State of Illinois Tier II Providers

PROVIDER DIRECTORY

State of Illinois Tier II Providers

You searched for a Physician who is a PCP in the State of Illinois Tier II Providers network within 40 mile(s) of the

61920 zip code area.

Your search returned a total of 196 result(s).

Thursday, June 02, 2011

HealthLink?, Inc., is an Illinois corporation. HealthLink, Inc. is an organizer of independently contracted provider networks, which it makes available by contract to a variety

of payors of health benefits, including insurers, third party administrators or employers. HealthLink has no control or right of control over the professional, medical judgment

of contracted providers, and is not liable for any acts or failures to act, by contracted providers. HealthLink, Inc. is not an insurance company and has no liability for benefits

under benefit plans offered or administered by payors. HealthLink? is a registered trademark of HealthLink, Inc. and a separately incorporated and capitalized subsidiary of

WellPoint, Inc.

PARTICIPATING PROVIDERS

FAMILY PRACTICE

Antonova, Svitlana MD

Carle Clinic

200 Lema Rd S

Mattoon, IL 61938

(217) 383-3311

Provider ID Number: 962239

Panel Status: Open

Antonova, Svitlana MD

Carle Clinic

1109 N State St

Monticello, IL 61856

(217) 383-3311

Provider ID Number: 962239

Panel Status: Open

Atienza-Tennison, Eleanor U. DO

Crawford Memorial Hosp

1101 N Allen Ste 600

Robinson, IL 62454

(618) 544-3125

Provider ID Number: 374213

Gender: Female

Panel Status: Open

Bailey, Stephanie (tess) MD

Carle Clinic

1109 N State St

Monticello, IL 61856

(217) 762-2518

Provider ID Number: 511268

Gender: Female

Panel Status: Open

Bajaj, Arun R. MD

Casey Family Med Ctr

11 N Central Ave

Casey, IL 62420

(217) 932-5904

Provider ID Number: 207199

Gender: Male

Panel Status: Open

Bajaj, Arun R. MD

Central Illinois Physicians Association

Inc

735 18th St

Charleston, IL 61920

(217) 345-6582

Provider ID Number: 207199

Gender: Male

Panel Status: Open

Bajaj, Renu MD

Central Illinois Physicians Association

Inc

901 W Lincoln

Charleston, IL 61920

(217) 345-3909

Provider ID Number: 122697

Gender: Female

Panel Status: Open

Ballard, Brooke N. MD

Hospital Sisters Health System

1200 N State Hwy 121

Mt Zion, IL 62549

(217) 864-5531

Provider ID Number: 715261

Gender: Female

Panel Status: Open

Bowers, Doris MD

Ciha

207 S Pine

Shelbyville, IL 62565

(217) 774-4305

Provider ID Number: 624318

Gender: Male

Panel Status: Open

Braddy, Michelle R. MD

Mid Illinois Med Care Assoc

512 N Maple St

Effingham, IL 62401

(217) 347-7030

Provider ID Number: 930280

Gender: Female

Panel Status: Open

Brock, Gregory K. DO

Vermillion Parke Comm Health Ctr

114 N Division

Cayuga, IN 47928

(765) 492-9042

Provider ID Number: 382793

Gender: Male

Panel Status: Open

Brown, Kenneth E. MD

Hospital Sisters Health System

525 N Vine St

Arthur, IL 61911

(217) 543-4030

Provider ID Number: 623087

Gender: Male

Panel Status: Open

Brummer, Jeffrey K. DO

Family Care Assoc Of Effingham

1106 N Merchant St

Effingham, IL 62401

(217) 342-7000

Provider ID Number: 711626

Gender: Male

Panel Status: Open

Brummer, Michael G. MD

Family Care Assoc Of Effingham

1106 N Merchant St

Effingham, IL 62401

(217) 342-7000

Provider ID Number: 256472

Gender: Male

Panel Status: Open

Buechler, James R. MD

Vermillion Parke Comm Health Ctr

114 N Division

Cayuga, IN 47928

(765) 828-1003

Provider ID Number: 182486

Gender: Male

Panel Status: Open

Casey Family Med Ctr

Casey Family Med Ctr

11 N Central Ave

Casey, IL 62420

(217) 932-5904

Provider ID Number: 998082

Panel Status: Open

Catt, Lucas MD

Sarah Bush Lincoln Reg Health Ctr

1005 Health Center Dr Ste 103

Mattoon, IL 61938

(217) 258-4051

Provider ID Number: 983288

Gender: Male

Panel Status: Open

Cavanagh, Patrick J. MD

Decatur Mem Hosp

550 Southland Dr Ste 1 & 2

Decatur, IL 62521

(217) 428-4180

Provider ID Number: 395339

Gender: Male

Panel Status: Open

Clark Co Family Med Pc

Clark Co Family Med Pc

890 Ridgelawn Rd

Martinsville, IL 62442

(217) 382-4191

Provider ID Number: 976154

Panel Status: Open

Costerisan, Dennis D. DO

Hospital Sisters Health System

1200 N State Hwy 121

Mt Zion, IL 62549

(217) 864-5531

Provider ID Number: 178026

Gender: Male

Panel Status: Open

An important notice about HealthLink and the HealthLink network of participating physicians, hospitals and other health care professionals. The doctors, hospitals and other

health care professionals that are part of the network organized by HealthLink are independent contractors who exercise independent medical judgment, and over whom

HealthLink has no control or right of control. When you or a covered family member seeks care from a physician, facility or other health care professional in the HealthLink

networks, either directly or by referral from another health care professional, you are seeking care from that health care professional, not from HealthLink. Your doctor and

other health care professionals and facilities exercise independent medical judgment and should discuss treatment options with you, including options that might not be

eligible for benefits under your health plan. HealthLink is not responsible for, does not provide, and does not hold itself out as the provider of your medical care.

Every effort has been made to ensure the accuracy of this directory. Occasionally physicians and hospitals change addresses or change their participation status in the

HealthLink network program. We recommend that you verify your physician's status before receiving care. For verification, you may contact the hospital or the physician's

office, or the Customer Service number listed in this directory. Keep in mind, certain care may not be covered by your employer's health benefit plan. Carefully read the

complete plan documents provided by, or available from, your employer for all coverage details.

