUREN ST STE 161 CHICAGO IL 606123228 20 1003474776 0 Physicians Anesthesia Services 20 1003474776 0 Physicians Fluoride varnish 20 1003474776 0 Physicians Healthy Kids Services 20 1003474776 0 Physicians Optical Supplies 20 1003474776 0 Physicians Physician Services 00 1003475591 0 EDMAN JEFFREY S 2019276 9999999 B 10 1003475591 0 200 HAWKINS DR IOWA CITY IA 522421009 20 1003475591 0 Physicians Anesthesia Services 20 1003475591 0 Physicians Healthy Kids Services 20 1003475591 0 Physicians Optical Supplies 20 1003475591 0 Physicians Physician Services 00 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varnish 20 1003494220 0 Physicians Healthy Kids Services 20 1003494220 0 Physicians Optical Supplies 20 1003494220 0 Physicians Physician Services 00 1003494501 0 KENNEDY KELSEY R 2021120 9999999 B 10 1003494501 0 PO BOX 3039 OAK BROOK IL 605223039 20 1003494501 0 Physicians Anesthesia Services 20 1003494501 0 Physicians Healthy Kids Services 20 1003494501 0 Physicians Optical Supplies 20 1003494501 0 Physicians Physician Services 00 1003494758 0 PAYTON KIMBERLY 2021103 9999999 H 10 1003494758 0 3941 W DAYTON ST MCHENRY IL 600508377 20 1003494758 0 Other behavior health professional Other Behavioral Health Services 00 1003496225 0 SOUSA CLAIRA 2022047 9999999 B 10 1003496225 0 PO BOX 60352 660 SOUTH EUCLID AVENUE SAINT LOUIS MO 631600352 20 1003496225 0 Nurse Practitioners Anesthesia Services 20 1003496225 0 Nurse Practitioners Nurse Practitioners Services 20 1003496225 0 Nurse Practitioners Physician Services 00 1003496431 0 BUCHER MEGAN A 2021113 9999999 B 10 1003496431 0 111 N COUNTY FARM RD WHEATON IL 601873977 20 1003496431 0 Other behavior health professional Other Behavioral Health Services 00 1003499278 0 ENRICO ANTHONY M 2021175 9999999 B 10 1003499278 0 1305 WALT WHITMAN RD STE 300 MELVILLE NY 117474300 20 1003499278 0 Nurse Practitioners Anesthesia Services 20 1003499278 0 Nurse Practitioners Nurse Practitioners Services 20 1003499278 0 Nurse Practitioners Physician Services 00 1003500794 0 LOPEZ RODRIGUEZ ANGELICA 2023236 9999999 B 10 1003500794 0 303 N JACKSON ST MORRISON IL 612703042 20 1003500794 0 Nurse Practitioners Healthy Kids Services 20 1003500794 0 Nurse Practitioners Nurse Practitioners Services 20 1003500794 0 Nurse Practitioners Physician Services 00 1003501669 0 FORSTER EMILY 2023178 9999999 B 10 1003501669 0 7974 UW HEALTH CT MIDDLETON WI 535625531 20 1003501669 0 Physicians Anesthesia Services 20 1003501669 0 Physicians Fluoride varnish 20 1003501669 0 Physicians Healthy Kids Services 20 1003501669 0 Physicians Optical Supplies 20 1003501669 0 Physicians Physician Services 00 1003502782 0 CHARVET CHRISTIAN 2023318 9999999 B 10 1003502782 0 680 N LAKE SHORE DR STE 1000 SUITE# 1000 CHICAGO IL 606118709 20 1003502782 0 Nurse Practitioners Healthy Kids Services 20 1003502782 0 Nurse Practitioners Nurse Practitioners Services 20 1003502782 0 Nurse Practitioners Physician Services 00 1003503699 0 SHIM BYEOL 2023128 9999999 B 10 1003503699 0 145 S VIRGINIA ST STE C CRYSTAL LAKE IL 600147226 20 1003503699 0 Other behavior health professional Licensed Clinical Professional Counselor 00 1003505967 0 WILLIAMS CHRISTOPHER P 2023237 9999999 B 10 1003505967 0 2650 RIDGE AVE # 1223 EVANSTON IL 602011700 20 1003505967 0 Psychologist Psychologist service 00 1003507906 0 STEWART GENEVA 2023244 9999999 B 10 1003507906 0 680 N LAKE SHORE DR STE 1000 SUITE# 1000 CHICAGO IL 606118709 20 1003507906 0 Nurse Practitioners Healthy Kids Services 20 1003507906 0 Nurse Practitioners Nurse Practitioners Services 20 1003507906 0 Nurse 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1003517210 0 WESSELS EMMA MARIE 2023083 9999999 B 10 1003517210 0 213 N RACINE AVE # 100 CHICAGO IL 606071644 20 1003517210 0 Physician Assistant Only Fluoride varnish 20 1003517210 0 Physician Assistant Only Healthy Kids Services 20 1003517210 0 Physician Assistant Only Physician Services 00 1003518036 0 STANCIU ANDREW 2023233 9999999 B 10 1003518036 0 7701 KENTON AVE SKOKIE IL 600763651 20 1003518036 0 Other behavior health professional Other Behavioral Health Services 00 1003518432 0 TRUPIANO NICOLE E 2023150 9999999 B 10 1003518432 0 4698 DEPT CAROL STREAM IL 601220021 20 1003518432 0 Physicians Anesthesia Services 20 1003518432 0 Physicians Fluoride varnish 20 1003518432 0 Physicians Healthy Kids Services 20 1003518432 0 Physicians Optical Supplies 20 1003518432 0 Physicians Physician Services 00 1003518747 0 SAMHAN ASHRAF 2023255 9999999 B 10 1003518747 0 4698 DEPT CAROL STREAM IL 601220021 20 1003518747 0 Physicians Anesthesia Services 20 1003518747 0 Physicians Fluoride varnish 20 1003518747 0 Physicians Healthy Kids Services 20 1003518747 0 Physicians Optical Supplies 20 1003518747 0 Physicians Physician Services 00 1003519133 0 ROBINSON ASHLEY R 2023178 9999999 B 10 1003519133 0 PO BOX 3039 OAK BROOK IL 605223039 20 1003519133 0 Physicians Anesthesia Services 20 1003519133 0 Physicians Fluoride varnish 20 1003519133 0 Physicians Healthy Kids Services 20 1003519133 0 Physicians Optical Supplies 20 1003519133 0 Physicians Physician Services 00 1003519679 0 SPIGNER SABINA T 2023185 9999999 B 10 1003519679 0 4698 DEPT CAROL STREAM IL 601220021 20 1003519679 0 Physicians Anesthesia Services 20 1003519679 0 Physicians Family Planning Counseling 20 1003519679 0 Physicians Healthy Kids Services 20 1003519679 0 Physicians Optical Supplies 20 1003519679 0 Physicians Physician Services 00 1003527532 0 ZAKHER HELANA 2023032 9999999 B 10 1003527532 0 PO BOX 734352 CHICAGO IL 606734352 20 1003527532 0 Physician Assistant Only Fluoride varnish 20 1003527532 0 Physician Assistant Only Healthy Kids Services 20 1003527532 0 Physician Assistant Only Physician Services 00 1003527722 0 MARTIN ALLISON J 2022350 9999999 B 10 1003527722 0 PO BOX 1230 EVANSVILLE IN 477061230 20 1003527722 0 Nurse Practitioners Healthy Kids Services 20 1003527722 0 Nurse Practitioners Nurse Practitioners Services 20 1003527722 0 Nurse Practitioners Physician Services 00 1003531120 0 PATEL ROMA 2023016 9999999 B 10 1003531120 0 1420 W PIONEER PKWY PEORIA IL 616151941 20 1003531120 0 Physician Assistant Only Fluoride varnish 20 1003531120 0 Physician Assistant Only Healthy Kids Services 20 1003531120 0 Physician Assistant Only Physician Services 00 1003532029 0 BADER NOOR S 2022306 9999999 B 10 1003532029 0 2361 PAYSPHERE CIR CHICAGO IL 606740023 20 1003532029 0 Nurse Practitioners Anesthesia Services 20 1003532029 0 Nurse Practitioners Nurse Practitioners Services 20 1003532029 0 Nurse Practitioners Physician Services 00 1003532771 0 KATALINICH MADELINE 2022306 9999999 B 10 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Services 20 1003536640 0 Physicians Optical Supplies 20 1003536640 0 Physicians Physician Services 00 1003536715 0 CONNELLY RACHAEL 2022266 9999999 B 10 1003536715 0 335 E CERRO GORDO ST DECATUR IL 625231013 20 1003536715 0 Speech Therapists Medical Supplies 20 1003536715 0 Speech Therapists Medical equipment/prosthetic devices 20 1003536715 0 Speech Therapists Speech Therapy/Pathology Services 00 1003537002 0 LOBNER MEGAN 2022339 9999999 B 10 1003537002 0 2 WESTBROOK CORP CTR STE 600 WESTCHESTER IL 601545716 20 1003537002 0 Audiologists Audiology Services 20 1003537002 0 Audiologists Medical Supplies 20 1003537002 0 Audiologists Medical equipment/prosthetic devices 00 1003537903 0 KRUCZEK MAXIMILIAN 2022252 9999999 B 10 1003537903 0 7101 N CICERO AVE STE 202 LINCOLNWOOD IL 607122143 20 1003537903 0 Other behavior health professional Other Behavioral Health Services 00 1003537986 0 KLEES NICOLE 2022252 9999999 H 10 1003537986 0 7101 N CICERO AVE STE 202 LINCOLNWOOD IL 607122143 20 1003537986 0 Other behavior health professional Other Behavioral Health Services 00 1003538950 0 FASKEN WALTER D 2022266 9999999 H 10 1003538950 0 111 BUCKLIN ST STE 1 LA SALLE IL 613012382 20 1003538950 0 Other behavior health