2019 Provider Directory

2019 Provider Directory

Blue Cross Medicare Advantage Choice Plus (PPO)SM Blue Cross Medicare Advantage Choice Premier (PPO)SM

Y0096_BEN_IL_PPOPRDR19_NM_C

Last updated 10/19 850792.1019

Blue Cross Medicare AdvantageSM

2019 Provider Directory

This directory is current as of October 4, 2019.

This directory provides a list of Blue Cross Medicare Advantage's current network providers.

This directory is for the entire Blue Cross Medicare Advantage provider network offered to people that are Medicare eligible and residing in Cook, DuPage, Kane and Will counties.

To access Blue Cross Medicare Advantage's online provider directory, you can visit mapd/providers. For any questions about the information contained in this directory, please call our Customer Service Department at 1-877-774-8592, 8:00 a.m. ? 8:00 p.m., local time, 7 days a week.TTY users should call: 711.

PPO plans provided by Blue Cross and Blue Shield of Illinois, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company (HCSC), an Independent Licensee of the Blue Cross and Blue Shield Association. HCSC is a Medicare Advantage organization with a Medicare contract. Enrollment in HCSC's plans depends on contract renewal. ATTENTION: If you speak English, language assistance services, free of charge, are available to you. Call 1-877-774-8592 (TTY: 711) We are open between 8:00 a.m. and 8:00 p.m., local time, 7 days a week. If you are calling from April 1 through September 30, alternate technologies (for example, voicemail) will be used on the weekends and holidays. ATENCI?N: si habla espa?ol, tiene a su disposici?n servicios gratuitos de asistencia ling??stica. Llame al 1-877-774-8592 (TTY: 711). Nuestro horario es de 8:00 a.m. a 8:00 p.m., hora local, los 7 d?as de la semana. Si usted llama del 1 de abril al 30 de septiembre, durante los fines de semana y feriados, se usar?n tecnolog?as alternas (por ejemplo, correo de voz). This document is available in other formats such as Braille and large print. For additional information, call us at 1-877-774-8592. (TTY users should call 711).

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Table of Contents

Section 1 ? Introduction ....................................................................................................................... iii

What is the service area for Blue Cross Medicare Advantage? ...................................................iv

How do you find Blue Cross Medicare Advantage providers in your area? .................................iv

Section 2 ? List of Network Providers .................................................................................................. 1

Primary Care Physicians ................................................................................................................ 1

Behavioral Health Providers ...................................................................................................... 273

Specialist ................................................................................................................................... 338

Medical Groups or Other Type .................................................................................................1279

Hospital or Other Facility ......................................................................................................... 1598

Skilled Nursing Facility............................................................................................................. 1673

Dialysis Centers....................................................................................................................... 1679

Home Health Agencies ............................................................................................................1746

Prostheses, Orthotics, & Pedorthist ....................................................................................... 1764

Doctor or Medical Professional ............................................................................................... 1783

Home Infusion Therapy ........................................................................................................... 1847

Immediate Care Centers ......................................................................................................... 1850

Durable Medical Equipment.................................................................................................... 1862

Specialty Alphabetic Listing .................................................................................................... 1882

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Section 1 ? Introduction

This directory provides a list of Blue Cross Medicare Advantage Choice Plus (PPO) and Blue Cross Medicare Advantage Choice Premier (PPO) network providers. To get detailed information about your health care coverage, please see your Evidence of Coverage (EOC).

Blue Cross Medicare Advantage is a Preferred Provider Organization (PPO) plan. All Blue Cross Medicare Advantage plan providers are available to members through self-referral, with the exception of services that require prior authorization.

The network providers listed in this directory have agreed to provide you with your health care services. You may go to any of our network providers listed in this directory. If you have been going to one network provider, you are not required to continue to go to the same provider. In some cases, you may get covered services from non-network providers. If you use providers within the Blue Cross Medicare Advantage network your copay and/or coinsurance will be less than going to non-network providers.

Out-of-network providers are under no obligation to treat Blue Cross Medicare Advantage enrollees, except in emergencies. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call our Customer Service Department at 1-877-774-8592, we are open 8:00 a.m. - 8:00 p.m., local time, 7 days a week. If you are calling from April 1 through September 30, alternate technologies (for example, voicemail) will be used on the weekends and holidays. TTY users should call 711. You may also refer to your Evidence of Coverage(EOC) for more information, including the cost sharing that applies to out-of-network services.

You do not need prior authorization to seek medical help in an urgent or emergency situation.

