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(DHS/DRS) 67 Marshall 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 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 3117.84 0 0 0 0 0 0 0 0 0 0 0 0 0 3117.84 0 0 0 1002607712 1063748531 10 Physicians PILLAI HARISH 629595896 108 Williamson 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8380.09 0 0 0 0 0 0 8380.09 0 0 0 1002609435 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1002609757 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1002610278 1730212309 16 Nurse Practitioners NETTGEN NICOLE 606321849 200 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(Non-registered) FAMILY HOME MEDICAL EQUIPMENT 601882120 30 DuPage 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 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42319.26 0 0 0 0 0 0 42319.26 0 0 0 1101010546 1003073735 10 Physicians FAIR KERI L 606751620 200 Cook 0 1 Family Practice 0 104 0 0 27 0 0 0 0 0 0 14 0 57 0 0 0 0 0 0 259 0 0 69 0 0 0 0 0 0 16 0 148 0 0 0 0 0 0 259 0 0 69 0 0 0 0 0 0 16 0 148 0 0 0 0 0 0 586 0 0 2459.04 0 0 0 0 0 0 68.64 0 3364.25 0 0 0 0 0 0 6477.93 0 0 0 1101010553 10 Physicians 72 McLean 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101010557 10 Physicians 852 Wisconsin 0 0 Pediatrics 0 0 0 0 0 0 0 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 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 0 296.85 0 0 0 0 0 0 296.85 0 0 0 1101010565 94 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CORISSA 605425142 53 Kane 0 0 Obstetric-Gynecology 0 0 0 0 3 0 0 0 0 0 0 53 0 105 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 211 0 377 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 211 0 377 0 0 0 0 0 0 0 0 0 228.26 0 0 0 0 0 0 3345.54 0 33976.31 0 0 0 0 0 0 37550.11 0 0 0 1101010589 1093913584 10 Physicians PADDOCK HEATHER 601533328 200 Cook 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15427.34 0 0 0 0 0 0 15427.34 0 0 0 1101010594 92 Waiver service provider--Disability (DHS/DRS) 53 Kane 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 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 3746.11 0 0 0 0 0 0 0 0 0 0 0 0 0 3746.11 0 0 0 1101010597 1609977305 10 Physicians CHITWOOD RICK 600505775 71 McHenry 0 1 Pediatrics 0 52 0 0 21 0 0 0 0 0 0 24 0 24 0 0 0 0 0 0 230 0 0 31 0 0 0 0 0 0 49 0 46 0 0 0 0 0 0 230 0 0 31 0 0 0 0 0 0 49 0 46 0 0 0 0 0 0 460 0 0 1802.86 0 0 0 0 0 0 465.23 0 1577.69 0 0 0 0 0 0 4305.78 0 0 0 1101010614 10 Physicians 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101010615 92 Waiver service provider--Disability (DHS/DRS) 24 Coles 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24435.35 0 0 0 0 0 0 0 0 0 0 0 0 0 24435.35 0 0 0 1101010627 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101010634 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 24057.97 0 0 0 0 0 0 0 0 0 0 0 0 0 24057.97 0 0 0 1101010637 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6797.99 0 0 0 0 0 0 0 0 0 0 0 0 0 6797.99 0 0 0 1101010643 1992927610 55 Early Intervention Services BANKS LOWE DEBRA 608052325 200 Cook 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 0 234 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 234 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13301.35 0 0 0 0 0 0 13301.35 0 0 0 1101010647 1558378059 10 Physicians RAMADURAI RAGHU 606223043 200 Cook 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 4 0 1509 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 3472 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 3472 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122.63 0 20765.47 0 0 0 0 0 0 20888.1 0 0 0 1101010650 10 Physicians 57 Lake 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101010656 92 Waiver service provider--Disability (DHS/DRS) 72 McLean 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101010658 92 Waiver service provider--Disability (DHS/DRS) 70 McDonough 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 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37750.61 0 0 0 0 0 0 0 0 0 0 0 0 0 37750.61 0 0 0 1101010663 13 Podiatrists 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101010670 98 Waiver service provider--TBI (DHS/DRS) 56 Knox 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101010672 1164440616 10 Physicians ADKINS DOUGLAS 631082259 826 Missouri 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 193 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 193 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20279.45 0 0 0 0 0 0 20279.45 0 0 0 1101010673 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15489.96 0 0 0 0 0 0 0 0 0 0 0 0 0 15489.96 0 0 0 1101010674 60 Pharmacies 98 Tazewell 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101010679 1053480533 10 Physicians SCHREIBER RONALD 601533304 200 Cook 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 1544 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2511 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2511 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16105.13 0 0 0 0 0 0 16105.13 0 0 0 1101010682 1992711808 10 Physicians OSMAN ISHRAT 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1073557401 10 Physicians EWALD GREGORY A 631600352 826 Missouri 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 254 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 254 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2518 0 0 0 0 0 0 2518 0 0 0 1101010727 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101010728 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 20957.47 0 0 0 0 0 0 0 0 0 0 0 0 0 20957.47 0 0 0 1101010733 1992049662 60 Pharmacies LUNA PHARMACY LTD 606252316 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5600 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 153267 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 302835.29 0 0 0 302835.29 0 0 0 1101010745 30 General Hospitals 801 Alabama ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101010749 1770518318 10 Physicians CANIGLIA RODNEY 605406547 30 DuPage 0 0 Otolaryngology 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1144.72 0 0 0 0 0 0 1144.72 0 0 0 1101010758 1821010760 10 Physicians PANDOLFI GONZALO 605400954 30 DuPage 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 5 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 254 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 254 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12390.47 0 0 0 0 0 0 12390.47 0 0 0 1101010762 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101010765 10 Physicians 806 Colorado 0 0 Radiology Therapeutic 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101010772 63 Other Providers of Medical Equipment/Supplies (Non-registered) 811 Georgia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101010782 1508855446 10 Physicians JOFFE MARTIN 604111748 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 0 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 233 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 233 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 976.73 0 0 0 0 0 0 976.73 0 0 0 1101010783 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101010788 10 Physicians 100 Vermilion 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101010794 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 25654.18 0 0 0 0 0 0 0 0 0 0 0 0 0 25654.18 0 0 0 1101010807 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3088.71 0 0 0 0 0 0 0 0 0 0 0 0 0 3088.71 0 0 0 1101010808 40 Federally Qualified Health Centers 200 Cook 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 15081 0 0 0 0 0 0 0 0 0 0 0 0 0 15081 0 0 0 1101011468 30 General Hospitals 833 New York NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101011478 1194032128 11 Dentists CHUNG CHOONGSEO 604361243 107 Will 0 0 General Dentistry 0 0 0 277 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1577 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1577 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70399.38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70399.38 0 0 0 1101011480 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101011482 10 Physicians 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 19126 0 0 17605.08 0 0 0 0 0 0 720.7 0 12836.82 0 0 0 0 0 0 50288.6 0 0 0 1101014876 92 Waiver service provider--Disability (DHS/DRS) 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101014878 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101014888 1447249875 10 Physicians THOMAS CYNTHIA 627025238 91 Sangamon 0 0 Family Practice 0 0 0 0 8 0 0 0 0 0 0 3 0 29 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 4 0 49 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 4 0 49 0 0 0 0 0 0 0 0 0 260.35 0 0 0 0 0 0 54.4 0 2185.5 0 0 0 0 0 0 2500.25 0 0 0 1101014890 1407086515 10 Physicians ABIONA TITILAYO C 606123714 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 311 0 0 3868.99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21668.88 0 0 25537.87 0 0 0 1101015013 1629083761 60 Pharmacies BOND DRUG COMPANY OF IL 5444 619384595 24 Coles 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 4503 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 38326 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 891227 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101.07 0 0 1928758.03 0 0 0 1928859.1 0 0 0 1101015016 91 Waiver service provider--Adults (DHS/DDD) 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101015030 1851547194 10 Physicians GOUDZWAARD CARMEL 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 185 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 185 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8654.31 0 0 0 0 0 0 8654.31 0 0 0 1101015032 92 Waiver service provider--Disability (DHS/DRS) 81 Perry 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6167.53 0 0 0 0 0 0 0 0 0 0 0 0 0 6167.53 0 0 0 1101015033 1568571420 60 Pharmacies WAUCONDA PHARMACY INC 600841828 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 347 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 8153 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 928.42 0 0 20555.6 0 0 0 21484.02 0 0 0 1101015041 55 Early Intervention Services 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101015048 1083646624 10 Physicians KENTNER RAINER 631101010 826 Missouri 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8230.75 0 0 0 0 0 0 8230.75 0 0 0 1101015049 2100005467 90 Waiver service provider--Elderly (DOA) WILLIAMSON COUNTY PROGRAMS 629482621 108 Williamson 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 641.99 0 0 0 0 0 0 641.99 0 0 0 1101015244 1811011125 47 Local Education Agencies WILL COUNTY SCHOOL DISTRICT 92 604412227 107 Will 0 0 0 0 0 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 6740 0 0 0 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 6740 0 0 0 0 740.69 0 0 0 0 0 0 0 0 0 0 0 0 0 158604.95 0 159345.64 0 0 0 1101015254 1578545612 10 Physicians OGUNREMI OLARONKE 631366119 826 Missouri 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1591.18 0 0 0 0 0 0 0 0 1591.18 0 0 0 1101015261 1306984216 10 Physicians SANKARI SUSAN 605406694 30 DuPage 0 1 Pediatrics 0 340 0 0 210 0 0 0 0 0 0 25 0 245 0 0 0 0 0 0 2611 0 0 657 0 0 0 0 0 0 29 0 723 0 0 0 0 0 0 2611 0 0 657 0 0 0 0 0 0 29 0 723 0 0 0 0 0 0 5222 0 0 24283.44 0 0 0 0 0 0 125.84 0 24673.43 0 0 0 0 0 0 54304.71 0 0 0 1101015265 1336201888 10 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1461.59 0 32956.53 0 0 0 0 0 0 34418.12 0 0 0 1101015321 55 Early Intervention Services 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101015325 1356315626 10 Physicians TOLENTINO MARIANO 617042817 72 McLean 0 0 Urological Surgery 0 0 0 0 0 0 0 0 0 0 0 53 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 226 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 226 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 367.99 0 16780.9 0 0 0 0 0 0 17148.89 0 0 0 1101015326 1689759177 10 Physicians DOSHI MUKESH 601691067 200 Cook 0 1 Pediatrics 0 38 0 0 47 0 0 0 0 0 0 0 0 55 0 0 0 0 0 0 162 0 0 147 0 0 0 0 0 0 0 0 124 0 0 0 0 0 0 162 0 0 147 0 0 0 0 0 0 0 0 124 0 0 0 0 0 0 324 0 0 5163.72 0 0 0 0 0 0 0 0 4900.83 0 0 0 0 0 0 10388.55 0 0 0 1101015328 30 General Hospitals 832 New Mexico NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 1 0 0 0 0 0 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1101015846 1417016809 10 Physicians MALLARI CEZAR 601344200 53 Kane 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7258.32 0 0 0 0 0 0 7258.32 0 0 0 1101015855 92 Waiver service provider--Disability (DHS/DRS) 33 Effingham 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11788.39 0 0 0 0 0 0 0 0 0 0 0 0 0 11788.39 0 0 0 1101015857 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6280.59 0 0 0 0 0 0 0 0 0 0 0 0 0 6280.59 0 0 0 1101015872 1285772384 10 Physicians HENDREN SARA 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 603 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 639 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 639 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21684.28 0 0 0 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provider--HIV/AIDS (DHS/DRS) 200 Cook 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 5495.04 0 0 0 0 0 0 0 0 0 0 0 0 0 5495.04 0 0 0 1101015939 92 Waiver service provider--Disability (DHS/DRS) 77 Morgan 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 19875.76 0 0 0 0 0 0 0 0 0 0 0 0 0 19875.76 0 0 0 1101015952 92 Waiver service provider--Disability (DHS/DRS) 57 Lake 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 17989.77 0 0 0 0 0 0 0 0 0 0 0 0 0 17989.77 0 0 0 1101015956 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101015958 1639393275 16 Nurse Practitioners LEIBLE 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Waiver service provider--Children's support (DHS/DDD) 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101016034 73 Other Transportation Providers ( Non-Registered) 87 Randolph 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101016035 1942274006 10 Physicians STOCKSTILL RONALD 999999999 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2012.53 0 0 0 0 0 0 0 0 2012.53 0 0 0 1101016039 1598878068 10 Physicians ROSENBERG MICHAEL 605064356 53 Kane 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 283.33 0 0 0 0 0 0 283.33 0 0 0 1101016041 1700151149 23 Occupational Therapists MUSSELMAN WHITNEY 999999999 91 Sangamon 0 0 0 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 0 171 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 171 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8554.47 8554.47 0 0 0 1101016050 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101016054 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 14 0 0 0 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 15404.16 0 0 0 0 0 0 0 0 0 0 0 0 0 15404.16 0 0 0 1101016055 92 Waiver service provider--Disability (DHS/DRS) 89 Rock Island 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 14722.89 0 0 0 0 0 0 0 0 0 0 0 0 0 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1101016534 91 Waiver service provider--Adults (DHS/DDD) 62 Logan 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 0 148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13770.9 0 0 0 0 0 0 0 0 0 0 0 0 0 13770.9 0 0 0 1101016536 91 Waiver service provider--Adults (DHS/DDD) 30 DuPage 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 0 315 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 315 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35161.84 0 0 0 0 0 0 0 0 0 0 0 0 0 35161.84 0 0 0 1101016538 1801850904 10 Physicians LOOYENGA DAVID 604292409 200 Cook 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 4 0 214 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 509 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 509 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22.92 0 5310.15 0 0 0 0 0 0 5333.07 0 0 0 1101016540 1932192622 64 Imaging Services PET/CT IMAGING CENTER 622261969 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 112 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101016686 1043205057 10 Physicians REGER CHRISTOPHER 606123835 200 Cook 0 0 Physical Medicine/Rehabilitation 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 0 500 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 500 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10230.21 0 0 0 0 0 0 10230.21 0 0 0 1101016688 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101016704 1306108105 10 Physicians FLORES JOSUE 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 219 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 244 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 244 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29777.05 0 0 0 0 0 0 29777.05 0 0 0 1101016718 2100007136 90 Waiver service provider--Elderly (DOA) CASA CENTRAL SOCIAL SVCS CORP 606222803 200 Cook 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2643 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2643 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 199504.82 0 0 0 0 0 0 0 0 0 0 0 0 0 199504.82 0 0 0 1101016725 1962767525 12 Optometrists PATEL PARISHA 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 318 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 649 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 649 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16428.78 0 0 0 0 0 0 16428.78 0 0 0 1101016729 1518296029 16 Nurse Practitioners SKOSKIEWICZ AMANDA 606112991 200 Cook 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 19.2 0 0 0 0 0 0 0 0 2118.05 0 0 0 0 0 0 2137.25 0 0 0 1101016768 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18450.1 0 0 0 0 0 0 0 0 0 0 0 0 0 18450.1 0 0 0 1101016773 10 Physicians 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 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47 Jackson 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1564.8 0 0 0 0 0 0 1564.8 0 0 0 1101021888 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101021890 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 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 33729.28 0 0 0 0 0 0 0 0 0 0 0 0 0 33729.28 0 0 0 1101021907 92 Waiver service provider--Disability (DHS/DRS) 105 White 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 11122.96 0 0 0 0 0 0 0 0 0 0 0 0 0 11122.96 0 0 0 1101021929 63 Other Providers of Medical Equipment/Supplies (Non-registered) 71 McHenry 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43.29 0 0 0 0 43.29 0 0 0 1101021930 92 Waiver service provider--Disability (DHS/DRS) 57 Lake 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3878.74 0 0 0 0 0 0 0 0 0 0 0 0 0 3878.74 0 0 0 1101021936 1952399255 33 Nursing Facilities NOKOMIS REHAB HEALTH CARE CTR 620751442 76 Montgomery 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 576 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14218 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1161669.82 0 0 0 0 0 0 0 1161669.82 0 0 0 1101021937 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 8941.64 0 0 0 0 0 0 0 0 0 0 0 0 0 8941.64 0 0 0 1101021938 10 Physicians 852 Wisconsin 0 0 Neonatal-Perinatal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101021955 12 Optometrists 27 Dekalb 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101021961 1366466658 10 Physicians BORENSTEIN MARTIN 604678898 200 Cook 0 1 Pediatrics 0 317 0 0 206 0 0 0 0 0 0 19 0 215 0 0 0 0 0 0 2860 0 0 747 0 0 0 0 0 0 27 0 457 0 0 0 0 0 0 2860 0 0 747 0 0 0 0 0 0 27 0 457 0 0 0 0 0 0 5720 0 0 25307.06 0 0 0 0 0 0 161.18 0 20135.62 0 0 0 0 0 0 51323.86 0 0 0 1101021974 1578897948 22 Physical Therapists SEELHOEFER JILL 630216879 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10087.01 10087.01 0 0 0 1101021986 1043510217 30 General Hospitals FRESENIUS MEDICAL CARE OF IL 999999999 200 Cook DIALYSIS Outpatient dialysis centers. 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 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1328 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47664.71 0 0 0 0 0 47664.71 0 0 0 1101021988 1255346433 60 Pharmacies BOND DRUG COMPANY OF IL 5033 606495026 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2418 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9275 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220020 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 409803 0 0 0 409803 0 0 0 1101021994 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101021998 1891756698 10 Physicians SIMON DAVID 606123701 200 Cook 0 0 Infectious Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 217 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 217 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2612.33 0 0 0 0 0 0 2612.33 0 0 0 1101022003 92 Waiver service provider--Disability (DHS/DRS) 58 La Salle 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 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 0 251.9 0 0 0 0 0 0 0 0 0 0 0 0 0 251.9 0 0 0 1101022006 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 19 0 0 0 0 0 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 14775.11 0 0 0 0 0 0 0 0 0 0 0 0 0 14775.11 0 0 0 1101022010 1881767762 16 Nurse Practitioners LUCKEY JOAN 627047450 91 Sangamon 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 119 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 189 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 189 0 0 0 0 0 0 0 0 0 545.09 0 0 0 0 0 0 0 0 7094.6 0 0 0 0 0 0 7639.69 0 0 0 1101022015 1144296351 10 Physicians THOMAS PRASAD 610327119 97 Stephenson 0 1 Pediatrics 0 200 0 0 89 0 0 0 0 0 0 0 0 189 0 0 0 0 0 0 2010 0 0 195 0 0 0 0 0 0 0 0 680 0 0 0 0 0 0 2010 0 0 195 0 0 0 0 0 0 0 0 680 0 0 0 0 0 0 4031 0 0 10530.9 0 0 0 0 0 0 0 0 45915.63 0 0 0 0 0 0 60477.53 0 0 0 1101022021 92 Waiver service provider--Disability (DHS/DRS) 58 La Salle 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 0 981.21 0 0 0 0 0 0 0 0 0 0 0 0 0 981.21 0 0 0 1101022024 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101022026 1396719431 61 Independent Laboratories QUINCY MEDICAL GROUP LAB 623014038 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 0 4769 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26800 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26800 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 243366.11 0 0 0 0 0 0 0 0 243366.11 0 0 0 1101022033 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101022034 16 Nurse Practitioners 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101022040 30 General Hospitals 829 Nevada NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 92.66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 92.66 0 0 0 1101022041 1164629531 10 Physicians VASQUEZ MICHELLE 613542769 58 La Salle 0 1 Family Practice 0 161 0 0 89 0 0 0 0 0 0 21 0 154 0 0 0 0 0 0 1408 0 0 301 0 0 0 0 0 0 25 0 303 0 0 0 0 0 0 1408 0 0 301 0 0 0 0 0 0 25 0 303 0 0 0 0 0 0 3126 0 0 8736.81 0 0 0 0 0 0 224.82 0 13067.35 0 0 0 0 0 0 25154.98 0 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100 Vermilion 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 3872 0 0 0 0 0 0 0 0 0 0 0 0 0 3872 0 0 0 1101023655 92 Waiver service provider--Disability (DHS/DRS) 71 McHenry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101023669 2100014087 90 Waiver service provider--Elderly (DOA) COMMUNITY CARE SYSTEMS INC 999999999 91 Sangamon 0 0 0 0 0 0 0 0 503 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37071 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37071 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2191548.57 0 0 0 0 0 0 0 0 0 0 0 0 0 2191548.57 0 0 0 1101023674 2100014092 90 Waiver service provider--Elderly (DOA) GREEK ARCH WELFARE FOUNDATION 606461106 200 Cook 0 0 0 0 0 0 0 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 881388.13 0 0 0 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0 0 1101023702 92 Waiver service provider--Disability (DHS/DRS) 37 Fulton 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101023705 1356597090 10 Physicians BALBORT LIBERTY 614553373 70 McDonough 0 0 Pediatrics 0 829 0 0 452 0 0 0 0 0 0 83 0 456 0 0 0 0 0 0 7228 0 0 2741 0 0 0 0 0 0 105 0 1272 0 0 0 0 0 0 7228 0 0 2741 0 0 0 0 0 0 105 0 1272 0 0 0 0 0 0 14456 0 0 71389.57 0 0 0 0 0 0 1256.62 0 50280.63 0 0 0 0 0 0 137382.82 0 0 0 1101023714 1649468372 10 Physicians PODGORNY KATHRYN 600442203 57 Lake 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3184.26 0 0 0 0 0 0 3184.26 0 0 0 1101023718 92 Waiver service provider--Disability (DHS/DRS) 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 36016.82 0 0 0 0 0 0 0 0 0 0 0 0 0 36016.82 0 0 0 1101023752 1124044318 36 Community mental health provider NO CENTRAL BEHAV HLTH SYSTEMS 613011084 58 La Salle 0 0 0 656 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1060 0 0 3336 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15027 0 0 3336 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15027 0 0 87905.44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 777324.4 0 0 865229.84 0 0 0 1101023755 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101023757 92 Waiver service provider--Disability (DHS/DRS) 67 Marshall 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 42521.45 0 0 0 0 0 0 0 0 0 0 0 0 0 42521.45 0 0 0 1101023762 1174538482 60 Pharmacies WALGREEN CO 9476 526015738 816 Iowa 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 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Montgomery 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 120.12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 162.24 0 0 282.36 0 0 0 1101023789 1235375395 10 Physicians RAPARIA KIRTEE 606118709 200 Cook 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1941.13 0 0 0 0 0 0 0 0 1941.13 0 0 0 1101023791 1023096294 10 Physicians KABRE NEELIMA 604319341 107 Will 0 0 Radiology Therapeutic 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3425.66 0 0 0 0 0 0 3425.66 0 0 0 1101023794 91 Waiver service provider--Adults (DHS/DDD) 852 Wisconsin 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 0 163 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 163 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15235.57 0 0 0 0 0 0 0 0 0 0 0 0 0 15235.57 0 0 0 1101023795 92 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101025693 1154438539 47 Local Education Agencies DANVILLE CCSD 118 618324677 100 Vermilion 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 545 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16493 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16493 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 189456.01 0 189456.01 0 0 0 1101025696 1518952449 63 Other Providers of Medical Equipment/Supplies (Non-registered) MED RESOURCES 630172026 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 380 0 826 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 987 0 877 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 987 0 877 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30084.45 0 32703.97 0 0 0 0 62788.42 0 0 0 1101025699 30 General Hospitals 803 Arizona NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 449.04 0 0 0 0 0 0 0 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of Medical Equipment/Supplies (Non-registered) SLEEPMED THERAPIES INC 601692172 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 207 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22003 0 0 0 0 0 0 22003 0 0 0 1101027522 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 287 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 287 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24453 0 0 0 0 0 0 0 0 0 0 0 0 0 24453 0 0 0 1101027526 1487699484 60 Pharmacies SCHNUCKS PHARMACY 119 622344410 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 343 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8593 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9363.11 0 0 0 9363.11 0 0 0 1101027531 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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(DHS/DRS) 109 Winnebago 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 14 0 0 0 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 0 809.81 0 0 0 0 0 0 0 0 0 0 0 0 0 809.81 0 0 0 1101027616 1982610457 60 Pharmacies BOND DRUG COMPANY OF ILLINOIS 604532701 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 351 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26584 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43941.95 0 0 0 43941.95 0 0 0 1101027619 10 Physicians 200 Cook 0 0 Internal Medicine 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 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 0 110.47 0 0 0 0 0 0 110.47 0 0 0 1101027621 1023274461 52 Certified local public health department DUPAGE COUNTY HEALTH DEPARTMEN 601483709 30 DuPage 0 0 0 0 413 0 203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 859 0 544 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 859 0 544 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21153.51 0 3462.4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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provider--Disability (DHS/DRS) 97 Stephenson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101027713 1659305407 33 Nursing Facilities SEMINARY MANOR 614011202 56 Knox 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 431 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11046 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 872135.72 0 0 0 0 0 0 0 872135.72 0 0 0 1101027715 92 Waiver service provider--Disability (DHS/DRS) 66 Marion 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101027716 92 Waiver service provider--Disability (DHS/DRS) 71 McHenry 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38380.33 0 0 0 0 0 0 0 0 0 0 0 0 0 38380.33 0 0 0 1101027718 1689604100 10 Physicians HAQUE MOHAMMED 631223325 826 Missouri 0 0 Internal Medicine 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 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1327.78 0 0 0 0 0 0 1327.78 0 0 0 1101027722 1215956271 10 Physicians MARTINEZ DANILO 608052701 200 Cook 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 947 0 181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1326 0 278 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1326 0 278 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12766.81 0 3200.17 0 0 0 0 0 0 15966.98 0 0 0 1101027725 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 8600.14 0 0 0 0 0 0 0 0 0 0 0 0 0 8600.14 0 0 0 1101027732 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 31465.08 0 0 0 0 0 0 0 0 0 0 0 0 0 31465.08 0 0 0 1101027734 1639286131 10 Physicians NEIL WILLIAM 617042101 72 McLean 0 1 Family Practice 0 9 0 0 5 0 0 0 0 0 0 10 0 86 0 0 0 0 0 0 55 0 0 9 0 0 0 0 0 0 15 0 232 0 0 0 0 0 0 55 0 0 9 0 0 0 0 0 0 15 0 232 0 0 0 0 0 0 126 0 0 611.01 0 0 0 0 0 0 69.62 0 3282.67 0 0 0 0 0 0 4089.3 0 0 0 1101027737 1427052851 10 Physicians LEYENSON VADIM 606576156 200 Cook 0 0 Pulmonary Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 403 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1353 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1353 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6383.89 0 0 0 0 0 0 6383.89 0 0 0 1101027746 1518244623 60 Pharmacies MARIANOS PHARMACY 8505 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 223 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5703 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12162.61 0 0 0 12162.61 0 0 0 1101027752 1932155926 10 Physicians SAYEED YOUSUF 605406558 30 DuPage 0 0 Anesthesiology 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 90 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Equipment/Supplies (Non-registered) LINCARE INC 618229674 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51897.95 0 0 0 0 0 0 51897.95 0 0 0 1101030039 1023089893 10 Physicians WILLIAMS SYBILANN 600992676 57 Lake 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 0 6 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 0 194.46 0 0 0 0 0 0 194.46 0 0 0 1101030051 1326007782 10 Physicians VELASCO MARIO R 625265858 200 Cook 0 0 Oncology 0 0 0 0 0 0 0 0 0 0 0 51 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 518 0 1249 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 518 0 1249 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3895.58 0 270329.4 0 0 0 0 0 0 274224.98 0 0 0 1101030058 1003826124 24 Speech Therapists BIELSKIS KRISTYN 610109180 79 Ogle 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 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 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0 0 0 0 0 0 0 0 0 0 0 0 153 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 883.2 0 0 0 0 0 0 883.2 0 0 0 1101031862 1184640666 36 Community mental health provider PILLARS COMMUNITY SERVICES 604571189 200 Cook 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 727 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 727 0 0 1229.34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51847.68 0 0 53077.02 0 0 0 1101031863 30 General Hospitals 815 Indiana NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101031871 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 18286.77 0 0 0 0 0 0 0 0 0 0 0 0 0 18286.77 0 0 0 1101031876 10 Physicians 826 Missouri 0 0 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provider--Disability (DHS/DRS) 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101031906 1508971789 22 Physical Therapists ADAMS ANN 624502623 101 Wabash 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 1192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 92126.84 92126.84 0 0 0 1101031909 1629268420 24 Speech Therapists BRADEN MAIA 535625531 852 Wisconsin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 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 0 116.91 116.91 0 0 0 1101031938 1376654327 10 Physicians PYGON BERNARD 606781350 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20411.51 0 0 0 0 0 0 20411.51 0 0 0 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0 0 0 128.09 0 0 0 0 0 0 128.09 0 0 0 1101031972 91 Waiver service provider--Adults (DHS/DDD) 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101031979 1750479457 12 Optometrists STAUDER PAUL 628372111 104 Wayne 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 256 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 736 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 736 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15599.33 0 3802.81 0 0 0 0 19402.14 0 0 0 1101031989 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101031990 47 Local Education Agencies 56 Knox 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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"Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101032011 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101032017 94 Waiver service provider--Children's support (DHS/DDD) 72 McLean 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101032019 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 17459.68 0 0 0 0 0 0 0 0 0 0 0 0 0 17459.68 0 0 0 1101032022 1134130321 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0 0 0 0 0 0 0 0 0 0 0 0 8625.54 0 0 0 1101032041 1871573592 63 Other Providers of Medical Equipment/Supplies (Non-registered) HOME CARE MEDICAL EQUIPMENT 623013257 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1031 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1031 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43150.74 0 0 0 0 0 0 43150.74 0 0 0 1101032053 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101032059 91 Waiver service provider--Adults (DHS/DDD) 77 Morgan 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 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2508.76 0 0 0 0 0 0 0 0 0 0 0 0 0 2508.76 0 0 0 1101032063 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 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0 0 0 0 237 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 237 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13112.72 0 0 0 0 0 0 13112.72 0 0 0 1101033889 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101033890 1558343301 63 Other Providers of Medical Equipment/Supplies (Non-registered) EDWARDSVILLE NRSNG REHAB