professional Other Behavioral Health Services 00 1003540063 0 EISENBERG JENNIFER M 2022271 9999999 B 10 1003540063 0 680 N LAKE SHORE DR STE 1000 SUITE# 1000 CHICAGO IL 606118709 20 1003540063 0 Nurse Practitioners Healthy Kids Services 20 1003540063 0 Nurse Practitioners Nurse Practitioners Services 20 1003540063 0 Nurse Practitioners Physician Services 00 1003540220 0 WANNIARACHCHI GAYANA H 2023158 9999999 B 10 1003540220 0 403 E 1ST ST DIXON IL 610213116 20 1003540220 0 Podiatrists Podiatric Services 00 1003540394 0 SHMAIS MANAR 2023213 9999999 B 10 1003540394 0 PO BOX 954467 SAINT LOUIS MO 631952334 20 1003540394 0 Physicians Anesthesia Services 20 1003540394 0 Physicians Fluoride varnish 20 1003540394 0 Physicians Healthy Kids Services 20 1003540394 0 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1003545112 0 3010 GRAND AVE ATTN: ADMINISTRATION WAUKEGAN IL 600852321 20 1003545112 0 Other behavior health professional Other Behavioral Health Services 00 1003545211 0 ALEMAYEHU ABEL 2022203 9999999 B 10 1003545211 0 75 REMITTANCE DR DEPT 1296 CHICAGO IL 606751296 20 1003545211 0 Physicians Anesthesia Services 20 1003545211 0 Physicians Fluoride varnish 20 1003545211 0 Physicians Healthy Kids Services 20 1003545211 0 Physicians Optical Supplies 20 1003545211 0 Physicians Physician Services 00 1003545799 0 GRACE NG ZEE K 2022194 9999999 B 10 1003545799 0 1501 S CALIFORNIA AVE # 7-140 CHICAGO IL 606081732 20 1003545799 0 Physicians Anesthesia Services 20 1003545799 0 Physicians Fluoride varnish 20 1003545799 0 Physicians Healthy Kids Services 20 1003545799 0 Physicians Optical Supplies 20 1003545799 0 Physicians Physician Services 00 1003546169 0 ZAFAR BUSHRA 2022203 9999999 B 10 1003546169 0 1137 N EOLA RD STE 109 AURORA IL 605027097 20 1003546169 0 Dentists Dental Services 20 1003546169 0 Dentists Physician Services 00 1003546771 0 HAN JUNGWUK 2022202 9999999 B 10 1003546771 0 75 REMITTANCE DR DEPT 1153 CHICAGO IL 606751153 20 1003546771 0 Physicians Anesthesia Services 20 1003546771 0 Physicians Fluoride varnish 20 1003546771 0 Physicians Healthy Kids Services 20 1003546771 0 Physicians Optical Supplies 20 1003546771 0 Physicians Physician Services 00 1003546847 0 BANDARA CHATHUSHKI 2022182 9999999 B 10 1003546847 0 PO BOX 70508 CHICAGO IL 606730508 20 1003546847 0 Physicians Anesthesia Services 20 1003546847 0 Physicians Healthy Kids Services 20 1003546847 0 Physicians Optical Supplies 20 1003546847 0 Physicians Physician Services 00 1003546953 0 LUCRE MAURICE 2022249 9999999 B 10 1003546953 0 1608 LINCOLNWAY STE G VALPARAISO IN 463835852 20 1003546953 0 Physical Therapists Medical Supplies 20 1003546953 0 Physical Therapists Medical equipment/prosthetic devices 20 1003546953 0 Physical Therapists Physical Therapy Services 00 1003547308 0 HERNANDEZ PAULINA 2022172 9999999 B 10 1003547308 0 111 N COUNTY FARM RD WHEATON IL 601873977 20 1003547308 0 Registered nurse Nursing service 20 1003547308 0 Registered nurse Waiver service 00 1003548470 0 WELP GRACE 2022181 9999999 B 10 1003548470 0 PO BOX 19639 SPRINGFIELD IL 627949639 20 1003548470 0 Physicians Anesthesia Services 20 1003548470 0 Physicians Healthy Kids Services 20 1003548470 0 Physicians Optical Supplies 20 1003548470 0 Physicians Physician Services 00 1003548702 0 HAMMED OLUWAFIKAYO M 2022237 9999999 B 10 1003548702 0 190 E DELAWARE PL CHICAGO IL 606111813 20 1003548702 0 Physicians Anesthesia Services 20 1003548702 0 Physicians Fluoride varnish 20 1003548702 0 Physicians Healthy Kids Services 20 1003548702 0 Physicians Optical Supplies 20 1003548702 0 Physicians Physician Services 00 1003549502 0 LEVSHETZ REBECCA JEAN 2023202 9999999 B 10 1003549502 0 PO BOX 5081 JANESVILLE WI 535475081 20 1003549502 0 Physician Assistant Only Physician Services 00 1003550195 0 KHAN SAAD 2022353 9999999 B 10 1003550195 0 4698 DEPT CAROL STREAM IL 601224698 20 1003550195 0 Physicians Anesthesia Services 20 1003550195 0 Physicians Fluoride varnish 20 1003550195 0 Physicians Healthy Kids Services 20 1003550195 0 Physicians Optical Supplies 20 1003550195 0 Physicians Physician Services 00 1003550203 0 VISANI ADRIENNE 2022230 9999999 B 10 1003550203 0 1 BARNES JEWISH HOSPITAL PLZ SAINT LOUIS MO 631101003 20 1003550203 0 Physicians Anesthesia Services 20 1003550203 0 Physicians Healthy Kids Services 20 1003550203 0 Physicians Optical Supplies 20 1003550203 0 Physicians Physician Services 00 1003550773 0 HOUSER JOHN J 2022173 9999999 B 10 1003550773 0 3545 LINDELL BLVD FL 3 SAINT LOUIS MO 631031020 20 1003550773 0 Physicians Anesthesia Services 20 1003550773 0 Physicians Healthy Kids Services 20 1003550773 0 Physicians Optical Supplies 20 1003550773 0 Physicians Physician Services 00 1003551433 0 DZEKEM BONAVENTURE S 2022137 9999999 B 10 1003551433 0 150 HARVESTER DR STE 300 BURR RIDGE IL 605275965 20 1003551433 0 Physicians Anesthesia Services 20 1003551433 0 Physicians Fluoride varnish 20 1003551433 0 Physicians Healthy Kids Services 20 1003551433 0 Physicians Optical Supplies 20 1003551433 0 Physicians Physician Services 00 1003551490 0 PAREKH POOJA 2022175 9999999 B 10 1003551490 0 150 HARVESTER DR STE 300 BURR RIDGE IL 605275965 20 1003551490 0 Physicians Anesthesia Services 20 1003551490 0 Physicians Fluoride varnish 20 1003551490 0 Physicians Healthy Kids Services 20 1003551490 0 Physicians Optical Supplies 20 1003551490 0 Physicians Physician Services 00 1003551581 0 WESTMORELAND TERRENCE 2022363 9999999 B 10 1003551581 0 3941 W DAYTON ST MCHENRY IL 600508377 20 1003551581 0 Other behavior health professional Other Behavioral Health Services 00 1003551672 0 BONOMO MATTHEW 2022176 9999999 B 10 1003551672 0 150 HARVESTER DR STE 300 BURR RIDGE IL 605275965 20 1003551672 0 Physicians Anesthesia Services 20 1003551672 0 Physicians Healthy Kids Services 20 1003551672 0 Physicians Optical Supplies 20 1003551672 0 Physicians Physician Services 00 1003552779 0 OYELOWO DEBORAH O 2022199 9999999 B 10 1003552779 0 1420 W PIONEER PKWY PEORIA IL 616151941 20 1003552779 0 Nurse Practitioners Healthy Kids Services 20 1003552779 0 Nurse Practitioners Nurse Practitioners Services 20 1003552779 0 Nurse Practitioners Physician Services 00 1003554015 0 ZEIN MIKE 2022212 9999999 B 10 1003554015 0 1901 W HARRISON ST CHICAGO IL 606123714 20 1003554015 0 Physicians Anesthesia Services 20 1003554015 0 Physicians Healthy Kids Services 20 1003554015 0 Physicians Optical Supplies 20 1003554015 0 Physicians Physician Services 00 1003555780 0 SHAMSHUDDIN NABIHA N 2022199 9999999 B 10 1003555780 0 3545 LINDELL BLVD FL 3 SAINT LOUIS MO 631031020 20 1003555780 0 Physicians Anesthesia Services 20 1003555780 0 Physicians Fluoride varnish 20 1003555780 0 Physicians Healthy Kids Services 20 1003555780 0 Physicians Optical Supplies 20 1003555780 0 Physicians 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0 Physicians Physician Services 00 1013152628 0 COWAN JENNIFER 2009006 9999999 B 10 1013152628 0 1739 N ELSTON AVE CHICAGO IL 606421544 20 1013152628 0 Physical Therapists Physical Therapy Services 00 1013154327 0 HUMAYUN WASAY 2016183 9999999 B 10 1013154327 0 1044 N FRANCISCO AVE CHICAGO IL 606222743 20 1013154327 0 Physicians Anesthesia Services 20 1013154327 0 Physicians Fluoride varnish 20 1013154327 0 Physicians Healthy Kids Services 20 1013154327 0 Physicians Optical Supplies 20 1013154327 0 Physicians Physician Services 00 1013154350 0 STACHURA SHANE T 2019204 9999999 B 10 1013154350 0 1120 N MELVIN ST GIBSON CITY IL 609361477 20 1013154350 0 Physical Therapists Medical Supplies 20 1013154350 0 Physical Therapists Medical equipment/prosthetic devices 20 1013154350 0 Physical Therapists Physical Therapy Services 00 1013155563 0 DEL CARLO BRIAN 2016275 9999999 B 10 1013155563 0 16533 W 159TH ST LOCKPORT IL 604417900 20 1013155563 0 Dentists Dental Services 20 1013155563 0 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INNOVATION DR STE 300 MILWAUKEE