If an out-of-network provider asks you to pay for covered services you receive, please call Customer Service at 1-877-774-8592 (TTY 711) or send the bill(s) with a note explaining the situation to:

Blue Cross Medicare Advantage P.O. Box 805107 Chicago, IL 60680

You should never pay any out-of-network provider more than what the provider is allowed by Medicare. Ask the out-of-network provider to bill us first. If you have already paid for the covered services, we will reimburse you for our share of the cost. If you get a bill for the services, you can send the bill to us for payment. We will pay your out-of-network provider for our share of the bill and will let you know the amount, if any, you must pay.

Emergency Care Services

Emergency Care services are health care services provided in a hospital or comparable facility to evaluate and stabilize medical conditions of a recent onset and severity, including but not limited to severe pain, that would lead a prudent layperson possessing an average knowledge of medicine and health to believe that his or her condition, sickness, or injury is of such a nature that failure to receive immediate medical care could result in:

? Serious jeopardy of the patient's health;

? Serious impairment to bodily functions;

? Serious dysfunction of any bodily organ or part;

? Serious disfigurement; or

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? Serious jeopardy to the health of the fetus, in the case of a pregnant patient. Emergency Care services necessary to evaluate and stabilize an emergency medical condition are covered by Blue Cross Medicare Advantage. Members with an emergency medical condition should be instructed to go to the nearest Emergency Provider. Evaluation and stabilization of an emergency medical condition in a hospital or comparable facility does not require precertification. Emergency Care services will be covered at the in-network benefit level.

What is the service area for Blue Cross Medicare Advantage?

The counties in our service area are listed below. ? Cook ? DuPage ? Kane ? Will

How do you find Blue Cross Medicare Advantage providers in your area?

The directory includes hospitals, physicians and other providers participating in the Blue Cross Medicare Advantage Choice Plus (PPO) Plan or Blue Cross Medicare Advantage Choice Premier (PPO) Plan. Please refer to the provider listings for section names. Each section is organized alphabetically by city. Within each city, the city and/or physician names are listed in alphabetical order along with the address and phone number. For the most updated Blue Cross Medicare Advantage provider information, please visit our Provider Finder at mapd/providers. While every provider listed in this directory is affiliated with or employed by a contracting medical group, not every provider listed will be accepting new patients. Although Blue Cross Medicare Advantage has identified those providers who were not accepting patients at the time this directory was created, the status of any physicians practice may have changed. For the most current information regarding the status of any physician's practice, please contact either the physician or the medical group you have selected at the phone number listed in this directory. If you have questions about Blue Cross Medicare Advantage or require assistance in selecting a PCP, please call our Customer Service Department at 1-877-774-8592. We are open 8:00 a.m.? 8:00 p.m., local time, 7 days a week. If you are calling from April 1 through September 30, alternate technologies (for example, voicemail) will be used on weekends and holidays. TTY users should call 711. Or, visit mapd/providers.

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HOW TO READ THE PHYSICIAN LISTING

Example: CHICAGO (Alphabetical listing of towns and cities)

FAMILY PRACTICE (Specialty)

Smith, John, MD (Physician's name)

(555)123-4567 (Phone number)

1234 First Street, Chicago, IL, 60601 (Physician's address)

This information changes on a frequent basis. Please refer to the online directory or call Customer Service below

for current updates.

Participation by providers in this directory is not guaranteed and may be subject to change. Please ask your

provider whether he/she is still participating in the network. If you have questions about Blue Cross Medicare

Advantage, please call our Customer Service number at 1-877-774-8592 (TTY users should call 711). We are

open 8:00 a.m. ? 8:00 p.m., local time, 7 days a week. If you are calling from April 1 through September 30,

alternate technologies (for example, voicemail) will be used on the weekends and holidays.

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CARROLL COUNTY LEMONT

LEMONT CARROLL COUNTY

INTERNAL MEDICINE Ahmed, Iffat S DO PCP# 0606744260 14233 McCarthy Rd Lemont, IL 60439 (630) 257-8300 M,Tu,W,Th,F 08:00 AM-05:00 PM

Section 2 ? List of Network Providers Primary Care Physicians

LEMONT

Board Certified in Listed Specialty. Primary Care Physician Number. Office Hours. 1

COOK COUNTY ARLINGTON HEIGHTS

Section 2 ? List of Network Providers Primary Care Physicians

ARLINGTON HEIGHTS

ARLINGTON HEIGHTS COOK COUNTY

FAMILY PRACTICE

Balagani, Radha K MD PCP# 0051644276 825 E Golf Rd 2nd Floor Arlington Heights, IL 60005 (847) 640-9180 M,Tu,W,Th 08:00 AM-07:00 PM F 08:00 AM-05:00 PM Sa 09:00 AM-12:00 PM