CTR 620254276 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31661.02 0 0 0 0 0 0 31661.02 0 0 0 1101033905 1356443147 10 Physicians GILLIAM MELISSA 605276686 30 DuPage 0 0 Obstetric-Gynecology 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 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2875.26 0 0 0 0 0 0 2875.26 0 0 0 1101033908 1588977532 10 Physicians VANACHARLA 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Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 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 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2619.99 0 0 0 0 0 0 2619.99 0 0 0 1101035333 91 Waiver service provider--Adults (DHS/DDD) 57 Lake 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 0 275 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 275 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41416.65 0 0 0 0 0 0 0 0 0 0 0 0 0 41416.65 0 0 0 1101035339 1649349564 10 Physicians ROHRBACHER MELISSA 601220021 53 Kane 0 1 Family Practice 0 87 0 0 28 0 0 0 0 0 0 24 0 196 0 0 0 0 0 0 771 0 0 94 0 0 0 0 0 0 27 0 316 0 0 0 0 0 0 771 0 0 94 0 0 0 0 0 0 27 0 316 0 0 0 0 0 0 2016 0 0 3154 0 0 0 0 0 0 117.72 0 13129.2 0 0 0 0 0 0 18416.92 0 0 0 1101035342 1023121167 10 Physicians GOODE MARK 605214875 107 Will 0 0 Pulmonary Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 233 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1199 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1199 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12820.76 0 0 0 0 0 0 12820.76 0 0 0 1101035357 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101035364 1588777627 10 Physicians MALONEY JOSEPH 601181416 53 Kane 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9435.06 0 0 0 0 0 0 9435.06 0 0 0 1101035386 1669522967 63 Other Providers of Medical Equipment/Supplies (Non-registered) INDEPENDENT FOR LIFE INC 613541123 58 La Salle 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 296 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 296 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4826.48 0 0 0 0 0 0 4826.48 0 0 0 1101035395 1639125842 10 Physicians SCHINSKY MARK 606123835 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 45 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118 0 332 0 0 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0 0 0 0 0 0 0 0 307 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 593 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 593 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47403.35 0 0 0 0 0 0 47403.35 0 0 0 1101035464 1699836379 70 Ambulance Service Providers ADVANCED MEDICAL TRANSPORT 616043831 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4022 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13445 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13445 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 749409.06 0 0 0 0 0 0 749409.06 0 0 0 1101035472 1447224456 10 Physicians ROY RUBY 605276686 30 DuPage 0 0 Pediatrics 0 0 0 0 308 0 0 0 0 0 0 0 0 325 0 0 0 0 0 0 0 0 0 608 0 0 0 0 0 0 0 0 557 0 0 0 0 0 0 0 0 0 608 0 0 0 0 0 0 0 0 557 0 0 0 0 0 0 0 0 0 12546.83 0 0 0 0 0 0 0 0 19895.61 0 0 0 0 0 0 32442.44 0 0 0 1101035473 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101035475 10 Physicians 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Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 332 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 342 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 342 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12592.07 0 0 0 0 0 0 12592.07 0 0 0 1101035572 10 Physicians 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101035579 1427145440 10 Physicians PATEL RAJESH 604301146 200 Cook 0 0 Urology 0 0 0 0 0 0 0 0 0 0 0 4 0 233 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 515 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 515 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28.32 0 16873.01 0 0 0 0 0 0 16901.33 0 0 0 1101035586 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 33171.43 0 0 0 0 0 0 0 0 0 0 0 0 0 33171.43 0 0 0 1101035588 1972550879 22 Physical Therapists DARZYNSKI AGNIESZKA 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provider--TBI (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101035613 1962419119 10 Physicians KIM SUSAN 606118709 200 Cook 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 229 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 229 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7104.3 0 0 0 0 0 0 7104.3 0 0 0 1101035623 10 Physicians 836 Ohio 0 0 Pediatrics 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48.7 0 0 0 0 0 0 0 0 48.7 0 0 0 1101035624 1245590074 16 Nurse Practitioners CAMPBELL KELLEY 620026722 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4212.12 0 0 0 0 0 0 4212.12 0 0 0 1101035636 98 Waiver service provider--TBI (DHS/DRS) 37 Fulton 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 5514.25 0 0 0 0 0 0 0 0 0 0 0 0 0 5514.25 0 0 0 1101035641 1679564629 10 Physicians RUFFER JAMES 600101948 57 Lake 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2680.17 0 0 0 0 0 0 2680.17 0 0 0 1101035642 92 Waiver service provider--Disability (DHS/DRS) 96 St Clair 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 5299.15 0 0 0 0 0 0 0 0 0 0 0 0 0 5299.15 0 0 0 1101035652 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101035657 92 Waiver service provider--Disability (DHS/DRS) 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101035667 63 Other Providers of Medical Equipment/Supplies (Non-registered) 200 Cook 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 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 0 445.35 0 0 0 0 445.35 0 0 0 1101035674 1619129632 10 Physicians FILIPOVA HANA 629595896 108 Williamson 0 0 Family Practice 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 0 282 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 282 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1429.73 0 0 0 0 0 0 1429.73 0 0 0 1101035675 92 Waiver service provider--Disability (DHS/DRS) 21 Clark 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 21700.97 0 0 0 0 0 0 0 0 0 0 0 0 0 21700.97 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 483 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 483 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 339.22 0 9924.92 0 0 0 0 0 0 10264.14 0 0 0 1101036086 1588712756 22 Physical Therapists BREFELD JOAN 622215884 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 960 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 960 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61041.79 61041.79 0 0 0 1101036095 1356366454 10 Physicians VILLALOBOS MILAGROS 606474939 200 Cook 0 1 Family Practice 0 282 0 0 17 0 0 0 0 0 0 15 0 103 0 0 0 0 0 0 790 0 0 49 0 0 0 0 0 0 25 0 342 0 0 0 0 0 0 790 0 0 49 0 0 0 0 0 0 25 0 342 0 0 0 0 0 0 2284 0 0 1629.32 0 0 0 0 0 0 60.17 0 6685.39 0 0 0 0 0 0 10658.88 0 0 0 1101036096 1639103310 10 Physicians MILLER JOHN 606118709 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 957 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1399 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1399 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8587.8 0 67.34 0 0 0 0 0 0 8655.14 0 0 0 1101036102 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24527.25 0 0 0 0 0 0 0 0 0 0 0 0 0 24527.25 0 0 0 1101036105 1700817863 60 Pharmacies KMART STORES OF IL LLC 7304 628642267 49 Jefferson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 297 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106648 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 248264.38 0 0 0 248264.38 0 0 0 1101036108 14 Chiropractors 54 Kankakee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101036114 92 Waiver service provider--Disability (DHS/DRS) 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101036121 1699775916 10 Physicians PROSPERO B 604301144 200 Cook 0 0 Internal Medicine 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 19 0 0 0 0 0 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 0 351.25 0 0 0 0 0 0 351.25 0 0 0 1101036140 1508857459 33 Nursing Facilities HERITAGE HEALTH GILLESPIE 620333232 64 Macoupin 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 0 677 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18021 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1354197.31 0 0 0 0 0 0 0 1354197.31 0 0 0 1101036144 55 Early Intervention Services 53 Kane 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 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1621.71 0 0 0 0 0 0 1621.71 0 0 0 1101036161 1841479573 63 Other Providers of Medical Equipment/Supplies (Non-registered) ADVANCED BIONICS LLC 913423728 805 California 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 109172.32 0 58.97 0 0 0 0 109231.29 0 0 0 1101036164 92 Waiver service provider--Disability (DHS/DRS) 72 McLean 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 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 12921.4 0 0 0 0 0 0 0 0 0 0 0 0 0 12921.4 0 0 0 1101036174 92 Waiver service provider--Disability (DHS/DRS) 96 St Clair 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 11982.52 0 0 0 0 0 0 0 0 0 0 0 0 0 11982.52 0 0 0 1101036180 1821016478 10 Physicians BERNSTEIN BRAD 631102515 826 Missouri 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3544.62 0 0 0 0 0 0 3544.62 0 0 0 1101036181 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101036182 1356560403 10 Physicians BIGGS ANTHONY 623014038 10 Adams 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4748.29 0 0 0 0 0 0 4748.29 0 0 0 1101036193 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101036194 92 Waiver service provider--Disability (DHS/DRS) 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101036196 1710071964 10 Physicians HATTORI STEVEN 606895323 200 Cook 0 1 Family Practice 0 39 0 0 4 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 250 0 0 4 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 250 0 0 4 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 667 0 0 260.11 0 0 0 0 0 0 0 0 2654.46 0 0 0 0 0 0 3581.57 0 0 0 1101036199 98 Waiver service provider--TBI (DHS/DRS) 56 Knox 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101036204 91 Waiver service provider--Adults (DHS/DDD) 107 Will 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 0 447 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 447 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12645.6 0 0 0 0 0 0 0 0 0 0 0 0 0 12645.6 0 0 0 1101036206 92 Waiver service provider--Disability (DHS/DRS) 33 Effingham 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101036207 1013086859 10 Physicians WANG LAWRENCE 616147300 80 Peoria 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 959 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1168 0 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1168 0 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61266.91 0 2662.77 0 0 0 0 0 0 63929.68 0 0 0 1101036208 1548444011 16 Nurse Practitioners SMITH MARLA 622983296 75 Monroe 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6080.15 0 0 0 0 0 0 6080.15 0 0 0 1101036209 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 184 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 184 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21441.72 0 0 0 0 0 0 0 0 0 0 0 0 0 21441.72 0 0 0 1101036223 91 Waiver service provider--Adults (DHS/DDD) 89 Rock Island 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 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4669.5 0 0 0 0 0 0 0 0 0 0 0 0 0 4669.5 0 0 0 1101036225 1982783338 40 Federally Qualified Health Centers EVANSTON ROGERS PARK FAM HLTH 606261707 200 Cook 0 1 0 1485 1334 0 358 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2795 6498 0 1415 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2795 6498 0 1415 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6468 393267.65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 399735.65 0 0 0 1101036226 1316184310 10 Physicians PANTEA LAYNE 463123049 815 Indiana 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4417.11 0 0 0 0 0 0 4417.11 0 0 0 1101036228 92 Waiver service provider--Disability (DHS/DRS) 34 Fayette 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101036231 10 Physicians 852 Wisconsin 0 0 Internal Medicine 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 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 0 332.5 0 0 0 0 0 0 332.5 0 0 0 1101036235 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 51 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 1924 0 0 0 0 0 0 1924 0 0 0 1101036274 92 Waiver service provider--Disability (DHS/DRS) 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101036278 1316986888 10 Physicians GHAZI ASKAR ZAHRA 600774302 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2998.2 0 0 0 0 0 0 2998.2 0 0 0 1101036279 1578598108 60 Pharmacies DELAVAN FAMILY PHARMACY 617340763 98 Tazewell 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 733 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17937 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32021.86 0 0 0 32021.86 0 0 0 1101036289 1245302199 16 Nurse Practitioners VON HEIMBURG CHANDA 600442203 57 Lake 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 372.56 0 0 0 0 0 0 372.56 0 0 0 1101036290 25 Audiologists 58 La Salle 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101036305 92 Waiver service provider--Disability (DHS/DRS) 101 Wabash 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 12973.19 0 0 0 0 0 0 0 0 0 0 0 0 0 12973.19 0 0 0 1101036306 1043304546 75 Department of Alcohol and Substance Abuse Provider LEYDEN FAMILY SERVICE SHARE 601941010 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 515 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1471 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 169706.45 0 0 169706.45 0 0 0 1101036309 63 Other 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0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101039218 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101039219 1063499754 10 Physicians DANAHEY DANIEL 606740018 200 Cook 0 0 Otolaryngology 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 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 0 809.97 0 0 0 0 0 0 809.97 0 0 0 1101039221 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101039230 1538262845 10 Physicians WEISBAUM JON 618562116 82 Piatt 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 1 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10.65 0 2906.4 0 0 0 0 0 0 2917.05 0 0 0 1101039234 1861499790 63 Other Providers of Medical Equipment/Supplies (Non-registered) GLEN BRIDGE NURSING AND REHAB 607141113 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 171 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 171 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11639.82 0 0 0 0 0 0 11639.82 0 0 0 1101039235 92 Waiver service provider--Disability (DHS/DRS) 57 Lake 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 10.74 0 0 0 0 0 0 0 0 0 0 0 0 0 10.74 0 0 0 1101039245 1508846429 10 Physicians RIDER SHANNON 629462702 90 Saline 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 31 0 1074 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 1738 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 1738 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21.86 0 13528.98 0 0 0 0 0 0 13550.84 0 0 0 1101039249 91 Waiver service provider--Adults (DHS/DDD) 65 Madison 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 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11454.3 0 0 0 0 0 0 0 0 0 0 0 0 0 11454.3 0 0 0 1101039268 1528043700 63 Other Providers of Medical Equipment/Supplies (Non-registered) SULLIVAN HOME HLTH PRODUCTS 620331516 64 Macoupin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 171 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 171 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9538.15 0 1091.84 0 0 0 0 10629.99 0 0 0 1101039275 1508987868 10 Physicians BOKHARI FARAN 618012500 19 Champaign 0 0 Traumatic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 170 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 222 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 222 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13484.34 0 0 0 0 0 0 13484.34 0 0 0 1101039285 1477727808 36 Community mental health provider HERITAGE BEHAVIORAL HEALTH CTR 625250710 63 Macon 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1009 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1009 0 0 1084.13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38214.93 0 0 39299.06 0 0 0 1101039301 1003068024 10 Physicians JOSEPH JOSELYN 618012529 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 279 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 279 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4849.85 0 0 0 0 0 0 4849.85 0 0 0 1101039315 16 Nurse Practitioners 815 Indiana 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 193.72 0 0 0 0 0 0 193.72 0 0 0 1101039319 92 Waiver service provider--Disability (DHS/DRS) 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101039321 91 Waiver service provider--Adults (DHS/DDD) 20 Christian 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 0 216 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 216 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21291.6 0 0 0 0 0 0 0 0 0 0 0 0 0 21291.6 0 0 0 1101039322 1538173091 10 Physicians LIN JUDITH 605256539 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32.04 0 0 0 0 0 0 32.04 0 0 0 1101039325 10 Physicians 91 Sangamon 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101039330 98 Waiver service provider--TBI (DHS/DRS) 82 Piatt 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 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 4266.5 0 0 0 0 0 0 0 0 0 0 0 0 0 4266.5 0 0 0 1101039331 1851388797 33 Nursing Facilities ALDEN TOWN MANOR REHAB AND HCC 608043743 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 228 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1788 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38821 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4731574.97 0 0 0 0 0 0 0 4731574.97 0 0 0 1101039341 1437423167 40 Federally Qualified Health Centers ALBION COMMUNITY HEALTH CTR 628061006 32 Edwards 0 1 0 1701 968 0 270 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14515 5555 0 423 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14515 5555 0 423 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35527 278468.85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 313995.85 0 0 0 1101039349 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101039351 92 Waiver service provider--Disability (DHS/DRS) 55 Kendall 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101039352 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101039354 1750530911 10 Physicians KIM GLORIA 605151549 30 DuPage 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 12 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 958.44 0 12331.79 0 0 0 0 0 0 13290.23 0 0 0 1101039355 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 19291.53 0 0 0 0 0 0 0 0 0 0 0 0 0 19291.53 0 0 0 1101039369 10 Physicians 98 Tazewell 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101039372 50 Home Health Agencies - In Home 200 Cook 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59.94 0 0 0 0 0 0 59.94 0 0 0 1101039375 11 Dentists 200 Cook 0 0 General Dentistry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101039383 1124173273 10 Physicians RAO SUJATHA 629015203 47 Jackson 0 0 Oncology 0 0 0 0 0 0 0 0 0 0 0 0 0 380 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2347 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2347 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37372.9 0 0 0 0 0 0 37372.9 0 0 0 1101039387 91 Waiver service provider--Adults (DHS/DDD) 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101039396 98 Waiver service provider--TBI (DHS/DRS) 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101039402 1184726382 10 Physicians MAHAY RINKI 622981568 75 Monroe 0 0 Anesthesiology 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 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 565.08 0 0 0 0 0 0 565.08 0 0 0 1101039412 1992843395 50 Home Health Agencies - In Home NURSEPOWER SERVICES CORP 604533614 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1796 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1796 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3457509.73 0 0 0 0 0 0 3457509.73 0 0 0 1101039420 1275559270 10 Physicians DEWEY JODIE 617042101 72 McLean 0 1 Pediatrics 0 59 0 0 114 0 0 0 0 0 0 80 0 178 0 0 0 0 0 0 471 0 0 406 0 0 0 0 0 0 93 0 279 0 0 0 0 0 0 471 0 0 406 0 0 0 0 0 0 93 0 279 0 0 0 0 0 0 942 0 0 12980.69 0 0 0 0 0 0 477.88 0 10380.1 0 0 0 0 0 0 24780.67 0 0 0 1101039422 33 Nursing Facilities 41 Hamilton 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101039423 1578506689 22 Physical Therapists POLICH SARAH 612821553 89 Rock Island 0 0 0 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 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3255.59 3255.59 0 0 0 1101039433 10 Physicians 826 Missouri 0 0 Emergency Medicine 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76.2 0 0 0 0 0 0 76.2 0 0 0 1101039434 91 Waiver service provider--Adults (DHS/DDD) 107 Will 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 0 336 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 336 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13414.5 0 0 0 0 0 0 0 0 0 0 0 0 0 13414.5 0 0 0 1101039439 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9326.35 0 0 0 0 0 0 0 0 0 0 0 0 0 9326.35 0 0 0 1101039443 1558457416 10 Physicians KIROV ESTHER 606082486 200 Cook 0 0 Pediatrics 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 678 0 0 0 0 0 0 678 0 0 0 1101039447 1487672747 10 Physicians SEWALL LUKE 605252600 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 23 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117.4 0 2457.36 0 0 0 0 0 0 2574.76 0 0 0 1101039450 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101039451 92 Waiver service provider--Disability (DHS/DRS) 53 Kane 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 28754.56 0 0 0 0 0 0 0 0 0 0 0 0 0 28754.56 0 0 0 1101039456 1427262005 34 State-operated facility (DHS) UNIT 0452 HOME 52 LUDEMAN 604661200 200 Cook 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 551 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 344922.82 0 0 0 0 0 0 0 0 0 0 344922.82 0 0 0 1101039457 94 Waiver service provider--Children's support (DHS/DDD) 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101039462 1811153570 10 Physicians TURNOCK BROOKE 606442342 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 233 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 233 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5129.09 0 0 0 0 0 0 5129.09 0 0 0 1101039465 1417019977 10 Physicians DUDEK STEVEN 606127323 200 Cook 0 0 Pulmonary Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37711 0 0 0 0 0 0 37711 0 0 0 1101039471 1538318308 10 Physicians LERTSBURAPA KEITH 605154652 30 DuPage 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3730.38 0 0 0 0 0 0 3730.38 0 0 0 1101039472 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 13236.21 0 0 0 0 0 0 0 0 0 0 0 0 0 13236.21 0 0 0 1101039473 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101039475 1831373836 61 Independent Laboratories HEMATOGENIX LABORATORY SRV LLC 604879319 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 311 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 970 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 970 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5981.88 0 0 0 0 0 0 0 0 5981.88 0 0 0 1101039478 1184885683 10 Physicians ZIEMLEWICZ TIMOTHY 535381960 852 Wisconsin 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 16 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 574.36 0 106.69 0 0 0 0 0 0 681.05 0 0 0 1101039481 98 Waiver service provider--TBI (DHS/DRS) 70 McDonough 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5992.86 0 0 0 0 0 0 0 0 0 0 0 0 0 5992.86 0 0 0 1101039497 1750332326 10 Physicians NDUKWE IHEANYI 604111748 200 Cook 0 1 Family Practice 0 2068 0 0 305 0 0 0 0 0 0 0 0 507 0 0 0 0 0 0 13831 0 0 731 0 0 0 0 0 0 0 0 1083 0 0 0 0 0 0 13831 0 0 731 0 0 0 0 0 0 0 0 1083 0 0 0 0 0 0 35601 0 0 30468.87 0 0 0 0 0 0 0 0 50352.82 0 0 0 0 0 0 116422.69 0 0 0 1101039501 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 1868.41 0 0 0 0 0 0 0 0 0 0 0 0 0 1868.41 0 0 0 1101039502 63 Other Providers of Medical Equipment/Supplies (Non-registered) 200 Cook 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17463.21 0 0 0 0 0 0 17463.21 0 0 0 1101039505 1356392906 13 Podiatrists EMERZIAN GARO 600532127 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 289 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 289 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4582.21 0 0 0 0 0 0 4582.21 0 0 0 1101039510 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 0 0 0 0 0 0 0 0 1 0 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rate." 0 0 General Hospital - Adult and Child 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 0 467.21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 467.21 0 0 0 1101039783 1326143215 10 Physicians SWEDLER WILLIAM 606743462 200 Cook 0 0 Rheumatology 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 256 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 256 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8790.51 0 0 0 0 0 0 8790.51 0 0 0 1101039808 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 6047.34 0 0 0 0 0 0 0 0 0 0 0 0 0 6047.34 0 0 0 1101039816 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 21310.01 0 0 0 0 0 0 0 0 0 0 0 0 0 21310.01 0 0 0 1101039821 1649482514 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2011.92 0 0 0 0 0 0 2011.92 0 0 0 1101039891 73 Other Transportation Providers ( Non-Registered) 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101039896 98 Waiver service provider--TBI (DHS/DRS) 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101039899 92 Waiver service provider--Disability (DHS/DRS) 10 Adams 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 5254.08 0 0 0 0 0 0 0 0 0 0 0 0 0 5254.08 0 0 0 1101039905 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 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200 Cook 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 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34791.29 0 0 0 0 0 0 0 0 0 0 0 0 0 34791.29 0 0 0 1101041846 92 Waiver service provider--Disability (DHS/DRS) 58 La Salle 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101041848 1578600615 75 Department of Alcohol and Substance Abuse Provider DEWITT COUNTY HUMAN RES CENTER 617272148 28 De Witt 0 0 0 0 0 0 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 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2642.83 0 0 2642.83 0 0 0 1101041851 10 Physicians 816 Iowa 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101041854 92 Waiver service provider--Disability (DHS/DRS) 64 Macoupin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101041863 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101041868 1114984283 10 Physicians SALARDA ELVIRA 554860362 96 St Clair 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 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 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2896.33 0 0 0 0 0 0 2896.33 0 0 0 1101041874 2100032292 91 Waiver service provider--Adults (DHS/DDD) CIL INC 999999999 99 Union 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1571799.68 0 0 0 0 0 0 0 0 0 0 0 0 0 1571799.68 0 0 0 1101041877 1467699827 36 Community mental health provider SONIA SHANKMAN ORTHOGENIC SCHO 606372616 200 Cook 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1485 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1485 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 456513.98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 456513.98 0 0 0 1101041878 1164539730 30 General Hospitals LUTHERAN GENERAL HOSPITAL 600681143 200 Cook DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adults Section 0 3 95 0 0 3887 0 0 0 0 3577 0 0 7 3612 0 0 0 0 0 3 527 0 0 5336 0 0 0 0 4350 0 0 7 6480 0 0 0 0 0 6 635 0 0 5437 0 0 0 0 18821 0 0 7 6549 0 0 0 0 0 0 39950.63 0 0 1114902.67 0 0 0 0 13286241.18 0 0 9742.34 1390240.7 0 0 0 0 0 15841077.52 0 0 0 1101041894 92 Waiver service provider--Disability (DHS/DRS) 13 Boone 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 12535.28 0 0 0 0 0 0 0 0 0 0 0 0 0 12535.28 0 0 0 1101041897 1528189743 10 Physicians SNYDER WARWICK ALISON 631600352 37 Fulton 0 0 Plastic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10642.58 0 0 0 0 0 0 10642.58 0 0 0 1101041904 73 Other Transportation Providers ( Non-Registered) 68 Mason 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101041906 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101041911 92 Waiver service provider--Disability (DHS/DRS) 57 Lake 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 8616.57 0 0 0 0 0 0 0 0 0 0 0 0 0 8616.57 0 0 0 1101041914 16 Nurse Practitioners 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101041915 1669447272 10 Physicians RIZZO NICHOLAS 606118709 200 Cook 0 1 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 574.56 0 0 0 0 0 0 574.56 0 0 0 1101041933 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 14 0 0 0 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 10141.01 0 0 0 0 0 0 0 0 0 0 0 0 0 10141.01 0 0 0 1101041940 92 Waiver service provider--Disability (DHS/DRS) 91 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 1136.35 0 0 0 0 0 0 0 0 0 0 0 0 0 1136.35 0 0 0 1101041941 10 Physicians 89 Rock Island 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101041942 10 Physicians 852 Wisconsin 0 0 Pediatrics 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 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 70.85 0 0 0 0 0 0 70.85 0 0 0 1101041943 1336153758 10 Physicians WANG CHEN CHII 606204626 200 Cook 0 1 Obstetric-Gynecology 0 304 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1022 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1022 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3012 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3012 0 0 0 1101041947 92 Waiver service provider--Disability (DHS/DRS) 28 De Witt 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 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 9130.56 0 0 0 0 0 0 0 0 0 0 0 0 0 9130.56 0 0 0 1101041961 1942521943 24 Speech Therapists KLEIBOEKER STACEY 627621000 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4390.15 4390.15 0 0 0 1101041966 1508078379 10 Physicians WILKINS JOHN 606118709 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 196 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 285 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 285 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2373.27 0 0 0 0 0 0 2373.27 0 0 0 1101041967 91 Waiver service provider--Adults (DHS/DDD) 107 Will 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 0 345 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 345 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23289.75 0 0 0 0 0 0 0 0 0 0 0 0 0 23289.75 0 0 0 1101041973 98 Waiver service provider--TBI (DHS/DRS) 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101041975 1134374929 10 Physicians RUIZ DAN 999999999 70 McDonough 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 217 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 217 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19083.91 0 0 0 0 0 0 19083.91 0 0 0 1101041979 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 0 311 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 311 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15100.8 0 0 0 0 0 0 0 0 0 0 0 0 0 15100.8 0 0 0 1101041993 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101041997 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101041999 1851390132 30 General Hospitals MEMORIAL HOSPITAL 622331116 87 Randolph ARS-PD Hospitals paid a Per Diem rate. 1 0 Government Owned 0 0 0 0 0 864 0 0 0 0 60 0 0 0 516 0 0 0 0 0 0 0 0 0 1490 0 0 0 0 71 0 0 0 1279 0 0 0 0 0 0 0 0 0 1490 0 0 0 0 220 0 0 0 1279 0 0 0 0 0 0 0 0 0 472314.1 0 0 0 0 94144.04 0 0 0 509325.78 0 0 0 0 0 1075783.92 0 0 0 1101042007 92 Waiver service provider--Disability (DHS/DRS) 87 Randolph 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12663.43 0 0 0 0 0 0 0 0 0 0 0 0 0 12663.43 0 0 0 1101042026 1306868112 60 Pharmacies TARGET PHARMACY T 753 600742817 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 325 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9445.86 0 0 0 9445.86 0 0 0 1101042027 98 Waiver service provider--TBI (DHS/DRS) 76 Montgomery 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27819.51 0 0 0 0 0 0 0 0 0 0 0 0 0 27819.51 0 0 0 1101042036 92 Waiver service provider--Disability (DHS/DRS) 100 Vermilion 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101042039 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3083.85 0 0 0 0 0 0 0 0 0 0 0 0 0 3083.85 0 0 0 1101042046 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 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 29 0 0 0 0 0 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 21282.3 0 0 0 0 0 0 0 0 0 0 0 0 0 21282.3 0 0 0 1101042047 2100032465 72 Taxicabs and Livery Companies MOST HIGH TRANSPORTATION 606513728 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10968 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10968 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66418.79 0 0 0 0 0 0 66418.79 0 0 0 1101042051 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101042053 10 Physicians 96 St Clair 0 0 Internal Medicine 0 0 0 0 0 0 0 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79.3 0 0 0 0 0 0 79.3 0 0 0 1101042067 1811966096 10 Physicians SHAH PARAG 606143363 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 356 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 703 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 703 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19749.77 0 0 0 0 0 0 19749.77 0 0 0 1101042071 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 13574.7 0 0 0 0 0 0 0 0 0 0 0 0 0 13574.7 0 0 0 1101042075 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101042078 47 Local Education Agencies 63 Macon 0 0 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 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4357.72 0 4357.72 0 0 0 1101042081 1568435584 10 Physicians NAUTH JUSTIN 602011718 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 216 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 216 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2838.98 0 0 0 0 0 0 2838.98 0 0 0 1101042086 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101042087 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10806.4 0 0 0 0 0 0 0 0 0 0 0 0 0 10806.4 0 0 0 1101042097 1548567373 30 General Hospitals FRESENIUS MEDICAL PALATINE 600742817 200 Cook DIALYSIS Outpatient dialysis centers. 