WI 532264837 20 1013203652 0 Physicians Anesthesia Services 20 1013203652 0 Physicians Healthy Kids Services 20 1013203652 0 Physicians Optical Supplies 20 1013203652 0 Physicians Physician Services 20 1013203652 0 Physicians Physicians Psychiatric Services 00 1013203660 0 KREZALEK MONIKA A 2019217 9999999 B 10 1013203660 0 2650 RIDGE AVE # 1223 EVANSTON IL 602011700 20 1013203660 0 Physicians Anesthesia Services 20 1013203660 0 Physicians Healthy Kids Services 20 1013203660 0 Physicians Optical Supplies 20 1013203660 0 Physicians Physician Services 00 1013204031 0 SHEIKH SAIMA 2011182 9999999 B 10 1013204031 0 1114 LEE ST DES PLAINES IL 600166517 20 1013204031 0 Dentists Dental Services 20 1013204031 0 Dentists Physician Services 00 1013204072 0 MILLER JUSTIN GRIFFITH 2022208 9999999 B 10 1013204072 0 2160 S 1ST AVE BLDG 201 MAYWOOD IL 601533328 20 1013204072 0 Physicians Anesthesia Services 20 1013204072 0 Physicians Healthy Kids Services 20 1013204072 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2016104 9999999 B 10 1013376581 0 225 E CHICAGO AVE # 118 CHICAGO IL 606112991 20 1013376581 0 Nurse Practitioners Fluoride varnish 20 1013376581 0 Nurse Practitioners Healthy Kids Services 20 1013376581 0 Nurse Practitioners Nurse Practitioners Services 20 1013376581 0 Nurse Practitioners Physician Services 00 1013376656 0 SPICER WAYNE 2017001 9999999 B 10 1013376656 0 9 CRESTWOOD DR CARLINVILLE IL 626261847 20 1013376656 0 Clinical Social Worker Social work service 00 1013377803 0 NELSON NOAH F 2022304 9999999 B 10 1013377803 0 1044 N FRANCISCO AVE CHICAGO IL 606222743 20 1013377803 0 Other behavior health professional Other Behavioral Health Services 00 1013378280 0 COOK DAWN J. 2016061 9999999 B 10 1013378280 0 2650 RIDGE AVE STE 1223 EVANSTON IL 602011718 20 1013378280 0 Nurse Practitioners Anesthesia Services 20 1013378280 0 Nurse Practitioners Nurse Practitioners Services 20 1013378280 0 Nurse Practitioners Physician Services 00 1013378652 0 COOPERSTEIN NOAH M 2019196 9999999 B 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9999999 B 10 1013388255 0 325 IL ROUTE 2 DIXON IL 610219118 20 1013388255 0 Clinical Social Worker Social work service 00 1013388784 0 PAYNE ALEXA T 2015320 9999999 B 10 1013388784 0 2605 KENTUCKY AVE STE 306 SUITE 306 PADUCAH KY 420033802 20 1013388784 0 Nurse Practitioners Fluoride varnish 20 1013388784 0 Nurse Practitioners Healthy Kids Services 20 1013388784 0 Nurse Practitioners Nurse Practitioners Services 20 1013388784 0 Nurse Practitioners Physician Services 00 1013389261 0 GLENN CHRISTOPHER 2016032 9999999 B 10 1013389261 0 835 S WOLCOTT AVE RM W140 CHICAGO IL 606123748 20 1013389261 0 Nurse Practitioners Anesthesia Services 20 1013389261 0 Nurse Practitioners Nurse Practitioners Services 20 1013389261 0 Nurse Practitioners Physician Services 00 1013390368 0 BURKHOLDER JUSTIN D 2022149 9999999 B 10 1013390368 0 PO BOX 43230 PHOENIX AZ 850803230 20 1013390368 0 Physicians Anesthesia Services 20 1013390368 0 Physicians Healthy Kids Services 20 1013390368 0 Physicians Optical 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STEFANI 2018233 9999999 B 10 1013433929 0 100 S GRAND AVE E FL 1 SPRINGFIELD IL 627621000 20 1013433929 0 Speech Therapists Medical Supplies 20 1013433929 0 Speech Therapists Medical equipment/prosthetic devices 20 1013433929 0 Speech Therapists Speech Therapy/Pathology Services 00 1013434620 0 MALTERS MICHELLE 2019318 9999999 H 10 1013434620 0 23 W CALENDAR AVE STE 207 LA GRANGE IL 605256327 20 1013434620 0 Other behavior health professional Other Behavioral Health Services 00 1013434836 0 YAN SHUO 2017234 9999999 B 10 1013434836 0 47 CLOCK TOWER PLZ ELGIN IL 601207800 20 1013434836 0 Dentists Dental Services 20 1013434836 0 Dentists Physician Services 00 1013435056 0 MELNICK MELISSA R 2017244 9999999 B 10 1013435056 0 100 S GRAND AVE E FL 1 SPRINGFIELD IL 627621000 20 1013435056 0 Occupational Therapists Medical Supplies 20 1013435056 0 Occupational Therapists Medical equipment/prosthetic devices 20 1013435056 0 Occupational Therapists Occupational Therapy Services 00 1013435072 0 JOKAY JUDITH I 2000251 9999999 B 10 1013435072 0 1200 S DUNTON AVE ARLINGTON HEIGH IL 600053111 20 1013435072 0 Speech Therapists Medical Supplies 20 1013435072 0 Speech Therapists Medical equipment/prosthetic devices 20 1013435072 0 Speech Therapists Speech Therapy/Pathology Services 00 1013435189 0 ZAGORSKI ANGELA R 2017290 9999999 B 10 1013435189 0 224 S LOCUST ST CENTRALIA IL 628013509 20 1013435189 0 Speech Therapists Medical Supplies 20 1013435189 0 Speech Therapists Medical equipment/prosthetic devices 20 1013435189 0 Speech Therapists Speech Therapy/Pathology Services 00 1013436039 0 DIEMER JOELI 2020153 9999999 B 10 1013436039 0 PO BOX 19639 SPRINGFIELD IL 627949639 20 1013436039 0 Physician Assistant Only Fluoride varnish 20 1013436039 0 Physician Assistant Only Healthy Kids Services 20 1013436039 0 Physician Assistant Only Physician Services 00 1013436500 0 BASKARAN ARCHIT B 2022176 9999999 B 10 1013436500 0 150 HARVESTER DR STE 300 BURR RIDGE IL 605275965 20 1013436500 0 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Physician Services 00 1013439777 0 LIEFER KATHY L 2017234 9999999 B 10 1013439777 0 3051 HOLLIS DR FL 2 SPRINGFIELD IL 627047452 20 1013439777 0 Nurse Practitioners Fluoride varnish 20 1013439777 0 Nurse Practitioners Healthy Kids Services 20 1013439777 0 Nurse Practitioners Nurse Practitioners Services 20 1013439777 0 Nurse Practitioners Physician Services 00 1013440221 0 CHOI ALEXANDER J 2021173 9999999 B 10 1013440221 0 680 N LAKE SHORE DR STE 1000 SUITE# 1000 CHICAGO IL 606118709 20 1013440221 0 Physicians Anesthesia Services 20 1013440221 0 Physicians Healthy Kids Services 20 1013440221 0 Physicians Optical Supplies 20 1013440221 0 Physicians Physician Services 20 1013440221 0 Physicians Physicians Psychiatric Services 00 1013440528 0 NABIJOHN AQEEL 2020227 9999999 B 10 1013440528 0 2100 POWELL ST STE 400 EMERYVILLE CA 946081826 20 1013440528 0 Physicians Anesthesia Services 20 1013440528 0 Physicians Healthy Kids Services 20 1013440528 0 Physicians Optical Supplies 20 1013440528 0 Physicians Physician Services 00 1013440551 0 PATEL PALAKKUMAK 2020232 9999999 B 10 1013440551 0 7732 SOLUTION CTR CHICAGO IL 606777007 20 1013440551 0 Physicians Anesthesia Services 20 1013440551 0 Physicians Fluoride varnish 20 1013440551 0 Physicians Healthy Kids Services 20 1013440551 0 Physicians Optical Supplies 20 1013440551 0 Physicians Physician Services 00 1013441773 0 SOLTYS MATTHEW 2020189 9999999 B 10 1013441773 0 200 HAWKINS DR IOWA CITY IA 522421009 20 1013441773 0 Physicians Anesthesia Services 20 1013441773 0 Physicians Fluoride varnish 20 1013441773 0 Physicians Healthy Kids Services 20 1013441773 0 Physicians Optical Supplies 20 1013441773 0 Physicians Physician Services 00 1013442839 0 LANDERS KATHRYN 2022151 9999999 B 10 1013442839 0 1700 W VAN BUREN ST STE 161 CHICAGO IL 606123228 20 1013442839 0 Physicians Anesthesia Services 20 1013442839 0 Physicians Healthy Kids Services 20 1013442839 0 Physicians Optical Supplies 20 1013442839 0 Physicians Physician Services 00 1013442946 0 WELCH BLAIR N 2023164 9999999 B 10 1013442946 0 PO BOX 778912 CHICAGO IL 606778912 20 1013442946 0 Physicians Anesthesia Services 20 1013442946 0 Physicians Fluoride varnish 20 1013442946 0 Physicians Healthy Kids Services 20 1013442946 0 Physicians Optical Supplies 20 1013442946 0 Physicians Physician Services 00 1013443175 0 WILSON SHANNON C 2020031 9999999 B 10 1013443175 0 29373 NETWORK PL CHICAGO IL 606733039 20 1013443175 0 Physicians Anesthesia Services 20 1013443175 0 Physicians Fluoride varnish 20 1013443175 0 Physicians Healthy Kids Services 20 1013443175 0 Physicians Optical Supplies 20 1013443175 0 Physicians Physician Services 00 1013443993 0 DONLEY THERESA 2017285 9999999 B 10 1013443993 0 210 N HAMMES AVE STE 205 