Page 2

PARTICIPATING PROVIDERS

FAMILY PRACTICE

Costerisan, Dennis D. DO

Two W Adams

Sullivan, IL 61951

(217) 728-7353

Provider ID Number: 178026

Gender: Male

Panel Status: Open

Costerisan, Dennis D. DO

Siu Physicians & Surgeons Inc

Two W Adams

Sullivan, IL 61951

(217) 728-7353

Provider ID Number: 178026

Gender: Male

Panel Status: Open

Crowell, Jeffrey G. MD

Family Care Assoc Of Effingham

1106 N Merchant St

Effingham, IL 62401

(217) 342-7000

Provider ID Number: 560561

Gender: Male

Panel Status: Open

Davis, David P. MD

Clark Co Family Med Pc

890 Ridgelawn Rd

Martinsville, IL 62442

(217) 382-4191

Provider ID Number: 238297

Gender: Male

Panel Status: Open

Dearnbarger, Kurt M. MD

101 W Jefferson

Sullivan, IL 61951

(217) 728-9999

Provider ID Number: 324027

Gender: Male

Panel Status: Open

Deters, Gregory J. MD

Sarah Bush Lincoln Reg Health Ctr

200 Richmond Ave Ste E

Mattoon, IL 61938

(217) 234-7011

Provider ID Number: 209170

Gender: Male

Panel Status: Open

Dimondo, John P. MD

Springfield Clinic

1770 E Lake Shore Dr Ste 105

Decatur, IL 62521

(217) 428-3424

Provider ID Number: 683752

Gender: Male

Panel Status: Open

Dorner, Matthew J. MD

Sarah Bush Lincoln Reg Health Ctr

116 W Buchanan Ave

Charleston, IL 61920

(217) 345-7700

Provider ID Number: 972340

Gender: Male

Panel Status: Open

Dorner, Matthew J. MD

Sarah Bush Lincoln Reg Health Ctr

Seven Hawthorne Ln

Charleston, IL 61920

(217) 728-8441

Provider ID Number: 972340

Gender: Male

Panel Status: Open

Duerfeldt, Todd W. DO

Good Samaritan Hosp

1404 E Main St

Robinson, IL 62454

(618) 544-8333

Provider ID Number: 694486

Gender: Male

Panel Status: Open

Dust, Glen E. MD

Illinois Heartland Physician Assn

Two W Adams

Sullivan, IL 61951

(217) 728-7353

Provider ID Number: 182358

Gender: Male

Panel Status: Open

Emenecker, Mark D. DO

116 W Buchanan Ave

Charleston, IL 61920

(217) 345-7700

Provider ID Number: 332994

Gender: Male

Panel Status: Open

Family Care Assoc Of Effingham Sc

Family Care Assoc Of Effingham

1106 N Merchant St

Effingham, IL 62401

(217) 342-7000

Provider ID Number: 325739

Panel Status: Open

Frost, Robert W. MD

300 N Maple

Effingham, IL 62401

(217) 342-4151

Provider ID Number: 387075

Gender: Male

Panel Status: Open

Fatima, Syeda MD

Sarah Bush Lincoln Reg Health Ctr

200 Richmond Ave E

Mattoon, IL 61938

(217) 234-7000

Provider ID Number: 936355

Gender: Female

Panel Status: Open

Gage, Andrew MD

Carle Foundation Hosp

200 Lerna Rd S

Mattoon, IL 61938

(217) 258-5900

Provider ID Number: 993113

Gender: Male

Panel Status: Open

Flores, Pedro MD

Carle Foundation Hosp

200 Lerna Rd S

Mattoon, IL 61938

(217) 258-5900

Provider ID Number: 886587

Gender: Male

Panel Status: Open

Gale, Bing W. MD

Vermillion Parke Comm Health Ctr

114 N Division

Cayuga, IN 47928

(765) 492-9042

Provider ID Number: 416965

Gender: Female

Panel Status: Open

Flynn, Sean F. MD

Arc Css Counseling Services

2502 S Veterans Dr