0 0 General Hospital - Adult and Child 0 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 0 128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1736 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16747.76 0 0 0 0 0 16747.76 0 0 0 1101042101 16 Nurse Practitioners 72 McLean 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101042103 1801804844 10 Physicians GIANVECCHIO CHRISTOPHER C 535111842 852 Wisconsin 0 1 Pediatrics 0 1 0 0 3 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 5 0 0 4 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101044680 1669572251 10 Physicians STEH BETH 627045352 91 Sangamon 0 1 Pediatrics 0 29 0 0 30 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 315 0 0 63 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 315 0 0 63 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 630 0 0 2893.05 0 0 0 0 0 0 0 0 2864.02 0 0 0 0 0 0 6387.07 0 0 0 1101044685 1295770295 60 Pharmacies SCHNUCKS PHARMACY 120 622262302 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 480 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12645 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17209.37 0 0 0 17209.37 0 0 0 1101044687 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101044688 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101044691 92 Waiver service provider--Disability (DHS/DRS) 63 Macon 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 2000.92 0 0 0 0 0 0 0 0 0 0 0 0 0 2000.92 0 0 0 1101044697 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21821.89 0 0 0 0 0 0 0 0 0 0 0 0 0 21821.89 0 0 0 1101044705 1013999168 10 Physicians RUDLOFF MARY 631366119 826 Missouri 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 38 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 0 675.34 0 0 0 0 0 0 0 0 675.34 0 0 0 1101044706 92 Waiver service provider--Disability (DHS/DRS) 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101044709 1093915423 10 Physicians LIN XIAOQI 606118709 200 Cook 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 153 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 310 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 310 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2665.05 0 155.47 0 0 0 0 0 0 2820.52 0 0 0 1101044710 1427369693 40 Federally Qualified Health Centers ALIVIO MED CTR AT LITTLE VLG 606234842 200 Cook 0 1 School-based 0 164 141 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1173 667 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1173 667 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4343 37888.14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42231.14 0 0 0 1101044713 92 Waiver service provider--Disability (DHS/DRS) 77 Morgan 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 17101.58 0 0 0 0 0 0 0 0 0 0 0 0 0 17101.58 0 0 0 1101044717 1639236573 10 Physicians MAZUREK WANDA 600442203 57 Lake 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6487.73 0 0 0 0 0 0 6487.73 0 0 0 1101044724 11 Dentists 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101044729 1912904673 33 Nursing Facilities ELSTON NURSING AND REHAB CENTR 606412121 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 802 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19720 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2651995.58 0 0 0 0 0 0 0 2651995.58 0 0 0 1101044731 1053392324 10 Physicians SCHOEN JAMES 631261827 826 Missouri 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 31 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 703.33 0 98.45 0 0 0 0 0 0 801.78 0 0 0 1101044732 1750340279 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Speech Therapists POPE TANIA V 605065205 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 212 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 212 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21953.73 21953.73 0 0 0 1101044757 92 Waiver service provider--Disability (DHS/DRS) 89 Rock Island 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4985.35 0 0 0 0 0 0 0 0 0 0 0 0 0 4985.35 0 0 0 1101044764 1598879223 10 Physicians BALDINGER MICHAEL 606142204 200 Cook 0 1 Internal Medicine 0 1 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 1582.57 0 0 0 0 0 0 1585.57 0 0 0 1101044766 1770721144 16 Nurse Practitioners BARTOLOMUCCI TAMMY 627047437 91 Sangamon 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 85.65 0 0 0 0 0 0 0 0 2107.67 0 0 0 0 0 0 2193.32 0 0 0 1101044770 1679571178 10 Physicians SANE PRAKASH G 604292043 200 Cook 0 0 Internal Medicine 0 25 0 0 0 0 0 0 0 0 0 1 0 7 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 2 0 24 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 2 0 24 0 0 0 0 0 0 308 0 0 0 0 0 0 0 0 0 0 0 696.29 0 0 0 0 0 0 1004.29 0 0 0 1101044772 1023103439 10 Physicians BOULAY BRIAN 606127323 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 1 0 242 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 538 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 538 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1.98 0 65210.75 0 0 0 0 0 0 65212.73 0 0 0 1101044773 1942229810 10 Physicians KHAN NAEEM 628642857 49 Jefferson 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 509 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 862 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 862 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13779.47 0 0 0 0 0 0 13779.47 0 0 0 1101044788 1932260742 10 Physicians FEINZIMER ELLYN 600153581 57 Lake 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 4415 0 46 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101044811 1326280868 16 Nurse Practitioners AIKEN CORIE A 477333407 815 Indiana 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 0 0 0 0 0 0 0 0 23 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 0 0 0 0 0 0 0 0 761.36 0 0 0 0 0 0 761.36 0 0 0 1101044813 10 Physicians 10 Adams 0 0 Internal Medicine 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 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101044814 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 237 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 237 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22407 0 0 0 0 0 0 0 0 0 0 0 0 0 22407 0 0 0 1101044816 1306105713 24 Speech Therapists SALISBURY LISA 999999999 45 Henry 0 0 0 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 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4461.76 4461.76 0 0 0 1101044823 1083765051 10 Physicians MACMAHON HEBER 605276686 30 DuPage 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 1128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1822 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1822 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10208.22 0 0 0 0 0 0 0 0 10208.22 0 0 0 1101044824 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101044830 1568566156 10 Physicians LOIACONO MICHAEL 607079998 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 388.52 0 0 0 0 0 0 388.52 0 0 0 1101044832 92 Waiver service provider--Disability (DHS/DRS) 90 Saline 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 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16229.26 0 0 0 0 0 0 0 0 0 0 0 0 0 16229.26 0 0 0 1101044834 22 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 5 0 0 0 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 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5594.97 5594.97 0 0 0 1101044837 1316056153 47 Local Education Agencies WESTVILLE COMMUNITY UNIT DIST2 618831233 100 Vermilion 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63739.02 0 63739.02 0 0 0 1101044845 1982887659 16 Nurse Practitioners KALAMARAS VALERIE 604488208 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1816.12 0 0 0 0 0 0 1816.12 0 0 0 1101044846 1619922382 70 Ambulance Service Providers CHERRY VALLEY FIRE PROTECTION 610169482 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 176 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 176 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5716.49 0 0 0 0 0 0 5716.49 0 0 0 1101044852 92 Waiver service provider--Disability (DHS/DRS) 97 Stephenson 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 16071.13 0 0 0 0 0 0 0 0 0 0 0 0 0 16071.13 0 0 0 1101044853 92 Waiver service provider--Disability (DHS/DRS) 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101044854 1689692410 10 Physicians TAN GLENN A 535112230 107 Will 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 3 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83.88 0 454.89 0 0 0 0 0 0 538.77 0 0 0 1101044855 46 Ambulatory Surgical Treatment Centers 826 Missouri NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101044857 16 Nurse Practitioners 200 Cook 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 1495.62 0 0 0 0 0 0 1495.62 0 0 0 1101044860 1366600132 10 Physicians POPOVICH KYLE 606123806 200 Cook 0 0 Infectious Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 6 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 24.1 0 0 0 0 0 0 24.1 0 0 0 1101044862 1780670596 10 Physicians BHATIA SUMIT P 617011784 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 6 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 508 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 508 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120.77 0 54294.15 0 0 0 0 0 0 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0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6403.93 0 0 0 0 0 0 6403.93 0 0 0 1101046084 1487769998 10 Physicians WILEY ELIZABETH 606743446 200 Cook 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 707 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1053 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1053 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135682.03 0 0 0 0 0 0 0 0 135682.03 0 0 0 1101046089 1285642439 10 Physicians PAUL SATNAM 604355765 107 Will 0 0 Anesthesiology 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 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9140.66 0 0 0 0 0 0 9140.66 0 0 0 1101046096 91 Waiver service provider--Adults (DHS/DDD) 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101046097 92 Waiver service provider--Disability (DHS/DRS) 32 Edwards 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 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 0 368.75 0 0 0 0 0 0 0 0 0 0 0 0 0 368.75 0 0 0 1101046105 1528165016 60 Pharmacies CVS PHARMACY 3742 606544507 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3204 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3207.75 0 0 0 3207.75 0 0 0 1101046106 1225043714 70 Ambulance Service Providers ELK GROVE RURAL FIRE PROTECTIO 600054715 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7862.49 0 0 0 0 0 0 7862.49 0 0 0 1101046110 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22936.15 0 0 0 0 0 0 0 0 0 0 0 0 0 22936.15 0 0 0 1101046113 1700900990 60 Pharmacies 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0 0 0 1101046151 1346245321 10 Physicians MISHRA SATYA 606123723 200 Cook 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2751.41 0 0 0 0 0 0 2751.41 0 0 0 1101046166 16 Nurse Practitioners 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101046170 1710018965 47 Local Education Agencies CHRISTOPHER UNIT SCH DIST 99 628221099 36 Franklin 0 0 0 0 0 0 229 0 0 0 0 0 0 0 0 0 0 0 0 0 87 0 0 0 0 413 0 0 0 0 0 0 0 0 0 0 0 0 0 3228 0 0 0 0 413 0 0 0 0 0 0 0 0 0 0 0 0 0 3228 0 0 0 0 2343.31 0 0 0 0 0 0 0 0 0 0 0 0 0 24915.86 0 27259.17 0 0 0 1101046172 92 Waiver service provider--Disability (DHS/DRS) 59 Lawrence 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 13916.99 0 0 0 0 0 0 0 0 0 0 0 0 0 13916.99 0 0 0 1101046192 91 Waiver service provider--Adults (DHS/DDD) 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101046193 92 Waiver service provider--Disability (DHS/DRS) 27 Dekalb 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101046205 91 Waiver service provider--Adults (DHS/DDD) 37 Fulton 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 0 335 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 335 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106134.03 0 0 0 0 0 0 0 0 0 0 0 0 0 106134.03 0 0 0 1101046206 1063668192 10 Physicians AHMED IFFAT 605406555 30 DuPage 0 1 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 157 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 157 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3087.08 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101050145 1780675553 10 Physicians CARLSON THOMAS A 606022001 200 Cook 0 1 Internal Medicine 0 10 0 0 0 0 0 0 0 0 0 6 0 40 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 10 0 70 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 10 0 70 0 0 0 0 0 0 186 0 0 0 0 0 0 0 0 0 38.1 0 2210.83 0 0 0 0 0 0 2434.93 0 0 0 1101050146 1053480434 10 Physicians DORSEY BRUCE 601344200 53 Kane 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 866.74 0 0 0 0 0 0 0 0 866.74 0 0 0 1101050150 92 Waiver service provider--Disability (DHS/DRS) 94 Shelby 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 12363.88 0 0 0 0 0 0 0 0 0 0 0 0 0 12363.88 0 0 0 1101050151 10 Physicians 826 Missouri 0 0 Orthopedic Surgery 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 7 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65.34 0 7573.33 0 0 0 0 0 0 7638.67 0 0 0 1101050166 92 Waiver service provider--Disability (DHS/DRS) 49 Jefferson 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 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35246.37 0 0 0 0 0 0 0 0 0 0 0 0 0 35246.37 0 0 0 1101050170 1528066347 10 Physicians FREILICH ROBERT A 60035 57 Lake 0 0 Internal Medicine 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 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 878.81 0 0 0 0 0 0 878.81 0 0 0 1101050176 1548242134 10 Physicians MAHR CHRISTOPHER 606313745 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 66 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159 0 337 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159 0 337 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1053.78 0 17092.85 0 0 0 0 0 0 18146.63 0 0 0 1101050179 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101050185 2100040603 72 Taxicabs and Livery Companies TRANSPORT PASS COMPANY 600164203 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3912 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3912 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20789.92 0 0 0 0 0 0 20789.92 0 0 0 1101050188 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101050196 10 Physicians 816 Iowa 0 0 Dermatopathology 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14.25 0 0 0 0 0 0 14.25 0 0 0 1101050197 92 Waiver service provider--Disability (DHS/DRS) 21 Clark 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 9436.21 0 0 0 0 0 0 0 0 0 0 0 0 0 9436.21 0 0 0 1101050210 1720142128 10 Physicians ISHMAEL OLUSEGUN 619442420 31 Edgar 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 757 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1015 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1015 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39613.84 0 0 0 0 0 0 39613.84 0 0 0 1101050221 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101050227 1689979015 70 Ambulance Service Providers ADVANCED MEDICAL TRANSPORT 522402600 816 Iowa 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11149.53 0 0 0 0 0 0 11149.53 0 0 0 1101050239 1972618635 13 Podiatrists CHIARAMONTE BRIAN 606086705 200 Cook 0 0 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 0 152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 672.07 0 0 0 0 0 0 672.07 0 0 0 1101050247 1265591036 10 Physicians LEVINE DAVID 600771057 200 Cook 0 1 Internal Medicine 0 61 0 0 0 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 451 0 0 0 0 0 0 0 0 0 0 0 106 0 0 0 0 0 0 451 0 0 0 0 0 0 0 0 0 0 0 106 0 0 0 0 0 0 1316 0 0 0 0 0 0 0 0 0 0 0 3504.54 0 0 0 0 0 0 4820.54 0 0 0 1101050252 1932371259 11 Dentists GORDON JEFFREY 606291443 200 Cook 0 0 General Dentistry 0 0 0 157 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 970 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 970 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29643.32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29643.32 0 0 0 1101050261 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101050264 1396725149 10 Physicians PROBST BEATRICE 604404906 107 Will 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 268 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 277 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 277 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9385.52 0 0 0 0 0 0 9385.52 0 0 0 1101050265 30 General Hospitals 804 Arkansas NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1311.54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1311.54 0 0 0 1101050269 1053537027 10 Physicians UBOGY DAVID 601534325 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 387 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 387 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47090.3 0 0 0 0 0 0 47090.3 0 0 0 1101050284 91 Waiver service provider--Adults (DHS/DDD) 39 Greene 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 0 235 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 235 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9247.86 0 0 0 0 0 0 0 0 0 0 0 0 0 9247.86 0 0 0 1101050291 1639194897 10 Physicians ROUMANY AMJAD 637035095 826 Missouri 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 25 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 406 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 406 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 515.62 0 14095.73 0 0 0 0 0 0 14611.35 0 0 0 1101050301 1750492328 22 Physical Therapists SOOD ROMIL 600772436 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 269 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 269 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6934.61 6934.61 0 0 0 1101050303 94 Waiver service provider--Children's support (DHS/DDD) 21 Clark 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101050309 1154639573 63 Other Providers of Medical Equipment/Supplies (Non-registered) MAPLE LEAF MEDICAL SERV LLC 999999999 45 Henry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101050337 91 Waiver service provider--Adults (DHS/DDD) 36 Franklin 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 0 219.96 0 0 0 0 0 0 0 0 0 0 0 0 0 219.96 0 0 0 1101050340 94 Waiver service provider--Children's support (DHS/DDD) 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101050349 91 Waiver service provider--Adults (DHS/DDD) 71 McHenry 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 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3872 0 0 0 0 0 0 0 0 0 0 0 0 0 3872 0 0 0 1101050351 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 2426 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2426 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 113667.83 0 0 0 0 0 0 113667.83 0 0 0 1101050381 92 Waiver service provider--Disability (DHS/DRS) 56 Knox 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 1093.25 0 0 0 0 0 0 0 0 0 0 0 0 0 1093.25 0 0 0 1101050382 16 Nurse Practitioners 818 Kentucky 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101050383 10 Physicians 109 Winnebago 0 1 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101050391 1841293032 10 Physicians DEALARCON PEDRO 616370001 80 Peoria 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 7 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 1701.36 0 0 0 0 0 0 1701.36 0 0 0 1101050413 1558439315 10 Physicians GAROFOLI ERIN M. 602011718 200 Cook 0 1 Pediatrics 0 47 0 0 38 0 0 0 0 0 0 14 0 43 0 0 0 0 0 0 419 0 0 126 0 0 0 0 0 0 19 0 58 0 0 0 0 0 0 419 0 0 126 0 0 0 0 0 0 19 0 58 0 0 0 0 0 0 838 0 0 4522.63 0 0 0 0 0 0 222.88 0 2777.64 0 0 0 0 0 0 8361.15 0 0 0 1101050443 1669436457 63 Other Providers of Medical Equipment/Supplies (Non-registered) SCHECK AND SIRESS PROSTHETICS 601812987 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 175 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 549 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 549 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2855.03 0 164288.96 0 0 0 0 167143.99 0 0 0 1101050459 1861417016 10 Physicians SOGLIN DAVID 606123723 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1878.8 0 0 0 0 0 0 1878.8 0 0 0 1101050465 1871510156 60 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TRAINING CENTER 629560296 85 Pulaski 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14038 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14038 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 739171.18 0 0 0 0 0 0 0 0 0 0 0 0 0 739171.18 0 0 0 1101055523 1598754764 33 Nursing Facilities NEIGHBORS REHABILITATION CNTR 610101464 79 Ogle 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 825 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1966994.18 0 0 0 0 0 0 0 1966994.18 0 0 0 1101055524 1356367585 10 Physicians TSENG GEORGE 631101010 826 Missouri 0 0 Affiliated with FQHC 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 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 3859.78 0 0 0 0 0 0 3859.78 0 0 0 1101055527 1366457558 60 Pharmacies BOND DRUG COMPANY OF ILL 545 625266157 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 761 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 3461 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 79237 0 0 0 0 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Independent Laboratories DERMATOPATHOLOGY OF WISCONSIN 530053111 852 Wisconsin 0 0 0 0 0 0 0 0 0 0 0 0 0 42 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 2120.98 0 0 0 0 0 0 0 0 2120.98 0 0 0 1101058460 22 Physical Therapists 30 DuPage 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 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 15.41 15.41 0 0 0 1101058464 10 Physicians 816 Iowa 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101058468 1750432738 10 Physicians ARNASON BARRY 605276686 30 DuPage 0 0 Neurology 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 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 170 0 0 0 0 0 0 170 0 0 0 1101058474 63 Other Providers of Medical Equipment/Supplies (Non-registered) 45 Henry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101058480 1548327562 10 Physicians HEIDMANN CAROL 600442203 57 Lake 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 23 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 0 767.05 0 0 0 0 0 0 767.05 0 0 0 1101058492 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 0 256 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 256 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11743.19 0 0 0 0 0 0 0 0 0 0 0 0 0 11743.19 0 0 0 1101058494 1164530465 30 General Hospitals ADVENTIST BOLINGBROOK HOSPITAL 604404906 107 Will DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 0 0 0 0 23 0 0 0 0 0 0 567 0 0 228 0 0 0 0 0 0 0 0 24 0 0 0 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of Medical Equipment/Supplies (Non-registered) 25 Crawford 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101059113 1467612044 10 Physicians KRAMPERT RYAN 631102539 826 Missouri 0 0 Anesthesiology 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 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 1909.17 0 0 0 0 0 0 1909.17 0 0 0 1101059117 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8487.6 0 0 0 0 0 0 0 0 0 0 0 0 0 8487.6 0 0 0 1101059118 1861422503 10 Physicians NUNES KENNETH 606574117 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 0 201 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56913.13 0 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1101062832 2100053250 91 Waiver service provider--Adults (DHS/DDD) SPECIAL TRAIN FOR ADULT REHAB 629662057 47 Jackson 0 0 0 0 0 0 0 0 128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32703 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32703 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2489060.6 0 0 0 0 0 0 0 0 0 0 0 0 0 2489060.6 0 0 0 1101062836 1316028723 12 Optometrists DE KOSTER LORETTA 607072046 200 Cook 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 109 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 293 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 293 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8760.14 0 3498.54 0 0 0 0 12258.68 0 0 0 1101062837 1881891240 10 Physicians FOX SAMUEL 614011251 56 Knox 0 0 Obstetric-Gynecology 0 0 0 0 11 0 0 0 0 0 0 245 0 375 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 574 0 964 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 574 0 964 0 0 0 0 0 0 0 0 0 177.15 0 0 0 0 0 0 14114.99 0 78856.11 0 0 0 0 0 0 93148.25 0 0 0 1101062850 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 0 1 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101062878 1710956727 10 Physicians SHANKS CANDACE 612655014 89 Rock Island 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 791.77 0 0 0 0 0 0 791.77 0 0 0 1101062880 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101062900 1346347903 60 Pharmacies HARTIG DRUG CO 5 610368215 51 Jo Daviess 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 531 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101928 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 286590.87 0 0 0 286590.87 0 0 0 1101062901 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101062956 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101062959 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 2262.48 0 0 0 0 0 0 0 0 0 0 0 0 0 2262.48 0 0 0 1101062963 1023104247 10 Physicians LAMPERT MARK 600771057 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 533 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 946 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 946 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11034.58 0 0 0 0 0 0 11034.58 0 0 0 1101062964 92 Waiver service provider--Disability (DHS/DRS) 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101062966 1104146786 60 Pharmacies BEST PHARMACY INC 606531917 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 771 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15668 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20112.71 0 0 0 20112.71 0 0 0 1101062971 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 730 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 730 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30718 0 0 0 0 0 0 0 0 0 0 0 0 0 30718 0 0 0 1101062972 93 Waiver service provider--HIV/AIDS (DHS/DRS) 102 Warren 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101062983 1790840528 10 Physicians GOTTLIEB LAWRENCE 605276686 30 DuPage 0 0 Plastic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34915.71 0 0 0 0 0 0 34915.71 0 0 0 1101062990 1023296779 56 School Based / Linked Health Clinics MAINE EAST SCHOOL BASED HEALTH 600681155 200 Cook 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1995.3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1995.3 0 0 0 1101062994 91 Waiver service provider--Adults (DHS/DDD) 27 Dekalb 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101063000 1902806086 10 Physicians WEISS STACY 600672414 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 2 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 143.8 0 1654.22 0 0 0 0 0 0 1798.02 0 0 0 1101063005 98 Waiver service provider--TBI (DHS/DRS) 54 Kankakee 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 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 2744.18 0 0 0 0 0 0 0 0 0 0 0 0 0 2744.18 0 0 0 1101063014 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101063017 1548359938 10 Physicians NANAVATI PARASHAR 627044183 91 Sangamon 0 0 Radiology Therapeutic 0 0 0 0 0 0 0 0 0 0 0 1 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 441 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 441 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71.35 0 11767.42 0 0 0 0 0 0 11838.77 0 0 0 1101063018 92 Waiver service provider--Disability (DHS/DRS) 63 Macon 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 32681.35 0 0 0 0 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0 0 0 0 0 30724.41 0 0 0 1101064820 92 Waiver service provider--Disability (DHS/DRS) 46 Iroquois 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 14 0 0 0 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 16177.93 0 0 0 0 0 0 0 0 0 0 0 0 0 16177.93 0 0 0 1101064823 2100055241 72 Taxicabs and Livery Companies NEEALY TRANSPORTATION 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 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 636.32 0 0 0 0 0 0 636.32 0 0 0 1101064827 1164553301 23 Occupational Therapists CROSS ARMENTHA 604091897 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2040 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2040 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 170444.05 170444.05 0 0 0 1101064828 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 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50 Jersey 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 368 0 244 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 757 0 257 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 757 0 257 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18953.98 0 7289.54 0 0 0 0 26243.52 0 0 0 1101065424 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9600.23 0 0 0 0 0 0 0 0 0 0 0 0 0 9600.23 0 0 0 1101065426 1932207859 10 Physicians SLOAN ROGER 614155087 37 Fulton 0 1 Family Practice 0 278 0 0 65 0 0 0 0 0 0 61 0 447 0 0 0 0 0 0 2306 0 0 206 0 0 0 0 0 0 131 0 1004 0 0 0 0 0 0 2306 0 0 206 0 0 0 0 0 0 131 0 1004 0 0 0 0 0 0 6153 0 0 5955.95 0 0 0 0 0 0 573.65 0 30176.41 0 0 0 0 0 0 42859.01 0 0 0 1101065429 94 Waiver service provider--Children's support (DHS/DDD) 91 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 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0 0 0 0 0 0 0 0 284 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18634 0 0 0 0 0 0 0 0 0 0 0 0 0 18634 0 0 0 1101065508 1033139399 10 Physicians PIERRO DANIELLE 606114402 200 Cook 0 1 Internal Medicine 0 3 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 937.11 0 0 0 0 0 0 950.11 0 0 0 1101065510 1477758571 10 Physicians DAIGLE CARRIE 622981592 75 Monroe 0 0 Family Practice 0 140 0 0 7 0 0 0 0 0 0 13 0 81 0 0 0 0 0 0 1263 0 0 9 0 0 0 0 0 0 16 0 119 0 0 0 0 0 0 1263 0 0 9 0 0 0 0 0 0 16 0 119 0 0 0 0 0 0 2859 0 0 515.31 0 0 0 0 0 0 65.59 0 5951.82 0 0 0 0 0 0 9391.72 0 0 0 1101065514 92 Waiver service provider--Disability (DHS/DRS) 19 Champaign 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 0 818.54 0 0 0 0 0 0 0 0 0 0 0 0 0 818.54 0 0 0 1101065519 25 Audiologists 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 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Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 377 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 377 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1666.79 0 0 0 0 0 0 1666.79 0 0 0 1101065749 1902030711 10 Physicians LEE PAUL 535381960 852 Wisconsin 0 0 Radiology Diagnosis 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 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 473.32 0 0 0 0 0 0 0 0 473.32 0 0 0 1101065750 10 Physicians 826 Missouri 0 0 Emergency Medicine 0 0 0 0 0 0 0 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 170.49 0 0 0 0 0 0 170.49 0 0 0 1101065755 93 Waiver service provider--HIV/AIDS (DHS/DRS) 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101065756 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14456.6 0 0 0 0 0 0 0 0 0 0 0 0 0 14456.6 0 0 0 1101065771 1689622250 10 Physicians MEISENBACH JOSEPH 609013693 54 Kankakee 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11.43 0 0 0 0 0 0 11.43 0 0 0 1101065774 34 State-operated facility (DHS) 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101065779 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101065781 60 Pharmacies 823 Michigan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101065814 1578504056 30 General Hospitals ST JOHNS REGIONAL HEALTH CENT 658042203 826 Missouri NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 12 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 3870.93 0 0 0 0 14185.85 0 0 0 0 0 0 0 0 0 18056.78 0 0 0 1101065816 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 8211.88 0 0 0 0 0 0 0 0 0 0 0 0 0 8211.88 0 0 0 1101065822 1285829572 16 Nurse Practitioners KLOSTERMANN KIRBY 620403714 65 Madison 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 50 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Physicians MUTCHNIK DAVID 600761267 200 Cook 0 0 Urological Surgery 0 0 0 0 0 0 0 0 0 0 0 9 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 260 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 260 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44.94 0 3075.66 0 0 0 0 0 0 3120.6 0 0 0 1101067514 1366437352 10 Physicians ROSS SHERI 600485249 57 Lake 0 1 Pediatrics 0 4 0 0 10 0 0 0 0 0 0 8 0 14 0 0 0 0 0 0 21 0 0 16 0 0 0 0 0 0 15 0 16 0 0 0 0 0 0 21 0 0 16 0 0 0 0 0 0 15 0 16 0 0 0 0 0 0 42 0 0 707.22 0 0 0 0 0 0 97.75 0 882.32 0 0 0 0 0 0 1729.29 0 0 0 1101067521 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101067522 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4929.19 0 0 0 0 0 0 0 0 0 0 0 0 0 4929.19 0 0 0 1101067523 10 Physicians 852 Wisconsin 0 0 Radiology Diagnosis 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17.29 0 0 0 0 0 0 0 0 17.29 0 0 0 1101067525 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101067536 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101067537 73 Other Transportation Providers ( Non-Registered) 37 Fulton 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 276.92 0 0 0 0 0 0 276.92 0 0 0 1101067539 1316957020 70 Ambulance Service Providers VILLAGE OF NORTHFIELD 600933417 200 Cook 0 0 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 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2157.96 0 0 0 0 0 0 2157.96 0 0 0 1101067543 1720373574 10 Physicians TEODORO CATHERINE 625571716 20 Christian 0 1 Family Practice 0 63 0 0 11 0 0 0 0 0 0 1 0 77 0 0 0 0 0 0 539 0 0 17 0 0 0 0 0 0 1 0 154 0 0 0 0 0 0 539 0 0 17 0 0 0 0 0 0 1 0 154 0 0 0 0 0 0 1403 0 0 464.8 0 0 0 0 0 0 4 0 3561.65 0 0 0 0 0 0 5433.45 0 0 0 1101067544 1982912655 10 Physicians KHAN MOHAMMAD 604519518 107 Will 0 0 Neurology Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9027.26 0 0 0 0 0 0 9027.26 0 0 0 1101067545 1962439232 63 Other Providers of Medical Equipment/Supplies (Non-registered) WOUND CARE RESOURCES INC 383890155 844 Tennessee 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 0 128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6681.73 0 0 0 0 0 0 6681.73 0 0 0 1101067547 1225246036 10 Physicians MADHIWALA AATISH 600184111 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 176 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 178 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 178 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31779.36 0 0 0 0 0 0 31779.36 0 0 0 1101067564 55 Early Intervention Services 27 Dekalb 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101067572 1740214881 10 Physicians MERK BRADLEY 606118702 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 119 0 148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 222 0 261 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 222 0 261 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3060.55 0 16544.15 0 0 0 0 0 0 19604.7 0 0 0 1101067594 92 Waiver service provider--Disability (DHS/DRS) 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101067599 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101067600 92 Waiver service provider--Disability (DHS/DRS) 55 Kendall 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101067606 30 General Hospitals 852 Wisconsin NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 3 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 0 668.05 0 0 0 0 0 0 0 0 0 0 0 0 0 0 668.05 0 0 0 1101067608 91 Waiver service provider--Adults (DHS/DDD) 57 Lake 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 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6062.67 0 0 0 0 0 0 0 0 0 0 0 0 0 6062.67 0 0 0 1101067612 1568602480 63 Other Providers of Medical Equipment/Supplies (Non-registered) PREMIER ORTHOPAEDIC HAND CTR 604224363 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 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 0 502.39 0 0 0 0 502.39 0 0 0 1101067620 92 Waiver service provider--Disability (DHS/DRS) 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101067622 10 Physicians 815 Indiana 0 0 Otolaryngology 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101067625 22 Physical Therapists 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101067651 10 Physicians 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101067653 1225203805 10 Physicians GHULYANI SHUKTI 618747812 19 Champaign 0 1 Internal Medicine 0 15 0 0 0 0 0 0 0 0 0 0 0 88 0 0 0 0 0 0 112 0 0 0 0 0 0 0 0 0 0 0 200 0 0 0 0 0 0 112 0 0 0 0 0 0 0 0 0 0 0 200 0 0 0 0 0 0 342 0 0 0 0 0 0 0 0 0 0 0 1528.28 0 0 0 0 0 0 1870.28 0 0 0 1101067660 92 Waiver service provider--Disability (DHS/DRS) 10 Adams 