SUITE 205 JOLIET IL 604358139 20 1013443993 0 Nurse Practitioners Healthy Kids Services 20 1013443993 0 Nurse Practitioners Nurse Practitioners Services 20 1013443993 0 Nurse Practitioners Physician Services 00 1013444934 0 ANTICEVICH SHERYL 2017145 9999999 B 10 1013444934 0 1420 RENAISSANCE DR STE 207 SUITE 207 PARK RIDGE IL 600681342 20 1013444934 0 Nurse Practitioners Healthy Kids Services 20 1013444934 0 Nurse Practitioners Nurse Practitioners Services 20 1013444934 0 Nurse Practitioners Physician Services 00 1013445915 0 ARVIN AMBER 2018220 9999999 B 10 1013445915 0 15732 S HOWARD ST PLAINFIELD IL 605442399 20 1013445915 0 Speech Therapists Medical Supplies 20 1013445915 0 Speech Therapists Medical equipment/prosthetic devices 20 1013445915 0 Speech Therapists Speech Therapy/Pathology Services 00 1013446061 0 PURI SHILPA 2020266 9999999 B 10 1013446061 0 3600 N PROW RD BLOOMINGTON IN 474041616 20 1013446061 0 Physicians Anesthesia Services 20 1013446061 0 Physicians Healthy Kids Services 20 1013446061 0 Physicians Optical Supplies 20 1013446061 0 Physicians Physician Services 20 1013446061 0 Physicians Physicians Psychiatric Services 00 1013446731 0 MCCROSSEN KATHERINE S 2020223 9999999 B 10 1013446731 0 680 N LAKE SHORE DR STE 1000 SUITE# 1000 CHICAGO IL 606118709 20 1013446731 0 Physician Assistant Only Fluoride varnish 20 1013446731 0 Physician Assistant Only Healthy Kids Services 20 1013446731 0 Physician Assistant Only Physician Services 00 1013446780 0 SIDEY KIRK 2022250 9999999 B 10 1013446780 0 200 HAWKINS DR IOWA CITY IA 522421009 20 1013446780 0 Physicians Anesthesia Services 20 1013446780 0 Physicians Healthy Kids Services 20 1013446780 0 Physicians Optical Supplies 20 1013446780 0 Physicians Physician Services 00 1013446905 0 COLE CORTNEY 2022189 9999999 B 10 1013446905 0 PO BOX 776926 CHICAGO IL 606776926 20 1013446905 0 Physicians Anesthesia Services 20 1013446905 0 Physicians Fluoride varnish 20 1013446905 0 Physicians Healthy Kids Services 20 1013446905 0 Physicians Optical Supplies 20 1013446905 0 Physicians Physician Services 00 1013446921 0 FORD-DAVIS JESSICA L 2019266 9999999 B 10 1013446921 0 1 ILLINI DR PEORIA IL 616052576 20 1013446921 0 Physicians Anesthesia Services 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Supplies 20 1013448620 0 Physicians Physician Services 20 1013448620 0 Physicians Physicians Psychiatric Services 00 1013449800 0 WU JING BO 2020021 9999999 B 10 1013449800 0 150 HARVESTER DR STE 300 BURR RIDGE IL 605275965 20 1013449800 0 Physicians Anesthesia Services 20 1013449800 0 Physicians Fluoride varnish 20 1013449800 0 Physicians Healthy Kids Services 20 1013449800 0 Physicians Optical Supplies 20 1013449800 0 Physicians Physician Services 00 1013451509 0 ELYEA HEIDIJO 2016356 9999999 B 10 1013451509 0 75 REMITTANCE DR DEPT 1611 SUITE 1611 CHICAGO IL 606751611 20 1013451509 0 Nurse Practitioners Fluoride varnish 20 1013451509 0 Nurse Practitioners Healthy Kids Services 20 1013451509 0 Nurse Practitioners Nurse Practitioners Services 20 1013451509 0 Nurse Practitioners Physician Services 00 1013451681 0 KRONBERG JESSICA 2017060 9999999 B 10 1013451681 0 225 E CHICAGO AVE BOX 44 CHICAGO IL 606112991 20 1013451681 0 Occupational Therapists Medical Supplies 20 1013451681 0 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professional Early Intervention Services 20 1013460518 0 Other behavior health professional Targeted case management service 00 1013460930 0 GOLDIN JULIA 2016259 9999999 B 10 1013460930 0 680 N LAKE SHORE DR STE 1000 SUITE# 1000 CHICAGO IL 606118709 20 1013460930 0 Nurse Practitioners Fluoride varnish 20 1013460930 0 Nurse Practitioners Healthy Kids Services 20 1013460930 0 Nurse Practitioners Nurse Practitioners Services 20 1013460930 0 Nurse Practitioners Physician Services 00 1013461797 0 DYER CANDICE 2016244 9999999 B 10 1013461797 0 1700 E HIGGINS RD STE 600 DES PLAINES IL 600185621 20 1013461797 0 Nurse Practitioners Fluoride varnish 20 1013461797 0 Nurse Practitioners Healthy Kids Services 20 1013461797 0 Nurse Practitioners Nurse Practitioners Services 20 1013461797 0 Nurse Practitioners Physician Services 00 1013462266 0 VOLPE NICHOLAS J 2021170 9999999 B 10 1013462266 0 541 N FAIRBANKS CT PFS 25TH FLOOR CHICAGO IL 606113319 20 1013462266 0 Physicians Anesthesia Services 20 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Other behavior health professional Licensed Clinical Professional Counselor 20 1013464254 0 Other behavior health professional Other Behavioral Health Services 00 1013464304 0 SAVANI RUCHI 2017053 9999999 B 10 1013464304 0 3450 OAKTON ST STE 300 SKOKIE IL 600762951 20 1013464304 0 Nurse Practitioners Fluoride varnish 20 1013464304 0 Nurse Practitioners Healthy Kids Services 20 1013464304 0 Nurse Practitioners Nurse Practitioners Services 20 1013464304 0 Nurse Practitioners Physician Services 00 1013464692 0 WALKER MEGAN 2016309 9999999 B 10 1013464692 0 PO BOX 233 13245 KESSLER RD CAIRO IL 629140233 20 1013464692 0 Nurse Practitioners Healthy Kids Services 20 1013464692 0 Nurse Practitioners Midwife Services 20 1013464692 0 Nurse Practitioners Nurse Practitioners Services 20 1013464692 0 Nurse Practitioners Physician Services 00 1013465103 0 AHMADI SABRENA 2023275 9999999 B 10 1013465103 0 PO BOX 781076 DETROIT MI 482781076 20 1013465103 0 Physicians Anesthesia Services 20 1013465103 0 Physicians Healthy Kids Services 20 1013465103 0 Physicians Optical Supplies 20 1013465103 0 Physicians Physician Services 20 1013465103 0 Physicians Physicians Psychiatric Services 00 1013467141 0 SMITH ELIZABETH 2018337 9999999 B 10 1013467141 0 1 WESTBROOK CORPORATE CTR STE 240 WESTCHESTER IL 601545745 20 1013467141 0 Physical Therapists Medical Supplies 20 1013467141 0 Physical Therapists Medical equipment/prosthetic devices 20 1013467141 0 Physical Therapists Physical Therapy Services 00 1013467257 0 METHIPARA ELSA 2022059 9999999 B 10 1013467257 0 1900 W POLK STE 220C CHICAGO IL 606123723 20 1013467257 0 Nurse Practitioners Healthy Kids Services 20 1013467257 0 Nurse Practitioners Nurse Practitioners Services 20 1013467257 0 Nurse Practitioners Physician Services 00 1013469246 0 KAMAL ADEEL 2018044 9999999 B 10 1013469246 0 5 TIMBERWOOD LN RIVERWOODS IL 600152463 20 1013469246 0 Physician Assistant Only Fluoride varnish 20 1013469246 0 Physician Assistant Only Healthy Kids 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0 7725 W RENO AVE OKLAHOMA CITY OK 731279711 20 1013661859 0 Licensed Practical Nurses Nursing service 00 1013662170 0 MULLER BRITTANY A 2022194 9999999 B 10 1013662170 0 PO BOX 3428 SPRINGFIELD IL 627083428 20 1013662170 0 Physician Assistant Only Fluoride varnish 20 1013662170 0 Physician Assistant Only Healthy Kids Services 20 1013662170 0 Physician Assistant Only Physician Services 00 1013662642 0 SHEFF DANIEL K 2022144 9999999 H 10 1013662642 0 318 W WASHINGTON ST STE 1A BLOOMINGTON IL 617013893 20 1013662642 0 Other behavior health professional Other Behavioral Health Services 00 1013662881 0 DIEHL TRACY ANNE 2022152 9999999 B 10 1013662881 0 3450 OAKTON ST STE 300 SKOKIE IL 600762951 20 1013662881 0 Clinical Social Worker Social work service 00 1013662964 0 PAPADOGIANNIS ALEXANDER 2023158 9999999 B 10 1013662964 0 4698 DEPT CAROL STREAM IL 601220021 20 1013662964 0 Physicians Anesthesia Services 20 1013662964 0 Physicians Fluoride varnish 20 1013662964 0 Physicians Healthy Kids 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Physicians Anesthesia Services 20 1013920297 0 Physicians Fluoride varnish 20 1013920297 0 Physicians Healthy Kids Services 20 1013920297 0 Physicians Optical Supplies 20 1013920297 0 Physicians Physician Services 00 1013920420 0 MORROW MICHAEL 2002035 9999999 B 10 1013920420 0 1401 E 12TH ST MENDOTA IL 613429216 20 1013920420 0 Physicians Anesthesia Services 20 1013920420 0 Physicians Healthy Kids Services 20 1013920420 0 Physicians