Effingham, IL 62401

(217) 347-5118

Provider ID Number: 461699

Gender: Male

Panel Status: Open

Gale, Bing W. MD

Union Hosp Inc

114 N Division St

Cayuga, IN 47928

(765) 492-9042

Provider ID Number: 416965

Gender: Female

Panel Status: Open

Flynn, Sean F. MD

Mid Illinois Med Care Assoc

512 N Maple St

Effingham, IL 62401

(217) 347-7030

Provider ID Number: 461699

Gender: Male

Panel Status: Open

Gindi, Mary Y. MD

302 N Main St

Georgetown, IL 61846

(217) 662-2282

Provider ID Number: 438240

Gender: Female

Panel Status: Open

Frost, Robert W. MD

205 N Main St

Altamont, IL 62411

(618) 483-6131

Provider ID Number: 387075

Gender: Male

Panel Status: Open

Thursday, June 02, 2011

State of Illinois Tier II Providers

Customer Service Phone Number

(800) 624-2356

Page 3

Gong, Chunling MD

John & Mary E Kirby Hosp

1109 N State St Ste A

Monticello, IL 61856

(217) 762-6320

Provider ID Number: 984468

Gender: Male

Panel Status: Open

PARTICIPATING PROVIDERS

FAMILY PRACTICE

Good, Robert G. DO

Carle Foundation Hosp

200 Lerna Rd S

Mattoon, IL 61938

(217) 258-5900

Provider ID Number: 282473

Gender: Male

Panel Status: Open

Hampton, Simone R. MD

Carle Clinic

200 Lerna Rd S

Mattoon, IL 61938

(217) 383-3311

Provider ID Number: 520217

Gender: Female

Panel Status: Open

Hampton, Simone R. MD

Carle Clinic

1109 N State St

Monticello, IL 61856

(217) 383-3311

Provider ID Number: 520217

Gender: Female

Panel Status: Open

Hanneken, Kimberley MD

Hospital Sisters Health System

1770 Lake Shore Dr Ste 207

Decatur, IL 62521

(217) 429-9700

Provider ID Number: 795660

Gender: Female

Panel Status: Open

Heim, Dennis O. MD

Springfield Clinic

1770 Lakeshore Dr Ste

Decatur, IL 62521

(217) 428-3424

Provider ID Number: 118375

Gender: Male

Panel Status: Open

Heimbrecht, Kurt J. MD

Springfield Clinic

1770 E Lake Shore Dr

Decatur, IL 62521

(217) 528-7541

Provider ID Number: 434649

Gender: Male

Panel Status: Open

Hewitt, Rebecca K. MD

Marshall Clinic

Four W Grant

Altamont, IL 62411

(618) 483-6111

Provider ID Number: 222107

Gender: Female

Panel Status: Open

Imburgia, Dominic C. MD

Consolidated Community Med Ctr

901 N Maple

Effingham, IL 62401

(217) 247-2900

Provider ID Number: 238531

Gender: Male

Panel Status: Open

Jenson, Jeffrey J. MD

Marshall Clinic

405 S Pine St

Stewardson, IL 62463

(217) 682-3373

Provider ID Number: 712689

Gender: Male

Panel Status: Open

Hewitt, Rebecca K. MD

Marshall Clinic

300 N Maple

Effingham, IL 62401

(217) 342-4151

Provider ID Number: 222107

Gender: Female

Panel Status: Open

Imburgia, Dominic C. MD

Consolidated Community Med Ctr

804 W Jourdan

Newton, IL 62448

(618) 783-4200

Provider ID Number: 238531

Gender: Male

Panel Status: Open

Knauer, Hope E. MD

Marshall Clinic

300 N Maple St

Effingham, IL 62401

(217) 342-4151

Provider ID Number: 406950

Gender: Female

Panel Status: Open

Howell, Sherri J. DO

Sarah Bush Lincoln Reg Health Ctr

241 W Springfield Rd

Arcola, IL 61910