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 21719.07 0 0 0 0 0 0 0 0 0 0 0 0 0 21719.07 0 0 0 1101067664 92 Waiver service provider--Disability (DHS/DRS) 73 Menard 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101067669 60 Pharmacies 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101067699 98 Waiver service provider--TBI (DHS/DRS) 71 McHenry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101067706 1831189919 10 Physicians HERRON MARIA 476308940 815 Indiana 0 0 Obstetric-Gynecology 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 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 578.09 0 0 0 0 0 0 578.09 0 0 0 1101067714 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101067721 1073678165 28 Waiver service provider--Supportive living facility (HFS) SAINT CLARES VILLA 620020340 65 Madison 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 687 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16355 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 972884.62 0 0 0 0 0 0 0 0 0 0 0 0 0 972884.62 0 0 0 1101067723 92 Waiver service provider--Disability (DHS/DRS) 106 Whiteside 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101067725 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101067728 1053311407 10 Physicians KAISTHA VIVEK 604772582 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 361 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 361 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4240.56 0 0 0 0 0 0 4240.56 0 0 0 1101067731 1447381074 40 Federally Qualified Health Centers SENECA HEALTH CENTER 601204205 53 Kane 0 1 0 325 2787 0 1134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1572 16157 0 3366 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1572 16157 0 3366 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3440 844430.83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 847870.83 0 0 0 1101067740 1124091988 10 Physicians CHRISTENSEN MATTHEW 618012530 19 Champaign 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 232 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 268 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 268 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34115.54 0 0 0 0 0 0 34115.54 0 0 0 1101067746 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101067748 92 Waiver service provider--Disability (DHS/DRS) 96 St Clair 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 10124.6 0 0 0 0 0 0 0 0 0 0 0 0 0 10124.6 0 0 0 1101067755 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101067759 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101067761 1215969308 10 Physicians LU EVAN 606118709 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 4 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40.71 0 697.37 0 0 0 0 0 0 738.08 0 0 0 1101067764 1639214760 34 State-operated facility (DHS) UNIT 4061 APPLE MURRAY 628015805 66 Marion 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3635 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2705241.19 0 0 0 0 0 0 0 0 0 0 2705241.19 0 0 0 1101067770 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1876.97 0 0 0 0 0 0 0 0 0 0 0 0 0 1876.97 0 0 0 1101067772 1538168372 70 Ambulance Service Providers ARCH AIR MEDICAL SERVICE INC 620406860 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 295 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 0 0 0 0 0 0 0 0 0 0 0 0 392 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 235944.36 0 0 0 0 0 0 235944.36 0 0 0 1101067774 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101067781 1194741405 10 Physicians VIJAYAN 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reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 0 0 0 0 0 3464 0 0 0 0 1636 0 0 0 2734 0 0 0 0 0 0 0 0 0 4787 0 0 0 0 1817 0 0 0 4944 0 0 0 0 0 0 0 0 0 4796 0 0 0 0 7711 0 0 0 5006 0 0 0 0 0 0 0 0 0 786233.19 0 0 0 0 3772665.98 0 0 0 694149.08 0 0 0 0 0 5253048.25 0 0 0 1101069700 1407016900 10 Physicians TSCHERNYAVSKY SYLVIA 477140541 815 Indiana 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 272.57 0 0 0 0 0 0 272.57 0 0 0 1101069701 10 Physicians 823 Michigan 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101069703 1386941326 60 Pharmacies COUNTY MARKET PHARMACY 409 634351685 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14475.06 0 0 0 0 0 0 0 0 0 0 0 0 0 14475.06 0 0 0 1101072773 1952407439 10 Physicians KARACHORLU KIRKOR 606213114 200 Cook 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 918 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5434 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5434 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27072.22 0 0 0 0 0 0 0 0 27072.22 0 0 0 1101072775 92 Waiver service provider--Disability (DHS/DRS) 97 Stephenson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101072779 1366739443 16 Nurse Practitioners WILLS CANDACE L 601159602 200 Cook 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 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 0 114.03 0 0 0 0 0 0 114.03 0 0 0 1101072782 1710084124 10 Physicians WILSON PAUL 618012530 19 Champaign 0 1 Endocrinology 0 18 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 78 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 78 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 228 0 0 0 0 0 0 0 0 0 0 0 237.88 0 0 0 0 0 0 465.88 0 0 0 1101072795 1346391976 11 Dentists WILSON KEITH 604232010 107 Will 0 0 General Dentistry 0 0 0 222 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 768 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 768 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24912.18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24912.18 0 0 0 1101072806 12 Optometrists 200 Cook 0 0 Therapeutic Pharmaceutical Agents 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 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 0 127.27 0 0 0 0 0 0 127.27 0 0 0 1101072813 1962403998 10 Physicians AHMED AZIZ 601391405 30 DuPage 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 2 0 891 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 1288 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 1288 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 142.48 0 23093.02 0 0 0 0 0 0 23235.5 0 0 0 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0 0 0 0 0 0 0 0 0 0 2822.78 0 0 0 0 0 0 2822.78 0 0 0 1101072860 10 Physicians 57 Lake 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101072863 1023223856 10 Physicians PATEL AMIT 605276686 30 DuPage 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 31 0 990 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 1354 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 1354 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1106.96 0 9589.31 0 0 0 0 0 0 10696.27 0 0 0 1101072865 91 Waiver service provider--Adults (DHS/DDD) 58 La Salle 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 0 350 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 350 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24072.5 0 0 0 0 0 0 0 0 0 0 0 0 0 24072.5 0 0 0 1101072867 10 Physicians 826 Missouri 0 0 Colon - Rectal Surgery 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1631.16 0 0 0 0 0 0 1631.16 0 0 0 1101072872 92 Waiver service provider--Disability (DHS/DRS) 54 Kankakee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101072873 1275806705 16 Nurse Practitioners SHAW LAURA 999999999 200 Cook 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 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 0 712.6 0 0 0 0 0 0 712.6 0 0 0 1101072879 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 339 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 339 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19522.75 0 0 0 0 0 0 0 0 0 0 0 0 0 19522.75 0 0 0 1101072882 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101072887 1922250414 55 Early Intervention Services WATT AMY 616033201 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14667.82 0 0 0 0 0 0 14667.82 0 0 0 1101072889 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 175 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 175 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22720.49 0 0 0 0 0 0 0 0 0 0 0 0 0 22720.49 0 0 0 1101072893 1407989957 63 Other Providers of Medical Equipment/Supplies (Non-registered) HOME MEDICAL INC 600625385 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 317 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3699 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3699 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 235481.45 0 1886.26 0 0 0 0 237367.71 0 0 0 1101072898 1104832799 60 Pharmacies WALGREEN CO 06186 528073034 816 Iowa 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2091 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3893.93 0 0 0 3893.93 0 0 0 1101072900 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 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 2260.11 0 0 0 0 0 0 0 0 0 0 0 0 0 2260.11 0 0 0 1101072906 1023187416 30 General Hospitals BEAVER DAM COMMUNITY HOSP INC 539163027 852 Wisconsin ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 1 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20.92 0 0 119.44 0 0 0 0 0 140.36 0 0 0 1101072907 1477651438 22 Physical Therapists MASUR NANCY 601181619 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14908.15 14908.15 0 0 0 1101072913 1508867821 10 Physicians CHALJUB NAJIB 606514940 200 Cook 0 1 Family Practice 0 62 0 0 4 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 116 0 0 5 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 116 0 0 5 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 278 0 0 288.69 0 0 0 0 0 0 0 0 1449.12 0 0 0 0 0 0 2015.81 0 0 0 1101072915 10 Physicians 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101072946 92 Waiver service provider--Disability (DHS/DRS) 83 Pike 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101072952 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 29310.83 0 0 0 0 0 0 0 0 0 0 0 0 0 29310.83 0 0 0 1101072953 63 Other Providers of Medical Equipment/Supplies (Non-registered) 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provider--Disability (DHS/DRS) 24 Coles 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 19 0 0 0 0 0 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 15197.89 0 0 0 0 0 0 0 0 0 0 0 0 0 15197.89 0 0 0 1101072970 1073700449 63 Other Providers of Medical Equipment/Supplies (Non-registered) MIDWEST BONE AND JOINT 622491285 65 Madison 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 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 1738.85 0 0 0 0 1738.85 0 0 0 1101072980 1548353428 10 Physicians HAKIM ASHFAQ 620404661 65 Madison 0 0 Gastroenterology 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 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1397.26 0 0 0 0 0 0 1397.26 0 0 0 1101072982 1073837738 91 Waiver service provider--Adults (DHS/DDD) KHAN IMRAN 606225132 200 Cook 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1178 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1178 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73435.29 0 0 0 0 0 0 0 0 0 0 0 0 0 73435.29 0 0 0 1101072986 92 Waiver service provider--Disability (DHS/DRS) 37 Fulton 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101072992 1508924614 10 Physicians MONTENEGRO HEDELITA S 606393764 200 Cook 0 1 General Practice 0 337 0 0 63 0 0 0 0 0 0 3 0 129 0 0 0 0 0 0 676 0 0 157 0 0 0 0 0 0 3 0 216 0 0 0 0 0 0 676 0 0 157 0 0 0 0 0 0 3 0 216 0 0 0 0 0 0 1494 0 0 5882.03 0 0 0 0 0 0 12 0 10059.41 0 0 0 0 0 0 17447.44 0 0 0 1101072993 1790776755 10 Physicians CHANG JOHN 600681270 200 Cook 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 0 1 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 185 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 185 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4434.5 0 0 0 0 0 0 4434.5 0 0 0 1101072998 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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Physicians ATALLAH CARL 999999999 200 Cook 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 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14498.96 0 0 0 0 0 0 14498.96 0 0 0 1101080535 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 12221.54 0 0 0 0 0 0 0 0 0 0 0 0 0 12221.54 0 0 0 1101080542 1447472964 24 Speech Therapists PICK JULIE 611032235 109 Winnebago 0 0 0 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1111.32 1111.32 0 0 0 1101080546 92 Waiver service provider--Disability (DHS/DRS) 27 Dekalb 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6759.35 0 0 0 0 0 0 0 0 0 0 0 0 0 6759.35 0 0 0 1101080559 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 8883.43 0 0 0 0 0 0 0 0 0 0 0 0 0 8883.43 0 0 0 1101080562 92 Waiver service provider--Disability (DHS/DRS) 107 Will 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16285.94 0 0 0 0 0 0 0 0 0 0 0 0 0 16285.94 0 0 0 1101080572 1134250582 10 Physicians NAGARAKANTI NAGESWARA 605062447 53 Kane 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 411 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 411 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6117.52 0 0 0 0 0 0 6117.52 0 0 0 1101080574 1912911991 10 Physicians FENNEWALD PAMELA 600313833 57 Lake 0 1 Internal Medicine 0 76 0 0 0 0 0 0 0 0 0 11 0 48 0 0 0 0 0 0 462 0 0 0 0 0 0 0 0 0 18 0 121 0 0 0 0 0 0 462 0 0 0 0 0 0 0 0 0 18 0 121 0 0 0 0 0 0 1351 0 0 0 0 0 0 0 0 0 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provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101081715 1841237401 10 Physicians ARNECILLA PABLO 606546994 200 Cook 0 0 Neonatal-Perinatal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 271 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 0 0 0 0 0 673 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68856.26 0 0 0 0 0 0 68856.26 0 0 0 1101081720 14 Chiropractors 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101081721 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101081722 1083916779 36 Community mental health provider PIONEER CENTER OF MCHENRY CO 600982472 71 McHenry 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 418 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 616 0 0 418 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 616 0 0 1423.71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16988.27 0 0 18411.98 0 0 0 1101081726 10 Physicians 30 DuPage 0 0 Infectious Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101081729 92 Waiver service provider--Disability (DHS/DRS) 71 McHenry 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 46783.31 0 0 0 0 0 0 0 0 0 0 0 0 0 46783.31 0 0 0 1101081737 92 Waiver service provider--Disability (DHS/DRS) 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101081741 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101081742 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101081747 1578559514 22 Physical Therapists WAMBEKE KRISTI 612702963 106 Whiteside 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 195 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 195 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5105.5 5105.5 0 0 0 1101081751 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 478.61 0 0 0 0 0 0 0 0 0 0 0 0 0 478.61 0 0 0 1101081759 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101081760 1558574319 10 Physicians GRUSS JASON 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 527 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 527 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101081763 1912990052 10 Physicians HAMILTON JEFFREY 600151830 57 Lake 0 0 Pulmonary Diseases 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 0 175 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 175 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2593.8 0 0 0 0 0 0 2593.8 0 0 0 1101081764 1710929419 10 Physicians DORNING MICHAEL 604355662 107 Will 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 5 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 566.52 0 0 0 0 0 0 566.52 0 0 0 1101081768 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3247.98 0 0 0 0 0 0 0 0 0 0 0 0 0 3247.98 0 0 0 1101081775 1679794523 10 Physicians BREWER AARON 627023719 91 Sangamon 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 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 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4968.6 0 0 0 0 0 0 4968.6 0 0 0 1101081789 1710077110 10 Physicians GRUBBS JOHN E 420033802 53 Kane 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1966.57 0 0 0 0 0 0 1966.57 0 0 0 1101081801 55 Early Intervention Services 54 Kankakee 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55.64 0 0 0 0 0 0 55.64 0 0 0 1101081807 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11653.26 0 0 0 0 0 0 0 0 0 0 0 0 0 11653.26 0 0 0 1101081810 1205909835 10 Physicians KOLTON DANA 600891970 57 Lake 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 0 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3084.34 0 0 0 0 0 0 3084.34 0 0 0 1101081817 92 Waiver service provider--Disability (DHS/DRS) 72 McLean 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101081819 1346224797 10 Physicians POMBAR XAVIER 608052701 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 676 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1157 0 235 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1157 0 235 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58193.79 0 29219.72 0 0 0 0 0 0 87413.51 0 0 0 1101081822 92 Waiver service provider--Disability (DHS/DRS) 64 Macoupin 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 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25812.82 0 0 0 0 0 0 0 0 0 0 0 0 0 25812.82 0 0 0 1101081828 12 Optometrists 100 Vermilion 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101081840 1306025010 10 Physicians MOADDAB GOLBARG 606173913 200 Cook 0 1 Internal Medicine 0 17 0 0 0 0 0 0 0 0 0 10 0 41 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 12 0 76 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 12 0 76 0 0 0 0 0 0 258 0 0 0 0 0 0 0 0 0 43.25 0 1521.8 0 0 0 0 0 0 1823.05 0 0 0 1101081843 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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Waiver service provider--Disability (DHS/DRS) 107 Will 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 28321.98 0 0 0 0 0 0 0 0 0 0 0 0 0 28321.98 0 0 0 1101082800 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 14331.48 0 0 0 0 0 0 0 0 0 0 0 0 0 14331.48 0 0 0 1101082804 91 Waiver service provider--Adults (DHS/DDD) 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101082807 1730318627 10 Physicians KHOSLA TINA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 1094 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 1293 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 1293 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 308.22 0 46606.11 0 0 0 0 0 0 46914.33 0 0 0 1101082813 30 General Hospitals 848 Virginia NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101082814 1457355323 10 Physicians KUPPER ROBERT 420033814 818 Kentucky 0 0 Urological Surgery 0 0 0 0 0 0 0 0 0 0 0 12 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125.55 0 3659.64 0 0 0 0 0 0 3785.19 0 0 0 1101082820 30 General Hospitals 801 Alabama ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 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 65.74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65.74 0 0 0 1101082823 2100073241 71 Medicar Provider ALPHA AND OMEGA TRANSIT 625261560 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 398 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101087761 1558462408 10 Physicians LIEBER DAVID 627949248 91 Sangamon 0 0 Urological Surgery 0 0 0 0 0 0 0 0 0 0 0 5 0 159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 294 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 294 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78.13 0 15479.5 0 0 0 0 0 0 15557.63 0 0 0 1101087767 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101087779 1467574848 55 Early Intervention Services BYRD JANICE 605552096 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 324 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 324 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17579.73 0 0 0 0 0 0 17579.73 0 0 0 1101087782 1477574945 10 Physicians LASIN STEVEN 600441687 57 Lake 0 0 Internal Medicine 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 22 0 0 0 0 0 0 0 0 0 0 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Hospitals 826 Missouri NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 Children's Hospital 0 0 0 0 0 3 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 493.2 0 0 0 0 0 0 0 0 494.49 0 0 0 0 0 987.69 0 0 0 1101087810 10 Physicians 826 Missouri 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101087814 10 Physicians 852 Wisconsin 0 0 Internal Medicine 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1.67 0 0 0 0 0 0 1.67 0 0 0 1101087824 1821161019 13 Podiatrists NELSON PAUL 600773701 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 212 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 277 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 277 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 334.63 0 0 0 0 0 0 334.63 0 0 0 1101087825 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101087875 1841516614 16 Nurse Practitioners TOMASIEWICZ JESSICA 601234748 53 Kane 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 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 251.85 0 0 0 0 0 0 251.85 0 0 0 1101087883 30 General Hospitals 803 Arizona NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 0 489.19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 489.19 0 0 0 1101087887 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9672.05 0 0 0 0 0 0 0 0 0 0 0 0 0 9672.05 0 0 0 1101087889 98 Waiver service provider--TBI (DHS/DRS) 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101087902 98 Waiver service provider--TBI (DHS/DRS) 71 McHenry 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 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 2014.67 0 0 0 0 0 0 0 0 0 0 0 0 0 2014.67 0 0 0 1101087904 92 Waiver service provider--Disability (DHS/DRS) 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101087905 1023138567 24 Speech Therapists MELTON KELLY 628019127 103 Washington 0 0 0 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 0 896 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 896 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66756.64 66756.64 0 0 0 1101087916 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 1101087967 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16137 0 0 0 0 0 0 0 0 0 0 0 0 0 16137 0 0 0 1101087968 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2768.28 0 0 0 0 0 0 0 0 0 0 0 0 0 2768.28 0 0 0 1101087971 1295893808 12 Optometrists RAMACHANDRAN PRASOD 605645802 107 Will 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 1036 0 195 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2037 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2037 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48238.67 0 5449.9 0 0 0 0 53688.57 0 0 0 1101087983 92 Waiver service provider--Disability (DHS/DRS) 37 Fulton 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 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 4378.59 0 0 0 0 0 0 0 0 0 0 0 0 0 4378.59 0 0 0 1101087984 10 Physicians 815 Indiana 0 0 Endocrinology 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101087985 10 Physicians 816 Iowa 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101087987 30 General Hospitals 824 Minnesota NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 205.94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 205.94 0 0 0 1101088001 10 Physicians 816 Iowa 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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Physicians 816 Iowa 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101088377 1942345616 55 Early Intervention Services HOWARD LINDA 604222009 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 185 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 921 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 921 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105578.31 0 0 0 0 0 0 105578.31 0 0 0 1101088383 11 Dentists 200 Cook 0 0 Oral Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101088384 70 Ambulance Service Providers 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101088385 16 Nurse Practitioners 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2502.15 0 0 0 0 0 0 2502.15 0 0 0 1101089774 1366762064 36 Community mental health provider LUTHERAN SOCIAL SERVICES OF IL 611011137 109 Winnebago 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70 0 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1019 0 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1019 0 0 6265.03 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62510.51 0 0 68775.54 0 0 0 1101089779 30 General Hospitals 810 Florida NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 3 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 417.2 0 0 0 0 8382.55 0 0 0 0 0 0 0 0 0 8799.75 0 0 0 1101089781 91 Waiver service provider--Adults (DHS/DDD) 34 Fayette 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101089783 92 Waiver service provider--Disability (DHS/DRS) 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101090423 1306871066 10 Physicians MINTZ ARI D 600451425 57 Lake 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 1884 0 252 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2707 0 341 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2707 0 341 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48950.72 0 5204.82 0 0 0 0 0 0 54155.54 0 0 0 1101090426 1558372615 10 Physicians JENSEN JERRY 604731308 200 Cook 0 1 General Practice 0 11 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 3.84 0 0 0 0 0 0 118.84 0 0 0 1101090442 1366501132 10 Physicians LERNER DAVID 600251777 200 Cook 0 1 Internal Medicine 0 36 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 221 0 0 0 0 0 0 0 0 0 0 0 66 0 0 0 0 0 0 221 0 0 0 0 0 0 0 0 0 0 0 66 0 0 0 0 0 0 648 0 0 0 0 0 0 0 0 0 0 0 1448.49 0 0 0 0 0 0 2096.49 0 0 0 1101090451 1700927993 62 Opticians / Optical Companies MAGER AND GOUGELMAN ST LOUIS 631171218 826 Missouri 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 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 3165.05 0 0 0 0 3165.05 0 0 0 1101090456 1679607485 10 Physicians NERI GREGORY 605064356 53 Kane 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 905 0 181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1197 0 289 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1197 0 289 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21632.53 0 6115.93 0 0 0 0 0 0 27748.46 0 0 0 1101090460 10 Physicians 200 Cook 0 0 Family Practice 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42.98 0 0 0 0 0 0 42.98 0 0 0 1101090464 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101090465 1710242185 11 Dentists OWEIS TAMARA 999999999 200 Cook 0 0 0 0 0 445 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1036 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1036 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 286362.5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 286362.5 0 0 0 1101090473 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101090487 36 Community mental health provider 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101090490 1689639957 10 Physicians CARL REBECCA 606112991 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 345 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 345 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19111.95 0 0 0 0 0 0 19111.95 0 0 0 1101090494 1235148032 16 Nurse Practitioners FOLEY MARY 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101090573 1922234921 16 Nurse Practitioners BEARD NYDIA 606474940 200 Cook 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 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6990.95 0 0 0 0 0 0 6990.95 0 0 0 1101090574 1750594073 10 Physicians MIAN RUBEENA 606121435 30 DuPage 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 527 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 527 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1130.25 0 0 0 0 0 0 1130.25 0 0 0 1101090582 1043221351 10 Physicians NELSON GREGORY 600052402 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 1 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1915.4 0 0 0 0 0 0 1915.4 0 0 0 1101090586 94 Waiver service provider--Children's support (DHS/DDD) 106 Whiteside 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 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3322 0 0 0 0 0 0 0 0 0 0 0 0 0 3322 0 0 0 1101090587 92 Waiver service provider--Disability (DHS/DRS) 99 Union 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 10278.68 0 0 0 0 0 0 0 0 0 0 0 0 0 10278.68 0 0 0 1101090609 1124326145 16 Nurse Practitioners KADONSKY CAROL 946081826 50 Jersey 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 333 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 333 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2374.1 0 0 0 0 0 0 2374.1 0 0 0 1101090610 1265459523 60 Pharmacies WAL MART 10 0830 610713504 106 Whiteside 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1591 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19281 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 508728 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 840027.56 0 0 0 840027.56 0 0 0 1101090612 1962731919 16 Nurse Practitioners CAMPOS ALLISON 629011414 47 Jackson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 362 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 547 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 547 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16864.8 0 0 0 0 0 0 16864.8 0 0 0 1101090617 94 Waiver service provider--Children's support (DHS/DDD) 72 McLean 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 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7998.1 0 0 0 0 0 0 0 0 0 0 0 0 0 7998.1 0 0 0 1101090620 30 General Hospitals 810 Florida NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101090621 92 Waiver service provider--Disability (DHS/DRS) 106 Whiteside 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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Waiver service provider--Adults (DHS/DDD) GOLDIE B. 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1101091649 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 1796.06 0 0 0 0 0 0 0 0 0 0 0 0 0 1796.06 0 0 0 1101091681 1477529626 10 Physicians KALLENBACH KYLE 605324418 30 DuPage 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 91 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1412.32 0 89.8 0 0 0 0 0 0 1502.12 0 0 0 1101091682 10 Physicians 836 Ohio 0 0 Pediatrics 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122.8 0 0 0 0 0 0 122.8 0 0 0 1101091687 2100082105 91 Waiver service provider--Adults (DHS/DDD) MILLENNIUM GARDENS INC 604116600 200 Cook 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9187 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9187 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 848282.91 0 0 0 0 0 0 0 0 0 0 0 0 0 848282.91 0 0 0 1101091688 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 16301.2 0 0 0 0 0 0 0 0 0 0 0 0 0 16301.2 0 0 0 1101091693 61 Independent Laboratories 76 Montgomery 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101091702 1033272554 10 Physicians TE HELEN 605276686 30 DuPage 0 0 Gastroenterology 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 0 169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5787.16 0 0 0 0 0 0 5787.16 0 0 0 1101091706 2100082124 90 Waiver service provider--Elderly (DOA) WHITE CRANE WELLNESS CENTER 606402214 200 Cook 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 2559 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2559 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86163.77 0 0 0 0 0 0 0 0 0 0 0 0 0 86163.77 0 0 0 1101091708 1225061732 10 Physicians BOK EDWARD 463212901 815 Indiana 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 276 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 485 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 485 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7286.91 0 36.99 0 0 0 0 0 0 7323.9 0 0 0 1101091709 1568581312 10 Physicians STARR FREDERIC 606123863 200 Cook 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9823.72 0 0 0 0 0 0 9823.72 0 0 0 1101091710 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 32409.04 0 0 0 0 0 0 0 0 0 0 0 0 0 32409.04 0 0 0 1101091716 1508960816 10 Physicians TSIPURSKY SVETLANA 600254762 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 44 0 1053 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 5183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 5183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123.81 0 74875.52 0 0 0 0 0 0 74999.33 0 0 0 1101091725 92 Waiver service provider--Disability (DHS/DRS) 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101091726 1679574461 10 Physicians SAGONA NANCY 600503151 71 McHenry 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 282 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 383 0 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 383 0 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5261.48 0 594.91 0 0 0 0 0 0 5856.39 0 0 0 1101091732 91 Waiver service provider--Adults (DHS/DDD) 107 Will 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 0 327 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 327 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13626.35 0 0 0 0 0 0 0 0 0 0 0 0 0 13626.35 0 0 0 1101091735 1023234143 10 Physicians GASTON DARRIEN 606432508 200 Cook 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15327.16 0 0 0 0 0 0 15327.16 0 0 0 1101091741 1972647808 34 State-operated facility (DHS) UNIT 8171 1B FOX 604201322 61 Livingston 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 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1530 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1074747.41 0 0 0 0 0 0 0 0 0 0 1074747.41 0 0 0 1101091742 92 Waiver service provider--Disability (DHS/DRS) 72 McLean 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101091747 1841394939 91 Waiver service provider--Adults (DHS/DDD) DOUGLAS JERRY 625261109 63 Macon 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 916 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 916 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24552.68 0 0 0 0 0 0 0 0 0 0 0 0 0 24552.68 0 0 0 1101091750 1407018583 10 Physicians LAGOSKI MEGAN 606112991 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 323 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 323 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50523.39 0 0 0 0 0 0 50523.39 0 0 0 1101091756 1306918164 23 Occupational Therapists SZMERGALSKI ANNE 606112065 200 Cook 0 0 0 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 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3195.54 3195.54 0 0 0 1101091760 2100082178 71 Medicar Provider TUSCOLA HEALTH CARE CENTER 619532050 29 Douglas 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 0 194 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 194 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1933.9 0 0 0 0 0 0 1933.9 0 0 0 1101091764 1669574562 12 Optometrists LAPP JOHN 626261304 64 Macoupin 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 357 0 167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 864 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 864 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21021.32 0 4716.16 0 0 0 0 25737.48 0 0 0 1101091768 30 General Hospitals 821 Maryland NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101091778 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101091780 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101091781 1033380910 16 Nurse Practitioners SEPE KAREN 630433411 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 168 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 168 