Optical Supplies 20 1013920420 0 Physicians Physician Services 00 1013921758 0 DESAI AMISH 2004032 9999999 B 10 1013921758 0 340 W MAIN ST CARPENTERSVILLE IL 601102844 20 1013921758 0 Dentists Dental Services 20 1013921758 0 Dentists Physician Services 00 1013923127 0 JOHNSON MARK 2008273 9999999 B 10 1013923127 0 621 S ILLINOIS AVE MASON CITY IA 504015405 20 1013923127 0 Physicians Anesthesia Services 20 1013923127 0 Physicians Fluoride varnish 20 1013923127 0 Physicians Healthy Kids Services 20 1013923127 0 Physicians Optical Supplies 20 1013923127 0 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Physicians Physician Services 00 1013931203 0 GRIGLIONE GARY R 1986169 9999999 B 10 1013931203 0 611 W PARK ST URBANA IL 618012529 20 1013931203 0 Physicians Anesthesia Services 20 1013931203 0 Physicians Fluoride varnish 20 1013931203 0 Physicians Healthy Kids Services 20 1013931203 0 Physicians Optical Supplies 20 1013931203 0 Physicians Physician Services 00 1013931567 0 GAGE ANDREW 2008183 9999999 B 10 1013931567 0 3051 HOLLIS DR FL 2 SPRINGFIELD IL 627047452 20 1013931567 0 Physicians Anesthesia Services 20 1013931567 0 Physicians Healthy Kids Services 20 1013931567 0 Physicians Optical Supplies 20 1013931567 0 Physicians Physician Services 00 1013932482 0 DAMASAUSKAS LUCILLE 1996214 9999999 B 10 1013932482 0 310 WALNUT ST PERU IL 613541946 20 1013932482 0 Physicians Anesthesia Services 20 1013932482 0 Physicians Healthy Kids Services 20 1013932482 0 Physicians Optical Supplies 20 1013932482 0 Physicians Physician Services 00 1013933068 0 KELLY JAMES 2010152 9999999 B 10 1013933068 0 PO BOX 60352 660 SOUTH EUCLID AVENUE SAINT LOUIS MO 631600352 20 1013933068 0 Physicians Anesthesia Services 20 1013933068 0 Physicians Healthy Kids Services 20 1013933068 0 Physicians Optical Supplies 20 1013933068 0 Physicians Physician Services 00 1013933233 0 SHIFREN ADRIAN 2002172 9999999 B 10 1013933233 0 PO BOX 60352 660 SOUTH EUCLID AVENUE SAINT LOUIS MO 631600352 20 1013933233 0 Physicians Anesthesia Services 20 1013933233 0 Physicians Healthy Kids Services 20 1013933233 0 Physicians Optical Supplies 20 1013933233 0 Physicians Physician Services 00 1013933431 0 ORSINI AMY 2006249 9999999 B 10 1013933431 0 1519 LEGACY CIR NAPERVILLE IL 605633161 20 1013933431 0 Physicians Anesthesia Services 20 1013933431 0 Physicians Healthy Kids Services 20 1013933431 0 Physicians Optical Supplies 20 1013933431 0 Physicians Physician Services 00 1013934447 0 PETERS MICHELLE C 2004197 9999999 B 10 1013934447 0 3301 W FOREST HOME AVE MILWAUKEE WI 532152843 20 1013934447 0 Physicians Anesthesia Services 20 1013934447 0 Physicians Healthy Kids Services 20 1013934447 0 Physicians Optical Supplies 20 1013934447 0 Physicians Physician Services 00 1013934579 0 MANN CAROLINE 2000183 9999999 B 10 1013934579 0 PO BOX 60352 660 SOUTH EUCLID AVENUE SAINT LOUIS MO 631600352 20 1013934579 0 Physicians Anesthesia Services 20 1013934579 0 Physicians Healthy Kids Services 20 1013934579 0 Physicians Optical Supplies 20 1013934579 0 Physicians Physician Services 00 1013934827 0 STA ROMANA LEILANE U 2017238 9999999 B 10 1013934827 0 6308 8TH AVE KENOSHA WI 531435031 20 1013934827 0 Physicians Anesthesia Services 20 1013934827 0 Physicians Fluoride varnish 20 1013934827 0 Physicians Healthy Kids Services 20 1013934827 0 Physicians Optical Supplies 20 1013934827 0 Physicians Physician Services 00 1013935535 0 COHEN ALBERT M 1992001 9999999 B 10 1013935535 0 PO BOX 60352 660 SOUTH EUCLID AVENUE SAINT LOUIS MO 631600352 20 1013935535 0 Physicians Anesthesia Services 20 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INDEPENDENCE AVE LEES SUMMIT MO 640642323 20 1013955848 0 Physicians Anesthesia Services 20 1013955848 0 Physicians Fluoride varnish 20 1013955848 0 Physicians Healthy Kids Services 20 1013955848 0 Physicians Optical Supplies 20 1013955848 0 Physicians Physician Services 00 1013956523 0 BENDER FRANK J 1996228 9999999 B 10 1013956523 0 400 MAPLE SUMMIT RD JERSEYVILLE IL 620522028 20 1013956523 0 Physicians Anesthesia Services 20 1013956523 0 Physicians Healthy Kids Services 20 1013956523 0 Physicians Optical Supplies 20 1013956523 0 Physicians Physician Services 00 1013956630 0 CHEN CATHERINE 2005206 9999999 B 10 1013956630 0 1701 W SUPERIOR ST CHICAGO IL 606225646 20 1013956630 0 Physicians Anesthesia Services 20 1013956630 0 Physicians Healthy Kids Services 20 1013956630 0 Physicians Optical Supplies 20 1013956630 0 Physicians Physician Services 00 1013957570 0 GOEL ANUPAM 2014001 9999999 B 10 1013957570 0 29373 NETWORK PL CHICAGO IL 606733039 20 1013957570 0 Physicians Anesthesia 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SHADELAND AVE STE 130 INDIANAPOLIS IN 462194959 20 1023198835 0 Physician Assistant Only Fluoride varnish 20 1023198835 0 Physician Assistant Only Healthy Kids Services 20 1023198835 0 Physician Assistant Only Physician Services 00 1023200326 0 LESKIS KATHRYN 2015230 9999999 B 10 1023200326 0 611 W PARK ST URBANA IL 618012529 20 1023200326 0 Psychologist Psychologist service 00 1023200870 0 KALTEUX JENNIFER 2008001 9999999 B 10 1023200870 0 524 E SCHAUMBURG RD SCHAUMBURG IL 601943510 20 1023200870 0 Speech Therapists Medical Supplies 20 1023200870 0 Speech Therapists Medical equipment/prosthetic devices 20 1023200870 0 Speech Therapists Speech Therapy/Pathology Services 00 1023202116 0 RENE HOLLY E 2008252 9999999 B 10 1023202116 0 150 HARVESTER DR STE 300 BURR RIDGE IL 605275965 20 1023202116 0 Nurse Practitioners Healthy Kids Services 20 1023202116 0 Nurse Practitioners Nurse Practitioners Services 20 1023202116 0 Nurse Practitioners Physician Services 00 1023202769 0 CHRISTIE CARL 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Services 00 1023205648 0 ANKROM JUDITH M 2007318 9999999 B 10 1023205648 0 3401 E PRAIRIE ST DECATUR IL 625212425 20 1023205648 0 Speech Therapists Medical Supplies 20 1023205648 0 Speech Therapists Medical equipment/prosthetic devices 20 1023205648 0 Speech Therapists Speech Therapy/Pathology Services 00 1023207115 0 ELAYYAN IBRAHIM 2010255 9999999 B 10 1023207115 0 2100 POWELL ST STE 900 EMERYVILLE CA 946081844 20 1023207115 0 Physicians Anesthesia Services 20 1023207115 0 Physicians Fluoride varnish 20 1023207115 0 Physicians Healthy Kids Services 20 1023207115 0 Physicians Optical Supplies 20 1023207115 0 Physicians Physician Services 00 1023209137 0 HUBER JEFFREY N 2022042 9999999 B 10 1023209137 0 PO BOX 110429 AURORA CO 800420429 20 1023209137 0 Physician Assistant Only Fluoride varnish 20 1023209137 0 Physician Assistant Only Healthy Kids Services 20 1023209137 0 Physician Assistant Only Physician Services 00 1023209160 0 RIORDAN ANTHONY 2014098 9999999 H 10 1023209160 0 4703 44TH STREET ROCK ISLAND IL 612017189 20 1023209160 0 Other behavior health professional Other Behavioral Health Services 00 1023209723 0 MIKHAEL MARCO N 2007213 9999999 B 10 1023209723 0 387 SHUMAN BLVD STE 240W NAPERVILLE IL 605638113 20 1023209723 0 Physicians Anesthesia Services 20 1023209723 0 Physicians Healthy Kids Services 20 1023209723 0 Physicians Optical Supplies 20 1023209723 0 Physicians Physician Services 00 1023212289 0 ELGHANNAM HESHAM 2013301 9999999 B 10 1023212289 0 1905 E HUEBBE PKWY BELOIT WI 535111842 20 1023212289 0 Physicians Anesthesia Services 20 1023212289 0 Physicians Fluoride varnish 20 1023212289 0 Physicians Healthy Kids Services 20 1023212289 0 Physicians Optical Supplies 20 1023212289 0 Physicians Physician Services 00 1023213030 0 BENSON REBECCA J 2010182 9999999 B 10 1023213030 0 200 HAWKINS DR IOWA CITY IA 522421009 20 1023213030 0 Physicians Anesthesia Services 20 1023213030 0 Physicians Healthy Kids Services 20 1023213030 0 Physicians Optical Supplies 20 1023213030 0 Physicians Physician Services 00 1023213626 0 ZILINSKI JODI L 2015305 9999999 B 10 1023213626 0 3301 W FOREST HOME AVE MILWAUKEE WI 532152843 20 1023213626 0 Physicians