(217) 268-4444

Provider ID Number: 341379

Gender: Female

Panel Status: Open

James, Amy C. MD

Union Hosp Inc

410 N Second St

Marshall, IL 62441

(217) 826-2361

Provider ID Number: 871788

Gender: Female

Panel Status: Open

Knauer, Hope E. MD

Marshall Clinic

607 Oak Ave

Neoga, IL 62447

(217) 895-2320

Provider ID Number: 406950

Gender: Female

Panel Status: Open

Howell, Sherri J. DO

Sarah Bush Lincoln Reg Health Ctr

168 Courthouse Sq

Toledo, IL 62468

(217) 849-3151

Provider ID Number: 341379

Gender: Female

Panel Status: Open

Jenson, Jeffrey J. MD

Marshall Clinic

300 N Maple St

Effingham, IL 62401

(217) 342-4151

Provider ID Number: 712689

Gender: Male

Panel Status: Open

Kremer, Marlene B. MD

Sarah Bush Lincoln Reg Health Ctr

200 Richmond Ave E

Mattoon, IL 61938

(217) 234-7000

Provider ID Number: 335299

Gender: Female

Panel Status: Open

Hughes, Christopher R. MD

Advocate Phys Partners

911 S Chestnut

Longview, IL 61852

(309) 962-2081

Provider ID Number: 463233

Gender: Male

Panel Status: Open

Jenson, Jeffrey J. MD

Marshall Clinic

223 E Sixth St

Neoga, IL 62447

(217) 895-2320

Provider ID Number: 712689

Gender: Male

Panel Status: Open

Lim, Dinnie C. MD

Terre Haute Regional Health Plan Pho

230 S High St

Paris, IL 61944

(217) 463-5412

Provider ID Number: 258175

Gender: Female

Panel Status: Open

Imburgia, Dominic C. MD

Consolidated Community Med Ctr

Six W Alabama

Casey, IL 62420

(217) 932-2626

Provider ID Number: 238531

Gender: Male

Panel Status: Open

Jenson, Jeffrey J. MD

Marshall Clinic

507 W Washington

Newton, IL 62448

(618) 783-5094

Provider ID Number: 712689

Gender: Male

Panel Status: Open

Lystila, Aja MD

Carle Foundation Hosp

200 Lerna Rd S

Mattoon, IL 61938

(217) 258-5900

Provider ID Number: 929792

Gender: Female

Panel Status: Open

Thursday, June 02, 2011

State of Illinois Tier II Providers

Customer Service Phone Number

(800) 624-2356

Page 4

PARTICIPATING PROVIDERS

FAMILY PRACTICE

Manint, James E. DO

John & Mary E Kirby Hosp

1109 N State St Ste A

Monticello, IL 61856

(217) 762-6241

Provider ID Number: 193923

Gender: Male

Panel Status: Open

Mantell, Susan K. MD

501 N Lincoln

Philo, IL 61864

(217) 684-2419

Provider ID Number: 718574

Gender: Female

Panel Status: Open

Marty, Anne C. MD

Carle Clinic

1109 N State St

Monticello, IL 61856

(217) 762-2518

Provider ID Number: 139354

Gender: Female

Panel Status: Open

Mccormack, Anthony T. MD

Decatur Mem Hosp

550 Southland Dr Ste 1 & 2

Decatur, IL 62521

(217) 428-4180

Provider ID Number: 250374

Gender: Male

Panel Status: Open

Mcneill, Leland E. MD

Central Illinois Physicians Association

Inc

506 W Lincoln Ave Ste 200 A B

Charleston, IL 61920

(217) 348-8727

Provider ID Number: 115467

Gender: Male

Panel Status: Open

Merkel, John U. MD

Mid Illinois Med Care Assoc

206 N Pearl St

Teutopolis, IL 62467

(217) 857-6481

Provider ID Number: 105492

Gender: Male

Panel Status: Open

Mikel, Gary M. MD

Sarah Bush Lincoln Reg Health Ctr