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4076.81 0 0 0 0 0 0 4076.81 0 0 0 1101091783 91 Waiver service provider--Adults (DHS/DDD) 72 McLean 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 0 346 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 346 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23433.55 0 0 0 0 0 0 0 0 0 0 0 0 0 23433.55 0 0 0 1101091785 92 Waiver service provider--Disability (DHS/DRS) 54 Kankakee 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 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 17984.36 0 0 0 0 0 0 0 0 0 0 0 0 0 17984.36 0 0 0 1101091788 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101091791 1386653582 24 Speech Therapists PALMER CAROL A 629522424 99 Union 0 0 0 0 0 0 0 0 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 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9797.88 9797.88 0 0 0 1101091793 1447295282 10 Physicians STONOV ALEXANDER 601261063 30 DuPage 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 1 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6034.46 0 0 0 0 0 0 6034.46 0 0 0 1101091797 1073643953 29 ICF/MR VICTORIAN MANOR 625681932 20 Christian 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 0 759 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9337 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 718925.53 0 0 0 0 0 0 0 0 0 0 718925.53 0 0 0 1101091800 1992023535 16 Nurse Practitioners KOPP JEAN 600761209 200 Cook 0 0 0 0 0 0 252 0 0 0 0 0 0 0 0 807 0 0 0 0 0 0 0 0 0 536 0 0 0 0 0 0 0 0 1324 0 0 0 0 0 0 0 0 0 536 0 0 0 0 0 0 0 0 1324 0 0 0 0 0 0 0 0 0 6768.06 0 0 0 0 0 0 0 0 38646.65 0 0 0 0 0 0 45414.71 0 0 0 1101091809 92 Waiver service provider--Disability (DHS/DRS) 89 Rock Island 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1385.88 0 0 0 0 0 0 0 0 0 0 0 0 0 1385.88 0 0 0 1101091818 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 19 0 0 0 0 0 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 17933.54 0 0 0 0 0 0 0 0 0 0 0 0 0 17933.54 0 0 0 1101091820 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 896.66 0 0 0 0 0 0 0 0 0 0 0 0 0 896.66 0 0 0 1101091850 1346314564 10 Physicians ALDALLAL NADA 606093833 200 Cook 0 1 Pediatrics 0 3209 0 0 2436 0 0 0 0 0 0 2411 0 2673 0 0 0 0 0 0 28642 0 0 11636 0 0 0 0 0 0 7842 0 12278 0 0 0 0 0 0 28642 0 0 11636 0 0 0 0 0 0 7842 0 12278 0 0 0 0 0 0 57397 0 0 293009.42 0 0 0 0 0 0 28491.09 0 589996.58 0 0 0 0 0 0 968894.09 0 0 0 1101091853 92 Waiver service provider--Disability (DHS/DRS) 11 Alexander 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101091858 1588925804 40 Federally Qualified Health Centers STREAMWOOD COMMUNITY HEALTH 601072950 200 Cook 0 1 0 123 926 0 343 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 428 4034 0 1007 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 428 4034 0 1007 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 952 246602.94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 247554.94 0 0 0 1101091859 1740355809 48 Rural Health Clinics MASSAC MEMORIAL MEDICAL CLINIC 629602467 69 Massac 0 1 0 2352 2209 0 429 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20102 12216 0 559 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20102 12216 0 559 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53656 456758.71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 510414.71 0 0 0 1101091865 1669666236 10 Physicians GHANI NISHATH 601484184 30 DuPage 0 1 Family Practice 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 163 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 163 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 433 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 433 0 0 0 1101091867 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101091871 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22412.5 0 0 0 0 0 0 0 0 0 0 0 0 0 22412.5 0 0 0 1101091878 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 0 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15609 0 0 0 0 0 0 0 0 0 0 0 0 0 15609 0 0 0 1101091879 1114054814 30 General Hospitals DECATUR MEMORIAL HOSP 625264163 63 Macon DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 0 0 0 0 11 0 0 0 0 0 0 2365 0 0 727 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 9468 0 0 3239 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 9468 0 0 3239 0 0 0 0 0 0 0 0 69.24 0 0 0 0 0 0 55848.26 0 0 208736.47 0 0 0 0 0 264653.97 0 0 0 1101091889 1568488781 10 Physicians PULLEY DEBRA 631101010 826 Missouri 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 23 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 0 0 0 0 0 0 0 0 3094.02 0 0 0 0 0 0 3094.02 0 0 0 1101091900 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 14516.77 0 0 0 0 0 0 0 0 0 0 0 0 0 14516.77 0 0 0 1101091902 92 Waiver service provider--Disability (DHS/DRS) 98 Tazewell 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101091904 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16469.68 0 0 0 0 0 0 0 0 0 0 0 0 0 16469.68 0 0 0 1101091906 92 Waiver service provider--Disability (DHS/DRS) 60 Lee 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 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 4344.69 0 0 0 0 0 0 0 0 0 0 0 0 0 4344.69 0 0 0 1101091909 92 Waiver service provider--Disability (DHS/DRS) 25 Crawford 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101091916 10 Physicians 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101091923 1265422844 10 Physicians CASEY CAROLINE 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Waiver service provider--TBI (DHS/DRS) 200 Cook 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 9722.61 0 0 0 0 0 0 0 0 0 0 0 0 0 9722.61 0 0 0 1101093992 10 Physicians 836 Ohio 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101094004 16 Nurse Practitioners 826 Missouri 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 11.62 0 0 0 0 0 0 11.62 0 0 0 1101094006 1578559266 22 Physical Therapists JONES LYNNETTE 610748409 17 Carroll 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 631 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 631 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13462.4 13462.4 0 0 0 1101094009 1982693370 10 Physicians MALHOTRA RAJAT 606731250 200 Cook 0 0 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(DHS/DRS) 57 Lake 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 29923.91 0 0 0 0 0 0 0 0 0 0 0 0 0 29923.91 0 0 0 1101094042 92 Waiver service provider--Disability (DHS/DRS) 63 Macon 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 1216.27 0 0 0 0 0 0 0 0 0 0 0 0 0 1216.27 0 0 0 1101094062 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101094063 1245259274 10 Physicians SHROFF RAJENDRA 628013060 66 Marion 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 634 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1546 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1546 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16358.72 0 0 0 0 0 0 16358.72 0 0 0 1101094066 10 Physicians 852 Wisconsin 0 0 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(DHS/DRS) 22 Clay 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101094933 1629090402 30 General Hospitals ADVOCATE EUREKA HOSPITAL 615301246 110 Woodford DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 1 0 General Hospital - Adult and Child 0 0 0 0 14 0 0 0 0 0 0 401 0 0 459 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 1733 0 0 771 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 1733 0 0 771 0 0 0 0 0 0 0 0 87.78 0 0 0 0 0 0 10391.66 0 0 48276.62 0 0 0 0 0 58756.06 0 0 0 1101094947 10 Physicians 816 Iowa 0 0 Neurology 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81.1 0 0 0 0 0 0 81.1 0 0 0 1101094948 1609095678 11 Dentists KWON MIN 600419208 57 Lake 0 0 General Dentistry 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 282 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 282 0 0 0 0 0 0 0 0 0 0 0 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Knox 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 700 0 0 0 0 0 0 0 0 0 0 0 0 0 700 0 0 0 1101098170 1215112305 63 Other Providers of Medical Equipment/Supplies (Non-registered) ALDEN VILLAGE NORTH INC 606261817 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9708.24 0 0 0 0 0 0 9708.24 0 0 0 1101098172 92 Waiver service provider--Disability (DHS/DRS) 107 Will 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 8308.77 0 0 0 0 0 0 0 0 0 0 0 0 0 8308.77 0 0 0 1101098185 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101098194 1619914496 10 Physicians NAZIR SAIF 463212901 815 Indiana 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1286.71 0 0 0 0 0 0 1286.71 0 0 0 1101098196 1669405528 10 Physicians LAWLOR DONNA 601533328 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 227 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 227 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9566.5 0 0 0 0 0 0 9566.5 0 0 0 1101098209 1932377652 36 Community mental health provider COMMUNITY RESOURCE CENTER 628810125 66 Marion 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 679 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 679 0 0 366.3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37088.5 0 0 37454.8 0 0 0 1101098215 1073564175 10 Physicians DONVITO MARK 629600850 69 Massac 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 724 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 898 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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"JH Stroger, Oak Forest and Provident Hospitals, paid under an alternate reimbursement system" 0 1 Direct Access 0 1775 16758 0 884 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5104 71001 0 2406 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5104 71001 0 2406 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13005 14624172.07 0 454083.91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15091260.98 0 0 0 1101098321 94 Waiver service provider--Children's support (DHS/DDD) 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101098325 1215986062 10 Physicians MAXOURIS KATE LYNN 606253611 200 Cook 0 1 Family Practice 0 227 0 0 95 0 0 0 0 0 0 30 0 136 0 0 0 0 0 0 1401 0 0 467 0 0 0 0 0 0 40 0 348 0 0 0 0 0 0 1401 0 0 467 0 0 0 0 0 0 40 0 348 0 0 0 0 0 0 3137 0 0 13987.04 0 0 0 0 0 0 327.76 0 13153.11 0 0 0 0 0 0 30604.91 0 0 0 1101098329 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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1861642134 55 Early Intervention Services DUELM KRISTI 620341374 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 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 0 0 0 0 0 0 0 0 0 0 0 260 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24894.36 0 0 0 0 0 0 24894.36 0 0 0 1101098485 10 Physicians 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 161.76 0 0 0 0 0 0 161.76 0 0 0 1101098487 1528042686 52 Certified local public health department SHELBY COUNTY HEALTH DEPT 625659510 94 Shelby 0 0 0 0 672 0 578 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1184 0 1842 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1184 0 1842 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15680.09 0 15748.83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31428.92 0 0 0 1101098492 1043224470 63 Other Providers of Medical Equipment/Supplies (Non-registered) EASE E MEDICAL INC 999999999 828 Nebraska 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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1101099872 1750308227 10 Physicians FERGUSON KRISTEN 626501136 77 Morgan 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 457 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 493 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 493 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15651.58 0 0 0 0 0 0 15651.58 0 0 0 1101099875 1194719328 63 Other Providers of Medical Equipment/Supplies (Non-registered) NORTHERN PROSTHETICS ORTHO 611081608 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 390 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 390 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6509.16 0 75923.38 0 0 0 0 82432.54 0 0 0 1101099877 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 15318.25 0 0 0 0 0 0 0 0 0 0 0 0 0 15318.25 0 0 0 1101099880 1396863924 10 Physicians RIVERA STEPHEN 600478993 57 Lake 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 149.53 0 0 0 0 0 0 149.53 0 0 0 1101099889 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101099890 98 Waiver service provider--TBI (DHS/DRS) 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101099899 1750345534 10 Physicians BURKE MARY 604111748 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1714.37 0 0 0 0 0 0 1714.37 0 0 0 1101099905 92 Waiver service provider--Disability (DHS/DRS) 51 Jo Daviess 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 428.1 0 0 0 0 0 0 428.1 0 0 0 1101099948 92 Waiver service provider--Disability (DHS/DRS) 60 Lee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101099949 1609894856 10 Physicians JONES JUDSON 605064355 53 Kane 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 0 8 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 0 990.46 0 0 0 0 0 0 990.46 0 0 0 1101099961 11 Dentists 91 Sangamon 0 0 General Dentistry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101099962 1891797262 10 Physicians MEHRPUYAN TSCHANGIS 601602229 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 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Hospital - Adult and Child 0 0 0 0 0 2 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 0 781.56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 781.56 0 0 0 1101100071 55 Early Intervention Services 54 Kankakee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101100078 92 Waiver service provider--Disability (DHS/DRS) 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101100083 1902911050 10 Physicians RAWDA AYMAN 604533767 200 Cook 0 1 Pediatrics 0 1241 0 0 824 0 0 0 0 0 0 642 0 995 0 0 0 0 0 0 10886 0 0 4504 0 0 0 0 0 0 1003 0 2843 0 0 0 0 0 0 10886 0 0 4504 0 0 0 0 0 0 1003 0 2843 0 0 0 0 0 0 21792 0 0 120869.52 0 0 0 0 0 0 6618.44 0 128699.22 0 0 0 0 0 0 277979.18 0 0 0 1101100089 1295828846 10 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Cook 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 548 0 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 721 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 721 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11689.33 0 1410.2 0 0 0 0 0 0 13099.53 0 0 0 1101100867 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 2691.6 0 0 0 0 0 0 0 0 0 0 0 0 0 2691.6 0 0 0 1101100871 1912925330 10 Physicians BROWN LAWRENCE 630284100 826 Missouri 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1509.31 0 0 0 0 0 0 1509.31 0 0 0 1101100877 1215030481 10 Physicians GUPTA MADAN L. 616151941 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 456 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 725 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 725 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8245.78 0 0 0 0 0 0 8245.78 0 0 0 1101100880 1760477004 10 Physicians DALE LYNN 619442460 19 Champaign 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 9 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54.9 0 0 0 0 0 0 0 0 54.9 0 0 0 1101100882 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101100883 2100091301 91 Waiver service provider--Adults (DHS/DDD) NEW HORIZON CTR FOR THE D.D. 606341418 200 Cook 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4621 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4621 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 251271.4 0 0 0 0 0 0 0 0 0 0 0 0 0 251271.4 0 0 0 1101100895 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101100900 1033137765 10 Physicians VANNUCCI ANDREA 631101010 826 Missouri 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4187.89 0 0 0 0 0 0 4187.89 0 0 0 1101100902 16 Nurse Practitioners 852 Wisconsin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101100903 63 Other Providers of Medical Equipment/Supplies (Non-registered) 828 Nebraska 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 196.92 0 0 0 0 0 0 196.92 0 0 0 1101100905 1194703694 10 Physicians SOLTYS STEPHEN 627949639 91 Sangamon 0 0 Child Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10669.14 0 0 0 0 0 0 10669.14 0 0 0 1101100906 92 Waiver service provider--Disability (DHS/DRS) 88 Richland 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 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8513.53 0 0 0 0 0 0 0 0 0 0 0 0 0 8513.53 0 0 0 1101100908 23 Occupational Therapists 33 Effingham 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 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 0 145.12 145.12 0 0 0 1101100912 1194739268 10 Physicians GHANI MOHAMMAD T K 601542662 200 Cook 0 0 Allergy-Immunization 0 0 0 0 9 0 0 0 0 0 0 5 0 394 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 5 0 4015 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 5 0 4015 0 0 0 0 0 0 0 0 0 68.37 0 0 0 0 0 0 23.7 0 43307.7 0 0 0 0 0 0 43399.77 0 0 0 1101100924 92 Waiver service provider--Disability (DHS/DRS) 60 Lee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101100926 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101100943 1417043977 30 General Hospitals RUSH UNIVERSITY MEDICAL CENTER 606123839 200 Cook DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adults Section 0 14 623 0 0 6394 0 0 0 0 3948 0 0 17 8223 0 0 0 0 0 29 1531 0 0 9557 0 0 0 0 4889 0 0 17 33028 0 0 0 0 0 30 1577 0 0 9606 0 0 0 0 25393 0 0 27 35644 0 0 0 0 0 934.03 94764.02 0 0 2040539.9 0 0 0 0 23908719.65 0 0 28946.15 3616392.23 0 0 0 0 0 29690295.98 0 0 0 1101100948 1285903146 13 Podiatrists BURGESS BRIAN 605644234 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 238 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 238 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9221.7 0 0 0 0 0 0 9221.7 0 0 0 1101100950 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101100956 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101100959 1346385473 34 State-operated facility (DHS) UNIT 4066 FIR COTTAGE 628015805 66 Marion 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 199 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4659 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3482985.65 0 0 0 0 0 0 0 0 0 0 3482985.65 0 0 0 1101100963 1235167602 11 Dentists ROONEY THOMAS 613501621 58 La Salle 0 0 Oral Surgery 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9818.96 0 0 0 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1101100991 1962541037 24 Speech Therapists DEMICHELE SARAH 610322806 97 Stephenson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 398 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 398 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31689.98 31689.98 0 0 0 1101100994 1477535151 10 Physicians ROSENBERG ROBERT 600302076 57 Lake 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 5 0 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77.06 0 18719.75 0 0 0 0 0 0 18796.81 0 0 0 1101101002 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 207 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 207 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11977.5 0 0 0 0 0 0 0 0 0 0 0 0 0 11977.5 0 0 0 1101101008 1336245315 70 Ambulance Service Providers ALTAMONT AMBULANCE SERVICE INC 624110154 33 Effingham 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 813 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156193.45 0 0 0 0 0 0 156193.45 0 0 0 1101101011 1922015767 10 Physicians SCHUETZ MAURICE 606860061 200 Cook 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 290 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 290 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3103.46 0 0 0 0 0 0 0 0 3103.46 0 0 0 1101101013 1336362300 29 ICF/MR HICKORY POINT TERRACE 625354084 63 Macon 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 0 385 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9610 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 778351.21 0 0 0 0 0 0 0 0 0 0 778351.21 0 0 0 1101101014 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101101015 1700105152 39 Hospice HEARTLAND HOME H C HOSPICE 622081341 96 St Clair 0 0 0 0 0 0 0 0 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 561 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13895 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1361823.76 0 0 0 0 0 0 0 0 0 0 0 1361823.76 0 0 0 1101101027 91 Waiver service provider--Adults (DHS/DDD) 53 Kane 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 0 425 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 425 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28864 0 0 0 0 0 0 0 0 0 0 0 0 0 28864 0 0 0 1101101034 1740475466 55 Early Intervention Services BYE AMY 600255522 200 Cook 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 0 308 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 308 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18168.3 0 0 0 0 0 0 18168.3 0 0 0 1101101045 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101101049 1518954890 10 Physicians YESHWANT CHILAKAMARRI 601239400 53 Kane 0 0 Oncology 0 0 0 0 0 0 0 0 0 0 0 0 0 96 0 0 0 0 0 0 0 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0 0 0 567 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 567 0 0 2730.6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36483.15 0 0 39213.75 0 0 0 1101104915 92 Waiver service provider--Disability (DHS/DRS) 24 Coles 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101104920 1457319154 30 General Hospitals ST JOSEPHS HOSPITAL 622300099 23 Clinton DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 0 0 0 0 0 637 0 0 0 0 212 0 0 0 792 0 0 0 0 0 0 0 0 0 867 0 0 0 0 222 0 0 0 1525 0 0 0 0 0 0 0 0 0 867 0 0 0 0 631 0 0 0 1822 0 0 0 0 0 0 0 0 0 119123.02 0 0 0 0 245656.01 0 0 0 209687.81 0 0 0 0 0 574466.84 0 0 0 1101104922 10 Physicians 816 Iowa 0 0 Internal Medicine 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 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 14.94 0 0 0 0 0 0 14.94 0 0 0 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0 0 0 0 0 0 0 0 0 13462.57 0 0 0 0 0 0 0 0 0 0 0 0 0 13462.57 0 0 0 1101106217 91 Waiver service provider--Adults (DHS/DDD) 19 Champaign 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 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17815.6 0 0 0 0 0 0 0 0 0 0 0 0 0 17815.6 0 0 0 1101106232 1568423572 63 Other Providers of Medical Equipment/Supplies (Non-registered) HOLLAND MEDICAL EQUIPMENT 420017106 818 Kentucky 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 276 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 276 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14830.51 0 0 0 0 0 0 14830.51 0 0 0 1101106244 94 Waiver service provider--Children's support (DHS/DDD) 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101106252 92 Waiver service provider--Disability (DHS/DRS) 106 Whiteside 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 144600.2 0 0 0 0 0 0 0 0 0 0 0 0 0 144600.2 0 0 0 1101106485 1205896495 10 Physicians KHARITON BORIS 631171811 826 Missouri 0 0 Physical Medicine/Rehabilitation 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 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1712.11 0 0 0 0 0 0 1712.11 0 0 0 1101106487 1467449280 63 Other Providers of Medical Equipment/Supplies (Non-registered) ALDEN NURS CENTER VALLEY RIDGE 601082135 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14506.92 0 0 0 0 0 0 14506.92 0 0 0 1101106488 94 Waiver service provider--Children's support (DHS/DDD) 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101106494 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101106495 1457502619 10 Physicians PATEL AMISH 606114264 200 Cook 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 0 0 0 629 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2248 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2248 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1982.38 0 0 0 0 0 0 1982.38 0 0 0 1101106497 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 19371.36 0 0 0 0 0 0 0 0 0 0 0 0 0 19371.36 0 0 0 1101106514 1518160910 10 Physicians KNOX MICHAEL 420033815 818 Kentucky 0 0 Urology 0 0 0 0 0 0 0 0 0 0 0 52 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 216 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 216 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 753.93 0 11171.58 0 0 0 0 0 0 11925.51 0 0 0 1101106518 1194896878 10 Physicians MARTINEZ DANIEL 606084209 200 Cook 0 0 Psychiatry 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 0 323 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 323 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8043.91 0 0 0 0 0 0 8043.91 0 0 0 1101106529 92 Waiver service provider--Disability (DHS/DRS) 47 Jackson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101106534 1912018870 10 Physicians VOINESCU ALEXANDRA 631102515 826 Missouri 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 639.17 0 0 0 0 0 0 639.17 0 0 0 1101106536 10 Physicians 200 Cook 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 24713.53 0 0 0 1101106566 1851336861 60 Pharmacies SCHNUCKS PHARMACY 702 637035796 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1246 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29897 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28104.89 0 0 0 28104.89 0 0 0 1101106570 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101106575 1841431913 28 Waiver service provider--Supportive living facility (HFS) HICKORY GROVE APARTMENTS 623211625 42 Hancock 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 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3699 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 206218.2 0 0 0 0 0 0 0 0 0 0 0 0 0 206218.2 0 0 0 1101106578 92 Waiver service provider--Disability (DHS/DRS) 71 McHenry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101106582 1639195464 10 Physicians IYER LAKSHMI 606123833 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 4 0 219 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 273 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 273 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14797.77 0 0 0 0 0 0 14797.77 0 0 0 1101106585 1750484473 60 Pharmacies CVS PHARMACY 06689 478421101 815 Indiana 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 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1237 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1055.42 0 0 0 1055.42 0 0 0 1101106592 1053316869 10 Physicians PATEL UMANG 477140521 815 Indiana 0 0 Cardiovascular Diseases 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 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1321.52 0 0 0 0 0 0 1321.52 0 0 0 1101106597 94 Waiver service provider--Children's support (DHS/DDD) 55 Kendall 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 0 288 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 288 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16483.5 0 0 0 0 0 0 0 0 0 0 0 0 0 16483.5 0 0 0 1101106598 1326064700 63 Other Providers of Medical Equipment/Supplies (Non-registered) AMERICARE RESPIRATORY SERV INC 927055723 805 California 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1673.31 0 0 0 0 0 0 1673.31 0 0 0 1101106602 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33884.99 0 0 0 0 0 0 0 0 0 0 0 0 0 33884.99 0 0 0 1101106605 98 Waiver service provider--TBI (DHS/DRS) 58 La Salle 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101106618 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101106619 92 Waiver service provider--Disability (DHS/DRS) 57 Lake 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 19 0 0 0 0 0 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 12852.83 0 0 0 0 0 0 0 0 0 0 0 0 0 12852.83 0 0 0 1101106623 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 9908.47 0 0 0 0 0 0 0 0 0 0 0 0 0 9908.47 0 0 0 1101106625 1871724369 40 Federally Qualified Health Centers AUNT MARTHAS SOUTH HOLLAND CO 604732061 200 Cook 0 1 0 420 638 0 173 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2016 2792 0 533 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2016 2792 0 533 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5745 177581.97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 183326.97 0 0 0 1101106626 22 Physical Therapists 72 McLean 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101106627 91 Waiver service provider--Adults (DHS/DDD) 102 Warren 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101106634 92 Waiver service provider--Disability (DHS/DRS) 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101106639 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 0 0 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 3167.28 0 0 0 0 0 0 0 0 0 0 0 0 0 3167.28 0 0 0 1101106641 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101106644 1770578809 10 Physicians RISNER DAVID 477470001 815 Indiana 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1431.08 0 0 0 0 0 0 0 0 1431.08 0 0 0 1101106649 1184791188 11 Dentists RHODES GAYLES KELLIE 606552018 200 Cook 0 0 General Dentistry 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4153.94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4153.94 0 0 0 1101106653 1093059743 22 Physical Therapists BANFIELD KELLIE 606575084 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 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 1422.73 1422.73 0 0 0 1101106655 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101106658 92 Waiver service provider--Disability (DHS/DRS) 54 Kankakee 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11642.99 0 0 0 0 0 0 0 0 0 0 0 0 0 11642.99 0 0 0 1101106662 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101106671 30 General Hospitals 818 Kentucky NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 273.48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 273.48 0 0 0 1101106682 1235182809 10 Physicians ATWOOD BRIAN 624502426 88 Richland 0 1 Family Practice 0 743 0 0 227 0 0 0 0 0 0 39 0 987 0 0 0 0 0 0 6277 0 0 588 0 0 0 0 0 0 103 0 3137 0 0 0 0 0 0 6277 0 0 588 0 0 0 0 0 0 103 0 3137 0 0 0 0 0 0 15658 0 0 28230.96 0 0 0 0 0 0 422.3 0 69372.89 0 0 0 0 0 0 113684.15 0 0 0 1101106689 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101106694 1861620833 12 Optometrists UPADHYAY SNEHALI 606164657 200 Cook 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 303 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 303 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6468.25 0 933.99 0 0 0 0 7402.24 0 0 0 1101106696 1902869670 10 Physicians BARE AARON 605553846 30 DuPage 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 40 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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of Medical Equipment/Supplies (Non-registered) 852 Wisconsin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101107269 1326090598 10 Physicians BANGASH JAVED I 601235888 200 Cook 0 1 Pediatrics 0 205 0 0 160 0 0 0 0 0 0 5 0 149 0 0 0 0 0 0 1354 0 0 707 0 0 0 0 0 0 7 0 249 0 0 0 0 0 0 1354 0 0 707 0 0 0 0 0 0 7 0 249 0 0 0 0 0 0 2723 0 0 19546.24 0 0 0 0 0 0 78.4 0 9119.17 0 0 0 0 0 0 31466.81 0 0 0 1101107281 1750568390 36 Community mental health provider NEW FOUND CTR INC CHURCH STR 600761534 200 Cook 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 1666 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 610 0 0 1666 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 610 0 0 11750.14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18746.07 0 0 30496.21 0 0 0 1101107282 92 Waiver service provider--Disability (DHS/DRS) 71 McHenry 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 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101107338 1184632127 10 Physicians TAVERAS MARIA E 535111842 852 Wisconsin 0 0 Cardiology 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 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 31.26 0 0 0 0 0 0 31.26 0 0 0 1101107339 91 Waiver service provider--Adults (DHS/DDD) 107 Will 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 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17011.5 0 0 0 0 0 0 0 0 0 0 0 0 0 17011.5 0 0 0 1101107343 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101107349 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 261 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101110466 1912197534 10 Physicians AMIN MEDHA 605151548 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 17 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 253 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 253 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 709.35 0 23475.32 0 0 0 0 0 0 24184.67 0 0 0 1101110468 91 Waiver service provider--Adults (DHS/DDD) 815 Indiana 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 0 226 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 226 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13516.8 0 0 0 0 0 0 0 0 0 0 0 0 0 13516.8 0 0 0 1101110469 92 Waiver service provider--Disability (DHS/DRS) 100 Vermilion 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101110474 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101110477 92 Waiver service provider--Disability (DHS/DRS) 45 Henry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101110498 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28641.02 0 0 0 0 0 0 0 0 0 0 0 0 0 28641.02 0 0 0 1101110504 11 Dentists 200 Cook 0 0 General Dentistry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101110510 1053415539 10 Physicians ARVIND RAJAGOPAL 606123839 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 4 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14420.94 0 0 0 0 0 0 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0 0 0 0 0 0 397.41 0 0 0 0 0 0 397.41 0 0 0 1101110531 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101110539 33 Nursing Facilities 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101110548 91 Waiver service provider--Adults (DHS/DDD) 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101110558 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 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 9489.09 0 0 0 0 0 0 0 0 0 0 0 0 0 9489.09 0 0 0 1101110570 1053664938 48 Rural Health Clinics GENESIS HEALTH GROUP ALEDO 999999999 74 Mercer 0 0 0 626 991 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5473 6480 0 232 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5473 6480 0 232 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13085 240610.46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 253695.46 0 0 0 1101110572 1235421900 75 Department of Alcohol and Substance Abuse Provider MENTAL HEALTH CENTERS 999999999 83 Pike 0 0 0 0 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 0 442 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 442 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27081.24 0 0 27081.24 0 0 0 1101110576 1891862678 10 Physicians LOQMAN MABRIA 600146207 71 McHenry 0 1 Family Practice 0 40 0 0 12 0 0 0 0 0 0 34 0 94 0 0 0 0 0 0 150 0 0 17 0 0 0 0 0 0 118 0 263 0 0 0 0 0 0 150 0 0 17 0 0 0 0 0 0 118 0 263 0 0 0 0 0 0 423 0 0 670.74 0 0 0 0 0 0 1100.99 0 6435.67 0 0 0 0 0 0 8630.4 0 0 0 1101110586 63 Other Providers of Medical Equipment/Supplies (Non-registered) 836 Ohio 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 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 0 445.66 0 0 0 0 0 0 445.66 0 0 0 1101110596 92 Waiver service provider--Disability (DHS/DRS) 53 Kane 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 33057.8 0 0 0 0 0 0 0 0 0 0 0 0 0 33057.8 0 0 0 1101110611 1689638702 10 Physicians SHIN HANG JIN 604023429 200 Cook 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 1 0 1295 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 2559 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 2559 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3.82 0 20845.21 0 0 0 0 0 0 20849.03 0 0 0 1101110614 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3948.95 0 0 0 0 0 0 0 0 0 0 0 0 0 3948.95 0 0 0 1101110621 1508802554 10 Physicians JOKHY BRIAN 611033655 109 Winnebago 0 0 Emergency