Anesthesia Services 20 1023213626 0 Physicians Fluoride varnish 20 1023213626 0 Physicians Healthy Kids Services 20 1023213626 0 Physicians Optical Supplies 20 1023213626 0 Physicians Physician Services 00 1023214749 0 GROSS CARLY 2007184 9999999 B 10 1023214749 0 65 MULBERRY EAST RD DEERFIELD IL 600155059 20 1023214749 0 Speech Therapists Medical Supplies 20 1023214749 0 Speech Therapists Medical equipment/prosthetic devices 20 1023214749 0 Speech Therapists Speech Therapy/Pathology Services 00 1023215076 0 HOLDEN LAUREN 2023263 9999999 B 10 1023215076 0 PO BOX 778912 CHICAGO IL 606778912 20 1023215076 0 Speech Therapists Medical Supplies 20 1023215076 0 Speech Therapists Medical equipment/prosthetic devices 20 1023215076 0 Speech Therapists Speech Therapy/Pathology Services 00 1023215282 0 LALLY ANGELLA 2003216 9999999 B 10 1023215282 0 505 S BRAINARD AVE LA GRANGE IL 605256107 20 1023215282 0 Speech Therapists Medical Supplies 20 1023215282 0 Speech Therapists Medical equipment/prosthetic devices 20 1023215282 0 Speech Therapists Speech Therapy/Pathology Services 00 1023216405 0 BAIG SHAJI M 2010017 9999999 B 10 1023216405 0 680 N LAKE SHORE DR STE 1000 SUITE# 1000 CHICAGO IL 606118709 20 1023216405 0 Physicians Anesthesia Services 20 1023216405 0 Physicians Healthy Kids Services 20 1023216405 0 Physicians Optical Supplies 20 1023216405 0 Physicians Physician Services 00 1023216603 0 JHAGROO ROY 2010213 9999999 B 10 1023216603 0 7974 UW HEALTH CT MIDDLETON WI 535625531 20 1023216603 0 Physicians Anesthesia Services 20 1023216603 0 Physicians Healthy Kids Services 20 1023216603 0 Physicians Optical Supplies 20 1023216603 0 Physicians Physician Services 00 1023216835 0 CESTERO RICARDO 2019323 9999999 B 10 1023216835 0 5590 S FORT APACHE RD LAS VEGAS NV 891487657 20 1023216835 0 Physicians Anesthesia Services 20 1023216835 0 Physicians Fluoride varnish 20 1023216835 0 Physicians Healthy Kids Services 20 1023216835 0 Physicians Optical Supplies 20 1023216835 0 Physicians Physician Services 00 1023217551 0 SHRISHRIMAL KUMARPAL 2012183 9999999 B 10 1023217551 0 1000 HEALTH CENTER DR MATTOON IL 619389253 20 1023217551 0 Physicians Anesthesia Services 20 1023217551 0 Physicians Healthy Kids Services 20 1023217551 0 Physicians Optical Supplies 20 1023217551 0 Physicians Physician Services 00 1023218278 0 KALVAITIS SAULIUS 1996183 9999999 B 10 1023218278 0 11155 DUNN RD STE 304E SUITE 304E SAINT LOUIS MO 631366111 20 1023218278 0 Physicians Anesthesia Services 20 1023218278 0 Physicians Fluoride varnish 20 1023218278 0 Physicians Healthy Kids Services 20 1023218278 0 Physicians Optical Supplies 20 1023218278 0 Physicians Physician Services 00 1023218807 0 MUKERJI RITA 2016032 9999999 B 10 1023218807 0 2300 N EDWARD ST DECATUR IL 625264163 20 1023218807 0 Physicians Anesthesia Services 20 1023218807 0 Physicians Fluoride varnish 20 1023218807 0 Physicians Healthy Kids Services 20 1023218807 0 Physicians Optical Supplies 20 1023218807 0 Physicians Physician Services 00 1023220464 0 HURST EVA A 2007244 9999999 B 10 1023220464 0 PO BOX 60352 660 SOUTH EUCLID AVENUE SAINT LOUIS MO 631600352 20 1023220464 0 Physicians Anesthesia Services 20 1023220464 0 Physicians Healthy Kids Services 20 1023220464 0 Physicians Optical Supplies 20 1023220464 0 Physicians Physician Services 00 1023221058 0 MAUCK JENNIFER 2004076 9999999 B 10 1023221058 0 9760 SORENG AVE SCHILLER PARK IL 601762105 20 1023221058 0 Speech Therapists Medical Supplies 20 1023221058 0 Speech Therapists Medical equipment/prosthetic devices 20 1023221058 0 Speech Therapists Speech Therapy/Pathology Services 00 1023221157 0 SHIVAKUMAR DEEPTI 2013121 9999999 B 10 1023221157 0 2 WESTBROOK CORP CTR STE 600 WESTCHESTER IL 601545716 20 1023221157 0 Physicians Anesthesia Services 20 1023221157 0 Physicians Healthy Kids Services 20 1023221157 0 Physicians Optical Supplies 20 1023221157 0 Physicians Physician Services 00 1023221264 0 YUDKOWSKY DAVID S 1993333 9999999 B 10 1023221264 0 PO BOX 5161 SKOKIE IL 600765161 20 1023221264 0 Dentists Dental Services 20 1023221264 0 Dentists Physician Services 00 1023221793 0 NORTON - HALE GAIL 2018193 9999999 H 10 1023221793 0 PO BOX 781076 DETROIT MI 482781076 20 1023221793 0 Other behavior health professional Other Behavioral Health Services 00 1023221926 0 WISE LEON J 2013204 9999999 B 10 1023221926 0 75 REMITTANCE DR DEPT 1186 DEPT 1186 CHICAGO IL 606751186 20 1023221926 0 Physicians Anesthesia Services 20 1023221926 0 Physicians Healthy Kids Services 20 1023221926 0 Physicians Optical Supplies 20 1023221926 0 Physicians Physician Services 00 1023222304 0 DEYOUNG NANCY A 2020001 9999999 B 10 1023222304 0 PO BOX 608 BEECHER IL 604010608 20 1023222304 0 Nurse Practitioners Fluoride varnish 20 1023222304 0 Nurse Practitioners Healthy Kids Services 20 1023222304 0 Nurse Practitioners Nurse Practitioners Services 20 1023222304 0 Nurse Practitioners Physician Services 00 1023222486 0 KAINZ FRANK 2008245 9999999 B 10 1023222486 0 2100 POWELL ST SUITE 900 EMERYVILLE CA 946081826 20 1023222486 0 Physicians Anesthesia Services 20 1023222486 0 Physicians Healthy Kids Services 20 1023222486 0 Physicians Optical Supplies 20 1023222486 0 Physicians Physician Services 00 1023222817 0 FARRIS SHONDA LYNN 2009121 9999999 B 10 1023222817 0 PO BOX 772 MC2295 WOONSOCKET RI 028950784 20 1023222817 0 Nurse Practitioners Fluoride varnish 20 1023222817 0 Nurse Practitioners Healthy Kids Services 20 1023222817 0 Nurse Practitioners Nurse Practitioners Services 20 1023222817 0 Nurse Practitioners Physician Services 00 1023223021 0 PEACOCK DENNIS A 2016351 9999999 B 10 1023223021 0 2160 S 1ST AVE MAYWOOD IL 601533328 20 1023223021 0 Physicians Anesthesia Services 20 1023223021 0 Physicians Fluoride varnish 20 1023223021 0 Physicians Healthy Kids Services 20 1023223021 0 Physicians Optical Supplies 20 1023223021 0 Physicians Physician Services 00 1023223088 0 BORSHESKI BETSY 2023054 9999999 B 10 1023223088 0 1 HOSPITAL DR COLUMBIA MO 652120001 20 1023223088 0 Physicians Anesthesia Services 20 1023223088 0 Physicians Healthy Kids Services 20 1023223088 0 Physicians Optical Supplies 20 1023223088 0 Physicians Physician Services 00 1023223120 0 KAMM ALAINE 2009091 9999999 B 10 1023223120 0 150 HARVESTER DR STE 300 BURR RIDGE IL 605275965 20 1023223120 0 Nurse Practitioners Healthy Kids Services 20 1023223120 0 Nurse Practitioners Nurse Practitioners Services 20 1023223120 0 Nurse Practitioners Physician Services 00 1023223161 0 BOBBA KISHORE 2007121 9999999 B 10 1023223161 0 1501 S CALIFORNIA AVE # 7-140 CHICAGO IL 606081732 20 1023223161 0 Physicians Anesthesia Services 20 1023223161 0 Physicians Healthy Kids Services 20 1023223161 0 Physicians Optical Supplies 20 1023223161 0 Physicians Physician Services 00 1023223310 0 PATEL AMEE 2016001 9999999 B 10 1023223310 0 1601 CUMMINS DR STE D MODESTO CA 953586411 20 1023223310 0 Physician Assistant Only Fluoride varnish 20 1023223310 0 Physician Assistant Only Healthy Kids Services 20 1023223310 0 Physician Assistant Only Physician Services 00 1023223856 0 PATEL AMIT R 2008214 9999999 B 10 1023223856 0 150 HARVESTER DR STE 300 BURR RIDGE IL 605275965 20 1023223856 0 Physicians Anesthesia Services 20 1023223856 0 Physicians Healthy Kids Services 20 1023223856 0 Physicians Optical Supplies 20 1023223856 0 Physicians Physician Services 00 1023224854 0 SELLEY JEREMY K 2023017 9999999 B 10 1023224854 0 4200 SUN N LAKE BLVD PO BOX 4200 SEBRING FL 338721986 20 1023224854 0 Physicians Anesthesia Services 20 1023224854 0 Physicians Healthy Kids Services 20 1023224854 0 Physicians Optical Supplies 20 1023224854 0 Physicians Physician Services 00 1023225554 0 VILLAMIL SANDRA 2006335 9999999 B 10 1023225554 0 1222 N ROSELLE RD SCHAUMBURG IL 601953649 20 1023225554 0 Dentists Dental Services 20 1023225554 0 Dentists Physician Services 00 1023227162 0 ATKINSON PAUL 2017075 9999999 B 10 1023227162 