412 Nw Third St

Casey, IL 62420

(217) 932-4061

Provider ID Number: 293597

Gender: Male

Panel Status: Open

Mikel, Gary M. MD

Sarah Bush Lincoln Reg Health Ctr

200 Richmond Ave E

Mattoon, IL 61938

(217) 234-7000

Provider ID Number: 293597

Gender: Male

Panel Status: Open

Miller, Brent E. MD

Sarah Bush Lincoln Reg Health Ctr

126 S Locus

Arcola, IL 61910

(217) 268-4444

Provider ID Number: 760660

Gender: Male

Panel Status: Open

Muneses, Marlon T. MD

Hospital Sisters Health System

1700 E Lake Shore Dr Ste 207

Decatur, IL 62521

(217) 429-9700

Provider ID Number: 384581

Gender: Male

Panel Status: Open

Muneses, Marlon T. MD

Ciha

1770 E Lakeshore Dr Ste 207

Decatur, IL 62521

(217) 429-2600

Provider ID Number: 384581

Gender: Male

Panel Status: Open

Oligschlaeger, David M. DO

Ciha

201 S Cedar

Shelbyville, IL 62565

(217) 774-7883

Provider ID Number: 412000

Gender: Male

Panel Status: Open

Oltman, Paul D. MD

900 W Temple Ste 204

Effingham, IL 62401

(217) 347-7776

Provider ID Number: 104128

Gender: Male

Panel Status: Open

Opilka, John P. DO

Mid Illinois Med Care Assoc

Eight N Third St

Altamont, IL 62411

(618) 483-6151

Provider ID Number: 412343

Gender: Male

Panel Status: Open

Phillippe, Michael G. MD

Crawford Memorial Hosp

1101 N Allen Ste 200

Robinson, IL 62454

(618) 544-3699

Provider ID Number: 106211

Gender: Male

Panel Status: Open

Phillippe, Michael G. MD

Crawford Memorial Hosp

1108 N Allen St

Robinson, IL 62454

(618) 544-3699

Provider ID Number: 106211

Gender: Male

Panel Status: Open

Phipps, Leland MD

Paris Community Hosp

727 E Court St

Paris, IL 61944

(217) 465-8411

Provider ID Number: 180041

Gender: Male

Panel Status: Open

Pine-Mattas, Denise MD

Union Hosp Inc

410 N Second St

Marshall, IL 62441

(217) 826-2361

Provider ID Number: 768665

Gender: Female

Panel Status: Open

Thursday, June 02, 2011

State of Illinois Tier II Providers

Customer Service Phone Number

(800) 624-2356

Page 5

Rademacher, Dennis J. MD

Springfield Clinic

1770 E Lakeshore Dr Ste 105

Decatur, IL 62521

(217) 528-7541

Provider ID Number: 117526

Gender: Male

Panel Status: Open

Richards, John J. MD

Clark Co Family Med Pc

890 Ridgelawn Rd

Martinsville, IL 62442

(217) 382-4191

Provider ID Number: 981563

Gender: Male

Panel Status: Open

Roberts, Nathan MD

Carle Clinic

301 E Southline Rd

Tuscola, IL 61953

(217) 253-5231

Provider ID Number: 462112

Gender: Male

Panel Status: Open

Rohde, Thomas W. MD

Ciha

3798 E Fulton Ave

Decatur, IL 62521

(217) 864-2700

Provider ID Number: 146083

Gender: Male

Panel Status: Open

Runde, Charles W. MD

Mid Illinois Med Care Assoc

206 N Pearl St

Teutopolis, IL 62467

(217) 857-6481

Provider ID Number: 246811

Gender: Male

Panel Status: Open

Scott, Mark D. MD

St Mary'S Hospital-Decatur

525 N Vine St

Arthur, IL 61911

(217) 543-4030

Provider ID Number: 249716

Gender: Male

Panel Status: Open

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