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Waiver service provider--Disability (DHS/DRS) 091 Sangamon 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1637 0 0 0 0 0 0 0 0 0 0 0 0 0 1637 0 0 1014029135 1871056283 016 Nurse Practitioners MCKAY ABIGAIL 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 392 0 0 0 0 0 0 392 0 0 1101418077 030 General Hospitals 200 Cook DIALYSIS Outpatient dialysis centers. 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3842 0 0 0 29631 0 0 0 0 0 33473 0 0 1101101696 1144246943 010 Physicians SUTTON SARAH C 601220021 053 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2031 0 0 0 0 0 0 2031 0 0 1020366928 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(DHS/DRS) 091 Sangamon 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34950 0 0 0 0 0 0 0 0 0 0 0 0 0 34950 0 0 1014364562 1013301605 010 Physicians RAMADORAI ANAND 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 1 1 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 4 0 543 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 4 0 543 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 225 9 0 9019 0 0 0 0 0 0 9253 0 0 1005268454 092 Waiver service provider--Disability (DHS/DRS) 091 Sangamon 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18147 0 0 0 0 0 0 0 0 0 0 0 0 0 18147 0 0 1014773706 092 Waiver service provider--Disability (DHS/DRS) 091 Sangamon 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22514 0 0 0 0 0 0 0 0 0 0 0 0 0 22514 0 0 1101500175 1770648917 040 Federally 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6849 0 0 0 0 0 0 7219 0 0 1101155331 1497861330 030 General Hospitals PASSAVANT AREA CHILDRENS HOSP 626501136 077 Morgan CHILDRENS Hospital designated as childrens hospitals and paid a Per Diem rate. 0 0 0 0 0 0 0 182 0 0 0 0 8 0 0 0 171 0 0 0 0 0 0 0 0 0 216 0 0 0 0 8 0 0 0 318 0 0 0 0 0 0 0 0 0 216 0 0 0 0 8 0 0 0 438 0 0 0 0 0 0 0 0 0 61264 0 0 0 0 23018 0 0 0 59199 0 0 0 0 0 143481 0 0 1019543381 016 Nurse Practitioners 030 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 120 0 0 1004784372 092 Waiver service provider--Disability (DHS/DRS) 091 Sangamon 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 673 0 0 0 0 0 0 0 0 0 0 0 0 0 673 0 0 1013481593 092 Waiver service provider--Disability (DHS/DRS) 091 Sangamon 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 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Therapists CRAIN EFFANEY 999999999 036 Franklin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 986 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 986 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93618 93618 0 0 1020556514 092 Waiver service provider--Disability (DHS/DRS) 091 Sangamon 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 766 0 0 0 0 0 0 0 0 0 0 0 0 0 766 0 0 1014764083 010 Physicians 030 DuPage 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2687 0 0 0 0 0 0 2687 0 0 1014372107 022 Physical Therapists 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88 88 0 0 1101322400 1619068061 010 Physicians BRADDY MICHELLE 624014632 033 Effingham 0 0 Family Practice 0 0 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Physicians SIEBERT RYAN 999999999 030 DuPage 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 141 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 163 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 163 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1818 0 152 0 0 0 0 0 0 1970 0 0 1011069490 1336384460 010 Physicians AKHTAR MUHAMMAD S 999999999 019 Champaign 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 2 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1258 0 0 0 0 0 0 1258 0 0 1014561833 1881207298 016 Nurse Practitioners BAKER CLAIRE M 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 908 0 0 0 0 0 0 908 0 0 1101114726 1447362694 063 Other Providers of Medical Equipment/Supplies (Non-registered) HANGER PROSTHETICS ORTHOTICS 622268308 096 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 260 0 0 0 0 0 0 0 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0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4450 0 0 0 0 0 0 0 0 0 0 0 0 0 4450 0 0 1101330744 1104998806 063 Other Providers of Medical Equipment/Supplies (Non-registered) EVERGREEN MEDICAL SUPPLIES INC 601375908 030 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1720 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1720 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133280 0 0 0 0 0 0 133280 0 0 1010936909 1366822975 010 Physicians SHAH IMARI P 999999999 053 Kane 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1393 0 0 0 0 0 0 1393 0 0 1020770618 092 Waiver service provider--Disability (DHS/DRS) 091 Sangamon 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7694 0 0 0 0 0 0 0 0 0 0 0 0 0 7694 0 0 1013981469 1750736013 010 Physicians CHRISTY SHARON 999999999 200 Cook 0 0 0 0 0 0 2 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1962569806 010 Physicians MADDEN DAVID 600442203 057 Lake 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5096 0 0 0 0 0 0 5096 0 0 1014968694 1124645114 010 Physicians WILLIAMS DIMEJI O 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 1 0 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 193 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 193 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190 0 0 4334 0 0 0 0 0 0 4524 0 0 1003611248 1457757247 016 Nurse Practitioners QUIRK SARAH 606225646 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4352 0 0 0 0 0 0 4352 0 0 1004631513 016 Nurse Practitioners 010 Adams 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77 0 0 1101130841 1417229832 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2972 0 0 0 0 0 0 2972 0 0 1005661408 1134678683 089 Physician Assistant Only(Encounter Only) EARNEST LAURA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 295 0 0 0 0 0 0 295 0 0 1014292500 092 Waiver service provider--Disability (DHS/DRS) 091 Sangamon 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35489 0 0 0 0 0 0 0 0 0 0 0 0 0 35489 0 0 1006535999 1659799377 010 Physicians ASHKINAZI JULIA E 999999999 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4001 0 0 0 0 0 0 4001 0 0 1013478187 1063071819 016 Nurse Practitioners ATOMORI ABIODUN J 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 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