0 2720 FAIRVIEW AVE N STE 100 ROSEVILLE MN 551131306 20 1023227162 0 Physicians Anesthesia Services 20 1023227162 0 Physicians Healthy Kids Services 20 1023227162 0 Physicians Optical Supplies 20 1023227162 0 Physicians Physician Services 20 1023227162 0 Physicians Physicians Psychiatric Services 00 1023227451 0 MOHAMED SHAKIR 2009182 9999999 B 10 1023227451 0 10176 CORPORATE SQUARE DR STE SAINT LOUIS MO 631322924 20 1023227451 0 Physicians Anesthesia Services 20 1023227451 0 Physicians Healthy Kids Services 20 1023227451 0 Physicians Optical Supplies 20 1023227451 0 Physicians Physician Services 00 1023227956 0 BUFFKIN KIMBERLY 2020364 9999999 B 10 1023227956 0 601 E ROLLINS ST ORLANDO FL 328031248 20 1023227956 0 Physicians Anesthesia Services 20 1023227956 0 Physicians Healthy Kids Services 20 1023227956 0 Physicians Optical Supplies 20 1023227956 0 Physicians Physician Services 00 1023229283 0 ARIYO WASIU 2013282 9999999 B 10 1023229283 0 PO BOX 1239 TROY MI 480991239 20 1023229283 0 Nurse Practitioners Healthy Kids Services 20 1023229283 0 Nurse Practitioners Nurse Practitioners Services 20 1023229283 0 Nurse Practitioners Physician Services 00 1023230083 0 ORTMAN MADELEINE 2021195 9999999 B 10 1023230083 0 1 CHILDRENS PL STE 3S-36 SAINT LOUIS MO 631101002 20 1023230083 0 Nurse Practitioners Fluoride varnish 20 1023230083 0 Nurse Practitioners Healthy Kids Services 20 1023230083 0 Nurse Practitioners Nurse Practitioners Services 20 1023230083 0 Nurse Practitioners Physician Services 00 1023230802 0 BERG CHRYSTAL 2021188 9999999 B 10 1023230802 0 PO BOX 917 NORTHBROOK IL 600650917 20 1023230802 0 Podiatrists Podiatric Services 00 1023230968 0 BILYEU JOE A 2009121 9999999 B 10 1023230968 0 PO BOX 3428 SPRINGFIELD IL 627083428 20 1023230968 0 Physicians Anesthesia Services 20 1023230968 0 Physicians Healthy Kids Services 20 1023230968 0 Physicians Optical Supplies 20 1023230968 0 Physicians Physician Services 00 1023232253 0 TRIVEDI SHRUTI S 2003244 9999999 B 10 1023232253 0 680 N LAKE SHORE DR STE 1000 SUITE# 1000 CHICAGO IL 606118709 20 1023232253 0 Physicians Anesthesia Services 20 1023232253 0 Physicians Healthy Kids Services 20 1023232253 0 Physicians Optical Supplies 20 1023232253 0 Physicians Physician Services 00 1023234143 0 GASTON DARRIEN 1994001 9999999 B 10 1023234143 0 10444 S WESTERN AVE CHICAGO IL 606432508 20 1023234143 0 Physicians Anesthesia Services 20 1023234143 0 Physicians Fluoride varnish 20 1023234143 0 Physicians Healthy Kids Services 20 1023234143 0 Physicians Optical Supplies 20 1023234143 0 Physicians Physician Services 00 1023235223 0 CHANDRASHEKAR BELLUR N 1981227 9999999 B 10 1023235223 0 17577 KEDZIE AVE STE 106 HAZEL CREST IL 604292052 20 1023235223 0 Dentists Dental Services 20 1023235223 0 Dentists Physician Services 00 1023235249 0 DAFTARY FARIDEH N 2014162 9999999 B 10 1023235249 0 1510 S WABASH AVE CHICAGO IL 606052809 20 1023235249 0 Dentists Dental Services 20 1023235249 0 Dentists Physician Services 00 1023235918 0 STOVALL CHARISSE 2022255 9999999 B 10 1023235918 0 PO BOX 954467 SAINT LOUIS MO 631952334 20 1023235918 0 Physicians Anesthesia Services 20 1023235918 0 Physicians Healthy Kids Services 20 1023235918 0 Physicians Optical Supplies 20 1023235918 0 Physicians Physician Services 00 1023235983 0 JOHNSON STEPHANIE A 2012069 9999999 B 10 1023235983 0 4835 MANHATTAN DR ROCKFORD IL 611082265 20 1023235983 0 Clinical Social Worker Social work service 00 1023237476 0 MORRIS MARK 2013258 9999999 B 10 1023237476 0 124 SW ADAMS ST PEORIA IL 616021308 20 1023237476 0 Nurse Practitioners Healthy Kids Services 20 1023237476 0 Nurse Practitioners Nurse Practitioners Services 20 1023237476 0 Nurse Practitioners Physician Services 00 1023237567 0 SIMON RACHEL E 2013044 9999999 B 10 1023237567 0 1420 W PIONEER PKWY PEORIA IL 616151941 20 1023237567 0 Other behavior health professional Licensed Clinical Professional Counselor 00 1023238862 0 TLEMCANI KAOUTAR 2011121 9999999 B 10 1023238862 0 2361 PAYSPHERE CIR CHICAGO IL 606740023 20 1023238862 0 Physicians Anesthesia Services 20 1023238862 0 Physicians Healthy Kids Services 20 1023238862 0 Physicians Optical Supplies 20 1023238862 0 Physicians Physician Services 00 1023239043 0 ZIEMBA SARAH 2001128 9999999 B 10 1023239043 0 100 S GRAND AVE E FL 1 SPRINGFIELD IL 627621000 20 1023239043 0 Speech Therapists Medical Supplies 20 1023239043 0 Speech Therapists Medical equipment/prosthetic devices 20 1023239043 0 Speech Therapists Speech Therapy/Pathology Services 00 1023239258 0 GORHAM STEPHANIE A 2009299 9999999 B 10 1023239258 0 2550 CHARLES ST ROCKFORD IL 611081673 20 1023239258 0 Physicians Anesthesia Services 20 1023239258 0 Physicians Healthy Kids Services 20 1023239258 0 Physicians Optical Supplies 20 1023239258 0 Physicians Physician Services 00 1023240652 0 OBEROI DIPIKA 2013135 9999999 B 10 1023240652 0 2650 RIDGE AVE # 1223 EVANSTON IL 602011700 20 1023240652 0 Physicians Anesthesia Services 20 1023240652 0 Physicians Healthy Kids Services 20 1023240652 0 Physicians Optical Supplies 20 1023240652 0 Physicians Physician Services 00 1023240918 0 NOURAHMADI MILAD 2009213 9999999 B 10 1023240918 0 9704 GRAND AVE FRANKLIN PARK IL 601313357 20 1023240918 0 Dentists Dental Services 20 1023240918 0 Dentists Physician Services 00 1023240934 0 KELCH ROBERT 2012092 9999999 B 10 1023240934 0 7213 N ALLEN RD PEORIA IL 616141107 20 1023240934 0 Chiropractors Chiropractic Services 00 1023242104 0 NGUYEN LINDA 2013032 9999999 B 10 1023242104 0 29373 NETWORK PL CHICAGO IL 606733039 20 1023242104 0 Physicians Anesthesia Services 20 1023242104 0 Physicians Healthy Kids Services 20 1023242104 0 Physicians Optical Supplies 20 1023242104 0 Physicians Physician Services 00 1023242252 0 LAMBERT ASHLEY A 2020062 9999999 B 10 1023242252 0 75 REMITTANCE DR DEPT 1611 SUITE 1611 CHICAGO IL 606751611 20 1023242252 0 Psychologist Psychologist service 00 1023242831 0 SWALLEN KAREN 2020141 9999999 B 10 1023242831 0 1808 W BELTLINE HWY MADISON WI 537132334 20 1023242831 0 Physicians Anesthesia Services 20 1023242831 0 Physicians Fluoride varnish 20 1023242831 0 Physicians Healthy Kids Services 20 1023242831 0 Physicians Optical Supplies 20 1023242831 0 Physicians Physician Services 00 1023242864 0 ACHARYA KARTIKEY 2017147 9999999 B 10 1023242864 0 10000 W INNOVATION DR STE 300 MILWAUKEE WI 532264837 20 1023242864 0 Physicians Anesthesia Services 20 1023242864 0 Physicians Fluoride varnish 20 1023242864 0 Physicians Healthy Kids Services 20 1023242864 0 Physicians Optical Supplies 20 1023242864 0 Physicians Physician Services 00 1023243151 0 HORBAL KERSTIN 2014091 9999999 B 10 1023243151 0 1329 N RAND RD PALATINE IL 600742922 20 1023243151 0 Dentists Dental Services 20 1023243151 0 Dentists Physician Services 00 1023243334 0 OKON STANLEY 2015299 9999999 B 10 1023243334 0 62311 COLLECTION CENTER DR CHICAGO IL 606930001 20 1023243334 0 Physicians Anesthesia Services 20 1023243334 0 Physicians Healthy Kids Services 20 1023243334 0 Physicians Optical Supplies 20 1023243334 0 Physicians Physician Services 20 1023243334 0 Physicians Physicians Psychiatric Services 00 1023243771 0 ROYER ALLISON 2020280 9999999 B 10 1023243771 0 1201 PINE ST ELDORADO IL 629301634 20 1023243771 0 Physicians Anesthesia Services 20 1023243771 0 Physicians Healthy Kids Services 20 1023243771 0 Physicians Optical Supplies 20 1023243771 0 Physicians Physician Services 00 1023244522 0 KELLY BRIAN 2016182 9999999 B 10 1023244522 0 3310 FIELDS SOUTH DR CHAMPAIGN IL 618223741 20 1023244522 0 Physicians Anesthesia Services 20 1023244522 0 Physicians Healthy Kids Services 20 1023244522 0 Physicians Optical Supplies 20 1023244522 0 Physicians Physician Services 00 1023244605 0 VOLERMAN BEASER ANNA 2013182 9999999 B 10 1023244605 0 150 HARVESTER DR STE 300 BURR RIDGE IL 605275965 20 1023244605 0 Physicians Anesthesia Services 20 1023244605 0 Physicians Fluoride