Medicine 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 1101111944 1952409765 30 General Hospitals MIDWEST MEDICAL CENTER 610368118 51 Jo Daviess DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 1 0 General Hospital - Adult and Child 0 0 0 0 87 0 0 0 0 0 0 427 0 0 808 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 1395 0 0 1950 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 1395 0 0 1950 0 0 0 0 0 0 0 0 2581.36 0 0 0 0 0 0 16329.81 0 0 148138.55 0 0 0 0 0 167049.72 0 0 0 1101111947 1831390897 47 Local Education Agencies TINLEY PARK CSD 146 604773514 200 Cook 0 0 0 0 0 0 427 0 0 0 0 0 0 0 0 0 0 0 0 0 475 0 0 0 0 736 0 0 0 0 0 0 0 0 0 0 0 0 0 12835 0 0 0 0 736 0 0 0 0 0 0 0 0 0 0 0 0 0 12835 0 0 0 0 4668.5 0 0 0 0 0 0 0 0 0 0 0 0 0 260176.02 0 264844.52 0 0 0 1101111955 92 Waiver service provider--Disability (DHS/DRS) 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101111957 92 Waiver service 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1942256474 60 Pharmacies OSCO DRUG 3288 603024012 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 310 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1608 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 41059 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33.27 0 0 48865.36 0 0 0 48898.63 0 0 0 1101111979 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14270.92 0 0 0 0 0 0 0 0 0 0 0 0 0 14270.92 0 0 0 1101111981 1316926967 10 Physicians BIDANI ANIL 601533304 200 Cook 0 0 Nephrology 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1683.02 0 0 0 0 0 0 1683.02 0 0 0 1101111986 92 Waiver service provider--Disability (DHS/DRS) 106 Whiteside 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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provider--Children's support (DHS/DDD) 200 Cook 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 0 236 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 236 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15185.5 0 0 0 0 0 0 0 0 0 0 0 0 0 15185.5 0 0 0 1101112029 1831227859 34 State-operated facility (DHS) UNIT 3565 HOME 45 KILEY 600856263 57 Lake 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 720 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 540298.39 0 0 0 0 0 0 0 0 0 0 540298.39 0 0 0 1101112035 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 27077.76 0 0 0 0 0 0 0 0 0 0 0 0 0 27077.76 0 0 0 1101112036 1093704462 23 Occupational Therapists CHAN GRANVIA 606466153 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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606081732 200 Cook 0 0 Pediatric Endocrinology 0 0 0 0 0 0 0 0 0 0 0 0 0 42 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 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3822.42 0 0 0 0 0 0 3822.42 0 0 0 1101113480 34 State-operated facility (DHS) 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101113490 1710918875 60 Pharmacies KMART STORES OF IL LLC 4297 612654599 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 536 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14936 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21854.2 0 0 0 21854.2 0 0 0 1101113495 1447280284 30 General Hospitals LORETTO HOSPITAL 606445059 200 Cook DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 0 0 0 0 2 0 0 0 0 0 0 221 0 0 177 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 1471 0 0 379 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 1471 0 0 379 0 0 0 0 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Physicians GUEVARA JOSE R 606313222 200 Cook 0 1 Family Practice 0 67 0 0 6 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 453 0 0 8 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 453 0 0 8 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 1188 0 0 356.3 0 0 0 0 0 0 0 0 3216.96 0 0 0 0 0 0 4761.26 0 0 0 1101113623 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101113627 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17014.09 0 0 0 0 0 0 0 0 0 0 0 0 0 17014.09 0 0 0 1101113634 1922088111 10 Physicians KO MICHAEL 601533328 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3533.24 0 0 0 0 0 0 3533.24 0 0 0 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1184997363 22 Physical Therapists OSWALD ASHLEY 999999999 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 277 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 277 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24921.47 24921.47 0 0 0 1101113699 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101113704 1780650481 25 Audiologists FABER LORI 627810001 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 574.12 574.12 0 0 0 1101113705 92 Waiver service provider--Disability (DHS/DRS) 33 Effingham 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 9286.01 0 0 0 0 0 0 0 0 0 0 0 0 0 9286.01 0 0 0 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0 0 0 1 0 0 0 7482 0 0 0 0 285 0 0 38 2002 0 0 0 0 0 1 0 0 0 7482 0 0 0 0 818 0 0 38 2022 0 0 0 0 0 0 0 0 0 1092882.02 0 0 0 0 518879.48 0 0 65810.31 758497.91 0 0 0 0 0 2436069.72 0 0 0 1101113723 22 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101113733 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 1719.51 0 0 0 0 0 0 0 0 0 0 0 0 0 1719.51 0 0 0 1101113738 1124148101 10 Physicians HERMAN LESLIE F. 602011718 200 Cook 0 0 Psychiatry 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 0 163 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 163 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4111.9 0 0 0 0 0 0 4111.9 0 0 0 1101113740 1356397038 60 Pharmacies OSCO DRUG 3102 605601363 55 Kendall 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12428.57 0 0 0 0 0 0 0 0 0 0 0 0 0 12428.57 0 0 0 1101119270 1740236835 10 Physicians SHANES JEFFREY 601601634 200 Cook 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 1 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 194 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 194 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101.29 0 2328.2 0 0 0 0 0 0 2429.49 0 0 0 1101119272 98 Waiver service provider--TBI (DHS/DRS) 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101119275 92 Waiver service provider--Disability (DHS/DRS) 42 Hancock 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101119285 30 General Hospitals 807 Connecticut NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101119298 92 Waiver service provider--Disability (DHS/DRS) 88 Richland 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101119305 92 Waiver service provider--Disability (DHS/DRS) 72 McLean 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 33325.02 0 0 0 0 0 0 0 0 0 0 0 0 0 33325.02 0 0 0 1101119306 1497701833 63 Other Providers of Medical Equipment/Supplies (Non-registered) ALL STATES MEDICAL SUPPLY 287048218 834 North Carolina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 672 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 672 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1770.32 0 48.86 0 0 0 0 1819.18 0 0 0 1101119313 1184635476 10 Physicians YU EVELYN 628642857 49 Jefferson 0 1 Pediatrics 0 503 0 0 455 0 0 0 0 0 0 347 0 684 0 0 0 0 0 0 4662 0 0 2048 0 0 0 0 0 0 810 0 1963 0 0 0 0 0 0 4662 0 0 2048 0 0 0 0 0 0 810 0 1963 0 0 0 0 0 0 9517 0 0 66584.47 0 0 0 0 0 0 1910.6 0 85303.11 0 0 0 0 0 0 163315.18 0 0 0 1101119317 10 Physicians 836 Ohio 0 0 Otolaryngology 0 0 0 0 0 0 0 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 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 1423.12 0 0 0 0 0 0 1423.12 0 0 0 1101119321 1215902986 10 Physicians NAHASS GEORGE 628646293 49 Jefferson 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 18 0 299 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 571 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 571 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45.2 0 14274.19 0 0 0 0 0 0 14319.39 0 0 0 1101119322 1285896423 55 Early Intervention Services MURPHY MEGAN 607141224 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7761.78 0 0 0 0 0 0 7761.78 0 0 0 1101119332 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101119333 1326073750 10 Physicians WALTERS NIGEL 600043906 200 Cook 0 0 Emergency Medicine 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 47 0 0 0 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 0 272.26 0 0 0 0 0 0 272.26 0 0 0 1101119348 1467435099 10 Physicians ADEEL MOHAMMED 477145559 815 Indiana 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 0 0 0 8 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 1812.28 0 0 0 0 0 0 1812.28 0 0 0 1101119354 1225012727 10 Physicians STRAND ERIC 631101010 826 Missouri 0 0 Obstetric-Gynecology 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1389.86 0 0 0 0 0 0 1389.86 0 0 0 1101119359 92 Waiver service provider--Disability (DHS/DRS) 72 McLean 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101119366 1992078497 60 Pharmacies COMMUNITY A WALGREENS PHARMACY 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 313 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42337 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3048420.25 0 0 0 3048420.25 0 0 0 1101119368 1780764696 10 Physicians TUGWELL FRANK 610811252 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 13 0 0 0 0 0 0 229 0 420 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 282 0 1462 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 282 0 1462 0 0 0 0 0 0 0 0 0 356.01 0 0 0 0 0 0 16783.52 0 151124.39 0 0 0 0 0 0 168263.92 0 0 0 1101119370 1194730200 60 Pharmacies WALGREENS 12556 464041244 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 284 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 303 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 303 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8916.63 0 0 0 0 0 0 8916.63 0 0 0 1101121888 91 Waiver service provider--Adults (DHS/DDD) 46 Iroquois 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 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1298 0 0 0 0 0 0 0 0 0 0 0 0 0 1298 0 0 0 1101121891 1134208317 10 Physicians JOHNSON BETH 601901295 30 DuPage 0 0 Pathology 0 0 0 0 6 0 0 0 0 0 0 4719 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 37974 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 37974 0 0 0 0 0 0 0 0 0 0 0 50.4 0 0 0 0 0 0 197521.92 0 0 0 0 0 0 0 0 197572.32 0 0 0 1101121893 33 Nursing Facilities 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101121898 92 Waiver service provider--Disability (DHS/DRS) 25 Crawford 0 0 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0 0 0 0 0 0 0 0 0 8 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 1050.43 0 0 0 0 6864.63 0 0 0 0 0 0 0 0 0 7915.06 0 0 0 1101124531 1235121781 10 Physicians PYLE JOSEPH 606753070 200 Cook 0 0 Clinical Pathology 0 0 0 0 0 0 0 0 0 0 0 306 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 511 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 511 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7129.6 0 0 0 0 0 0 0 0 7129.6 0 0 0 1101124532 1003054818 55 Early Intervention Services TAYLOR ELIZABETH 605856136 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4856.49 0 0 0 0 0 0 4856.49 0 0 0 1101124534 94 Waiver service provider--Children's support (DHS/DDD) 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101124540 2100114958 91 Waiver service provider--Adults (DHS/DDD) CAREER DEVELOPMENT CENTER 628372359 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346 0 0 2 3184 0 0 0 0 0 0 0 0 0 4668 0 0 0 0 853 0 0 2 3395 0 0 0 0 0 0 0 0 0 1141130.43 0 0 0 0 514042.29 0 0 7150.44 1450888.81 0 0 0 0 0 3113211.97 0 0 0 1101124570 1245234970 63 Other Providers of Medical Equipment/Supplies (Non-registered) ILLIANA MEDICAL EQUIPMENT 618323056 100 Vermilion 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 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1014.21 0 0 0 0 0 0 1014.21 0 0 0 1101124582 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 22568.41 0 0 0 0 0 0 0 0 0 0 0 0 0 22568.41 0 0 0 1101124590 1851328793 16 Nurse Practitioners JABLONSKI LISA 616145069 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 149.33 0 0 0 0 0 0 149.33 0 0 0 1101124599 1740439215 10 Physicians NOWAK MAGDALENA 611033655 109 Winnebago 0 1 Family Practice 0 67 0 0 39 0 0 0 0 0 0 36 0 283 0 0 0 0 0 0 488 0 0 64 0 0 0 0 0 0 40 0 504 0 0 0 0 0 0 488 0 0 64 0 0 0 0 0 0 40 0 504 0 0 0 0 0 0 1219 0 0 3416.2 0 0 0 0 0 0 211.73 0 12902.18 0 0 0 0 0 0 17749.11 0 0 0 1101124607 1386891679 10 Physicians RII JOYCE 604451824 200 Cook 0 0 Infectious Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 334 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1361 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1361 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17389.91 0 0 0 0 0 0 17389.91 0 0 0 1101124617 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 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 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35637.64 0 0 0 0 0 0 0 0 0 0 0 0 0 35637.64 0 0 0 1101124618 92 Waiver service provider--Disability (DHS/DRS) 37 Fulton 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101124625 92 Waiver service provider--Disability (DHS/DRS) 47 Jackson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101124634 1639136484 10 Physicians OVERCASH LARRY 616142085 80 Peoria 0 0 Obstetrics 0 0 0 0 7 0 0 0 0 0 0 96 0 191 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 250 0 493 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 250 0 493 0 0 0 0 0 0 0 0 0 530.12 0 0 0 0 0 0 7496.49 0 36363.84 0 0 0 0 0 0 44390.45 0 0 0 1101124640 92 Waiver service provider--Disability (DHS/DRS) 98 Tazewell 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 3355.47 0 0 0 0 0 0 0 0 0 0 0 0 0 3355.47 0 0 0 1101124647 1306046743 55 Early Intervention Services WELLING KAREN 622231616 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 252 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 252 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15450.02 0 0 0 0 0 0 15450.02 0 0 0 1101124671 1831314186 10 Physicians SOLARO CHRISTOPHER 623012834 10 Adams 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 2556 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101307.81 0 0 0 0 0 0 101307.81 0 0 0 1101124681 11 Dentists 107 Will 0 0 General Dentistry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101124686 1134349202 52 Certified local public health department LAWRENCE CO HEALTH DEPT 624399499 59 Lawrence 0 0 0 0 828 0 643 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 1460 0 2343 0 0 389 0 0 0 0 0 0 0 0 0 0 0 0 0 1460 0 2343 0 0 389 0 0 0 0 0 0 0 0 0 0 0 0 0 19125.95 0 16782.48 0 0 28080 0 0 0 0 0 0 0 0 0 0 0 0 63988.43 0 0 0 1101124688 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15463.68 0 0 0 0 0 0 0 0 0 0 0 0 0 15463.68 0 0 0 1101124689 92 Waiver service provider--Disability (DHS/DRS) 66 Marion 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7025.65 0 0 0 0 0 0 0 0 0 0 0 0 0 7025.65 0 0 0 1101124704 1033156781 10 Physicians FREIER PAUL 605212990 30 DuPage 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 701 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6448.4 0 0 0 0 0 0 6448.4 0 0 0 1101124707 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 313 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 313 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11540.68 0 0 0 0 0 0 0 0 0 0 0 0 0 11540.68 0 0 0 1101124715 1497749931 10 Physicians JOHNSON VINCENT 606112991 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 214 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 214 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4315.57 0 0 0 0 0 0 4315.57 0 0 0 1101124720 1194754952 10 Physicians PARAYNO PEPITO 601691019 200 Cook 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 273 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 457 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 457 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2691.3 0 0 0 0 0 0 0 0 2691.3 0 0 0 1101124722 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101124723 1588618516 10 Physicians PHILLIPS CRAIG 600257645 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 42 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 205 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 205 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1329.72 0 8998.4 0 0 0 0 0 0 10328.12 0 0 0 1101124728 1851411847 10 Physicians DOREN GREGORY 606575194 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 52 0 227 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 717 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 717 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 212.72 0 11256.11 0 0 0 0 0 0 11468.83 0 0 0 1101124729 1063411346 10 Physicians HENSEL XIAOYING 60091 200 Cook 0 0 General Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3845.3 0 0 0 0 0 0 3845.3 0 0 0 1101124733 1053328609 10 Physicians JAMMA KIRANMAI 618226217 19 Champaign 0 1 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 106 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 0 0 0 0 0 0 0 0 0 0 0 0 295 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5078.97 0 0 0 0 0 0 5078.97 0 0 0 1101124738 92 Waiver service provider--Disability (DHS/DRS) 66 Marion 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 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31649.16 0 0 0 0 0 0 0 0 0 0 0 0 0 31649.16 0 0 0 1101124739 1588853113 10 Physicians DUNNE MATTHEW 606781034 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 290 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 290 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3979.03 0 0 0 0 0 0 3979.03 0 0 0 1101124759 1013194042 10 Physicians DODDA VENKATA 999999999 72 McLean 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 266 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 613 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 613 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11683.82 0 0 0 0 0 0 11683.82 0 0 0 1101124762 10 Physicians 72 McLean 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101124772 92 Waiver service provider--Disability (DHS/DRS) 24 Coles 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101124777 98 Waiver service provider--TBI (DHS/DRS) 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101124778 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101124784 1790776888 50 Home Health Agencies - In Home GREATLAND HOME HEALTH SERVICES 605406057 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 620 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 620 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43411.24 0 0 0 0 0 0 43411.24 0 0 0 1101124791 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 38015.85 0 0 0 0 0 0 0 0 0 0 0 0 0 38015.85 0 0 0 1101124808 1891054060 16 Nurse Practitioners GOTTLIEB KIMBERLY 605276686 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 195.41 0 0 0 0 0 0 195.41 0 0 0 1101124812 10 Physicians 815 Indiana 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101124832 1750334470 10 Physicians WILLIAMS MICHAEL 606118709 200 Cook 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 30 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 1247.3 0 0 0 0 0 0 1247.3 0 0 0 1101124838 1730185257 63 Other Providers of Medical Equipment/Supplies (Non-registered) MARS MED EQUIPMENT AND SUPPLY 604511633 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 693 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8934 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8934 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 699840.84 0 1090.39 0 0 0 0 700931.23 0 0 0 1101124840 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 23482.54 0 0 0 0 0 0 0 0 0 0 0 0 0 23482.54 0 0 0 1101124857 1982764759 62 Opticians / Optical Companies PEARLE VISION EXPRESS 605461498 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4703.68 0 0 0 0 4703.68 0 0 0 1101124858 92 Waiver service provider--Disability (DHS/DRS) 17 Carroll 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 14 0 0 0 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 13763.97 0 0 0 0 0 0 0 0 0 0 0 0 0 13763.97 0 0 0 1101124862 1437281391 10 Physicians OSTA AMANDA 606127323 200 Cook 0 1 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Nurse Practitioners DAVIS MYRIAM 606127232 58 La Salle 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1103.84 0 0 0 0 0 0 1103.84 0 0 0 1101126361 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101126366 94 Waiver service provider--Children's support (DHS/DDD) 826 Missouri 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 965.25 0 0 0 0 0 0 0 0 0 0 0 0 0 965.25 0 0 0 1101126371 1205933355 10 Physicians KIM SUNGSUP 606253645 200 Cook 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 0 0 614 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2065 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2065 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20980.75 0 0 0 0 0 0 20980.75 0 0 0 1101126376 23 Occupational Therapists 200 Cook 0 0 0 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 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5295.2 5295.2 0 0 0 1101126388 10 Physicians 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101126392 1457308926 10 Physicians KAPOOR DEEPAK 600761259 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 232 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 845 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 845 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7028.88 0 0 0 0 0 0 7028.88 0 0 0 1101126398 92 Waiver service provider--Disability (DHS/DRS) 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101126404 16 Nurse Practitioners 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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Cook 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 34269.58 0 0 0 0 0 0 0 0 0 0 0 0 0 34269.58 0 0 0 1101126432 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12434.27 0 0 0 0 0 0 0 0 0 0 0 0 0 12434.27 0 0 0 1101126438 91 Waiver service provider--Adults (DHS/DDD) 98 Tazewell 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 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21950.9 0 0 0 0 0 0 0 0 0 0 0 0 0 21950.9 0 0 0 1101126445 1194730861 10 Physicians OSMANOVIC SMAJO 60005 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 25 0 270 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 1932 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 1932 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63.6 0 28544.54 0 0 0 0 0 0 28608.14 0 0 0 1101126462 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101126465 10 Physicians 19 Champaign 0 0 Plastic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101126483 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 20083.8 0 0 0 0 0 0 0 0 0 0 0 0 0 20083.8 0 0 0 1101126508 1205963485 63 Other Providers of Medical Equipment/Supplies (Non-registered) HLS HOME MEDICAL 477152144 815 Indiana 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 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1015.02 0 0 0 0 0 0 1015.02 0 0 0 1101126523 1013960715 70 Ambulance Service Providers PINCKNEYVILLE AMBULANCE SRVC 622741740 81 Perry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 472 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1635 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1635 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79060.01 0 0 0 0 0 0 79060.01 0 0 0 1101126524 91 Waiver service provider--Adults (DHS/DDD) 96 St Clair 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 0 245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24406.89 0 0 0 0 0 0 0 0 0 0 0 0 0 24406.89 0 0 0 1101126527 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101126531 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 15918.06 0 0 0 0 0 0 0 0 0 0 0 0 0 15918.06 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101127238 1891768636 10 Physicians BOSTWICK BRIAN 616033170 80 Peoria 0 0 Internal Medicine 0 0 0 0 1 0 0 0 0 0 0 45 0 95 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 91 0 198 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 91 0 198 0 0 0 0 0 0 0 0 0 6.4 0 0 0 0 0 0 499.27 0 22144.67 0 0 0 0 0 0 22650.34 0 0 0 1101127240 10 Physicians 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101127245 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 14086.18 0 0 0 0 0 0 0 0 0 0 0 0 0 14086.18 0 0 0 1101127262 1629236047 10 Physicians REDDY ARCHANA 600508409 71 McHenry 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 260 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 281 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 281 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8015.47 0 0 0 0 0 0 8015.47 0 0 0 1101127265 10 Physicians 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101127268 10 Physicians 816 Iowa 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101127274 1992784094 10 Physicians PACOLD IVAN 601545716 200 Cook 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 0 0 157 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 231 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 231 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2063.46 0 0 0 0 0 0 2063.46 0 0 0 1101127277 1760453047 10 Physicians AHMAD FATIMA 601533328 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 4 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36.06 0 31061.84 0 0 0 0 0 0 31097.9 0 0 0 1101127281 1265654347 11 Dentists SAPARIA AMIT 463123307 815 Indiana 0 0 General Dentistry 0 0 0 13 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 0 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1958.99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1958.99 0 0 0 1101127282 92 Waiver service provider--Disability (DHS/DRS) 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101127283 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101127286 1194812602 10 Physicians SINGH JITINDER 604322056 107 Will 0 1 Family Practice 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 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 715.9 0 0 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1101127308 1619972130 63 Other Providers of Medical Equipment/Supplies (Non-registered) TOTAL E MEDICAL INC 330694828 810 Florida 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14.67 0 8955.28 0 0 0 0 8969.95 0 0 0 1101127309 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101127312 10 Physicians 826 Missouri 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101127316 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 240 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 240 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23459.28 0 0 0 0 0 0 0 0 0 0 0 0 0 23459.28 0 0 0 1101127318 22 Physical Therapists 53 Kane 0 0 0 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 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5013.95 5013.95 0 0 0 1101127323 1780846147 12 Optometrists HAN ANITA M 600902247 200 Cook 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 317 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 629 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 629 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18168 0 0 0 0 0 0 18168 0 0 0 1101127325 1285635094 60 Pharmacies THE 200 PHARMACY INC 606173512 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 532 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3199 0 0 628 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3199 0 0 6407 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 237599.35 0 0 8195.86 0 0 0 245795.21 0 0 0 1101127327 93 Waiver service provider--HIV/AIDS (DHS/DRS) 72 McLean 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 6816.86 0 0 0 0 0 0 0 0 0 0 0 0 0 6816.86 0 0 0 1101127337 1821264730 10 Physicians PATEL PRIYESH 600123711 71 McHenry 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 42 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1131.29 0 6004.03 0 0 0 0 0 0 7135.32 0 0 0 1101127348 10 Physicians 815 Indiana 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101127351 1447243241 10 Physicians GARTEL MEDEIA 606081732 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 457 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1512 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1512 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46156.85 0 0 0 0 0 0 46156.85 0 0 0 1101127352 92 Waiver service provider--Disability (DHS/DRS) 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101127354 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 4239.47 0 0 0 0 0 0 0 0 0 0 0 0 0 4239.47 0 0 0 1101127356 1790758894 10 Physicians SHEEDY MICHAEL 626298047 91 Sangamon 0 1 Family Practice 0 133 0 0 16 0 0 0 0 0 0 14 0 78 0 0 0 0 0 0 1025 0 0 26 0 0 0 0 0 0 18 0 136 0 0 0 0 0 0 1025 0 0 26 0 0 0 0 0 0 18 0 136 0 0 0 0 0 0 2658 0 0 1872.09 0 0 0 0 0 0 159.08 0 5417.22 0 0 0 0 0 0 10106.39 0 0 0 1101127363 1447321898 40 Federally Qualified Health Centers WESTSIDE FAMILY HEALTH CENTER 606232023 200 Cook 0 1 0 913 760 0 237 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4492 3485 0 682 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4492 3485 0 682 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11646 199171.34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 210817.34 0 0 0 1101127365 1215019187 10 Physicians TONSIENGSOM SAGUL 606223043 200 Cook 0 0 Pathology 0 0 0 0 139 0 0 0 0 0 0 3780 0 7 0 0 0 0 0 0 0 0 0 140 0 0 0 0 0 0 16718 0 7 0 0 0 0 0 0 0 0 0 140 0 0 0 0 0 0 16718 0 7 0 0 0 0 0 0 0 0 0 810.4 0 0 0 0 0 0 73718.75 0 59.51 0 0 0 0 0 0 74588.66 0 0 0 1101127371 1295725018 10 Physicians POSNER ADAM 601601634 200 Cook 0 0 Pulmonary Diseases 0 0 0 0 0 0 0 0 0 0 0 1 0 226 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 358 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 358 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12.02 0 6182.5 0 0 0 0 0 0 6194.52 0 0 0 1101127372 1174674147 10 Physicians LEEF JEFFREY 605276686 30 DuPage 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 454 0 190 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 639 0 454 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 639 0 454 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3532.69 0 17513.51 0 0 0 0 0 0 21046.2 0 0 0 1101127401 98 Waiver service provider--TBI (DHS/DRS) 109 Winnebago 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 24175.35 0 0 0 0 0 0 0 0 0 0 0 0 0 24175.35 0 0 0 1101127406 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101127411 1790865277 10 Physicians PAI APARNA U 604355263 107 Will 0 1 Internal Medicine 0 311 0 0 0 0 0 0 0 0 0 0 0 288 0 0 0 0 0 0 2212 0 0 0 0 0 0 0 0 0 0 0 1263 0 0 0 0 0 0 2212 0 0 0 0 0 0 0 0 0 0 0 1263 0 0 0 0 0 0 6571 0 0 0 0 0 0 0 0 0 0 0 34269.37 0 0 0 0 0 0 40840.37 0 0 0 1101127416 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 221 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 221 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9207 0 0 0 0 0 0 0 0 0 0 0 0 0 9207 0 0 0 1101127417 40 Federally Qualified Health Centers 55 Kendall 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101127420 1346235264 10 Physicians VEERABAHU ANAND 600475292 57 Lake 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 246 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 246 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3906.52 0 0 0 0 0 0 3906.52 0 0 0 1101127437 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101127438 91 Waiver service provider--Adults (DHS/DDD) 58 La Salle 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 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20171.22 0 0 0 0 0 0 0 0 0 0 0 0 0 20171.22 0 0 0 1101127446 91 Waiver service provider--Adults (DHS/DDD) 24 Coles 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 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2587.2 0 0 0 0 0 0 0 0 0 0 0 0 0 2587.2 0 0 0 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1101127464 1679638894 10 Physicians MOSS HEATHER 606127242 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 343 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 343 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28746.24 0 0 0 0 0 0 28746.24 0 0 0 1101127474 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 24914.51 0 0 0 0 0 0 0 0 0 0 0 0 0 24914.51 0 0 0 1101127479 1407877418 10 Physicians RAAD PIERRE 623012728 10 Adams 0 1 Pediatrics 0 851 0 0 564 0 0 0 0 0 0 64 0 666 0 0 0 0 0 0 7998 0 0 2150 0 0 0 0 0 0 68 0 1932 0 0 0 0 0 0 7998 0 0 2150 0 0 0 0 0 0 68 0 1932 0 0 0 0 0 0 15996 0 0 64654.8 0 0 0 0 0 0 685.11 0 78035.84 0 0 0 0 0 0 159371.75 0 0 0 1101127480 1811255292 22 Physical Therapists RIESMEYER JENNIFER P 605152317 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 224 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 224 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16184.08 16184.08 0 0 0 1101127485 1245246321 22 Physical Therapists AHMED IMTIAZ 601735403 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 930 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 930 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6618.28 6618.28 0 0 0 1101127493 1881824910 16 Nurse Practitioners BEARD LACY 626503924 77 Morgan 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 318 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 384 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 384 0 0 0 0 0 0 0 0 0 32.15 0 0 0 0 0 0 0 0 5539.87 0 0 0 0 0 0 5572.02 0 0 0 1101127496 1275755241 22 Physical Therapists VALIULLAH FEHMIDA M 627621000 57 Lake 0 0 0 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 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4355.11 4355.11 0 0 0 1101127501 1538100409 60 Pharmacies CVS PHARMACY 08695 606574413 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 167 0 0 0 0 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DANIEL 626503918 77 Morgan 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 358 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1068 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1068 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79278.89 0 0 0 0 0 0 79278.89 0 0 0 1101127645 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101127646 91 Waiver service provider--Adults (DHS/DDD) 54 Kankakee 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 0 359 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 359 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24552 0 0 0 0 0 0 0 0 0 0 0 0 0 24552 0 0 0 1101127653 1780619114 10 Physicians SHETH KIRITKUMAR 628642157 109 Winnebago 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28773.45 0 0 0 0 0 0 28773.45 0 0 0 1101127664 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1101127705 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 2378.46 0 0 0 0 0 0 0 0 0 0 0 0 0 2378.46 0 0 0 1101127706 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101127710 92 Waiver service provider--Disability (DHS/DRS) 30 DuPage 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 14 0 0 0 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 11627.61 0 0 0 0 0 0 0 0 0 0 0 0 0 11627.61 0 0 0 1101127711 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101127717 92 Waiver service provider--Disability (DHS/DRS) 106 Whiteside 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101127722 1467646141 10 Physicians GUNDALA SRILATA 601265626 30 DuPage 0 0 Hematology 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2485.88 0 0 0 0 0 0 2485.88 0 0 0 1101127733 93 Waiver service provider--HIV/AIDS (DHS/DRS) 53 Kane 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 11648.33 0 0 0 0 0 0 0 0 0 0 0 0 0 11648.33 0 0 0 1101127737 1649325895 10 Physicians GUNDA ARUN 625262472 63 Macon 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 140 0 413 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159 0 506 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159 0 506 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1419.82 0 15682.43 0 0 0 0 0 0 17102.25 0 0 0 1101127743 1720134208 11 Dentists SAMEE ARIF 606243312 200 Cook 0 0 General Dentistry 0 0 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 886 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 886 