Bryant, Gail G MD PCP# 0098143109 125 S Wilke Rd Ste 100 Arlington Heights, IL 60005 (847) 637-1600 M,Tu,W,Th 07:30 AM-07:00 PM F 07:30 AM-04:00 PM Sa 09:00 AM-11:59 PM Su 09:00 AM-11:00 AM

Choi, Caroline J MD PCP# 0098142632 1614 W Central Rd Ste 202 Arlington Heights, IL 60005 (847) 818-1184 M,W,Th,F 08:30 AM-04:30 PM Tu 10:00 AM-04:30 PM

Edwards, Elena MD 3295 N Arlington Hts Rd Ste 102 Arlington Heights, IL 60004 (847) 392-7400 M,Tu,W,Th,F 08:00 AM-04:00 PM

Jurkonie, Michelle DO PCP# 0098444537 1538 N Arlington Heights Rd Arlington Heights, IL 60004 (847) 253-6464 M,Tu 08:00 AM-04:30 PM W 07:30 AM-07:00 PM Th,F 08:00 AM-01:00 PM

Lim, Michael E MD PCP# 0071643085 1100 W Central Rd Suite 301 Arlington Heights, IL 60005 (847) 439-2200 M,Tu,W,Th,F 09:00 AM-05:00 PM

Patel, Satish N MD PCP# 0718442281 1614 W Central Rd Ste 209 Arlington Heights, IL 60005 (847) 259-8777 M,Tu,W,Th 08:30 AM-05:30 PM Sa 08:30 AM-01:00 PM

Siddiqui, Rumana F MD PCP# 0665741175 2010 S Arlington Heights Road Ste 110 Arlington Heights, IL 60005 (849) 130-6057 M,Tu,Th,F 09:00 AM-05:00 PM W 09:00 AM-03:00 PM Sa 08:00 AM-12:00 PM

Skyba, Nicholas DO PCP# 0579742393 1051 W Rand Rd Suite 102 Arlington Heights, IL 60004 (847) 342-8220 M,Tu,W,Th 08:00 AM-07:00 PM F 08:00 AM-05:00 PM

Trevino, Kristin M MD PCP# 0133243823 1051 W Rand Rd Ste 102 Arlington Heights, IL 60004 (847) 342-8220 M,Tu,W,Th,F 08:00 AM-05:00 PM

INTERNAL MEDICINE

Ahn, Chong H MD PCP# 0098142684 1430 N Arlington Heights Rd Ste 104 Arlington Heights, IL 60004 (847) 253-5985 M,Tu,Th,F 02:00 PM-06:30 PM

Bakken, Carl D MD PCP# 0098141321 1538 N Arlington Heights Rd Arlington Heights, IL 60004 (847) 253-6464 M,Tu,W,Th 08:00 AM-07:00 PM F 08:00 AM-05:00 PM

Bartels, Stephanie A MD PCP# 0098141225 1051 W Rand Rd Arlington Heights, IL 60004 (847) 342-8220 M,Tu,W,Th 08:00 AM-07:00 PM F 08:00 AM-05:00 PM

Charman, David S MD PCP# 0109647995 1051 W Rand Rd Ste 102 Arlington Heights, IL 60004 (847) 342-8220 M 12:00 AM-11:59 PM Tu,W,Th 07:00 AM-07:00 PM F 07:00 AM-05:00 PM Sa 08:00 AM-12:00 PM

Cohen, Monika MD PCP# 0034946581 1410 N. Arlington Heights Rd. Suite 200 Arlington Heights, IL 60004 (847) 618-1640 M,Tu,W,Th 08:00 AM-07:00 PM F 08:00 AM-05:00 PM

Damera, Madhukar MD PCP# 0576242758 800 W Central Rd Arlington Heights, IL 60005 (847) 227-8987 M,Tu,W,Th,F 09:00 AM-05:00 PM

Devarapalli, Heyer C MD PCP# 0098345770 1635 N Arlington Heights Rd Ste 203 Arlington Heights, IL 60004 (847) 392-1500 M,Tu 02:00 PM-06:00 PM Th 10:00 AM-06:00 PM Sa 10:00 AM-02:00 PM

Board Certified in Listed Specialty. Primary Care Physician Number. Office Hours.

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