varnish 20 1023244605 0 Physicians Healthy Kids Services 20 1023244605 0 Physicians Optical Supplies 20 1023244605 0 Physicians Physician Services 00 1023245057 0 KIMES NATHAN E 2009156 9999999 B 10 1023245057 0 387 SHUMAN BLVD STE 240W NAPERVILLE IL 605638113 20 1023245057 0 Nurse Practitioners Anesthesia Services 20 1023245057 0 Nurse Practitioners Nurse Practitioners Services 20 1023245057 0 Nurse Practitioners Physician Services 00 1023245107 0 PLAYER BRITTANY 2012240 9999999 B 10 1023245107 0 10000 W INNOVATION DR STE 300 MILWAUKEE WI 532264837 20 1023245107 0 Physicians Anesthesia Services 20 1023245107 0 Physicians Healthy Kids Services 20 1023245107 0 Physicians Optical Supplies 20 1023245107 0 Physicians Physician Services 00 1023245115 0 SATO TAKASHI S 2016213 9999999 B 10 1023245115 0 200 HAWKINS DR IOWA CITY IA 522421009 20 1023245115 0 Physicians Anesthesia Services 20 1023245115 0 Physicians Healthy Kids Services 20 1023245115 0 Physicians Optical Supplies 20 1023245115 0 Physicians Physician Services 00 1023245412 0 GULATI NEHA 2010182 9999999 B 10 1023245412 0 3450 LACEY RD DOWNERS GROVE IL 605155430 20 1023245412 0 Optometrists Optical Supplies 20 1023245412 0 Optometrists Optometric Services 20 1023245412 0 Optometrists Physician Services 00 1023245446 0 PATEL JAGRUTI 2014321 9999999 B 10 1023245446 0 611 W PARK ST URBANA IL 618012529 20 1023245446 0 Podiatrists Podiatric Services 00 1023245511 0 JANIK LUKE S. 2015271 9999999 B 10 1023245511 0 2650 RIDGE AVE # 1223 EVANSTON IL 602011700 20 1023245511 0 Physicians Anesthesia Services 20 1023245511 0 Physicians Healthy Kids Services 20 1023245511 0 Physicians Optical Supplies 20 1023245511 0 Physicians Physician Services 00 1023245693 0 FAN DI 2014276 9999999 B 10 1023245693 0 PO BOX 451 NORTHBROOK IL 600650451 20 1023245693 0 Physicians Anesthesia Services 20 1023245693 0 Physicians Healthy Kids Services 20 1023245693 0 Physicians Optical Supplies 20 1023245693 0 Physicians Physician Services 00 1023245859 0 DAS KOUSHIK K 2016181 9999999 B 10 1023245859 0 PO BOX 60352 660 SOUTH EUCLID AVENUE SAINT LOUIS MO 631600352 20 1023245859 0 Physicians Anesthesia Services 20 1023245859 0 Physicians Fluoride varnish 20 1023245859 0 Physicians Healthy Kids Services 20 1023245859 0 Physicians Optical Supplies 20 1023245859 0 Physicians Physician Services 00 1023245925 0 RIZVI ASGHAR PAIN 2016201 9999999 B 10 1023245925 0 PO BOX 631 LAKE FOREST IL 600450631 20 1023245925 0 Physicians Anesthesia Services 20 1023245925 0 Physicians Healthy Kids Services 20 1023245925 0 Physicians Optical Supplies 20 1023245925 0 Physicians Physician Services 00 1023246261 0 BARDOWELL RACHEL H 2012183 9999999 B 10 1023246261 0 PO BOX 60352 660 SOUTH EUCLID AVENUE SAINT LOUIS MO 631600352 20 1023246261 0 Physicians Anesthesia Services 20 1023246261 0 Physicians Healthy Kids Services 20 1023246261 0 Physicians Optical Supplies 20 1023246261 0 Physicians Physician Services 00 1023246980 0 ROBINSON RICHMOND 2013105 9999999 B 10 1023246980 0 3471 GREEN BAY RD NORTH CHICAGO IL 600643090 20 1023246980 0 Podiatrists Podiatric Services 00 1023247236 0 JENKINS VOGEL MARY TILLEY 2016197 9999999 B 10 1023247236 0 2650 RIDGE AVE # 1223 EVANSTON IL 602011700 20 1023247236 0 Physicians Anesthesia Services 20 1023247236 0 Physicians Healthy Kids Services 20 1023247236 0 Physicians Optical Supplies 20 1023247236 0 Physicians Physician Services 00 1023247699 0 WANG PEGGY 2012340 9999999 B 10 1023247699 0 2424 W PETERSON AVE CHICAGO IL 606594100 20 1023247699 0 Physicians Anesthesia Services 20 1023247699 0 Physicians Healthy Kids Services 20 1023247699 0 Physicians Optical Supplies 20 1023247699 0 Physicians Physician Services 00 1023248184 0 MATTHEWS SURUCHI 2010231 9999999 B 10 1023248184 0 29373 NETWORK PL CHICAGO IL 606733039 20 1023248184 0 Speech Therapists Medical Supplies 20 1023248184 0 Speech Therapists Medical equipment/prosthetic devices 20 1023248184 0 Speech Therapists Speech Therapy/Pathology Services 00 1023249075 0 HUGHES CARLETHA C 2010305 9999999 B 10 1023249075 0 165 W 10TH ST CHICAGO HEIGHTS IL 604112000 20 1023249075 0 Physicians Anesthesia Services 20 1023249075 0 Physicians Healthy Kids Services 20 1023249075 0 Physicians Optical Supplies 20 1023249075 0 Physicians Physician Services 00 1023249364 0 MORROW STEPHEN 2013182 9999999 B 10 1023249364 0 301 JOHN ST BOX 42 KALAMAZOO MI 490075295 20 1023249364 0 Physicians Anesthesia Services 20 1023249364 0 Physicians Fluoride varnish 20 1023249364 0 Physicians Healthy Kids Services 20 1023249364 0 Physicians Optical Supplies 20 1023249364 0 Physicians Physician Services 00 1023250511 0 TANNOUS PAUL 2017121 9999999 B 10 1023250511 0 225 E CHICAGO AVE # 118 CHICAGO IL 606112991 20 1023250511 0 Physicians Anesthesia Services 20 1023250511 0 Physicians Fluoride varnish 20 1023250511 0 Physicians Healthy Kids Services 20 1023250511 0 Physicians Optical Supplies 20 1023250511 0 Physicians Physician Services 00 1023250677 0 HAHN DANITA 2012159 9999999 B 10 1023250677 0 10000 W INNOVATION DR STE 300 MILWAUKEE WI 532264837 20 1023250677 0 Physicians Anesthesia Services 20 1023250677 0 Physicians Fluoride varnish 20 1023250677 0 Physicians Healthy Kids Services 20 1023250677 0 Physicians Optical Supplies 20 1023250677 0 Physicians Physician Services 00 1023251055 0 MARTINEZ KARA D 2021076 9999999 B 10 1023251055 0 PO BOX 10010 GLENDALE AZ 853180010 20 1023251055 0 Physicians Anesthesia Services 20 1023251055 0 Physicians Healthy Kids Services 20 1023251055 0 Physicians Optical Supplies 20 1023251055 0 Physicians Physician Services 20 1023251055 0 Physicians Physicians Psychiatric Services 00 1023251428 0 COHEN JASON MATTHEW 2016273 9999999 B 10 1023251428 0 18167 US HIGHWAY 19 N STE 650 CLEARWATER FL 337646576 20 1023251428 0 Physician Assistant Only Fluoride varnish 20 1023251428 0 Physician Assistant Only Healthy Kids Services 20 1023251428 0 Physician Assistant Only Physician Services 00 1023251709 0 TEGGATZ ERIC 2014237 9999999 B 10 1023251709 0 1808 W BELTLINE HWY MADISON WI 537132334 20 1023251709 0 Physicians Anesthesia Services 20 1023251709 0 Physicians Healthy Kids Services 20 1023251709 0 Physicians Optical Supplies 20 1023251709 0 Physicians Physician Services 00 1023251832 0 ATTY CORINNE 2015281 9999999 B 10 1023251832 0 900 RAND RD STE 300 SUITE 300 DES PLAINES IL 600162359 20 1023251832 0 Physicians Anesthesia Services 20 1023251832 0 Physicians Healthy Kids Services 20 1023251832 0 Physicians Optical Supplies 20 1023251832 0 Physicians Physician Services 00 1023251915 0 HANSON TONIA C 2018008 9999999 B 10 1023251915 0 5777 DEPT CAROL STREAM IL 601228942 20 1023251915 0 Physician Assistant Only Fluoride varnish 20 1023251915 0 Physician Assistant Only Healthy Kids Services 20 1023251915 0 Physician Assistant Only Physician Services 00 1023252707 0 WALLEN TRAM T 2020125 9999999 B 10 1023252707 0 1 BARNES JEWISH HOSPITAL PLZ SAINT LOUIS MO 631101003 20 1023252707 0 Nurse Practitioners Healthy Kids Services 20 1023252707 0 Nurse Practitioners Nurse Practitioners Services 20 1023252707 0 Nurse Practitioners Physician Services 00 1023252780 0 SULLIVAN MEGAN E 2009182 9999999 B 10 1023252780 0 2650 RIDGE AVE # 1223 EVANSTON IL 602011700 20 1023252780 0 Physicians Anesthesia Services 20 1023252780 0 Physicians Healthy Kids Services 20 1023252780 0 Physicians Optical Supplies 20 1023252780 0 Physicians Physician Services 00 1023253648 0 JEAN-JACQUES EMMANUEL 2020028 9999999 B 10 1023253648 0 680 N LAKE SHORE DR STE 1000 SUITE# 1000 CHICAGO IL 606118709 20 1023253648 0 Physician Assistant Only Fluoride varnish 20 1023253648 0 Physician Assistant Only Healthy Kids Services 20 1023253648 0 Physician Assistant Only Physician Services 00 1023253879 0 DHAWAN ANKUR A 2009121 9999999 B 10 1023253879 0 PO BOX 4195 SAN DIMAS CA 917738195 20 1023253879 0 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