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32613.35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32613.35 0 0 0 1101127759 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 0 245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15245.6 0 0 0 0 0 0 0 0 0 0 0 0 0 15245.6 0 0 0 1101127763 10 Physicians 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101127764 23 Occupational Therapists 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101127765 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6612.83 0 0 0 0 0 0 0 0 0 0 0 0 0 6612.83 0 0 0 1101127768 10 Physicians 100 Vermilion 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101127770 1205801313 10 Physicians CASTILLO SAMUEL 600101809 57 Lake 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 265 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 608 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 608 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8536.53 0 0 0 0 0 0 8536.53 0 0 0 1101127787 1164423687 10 Physicians KURITZA GEORGE 600683066 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 18 0 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 400 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 400 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101.9 0 7.15 0 0 0 0 0 0 1109.05 0 0 0 1101127790 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101127802 1780750216 10 Physicians WHITNEY JACK 600352432 57 Lake 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4975.67 0 0 0 0 0 0 4975.67 0 0 0 1101127812 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 41602.81 0 0 0 0 0 0 0 0 0 0 0 0 0 41602.81 0 0 0 1101127817 1780739870 10 Physicians ADAMS DENNIS 627046487 91 Sangamon 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 91 0 282 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 174 0 338 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 174 0 338 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1670.4 0 7687.25 0 0 0 0 0 0 9357.65 0 0 0 1101127822 60 Pharmacies 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101127859 1134168263 30 General Hospitals GREAT RIVER MEDICAL CENTER 526551679 816 Iowa DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 0 0 0 0 0 381 0 0 0 0 20 0 0 0 42 0 0 0 0 0 0 0 0 0 752 0 0 0 0 22 0 0 0 68 0 0 0 0 0 0 0 0 0 752 0 0 0 0 76 0 0 0 69 0 0 0 0 0 0 0 0 0 139226.32 0 0 0 0 114335.84 0 0 0 31805.06 0 0 0 0 0 285367.22 0 0 0 1101127861 1912127341 47 Local Education Agencies LYONS TWP H S DIST 204 605252101 200 Cook 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 92 0 0 0 0 113 0 0 0 0 0 0 0 0 0 0 0 0 0 3227 0 0 0 0 113 0 0 0 0 0 0 0 0 0 0 0 0 0 3227 0 0 0 0 765.99 0 0 0 0 0 0 0 0 0 0 0 0 0 98152.59 0 98918.58 0 0 0 1101127865 98 Waiver service provider--TBI (DHS/DRS) 72 McLean 0 0 0 0 0 0 0 0 0 0 0 0 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14185.09 0 0 0 1101128192 63 Other Providers of Medical Equipment/Supplies (Non-registered) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101128194 92 Waiver service provider--Disability (DHS/DRS) 94 Shelby 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 4844.11 0 0 0 0 0 0 0 0 0 0 0 0 0 4844.11 0 0 0 1101128200 1225217748 10 Physicians ZAYED HYTHEM 605591296 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 238 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 238 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4038.86 0 0 0 0 0 0 4038.86 0 0 0 1101128203 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 0 218 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 218 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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107 Will 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 0 343 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 343 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24160.07 0 0 0 0 0 0 0 0 0 0 0 0 0 24160.07 0 0 0 1101130107 1154314961 10 Physicians MOKWE MARIUS 601202130 53 Kane 0 1 Internal Medicine 0 28 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 153 0 0 0 0 0 0 0 0 0 0 0 224 0 0 0 0 0 0 153 0 0 0 0 0 0 0 0 0 0 0 224 0 0 0 0 0 0 459 0 0 0 0 0 0 0 0 0 0 0 4128.04 0 0 0 0 0 0 4587.04 0 0 0 1101130110 1285600676 10 Physicians BOBLICK JOHN 603023304 200 Cook 0 1 Internal Medicine 0 288 0 0 108 0 0 0 0 0 0 0 0 186 0 0 0 0 0 0 2341 0 0 158 0 0 0 0 0 0 0 0 334 0 0 0 0 0 0 2341 0 0 158 0 0 0 0 0 0 0 0 334 0 0 0 0 0 0 5192 0 0 12151.69 0 0 0 0 0 0 0 0 8256.9 0 0 0 0 0 0 25600.59 0 0 0 1101130119 92 Waiver service provider--Disability (DHS/DRS) 108 Williamson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101130121 1235227604 16 Nurse Practitioners HULL LOIS H 611094020 109 Winnebago 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 119 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 119 0 0 0 0 0 0 0 0 0 29.2 0 0 0 0 0 0 0 0 7200.27 0 0 0 0 0 0 7229.47 0 0 0 1101130123 1588713788 33 Nursing Facilities ST JOSEPHS HOME FOR THE ELDERL 600673582 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 565 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15991 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1519460.72 0 0 0 0 0 0 0 1519460.72 0 0 0 1101130130 98 Waiver service provider--TBI (DHS/DRS) 37 Fulton 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101130138 1821053380 10 Physicians JAWDI SAAD 606284247 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 221 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 228 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 228 0 0 0 0 0 0 0 0 0 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8954.9 0 0 0 0 0 0 0 0 0 0 0 0 0 8954.9 0 0 0 1101130193 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 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 10329.2 0 0 0 0 0 0 0 0 0 0 0 0 0 10329.2 0 0 0 1101130203 1962472886 10 Physicians WATSON RICHARD 478042706 815 Indiana 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 1394 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1497 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1497 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51840.22 0 0 0 0 0 0 51840.22 0 0 0 1101130205 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101130213 10 Physicians 815 Indiana 0 0 Neonatology 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 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 0 228.25 0 0 0 0 0 0 228.25 0 0 0 1101130221 1811077431 30 General Hospitals SAINT MARGARET MERCY SO 463111799 815 Indiana DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 276 0 0 196 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 276 0 0 196 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1423.51 0 0 13067.65 0 0 0 0 0 14491.16 0 0 0 1101130225 10 Physicians 200 Cook 0 1 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101130228 1346259553 14 Chiropractors KERKHOFF JARROD 611115040 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 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 81.7 0 0 0 0 0 0 81.7 0 0 0 1101130233 1104845825 16 Nurse Practitioners PRICE KIM 604356565 107 Will 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 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 525.63 0 0 0 0 0 0 525.63 0 0 0 1101130234 92 Waiver service provider--Disability (DHS/DRS) 100 Vermilion 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6818.64 0 0 0 0 0 0 0 0 0 0 0 0 0 6818.64 0 0 0 1101130237 1295791127 10 Physicians NICOL RICHARD 622300099 23 Clinton 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 876 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1054 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1054 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35344.05 0 0 0 0 0 0 35344.05 0 0 0 1101130243 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10668.72 0 0 0 0 0 0 0 0 0 0 0 0 0 10668.72 0 0 0 1101130255 1386714046 10 Physicians CHOUDRY ABDUSSALAM 605615612 30 DuPage 0 0 Neurology 0 0 0 0 0 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0 0 0 0 0 0 0 0 28005 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77770.89 0 0 0 77770.89 0 0 0 1101132943 1518971092 10 Physicians DYKEWICZ MARK 631102515 826 Missouri 0 0 Internal Medicine 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 23 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 0 0 0 0 0 0 0 0 187.93 0 0 0 0 0 0 187.93 0 0 0 1101132946 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101132959 10 Physicians 826 Missouri 0 0 Emergency Medicine 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 0 182.5 0 0 0 0 0 0 182.5 0 0 0 1101132962 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 0 817.47 0 0 0 0 0 0 0 0 0 0 0 0 0 817.47 0 0 0 1101132965 10 Physicians 826 Missouri 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101132970 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101132973 94 Waiver service provider--Children's support (DHS/DDD) 54 Kankakee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101132979 1043318223 10 Physicians SCHINDLER NANCY 600771057 200 Cook 0 0 Vascular Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1193.78 0 0 0 0 0 0 1193.78 0 0 0 1101132990 92 Waiver service provider--Disability (DHS/DRS) 89 Rock Island 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3246.05 0 0 0 0 0 0 0 0 0 0 0 0 0 3246.05 0 0 0 1101132993 1184702078 10 Physicians MORGAN CHRISTOPHER 605212602 30 DuPage 0 0 Anesthesiology 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 47 0 0 0 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 0 315.6 0 0 0 0 0 0 315.6 0 0 0 1101133000 30 General Hospitals 805 California NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 196.9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 196.9 0 0 0 1101133005 1396865077 43 Encounter rate clinic NEAR SOUTH HEALTH CENTER 606531019 200 Cook ARS-C.O.P. "JH Stroger, Oak Forest and Provident Hospitals, paid under an alternate reimbursement system" 0 1 Direct Access 0 245 1147 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 723 3845 0 349 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 723 3845 0 349 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1766 772327.02 0 63619.25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 837712.27 0 0 0 1101133011 1750583217 47 Local Education Agencies SPRING VALLEY CC SCH DIST 99 613621238 15 Bureau 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 1388 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 1388 0 0 0 0 306.32 0 0 0 0 0 0 0 0 0 0 0 0 0 15577.08 0 15883.4 0 0 0 1101133013 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101133032 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101133034 1457430175 10 Physicians SIDDIQUI MOHAMMED 601484010 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 329 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 381 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 381 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8344.64 0 0 0 0 0 0 8344.64 0 0 0 1101133036 10 Physicians 53 Kane 0 0 Urological Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101133042 1417953316 10 Physicians MULLIGAN MICHAEL 620342916 65 Madison 0 1 Family Practice 0 9 0 0 6 0 0 0 0 0 0 6 0 23 0 0 0 0 0 0 93 0 0 14 0 0 0 0 0 0 6 0 55 0 0 0 0 0 0 93 0 0 14 0 0 0 0 0 0 6 0 55 0 0 0 0 0 0 220 0 0 676.91 0 0 0 0 0 0 63.51 0 1930.89 0 0 0 0 0 0 2891.31 0 0 0 1101133044 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101133045 30 General Hospitals 823 Michigan NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101133047 1700916269 22 Physical Therapists CAHILL DIANE 610218829 60 Lee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 455 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 455 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30244.39 30244.39 0 0 0 1101133053 1780858472 40 Federally Qualified Health Centers HARRISBURG COMMUNITY HLTH CTR 629461256 90 Saline 0 1 0 1205 2789 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9180 14440 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9180 14440 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25503 563967.97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 589470.97 0 0 0 1101133054 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 350 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 350 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12714.43 0 0 0 0 0 0 0 0 0 0 0 0 0 12714.43 0 0 0 1101133057 92 Waiver service provider--Disability (DHS/DRS) 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101133059 94 Waiver service provider--Children's support (DHS/DDD) 58 La Salle 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 82 0 0 0 0 0 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 6590.65 0 0 0 0 0 0 0 0 0 0 0 0 0 6590.65 0 0 0 1101133062 1376529743 30 General Hospitals MORTON F PLANT HOSPITAL 337563804 810 Florida NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 8 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 0 916.39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 916.39 0 0 0 1101133084 1780726430 10 Physicians HRYNEWYCH ALEXANDER 626501136 77 Morgan 0 0 Obstetric-Gynecology 0 0 0 0 22 0 0 0 0 0 0 217 0 572 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 451 0 1922 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 451 0 1922 0 0 0 0 0 0 0 0 0 671.86 0 0 0 0 0 0 27106.13 0 239087.76 0 0 0 0 0 0 266865.75 0 0 0 1101133090 1548530785 33 Nursing Facilities ALDEN ESTATES OF SHOREWOOD 604048400 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3058 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 278437.43 0 0 0 0 0 0 0 278437.43 0 0 0 1101133105 1215900519 10 Physicians SCHLEICH JEFFREY 610326600 97 Stephenson 0 1 Family Practice 0 327 0 0 81 0 0 0 0 0 0 32 0 275 0 0 0 0 0 0 3100 0 0 178 0 0 0 0 0 0 66 0 605 0 0 0 0 0 0 3100 0 0 178 0 0 0 0 0 0 66 0 605 0 0 0 0 0 0 8105 0 0 8268.7 0 0 0 0 0 0 447.46 0 21506.46 0 0 0 0 0 0 38327.62 0 0 0 1101133110 92 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(DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101135176 98 Waiver service provider--TBI (DHS/DRS) 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101135181 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26151.75 0 0 0 0 0 0 0 0 0 0 0 0 0 26151.75 0 0 0 1101135182 63 Other Providers of Medical Equipment/Supplies (Non-registered) 56 Knox 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101135185 1790983690 10 Physicians ABOYEJI OLUFEMI 604264264 200 Cook 0 0 Infectious 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101137639 10 Physicians 826 Missouri 0 0 Emergency Medicine 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 96.06 0 0 0 0 0 0 96.06 0 0 0 1101137652 92 Waiver service provider--Disability (DHS/DRS) 100 Vermilion 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101137655 92 Waiver service provider--Disability (DHS/DRS) 81 Perry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101137658 1184714487 10 Physicians PEQUETTE TROY 616031748 80 Peoria 0 1 Pediatrics 0 701 0 0 385 0 0 0 0 0 0 171 0 518 0 0 0 0 0 0 4976 0 0 988 0 0 0 0 0 0 205 0 794 0 0 0 0 0 0 4976 0 0 988 0 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0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3074.5 0 0 0 0 0 0 0 0 0 0 0 0 0 3074.5 0 0 0 1101140803 92 Waiver service provider--Disability (DHS/DRS) 88 Richland 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 23 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 0 0 0 0 0 0 0 0 3522 0 0 0 0 0 0 0 0 0 0 0 0 0 3522 0 0 0 1101140830 1902912025 10 Physicians GIRARDOT JOHN 601262966 30 DuPage 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5933.88 0 0 0 0 0 0 5933.88 0 0 0 1101140836 1235124025 10 Physicians ROBACKER ELBERT 622201914 96 St Clair 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 1 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 9685.32 0 0 0 0 0 0 9689.32 0 0 0 1101140844 1356367718 10 Physicians MANQUEN LOUIS 600483199 57 Lake 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 1001 0 256 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1387 0 377 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1387 0 377 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26738.57 0 6195.46 0 0 0 0 0 0 32934.03 0 0 0 1101140845 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101140861 1437231529 10 Physicians MACKENDRICK WILLIAM 602011718 200 Cook 0 0 Neonatology 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 0 0 0 486 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 486 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58035.04 0 0 0 0 0 0 58035.04 0 0 0 1101140863 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101140869 92 Waiver service 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(Non-registered) BARTON DIRECT INC 787441154 845 Texas 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9297.61 0 0 0 0 0 0 9297.61 0 0 0 1101141268 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101141276 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101141277 1558419325 12 Optometrists SMITH ROBERT 629594437 108 Williamson 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 937 0 466 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2000 0 477 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2000 0 477 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47735.15 0 13592.09 0 0 0 0 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1101141368 1417998907 16 Nurse Practitioners BUTLER CHRISTINA 600051529 200 Cook 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 141 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 666 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 666 0 0 0 0 0 0 0 0 0 539.86 0 0 0 0 0 0 0 0 39933.03 0 0 0 0 0 0 40472.89 0 0 0 1101141369 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 16075.87 0 0 0 0 0 0 0 0 0 0 0 0 0 16075.87 0 0 0 1101141374 1922021773 10 Physicians PARNASS SAMUEL 600761214 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 211 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 211 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19246.22 0 0 0 0 0 0 19246.22 0 0 0 1101141387 1396715595 10 Physicians SIROTA SUSAN 600352471 57 Lake 0 1 Pediatrics 0 16 0 0 44 0 0 0 0 0 0 13 0 51 0 0 0 0 0 0 91 0 0 111 0 0 0 0 0 0 14 0 66 0 0 0 0 0 0 91 0 0 111 0 0 0 0 0 0 14 0 66 0 0 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0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8249.76 0 0 0 0 0 0 8249.76 0 0 0 1101141451 92 Waiver service provider--Disability (DHS/DRS) 30 DuPage 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 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 7823.41 0 0 0 0 0 0 0 0 0 0 0 0 0 7823.41 0 0 0 1101141452 36 Community mental health provider 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101141459 1437212958 10 Physicians PURSELL KENNETH 605276686 30 DuPage 0 0 Infectious Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2319.02 0 0 0 0 0 0 2319.02 0 0 0 1101141461 1336115047 10 Physicians TINGLE THOMAS 600044767 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 6 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 498.13 0 3425.13 0 0 0 0 0 0 3923.26 0 0 0 1101141466 91 Waiver service provider--Adults (DHS/DDD) 18 Cass 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101141470 1417908724 10 Physicians VALIKA SHUJAUDDIN 601234968 53 Kane 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 6 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 225 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 225 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11.48 0 2773.57 0 0 0 0 0 0 2785.05 0 0 0 1101141473 55 Early Intervention Services 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101141477 1063581551 10 Physicians DAMERA BHASKAR R 625250710 63 Macon 0 0 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PHARMACY AND LIQUOR 601651117 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 173 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 1044 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 23220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 562.58 0 0 39145.74 0 0 0 39708.32 0 0 0 1101145113 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101145120 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101145122 30 General Hospitals 834 North Carolina NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 0 672.35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 672.35 0 0 0 1101145131 1083711659 10 Physicians SHADMAN SHAWYON 537151830 852 Wisconsin 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 30 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1316.68 0 104.86 0 0 0 0 0 0 1421.54 0 0 0 1101145137 1578862710 33 Nursing Facilities SUNRISE SKILLED NURSING REHAB 999999999 64 Macoupin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 587 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16348 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1325934.79 0 0 0 0 0 0 0 1325934.79 0 0 0 1101145140 1649247586 13 Podiatrists CHAN PING 606174304 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 437 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30187.15 0 0 0 0 0 0 30187.15 0 0 0 1101145157 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101145164 1699849786 61 Independent Laboratories LITHOLINK CORPORATION 606123502 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 225 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4932 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4932 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19789.32 0 0 0 0 0 0 0 0 19789.32 0 0 0 1101145166 1013957935 10 Physicians RHEE BENJAMIN 618012530 19 Champaign 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 553 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 717 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 717 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14348.75 0 0 0 0 0 0 14348.75 0 0 0 1101145182 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101145196 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101145207 92 Waiver service provider--Disability (DHS/DRS) 98 Tazewell 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 9670.61 0 0 0 0 0 0 0 0 0 0 0 0 0 9670.61 0 0 0 1101145209 91 Waiver service provider--Adults (DHS/DDD) 96 St Clair 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 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10698.75 0 0 0 0 0 0 0 0 0 0 0 0 0 10698.75 0 0 0 1101145213 92 Waiver service provider--Disability (DHS/DRS) 56 Knox 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101145217 1144292681 10 Physicians ANDERSON PROCTOR R 606112921 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 5 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151.81 0 0 0 0 0 0 151.81 0 0 0 1101145218 1093782666 10 Physicians GILL MICHAEL 601533304 200 Cook 0 1 Internal Medicine 0 197 0 0 58 0 0 0 0 0 0 0 0 142 0 0 0 0 0 0 1408 0 0 77 0 0 0 0 0 0 0 0 218 0 0 0 0 0 0 1408 0 0 77 0 0 0 0 0 0 0 0 218 0 0 0 0 0 0 3209 0 0 6064.44 0 0 0 0 0 0 0 0 8475.05 0 0 0 0 0 0 17748.49 0 0 0 1101145221 10 Physicians 30 DuPage 0 0 Family Practice 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72.97 0 0 0 0 0 0 72.97 0 0 0 1101145223 91 Waiver service provider--Adults (DHS/DDD) 64 Macoupin 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 0 350 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 350 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10456.56 0 0 0 0 0 0 0 0 0 0 0 0 0 10456.56 0 0 0 1101145225 1811902026 60 Pharmacies WALGREENS #03714 620025150 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 826 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4024 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 146250.79 0 0 0 146250.79 0 0 0 1101145231 1316117609 60 Pharmacies LEEDS ENTERPRISES INC 600693343 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3407 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90971 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 188702.18 0 0 0 188702.18 0 0 0 1101145232 1386837474 10 Physicians AMDE WENDEWESSEN 606011910 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 7 0 229 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 1862 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 1862 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130.7 0 59067.23 0 0 0 0 0 0 59197.93 0 0 0 1101145242 1548362775 10 Physicians GUNDERSEN KARL 620404744 65 Madison 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 510 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2205 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2205 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61928.63 0 0 0 0 0 0 61928.63 0 0 0 1101145250 1316908759 10 Physicians SWEET ALBORES MICHELLE 605256558 200 Cook 0 1 Family Practice 0 7 0 0 4 0 0 0 0 0 0 1 0 20 0 0 0 0 0 0 72 0 0 5 0 0 0 0 0 0 1 0 41 0 0 0 0 0 0 72 0 0 5 0 0 0 0 0 0 1 0 41 0 0 0 0 0 0 156 0 0 393.43 0 0 0 0 0 0 2.6 0 1408.46 0 0 0 0 0 0 1960.49 0 0 0 1101145251 92 Waiver service provider--Disability (DHS/DRS) 37 Fulton 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 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 10678.68 0 0 0 0 0 0 0 0 0 0 0 0 0 10678.68 0 0 0 1101145257 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4649.14 0 0 0 0 0 0 0 0 0 0 0 0 0 4649.14 0 0 0 1101145266 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17925.57 0 0 0 0 0 0 0 0 0 0 0 0 0 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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 0 213.97 0 0 0 0 213.97 0 0 0 1101145311 1508957705 10 Physicians COOK RICHARD 600987401 71 McHenry 0 0 Family Practice 0 0 0 0 15 0 0 0 0 0 0 158 0 195 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 1289 0 839 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 1289 0 839 0 0 0 0 0 0 0 0 0 726.42 0 0 0 0 0 0 29222.11 0 50409.22 0 0 0 0 0 0 80357.75 0 0 0 1101145317 91 Waiver service provider--Adults (DHS/DDD) 107 Will 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 0 334 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 334 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12936 0 0 0 0 0 0 0 0 0 0 0 0 0 12936 0 0 0 1101145318 1396728978 10 Physicians BRUKASZ PETER 604651934 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159.65 0 0 0 0 0 0 159.65 0 0 0 1101145319 1407005275 11 Dentists LOGAN QUANEEDRIA 627026309 91 Sangamon 0 0 General Dentistry 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11273.13 0 0 0 0 0 0 0 0 0 0 0 0 0 11273.13 0 0 0 1101145351 1942221890 10 Physicians HONORE KIERRE 463123049 815 Indiana 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 222 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 243 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 243 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7457.21 0 0 0 0 0 0 7457.21 0 0 0 1101145352 92 Waiver service provider--Disability (DHS/DRS) 28 De Witt 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101145354 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101145355 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 12928.97 0 0 0 0 0 0 0 0 0 0 0 0 0 12928.97 0 0 0 1101145358 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9746 0 0 0 0 0 0 0 0 0 0 0 0 0 9746 0 0 0 1101145362 1912163114 10 Physicians DAWRAVOO KEVIN 605553269 30 DuPage 0 0 Oncology 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 205 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 205 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5255.99 0 0 0 0 0 0 5255.99 0 0 0 1101145375 1154501799 10 Physicians JONG SHINTA 605582267 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 3 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11.8 0 1914.6 0 0 0 0 0 0 1926.4 0 0 0 1101145380 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13500.3 0 0 0 0 0 0 0 0 0 0 0 0 0 13500.3 0 0 0 1101145382 1306030648 10 Physicians JAVAID KAMRAN 617013534 72 McLean 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 249 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 249 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7113.65 0 0 0 0 0 0 7113.65 0 0 0 1101145389 1841224045 10 Physicians COKE COURTNEY 601234912 53 Kane 0 0 Radiation Oncology 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 0 146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2563.33 0 0 0 0 0 0 2563.33 0 0 0 1101145393 1861796724 16 Nurse Practitioners KACZKOWSKI MARIOLA 600681144 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 632 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 632 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 288.42 0 0 0 0 0 0 288.42 0 0 0 1101145396 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101145399 98 Waiver service provider--TBI (DHS/DRS) 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101145412 1346293438 10 Physicians AHUJA RICHARD 606133011 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 12 0 169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 412 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 412 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 149.34 0 14206.37 0 0 0 0 0 0 14355.71 0 0 0 1101145413 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4336.16 0 0 0 0 0 0 0 0 0 0 0 0 0 4336.16 0 0 0 1101145415 10 Physicians 30 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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 97.42 0 0 0 0 0 0 97.42 0 0 0 1101146106 1710973284 33 Nursing Facilities ST PAULS HOME 622220347 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 495 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 975836.85 0 0 0 0 0 0 0 975836.85 0 0 0 1101146108 1053365932 10 Physicians GONZALEZ JORGE 604489360 107 Will 0 0 Anesthesiology 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 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 5440.85 0 0 0 0 0 0 5440.85 0 0 0 1101146112 63 Other Providers of Medical Equipment/Supplies (Non-registered) 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101146113 1821315961 10 Physicians GOEL ANKUSH 601734776 200 Cook 0 0 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0 0 0 0 0 5725.01 0 0 0 1101146300 55 Early Intervention Services 200 Cook 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 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 4873.28 0 0 0 0 0 0 4873.28 0 0 0 1101146303 1306835517 11 Dentists AIVAZIAN ARAM 606593449 200 Cook 0 0 General Dentistry 0 0 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 659 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 659 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18553.39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18553.39 0 0 0 1101146309 1407010945 11 Dentists SHAIKH SOBIA 605062453 53 Kane 0 0 General Dentistry 0 0 0 173 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32750.05 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32750.05 0 0 0 1101146320 1417902537 10 Physicians GOLDSTEIN JOSHUA 606112991 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 400 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 400 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20936.98 0 0 0 0 0 0 20936.98 0 0 0 1101146322 92 Waiver service provider--Disability (DHS/DRS) 106 Whiteside 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101146324 10 Physicians 852 Wisconsin 0 0 Pulmonary Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101146326 1942312558 10 Physicians LAUDERDALE VANCE 606751611 200 Cook 0 1 Internal Medicine 0 60 0 0 0 0 0 0 0 0 0 23 0 353 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 24 0 663 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 24 0 663 0 0 0 0 0 0 467 0 0 0 0 0 0 0 0 0 131.35 0 9088.05 0 0 0 0 0 0 9686.4 0 0 0 1101146337 1417915653 60 Pharmacies ACCREDO HEALTH GROUP 150867502 839 Pennsylvania 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 610 0 0 1826 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 610 0 0 17647 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17623.71 0 0 7266979.83 0 0 0 7284603.54 0 0 0 1101146339 10 Physicians 826 Missouri 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101146344 1326052309 10 Physicians UPADHYAY NARESH 604627439 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 280 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 982 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 982 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18558.17 0 0 0 0 0 0 18558.17 0 0 0 1101146348 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101146349 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 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FOR THE DD WOODFORD CO 615301705 110 Woodford 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9959 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9959 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 786051.8 0 0 0 0 0 0 0 0 0 0 0 0 0 786051.8 0 0 0 1101147280 63 Other Providers of Medical Equipment/Supplies (Non-registered) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101147283 10 Physicians 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101147284 1265601397 29 ICF/MR HUNTER HOUSE 616033708 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 7 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 0 413 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24018.24 0 0 0 0 0 0 0 0 0 0 24018.24 0 0 0 1101147285 1851490791 10 Physicians ANDERSON TANYA 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0 0 0 0 0 0 0 0 0 0 1101147322 1962608836 12 Optometrists PETERSON LELAND 610811772 106 Whiteside 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 283 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 557 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 557 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15030.17 0 0 0 0 0 0 15030.17 0 0 0 1101147329 94 Waiver service provider--Children's support (DHS/DDD) 49 Jefferson 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 356.38 0 0 0 0 0 0 0 0 0 0 0 0 0 356.38 0 0 0 1101147334 22 Physical Therapists 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 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 0 378.57 378.57 0 0 0 1101147336 1235197161 10 Physicians ALIC LINDA L 600508417 71 McHenry 0 0 Internal Medicine 0 1 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 193 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 193 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 1933.43 0 0 0 0 0 0 1939.43 0 0 0 1101147340 1619251980 16 Nurse Practitioners SCRANTON ANNE 999999999 200 Cook 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 0 0 0 0 0 0 0 0 23 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 0 0 0 0 0 0 0 0 451.08 0 0 0 0 0 0 451.08 0 0 0 1101147342 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101147359 1851404768 10 Physicians SULLIVAN JILL 616147300 80 Peoria 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 300 0 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 386 0 128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 386 0 128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6168.42 0 1520.13 0 0 0 0 0 0 7688.55 0 0 0 1101147364 1659366482 10 Physicians SCHULTHEIS THOMAS 476309225 815 Indiana 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 208 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 312 0 19 0 0 0 0 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0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 524.6 0 0 0 0 0 0 0 0 295.97 0 0 0 0 0 820.57 0 0 0 1101148130 91 Waiver service provider--Adults (DHS/DDD) 12 Bond 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 0 299 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 299 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42966 0 0 0 0 0 0 0 0 0 0 0 0 0 42966 0 0 0 1101148140 1912123274 63 Other Providers of Medical Equipment/Supplies (Non-registered) EDLUCY INC 628372309 104 Wayne 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 420 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2413 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2413 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86027.52 0 10132.66 0 0 0 0 96160.18 0 0 0 1101148141 92 Waiver service provider--Disability (DHS/DRS) 98 Tazewell 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 20841.79 0 0 0 0 0 0 0 0 0 0 0 0 0 20841.79 0 0 0 1101148149 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2788.22 0 0 0 0 0 0 2788.22 0 0 0 1101148377 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101148392 1487730792 10 Physicians KHAN FEHMIDA 600854960 57 Lake 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 10 0 217 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 691 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 691 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16.76 0 21550.45 0 0 0 0 0 0 21567.21 0 0 0 1101148398 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 11179.36 0 0 0 0 0 0 0 0 0 0 0 0 0 11179.36 0 0 0 1101148407 1396945507 24 Speech Therapists CONNELLY DIANE 627621000 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 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RCG CENTRAL ILLINOIS-PONTIAC 617641624 61 Livingston DIALYSIS Outpatient dialysis centers. 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60444.85 0 0 0 0 0 60444.85 0 0 0 1101152100 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101152104 1073690319 22 Physical Therapists LAJEUNE SHEILA 606466153 200 Cook 0 0 0 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 0 217 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 217 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9931.78 9931.78 0 0 0 1101152108 1669422630 10 Physicians BRACK TODD 606223043 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 4405 0 382 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7365 0 404 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7365 0 404 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121982.2 0 5067.24 0 0 0 0 0 0 127049.44 0 0 0 1101152124 1528130267 63 Other Providers of Medical Equipment/Supplies (Non-registered) MOBILITY SYSTEMS AND SOLUTIONS 604572301 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37472.69 0 0 0 0 0 0 37472.69 0 0 0 1101152125 33 Nursing Facilities 105 White 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101152137 16 Nurse Practitioners 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101152151 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101152152 1023057254 10 Physicians HA DANIEL 617612132 72 McLean 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 554 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 750 0 146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 750 0 146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12952.24 0 2231.34 0 0 0 0 0 0 15183.58 0 0 0 1101152154 10 Physicians 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101152159 1316002520 30 General Hospitals VALLEY WEST COMMUNITY HOSPITAL 605481100 27 Dekalb DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 1 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 382 0 0 296 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1359 0 0 940 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1359 0 0 940 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7614.2 0 0 107095.73 0 0 0 0 0 114709.93 0 0 0 1101152163 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 272 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 272 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15799.18 0 0 0 0 0 0 0 0 0 0 0 0 0 15799.18 0 0 0 1101152172 92 Waiver service provider--Disability (DHS/DRS) 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101152186 1366460040 10 Physicians HILLIKER ELIZABETH 631101010 826 Missouri 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 753.39 0 0 0 0 0 0 753.39 0 0 0 1101152188 1598000770 48 Rural Health Clinics DANVILLE PEDIATRICS 618324384 100 Vermilion 0 1 0 284 121 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1844 826 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1844 826 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4921 36107.13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41028.13 0 0 0 1101152194 98 Waiver service provider--TBI (DHS/DRS) 12 Bond 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101152197 10 Physicians 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 488.28 0 0 0 0 0 0 488.28 0 0 0 1101152198 98 Waiver service provider--TBI (DHS/DRS) 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101152200 1619926839 25 Audiologists MORRISON MARIA 601342159 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 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 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 635.05 635.05 0 0 0 1101152214 1639274491 10 Physicians 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0 0 0 0 0 0 0 0 0 0 0 0 0 9756.79 9756.79 0 0 0 1101152245 30 General Hospitals 813 Idaho NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 445.89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 445.89 0 0 0 1101152250 1861482473 10 Physicians RAJENDRAN MALLIKA 605859518 30 DuPage 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 10 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28.18 0 2689.16 0 0 0 0 0 0 2717.34 0 0 0 1101152251 91 Waiver service provider--Adults (DHS/DDD) 42 Hancock 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101152255 1750383758 10 Physicians ALI MOHAMMAD 606592127 200 Cook 0 1 Family Practice 0 134 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 286 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 286 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 803 0 0 0 0 0 0 0 0 0 0 0 265.47 0 0 0 0 0 0 1068.47 0 0 0 1101152257 1841220704 10 Physicians ZAYTSEV POLINA 601975966 200 Cook 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 5716 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45194 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45194 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 198709.54 0 0 0 0 0 0 0 0 198709.54 0 0 0 1101152258 92 Waiver service provider--Disability (DHS/DRS) 79 Ogle 0 0 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 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37095.81 0 0 0 0 0 0 0 0 0 0 0 0 0 37095.81 0 0 0 1101152264 1447315783 22 Physical Therapists GORSKI KATHERINE 604397348 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 226 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 226 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16642.68 16642.68 0 0 0 1101152267 1558346544 10 Physicians ESCORCIA FREDDY ANTONIO 615486004 98 Tazewell 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 252 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 270 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 270 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8282.45 0 0 0 0 0 0 8282.45 0 0 0 1101152277 1295813335 40 Federally Qualified Health Centers BRANDON FAMILY HEALTH CENTER 606172655 200 Cook 0 1 0 2546 1388 0 427 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16069 6345 0 1390 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16069 6345 0 1390 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40842 400319.32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 441161.32 0 0 0 1101152289 93 Waiver service provider--HIV/AIDS (DHS/DRS) 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101152290 1275776445 10 Physicians AYYAGARI SUSMITA 999999999 852 Wisconsin 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 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190.34 0 0 0 0 0 0 190.34 0 0 0 1101153809 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 15757.8 0 0 0 0 0 0 0 0 0 0 0 0 0 15757.8 0 0 0 1101153816 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 15800.08 0 0 0 0 0 0 0 0 0 0 0 0 0 15800.08 0 0 0 1101153817 1932144078 10 Physicians JONES DONALD 606118709 200 Cook 0 0 Cardiology 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 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 38.6 0 0 0 0 0 0 38.6 0 0 0 1101153820 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 448.83 0 0 0 0 0 3802.29 0 0 0 1101153853 91 Waiver service provider--Adults (DHS/DDD) 99 Union 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 0 216 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 216 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13404.84 0 0 0 0 0 0 0 0 0 0 0 0 0 13404.84 0 0 0 1101153856 1629087523 10 Physicians BRADLEY JULIET 606123723 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1542.6 0 0 0 0 0 0 1542.6 0 0 0 1101153859 1669553863 10 Physicians WILK JOANNA 605445620 107 Will 0 0 Family Practice 0 0 0 0 1 0 0 0 0 0 0 2 0 16 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 2 0 36 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 2 0 36 0 0 0 0 0 0 0 0 0 84.62 0 0 0 0 0 0 20.5 0 446.23 0 0 0 0 0 0 551.35 0 0 0 1101153865 1548280225 30 General Hospitals MERITER HOSPITAL INC 537151507 852 Wisconsin NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital 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JULIE 606112991 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 294 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 294 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13138.08 0 0 0 0 0 0 13138.08 0 0 0 1101155436 1790859866 11 Dentists NAGELE DAVID C 609701902 46 Iroquois 0 0 General Dentistry 0 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 646 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 646 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19751.61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19751.61 0 0 0 1101155447 16 Nurse Practitioners 816 Iowa 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101155453 1932298890 10 Physicians SANATI MARYAM 606123723 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 444.8 0 0 0 0 0 0 444.8 0 0 0 1101155464 1457465262 10 Physicians CARROLL ROBERT 606743462 200 Cook 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 195 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 333 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 333 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62166.88 0 0 0 0 0 0 62166.88 0 0 0 1101155470 92 Waiver service provider--Disability (DHS/DRS) 62 Logan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101155476 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101155477 1619046174 16 Nurse Practitioners WILLE PHYLLIS 618323752 100 Vermilion 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1554.45 0 0 0 0 0 0 1554.45 0 0 0 1101155480 36 Community mental 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Federally Qualified Health Centers GRAND BOULEVARD HEALTH CENTER 606096300 200 Cook 0 1 0 2271 1820 0 399 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12704 6641 0 1213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12704 6641 0 1213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32999 384642.31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 417641.31 0 0 0 1101155498 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101155500 1366634487 10 Physicians DUVAL SHARON 601228942 30 DuPage 0 1 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 2 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7.34 0 1982.64 0 0 0 0 0 0 1989.98 0 0 0 1101155506 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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provider--Children's support (DHS/DDD) 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101155603 1770549321 10 Physicians GANDIA JUSTIN 606123723 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 0 13 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1712.57 0 0 0 0 0 0 1712.57 0 0 0 1101155612 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 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 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 0 498.9 0 0 0 0 0 0 0 0 0 0 0 0 0 498.9 0 0 0 1101155619 1124099809 10 Physicians PETSCHE TIMOTHY 601342578 53 Kane 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 21 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 311.71 0 1576.82 0 0 0 0 0 0 1888.53 0 0 0 1101155644 10 Physicians 53 Kane 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101155647 1033363270 61 Independent Laboratories AVEE LABORATORIES INC 337602813 810 Florida 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 367 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 367 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4201.25 0 0 0 0 0 0 0 0 4201.25 0 0 0 1101155649 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101155653 10 Physicians 30 DuPage 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101155657 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 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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 30050.12 0 0 0 0 0 0 0 0 0 0 0 0 0 30050.12 0 0 0 1101159343 1366582421 60 Pharmacies FARMACIA DE LAWNDALE INC 606234520 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 249 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1328 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32748 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50695.72 0 0 0 50695.72 0 0 0 1101159344 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 320 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 320 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18793.83 0 0 0 0 0 0 0 0 0 0 0 0 0 18793.83 0 0 0 1101159370 92 Waiver service provider--Disability (DHS/DRS) 12 Bond 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 1497.83 0 0 0 0 0 0 0 0 0 0 0 0 0 1497.83 0 0 0 1101159377 1063615284 10 Physicians LABUNDY JENNIFER 631102515 826 Missouri 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3085.82 0 0 0 0 0 0 3085.82 0 0 0 1101159378 1235391491 10 Physicians DAVISON JAMIE 999999999 815 Indiana 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 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2618.36 0 0 0 0 0 0 2618.36 0 0 0 1101159381 1073503744 10 Physicians ERNST JOSEPH J 370689022 30 DuPage 0 0 Urology 0 0 0 0 0 0 0 0 0 0 0 41 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 422 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 422 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 264.9 0 10982.71 0 0 0 0 0 0 11247.61 0 0 0 1101159406 1376522870 10 Physicians TWEEDY PHILIP 634013179 826 Missouri 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80.67 0 0 0 0 0 0 80.67 0 0 0 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0 1101161818 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 13355.77 0 0 0 0 0 0 0 0 0 0 0 0 0 13355.77 0 0 0 1101161819 92 Waiver service provider--Disability (DHS/DRS) 107 Will 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6308.01 0 0 0 0 0 0 0 0 0 0 0 0 0 6308.01 0 0 0 1101161823 30 General Hospitals 805 California NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 0 270.09 0 0 0 0 0 0 0 0 0 0 0 0 0 0 270.09 0 0 0 1101161832 1316098387 10 Physicians ROSANIA STEPHANIE 606910263 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 1382 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2141 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2141 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33008.4 0 255.61 0 0 0 0 0 0 33264.01 0 0 0 1101161833 1821007824 10 Physicians WILMOTT ROBERT 631102515 826 Missouri 0 0 Pediatrics 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 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 0 660.9 0 0 0 0 0 0 660.9 0 0 0 1101161836 1194743617 60 Pharmacies WAL MART PHARMACY 10 2204 601302507 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 639 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2980 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85312 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108313.16 0 0 0 108313.16 0 0 0 1101161846 1801895701 10 Physicians ONYIBOR KATE 605212962 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 317 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 317 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2706.43 0 0 0 0 0 0 2706.43 0 0 0 1101161852 92 Waiver service provider--Disability (DHS/DRS) 53 Kane 0 0 0 0 0 0 0 0 1 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(DHS/DRS) 10 Adams 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 47 0 0 0 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 22859.11 0 0 0 0 0 0 0 0 0 0 0 0 0 22859.11 0 0 0 1101161909 1790712347 10 Physicians ADAMO GREGORY P 600073311 200 Cook 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 985 0 171 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1600 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1600 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25584.21 0 2195.41 0 0 0 0 0 0 27779.62 0 0 0 1101161910 60 Pharmacies 816 Iowa 0 0 0 0 0 0 0 0 0 0 0 0 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 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 284 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 763.02 0 0 0 763.02 0 0 0 1101161926 92 Waiver service provider--Disability (DHS/DRS) 72 McLean 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 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21421.64 0 0 0 0 0 0 0 0 0 0 0 0 0 21421.64 0 0 0 1101161946 1285740167 10 Physicians GROSSMAN AARON 606454512 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 218 0 2295 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 359 0 5466 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 359 0 5466 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3667.57 0 110835.47 0 0 0 0 0 0 114503.04 0 0 0 1101161953 2100152371 94 Waiver service provider--Children's support (DHS/DDD) CLAY COUNTY REHAB CENTER INC 628399000 22 Clay 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 240 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 240 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7168.19 0 0 0 0 0 0 0 0 0 0 0 0 0 7168.19 0 0 0 1101161955 1891802096 10 Physicians CHOW ALAN 601783103 27 Dekalb 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 1 0 245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 1133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 1133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10.96 0 42293.73 0 0 0 0 0 0 42304.69 0 0 0 1101161959 92 Waiver service provider--Disability (DHS/DRS) 107 Will 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 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 498 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3324.08 0 0 0 0 0 0 3324.08 0 0 0 1101162016 1336167402 55 Early Intervention Services WIRTH PAMELA 622601802 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13396.98 0 0 0 0 0 0 13396.98 0 0 0 1101162018 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 31955.89 0 0 0 0 0 0 0 0 0 0 0 0 0 31955.89 0 0 0 1101162028 94 Waiver service provider--Children's support (DHS/DDD) 107 Will 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 29 0 0 0 0 0 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 2806.1 0 0 0 0 0 0 0 0 0 0 0 0 0 2806.1 0 0 0 1101162037 1952386054 10 Physicians TRIPATHI PETERS ANJU 606113092 200 Cook 0 0 Allergy-Immunization 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2001.76 0 0 0 0 0 0 2001.76 0 0 0 1101162041 1912109489 47 Local Education Agencies NORTH GREEN UNIT SCHOOL DIST 3 620921359 39 Greene 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3666 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3666 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38420.52 0 38420.52 0 0 0 1101162042 1922051275 10 Physicians KERNEK KEVIN 476309225 815 Indiana 0 0 Pathology 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 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1335.09 0 0 0 0 0 0 0 0 1335.09 0 0 0 1101162060 1053312918 10 Physicians HORCHER HEIDI 600508409 71 McHenry 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 231 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 231 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1669.97 0 0 0 0 0 0 0 0 1669.97 0 0 0 1101162079 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 18252.72 0 0 0 0 0 0 0 0 0 0 0 0 0 18252.72 0 0 0 1101162094 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22681.56 0 0 0 0 0 0 0 0 0 0 0 0 0 22681.56 0 0 0 1101162097 1235118894 10 Physicians GRANZOTTI ANDREA 625264163 63 Macon 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 157 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16777.47 0 0 0 0 0 0 16777.47 0 0 0 1101162105 1679552269 10 Physicians MICHAELSON JOANNE 600442203 57 Lake 0 0 Anesthesiology 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 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 0 952.86 0 0 0 0 0 0 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0 0 0 0 3062.14 0 0 0 0 0 0 0 0 0 0 0 0 0 83021.59 0 86083.73 0 0 0 1101162155 1669481180 13 Podiatrists MACNAB ROBERT 604356572 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 173 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 173 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5708.54 0 0 0 0 0 0 5708.54 0 0 0 1101162162 10 Physicians 200 Cook 0 0 Family Practice 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115.1 0 0 0 0 0 0 115.1 0 0 0 1101162166 1093746927 10 Physicians KRAMER JASON 600614304 57 Lake 0 1 Internal Medicine 0 56 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 499 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 499 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 1437 0 0 0 0 0 0 0 0 0 0 0 3961.68 0 0 0 0 0 0 5398.68 0 0 0 1101162170 91 Waiver service provider--Adults (DHS/DDD) 76 Montgomery 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 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0 0 0 0 0 0 136 0 0 0 0 0 0 0 0 217 0 0 0 0 0 0 0 0 0 136 0 0 0 0 0 0 0 0 217 0 0 0 0 0 0 0 0 0 4554.28 0 0 0 0 0 0 0 0 6267.96 0 0 0 0 0 0 10822.24 0 0 0 1101162732 1154366888 10 Physicians ENSER LOWELL 611112754 109 Winnebago 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8947.62 0 0 0 0 0 0 8947.62 0 0 0 1101162737 10 Physicians 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 651.4 0 0 0 0 0 0 651.4 0 0 0 1101162739 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3652.92 0 0 0 0 0 0 0 0 0 0 0 0 0 3652.92 0 0 0 1101162764 1821312000 16 Nurse Practitioners HOLSTROM CHRISTINE 605277594 30 DuPage 0 0 0 0 0 0 0 0 0 0 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Providers of Medical Equipment/Supplies (Non-registered) FRANKLIN GROVE LIVING AND REHB 999999999 60 Lee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 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 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4688.62 0 0 0 0 0 0 4688.62 0 0 0 1101162796 92 Waiver service provider--Disability (DHS/DRS) 96 St Clair 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22563.76 0 0 0 0 0 0 0 0 0 0 0 0 0 22563.76 0 0 0 1101162799 1437290905 10 Physicians JAGIELO TED 606319892 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 869 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 869 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2507.76 0 0 0 0 0 0 2507.76 0 0 0 1101162824 1346279213 10 Physicians LINDQUIST LEE 606118709 200 Cook 0 1 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46.8 0 0 0 0 0 0 46.8 0 0 0 1101162836 92 Waiver service provider--Disability (DHS/DRS) 46 Iroquois 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 226.99 0 0 0 0 0 0 0 0 0 0 0 0 0 226.99 0 0 0 1101162846 92 Waiver service provider--Disability (DHS/DRS) 56 Knox 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 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 4007.74 0 0 0 0 0 0 0 0 0 0 0 0 0 4007.74 0 0 0 1101162848 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 24522.68 0 0 0 0 0 0 0 0 0 0 0 0 0 24522.68 0 0 0 1101162867 2100153285 28 Waiver service provider--Supportive living facility (HFS) HERITAGE WOODS OF BELVIDERE 610088800 13 Boone 0 0 0 0 0 0 0 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1263 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33434 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1821739.23 0 0 0 0 0 0 0 0 0 0 0 0 0 1821739.23 0 0 0 1101162869 92 Waiver service provider--Disability (DHS/DRS) 49 Jefferson 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 34778.16 0 0 0 0 0 0 0 0 0 0 0 0 0 34778.16 0 0 0 1101162883 10 Physicians 35 Ford 0 1 Family Practice 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 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 56.73 0 0 0 0 0 0 56.73 0 0 0 1101162888 1467647883 53 State-operated school (DHS) IL CENTER FOR REHAB AND ED 606081230 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1943 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1943 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 124410.88 0 124410.88 0 0 0 1101162891 2100153309 90 Waiver service provider--Elderly (DOA) RELIABLE HOME CARE PROVIDERS 600693015 57 Lake 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2782 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2782 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 189417.74 0 0 0 0 0 0 0 0 0 0 0 0 0 189417.74 0 0 0 1101162903 1306880414 63 Other Providers of Medical Equipment/Supplies (Non-registered) ROCKFORD ORTHOPEDIC ASSOCIATES 611075090 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 566 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 720 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 720 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2068.1 0 54256.77 0 0 0 0 56324.87 0 0 0 1101162934 92 Waiver service provider--Disability (DHS/DRS) 99 Union 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 18095.46 0 0 0 0 0 0 0 0 0 0 0 0 0 18095.46 0 0 0 1101162941 1891843199 10 Physicians MILLER SCOTT 600483100 57 Lake 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 1 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2.12 0 9574.43 0 0 0 0 0 0 9576.55 0 0 0 1101162947 1730297789 10 Physicians KOGAN MICHAEL 600106812 57 Lake 0 0 General Practice 0 0 0 0 0 0 0 0 0 0 0 15 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 304.9 0 1961.61 0 0 0 0 0 0 2266.51 0 0 0 1101162958 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 12927.86 0 0 0 0 0 0 0 0 0 0 0 0 0 12927.86 0 0 0 1101162963 22 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 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5391.28 5391.28 0 0 0 1101162969 1720286552 10 Physicians SHUAIPAJ TASIN 605238723 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 229 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 229 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3845.58 0 0 0 0 0 0 3845.58 0 0 0 1101162972 1669664892 10 Physicians KOULIEV TIMUR 606222743 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 410 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 436 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 436 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16093.44 0 0 0 0 0 0 16093.44 0 0 0 1101162980 1699862698 10 Physicians GIERKE PETER 528032459 816 Iowa 0 0 Family Practice 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 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 233.83 0 0 0 0 0 0 233.83 0 0 0 1101162987 10 Physicians 30 DuPage 0 0 Psychiatry 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101162990 10 Physicians 826 Missouri 0 0 Anesthesiology 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 84.62 0 0 0 0 0 0 84.62 0 0 0 1101162997 1104833961 10 Physicians HOENIG JEREMY 606233501 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 402 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 454 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 454 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11403.83 0 0 0 0 0 0 11403.83 0 0 0 1101163007 92 Waiver service provider--Disability (DHS/DRS) 64 Macoupin 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 12770.37 0 0 0 0 0 0 0 0 0 0 0 0 0 12770.37 0 0 0 1101163021 1649354267 16 Nurse Practitioners LONGO THERESA 604624508 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137.36 0 0 0 0 0 0 137.36 0 0 0 1101163028 1942278890 10 Physicians OLEARY PATRICK 606740018 200 Cook 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 158 0 0 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Equipment/Supplies (Non-registered) HERITAGE MANOR EL PASO LLC 617381508 110 Woodford 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 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5758.97 0 0 0 0 0 0 5758.97 0 0 0 1101163065 1366409393 10 Physicians KLAWITTER KAREN 600504053 71 McHenry 0 1 Pediatrics 0 62 0 0 97 0 0 0 0 0 0 50 0 117 0 0 0 0 0 0 362 0 0 260 0 0 0 0 0 0 61 0 191 0 0 0 0 0 0 362 0 0 260 0 0 0 0 0 0 61 0 191 0 0 0 0 0 0 724 0 0 9474.65 0 0 0 0 0 0 493.84 0 9059.36 0 0 0 0 0 0 19751.85 0 0 0 1101163066 1730181306 10 Physicians REDDY N H 604611029 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 2 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.34 0 265.77 0 0 0 0 0 0 266.11 0 0 0 1101163069 1851601462 10 Physicians BHAMIDIPATI PRASANTA 627118081 91 Sangamon 0 1 Pediatrics 0 13 0 0 329 0 0 0 0 0 0 63 0 340 0 0 0 0 0 0 28 0 0 1139 0 0 0 0 0 0 67 0 438 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0 0 0 0 0 0 0 93 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 196 0 293 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 196 0 293 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27183.41 0 34673.87 0 0 0 0 61857.28 0 0 0 1101163573 1497856785 33 Nursing Facilities SUNNY ACRES NURSING HOME 626759803 73 Menard 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 491 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12420 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 882655.65 0 0 0 0 0 0 0 882655.65 0 0 0 1101163582 1235246463 10 Physicians TU KEVIN 601265640 30 DuPage 0 0 Orthopedic Surgery 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 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 90.98 0 0 0 0 0 0 90.98 0 0 0 1101163593 1558346007 30 General Hospitals GIBSON GENERAL HOSPITAL 476701043 815 Indiana NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 215 0 0 0 0 1 0 0 0 22 0 0 0 0 0 0 0 0 0 340 0 0 0 0 1 0 0 0 31 0 0 0 0 0 0 0 0 0 340 0 0 0 0 2 0 0 0 44 0 0 0 0 0 0 0 0 0 39795.91 0 0 0 0 1289.62 0 0 0 6721.18 0 0 0 0 0 47806.71 0 0 0 1101163602 1720141245 10 Physicians GODLEY LUCY 604402100 107 Will 0 0 Hematology 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 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1045.56 0 0 0 0 0 0 1045.56 0 0 0 1101163605 1891743175 10 Physicians ABUJAMRA LINA 605407430 30 DuPage 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 174.49 0 0 0 0 0 0 174.49 0 0 0 1101163626 91 Waiver service provider--Adults (DHS/DDD) 52 Johnson 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 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13428.25 0 0 0 0 0 0 0 0 0 0 0 0 0 13428.25 0 0 0 1101163638 1609982586 10 Physicians CONRAN AISLING 601901295 30 DuPage 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 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611031526 109 Winnebago 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13402 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13402 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3564078.56 0 0 0 0 0 0 0 0 0 0 0 0 0 3564078.56 0 0 0 1101163736 22 Physical Therapists 30 DuPage 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 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 929.92 929.92 0 0 0 1101163739 1447457585 10 Physicians KAMYSZ JEFFERY 606252588 200 Cook 0 0 Pathology 0 25 0 0 0 0 0 0 0 0 0 3 0 28 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 3 0 998 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 3 0 998 0 0 0 0 0 0 123 0 0 0 0 0 0 0 0 0 17 0 808.47 0 0 0 0 0 0 948.47 0 0 0 1101163746 30 General Hospitals 836 Ohio ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 253.49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 5333.86 0 0 0 0 0 0 0 0 0 0 0 0 0 5333.86 0 0 0 1101163788 1619002326 22 Physical Therapists LUNDE AMY M 604428167 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6929.48 6929.48 0 0 0 1101163789 1851384754 10 Physicians HILL KALISHA 463619231 815 Indiana 0 0 Pathology 0 0 0 0 14 0 0 0 0 0 0 1970 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 12372 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 12372 0 0 0 0 0 0 0 0 0 0 0 80.05 0 0 0 0 0 0 60410.81 0 0 0 0 0 0 0 0 60490.86 0 0 0 1101163791 1710921606 10 Physicians HARVEY DAVID 616145069 80 Peoria 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 234 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 262 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 262 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7954.43 0 0 0 0 0 0 7954.43 0 0 0 1101163807 98 Waiver service provider--TBI (DHS/DRS) 85 Pulaski 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 13455.95 0 0 0 0 0 0 0 0 0 0 0 0 0 13455.95 0 0 0 1101163811 1831162411 16 Nurse Practitioners NOVAK KAREN 606118709 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1053.13 0 0 0 0 0 0 1053.13 0 0 0 1101163832 2100154250 91 Waiver service provider--Adults (DHS/DDD) BARBARA OLSON CENTER OF HOPE 611011756 109 Winnebago 0 0 0 0 0 0 0 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1360386.68 0 0 0 0 0 0 0 0 0 0 0 0 0 1360386.68 0 0 0 1101163835 1386838399 10 Physicians HOFF STEPHANIE 527325067 816 Iowa 0 1 Family Practice 0 23 0 0 0 0 0 0 0 0 0 34 0 58 0 0 0 0 0 0 216 0 0 0 0 0 0 0 0 0 174 0 151 0 0 0 0 0 0 216 0 0 0 0 0 0 0 0 0 174 0 151 0 0 0 0 0 0 570 0 0 0 0 0 0 0 0 0 1325.35 0 9528.25 0 0 0 0 0 0 11423.6 0 0 0 1101163839 1497723951 16 Nurse Practitioners VAN DEN LANGENBERG BETH 535625531 852 Wisconsin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 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 0 500.86 0 0 0 0 0 0 500.86 0 0 0 1101163847 1336250380 10 Physicians VIERLING TIMOTHY 905859518 30 DuPage 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 7 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25.57 0 8677.83 0 0 0 0 0 0 8703.4 0 0 0 1101163850 1134331382 10 Physicians WELLEN JASON 631101010 826 Missouri 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3288.94 0 0 0 0 0 0 3288.94 0 0 0 1101163859 10 Physicians 826 Missouri 0 0 Emergency Medicine 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80.63 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 2305 0 0 0 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 2305 0 0 0 0 398.44 0 0 0 0 0 0 0 0 0 0 0 0 0 22997.45 0 23395.89 0 0 0 1101163918 16 Nurse Practitioners 816 Iowa 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 0 1101163923 1134227135 10 Physicians MALCOTT JOHN 626503918 77 Morgan 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1585.11 0 0 0 0 0 0 1585.11 0 0 0 1101163946 1255568853 10 Physicians MOHIUDDIN SHAHAB 999999999 10 Adams 0 0 0 42 0 0 4 0 0 0 0 0 0 0 0 238 0 0 0 0 0 0 164 0 0 12 0 0 0 0 0 0 0 0 331 0 0 0 0 0 0 164 0 0 12 0 0 0 0 0 0 0 0 331 0 0 0 0 0 0 465 0 0 408.44 0 0 0 0 0 0 0 0 12338.45 0 0 0 0 0 0 13211.89 0 0 0 1101163952 1992781702 10 Physicians HALL CALVIN H 606162477 200 Cook 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 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Dermatology 0 0 0 0 0 0 0 0 0 0 0 171 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 231 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 231 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4652.89 0 51.84 0 0 0 0 0 0 4704.73 0 0 0 1101163975 1588785307 55 Early Intervention Services TANNER DEBRA 629342613 38 Gallatin 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 0 385 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 385 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24903.5 0 0 0 0 0 0 24903.5 0 0 0 1101163979 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 0 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8758.75 0 0 0 0 0 0 0 0 0 0 0 0 0 8758.75 0 0 0 1101163981 91 Waiver service provider--Adults (DHS/DDD) 76 Montgomery 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 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6336 0 0 0 0 0 0 0 0 0 0 0 0 0 6336 0 0 0 1101164000 1598883613 48 Rural Health Clinics SULLIVAN CLINIC 619519490 78 Moultrie 0 1 0 415 413 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3896 2405 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3896 2405 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9745 97627.92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107372.92 0 0 0 1101164005 1275508731 10 Physicians CLASEN JACLYNN 601374402 30 DuPage 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 7 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 162.14 0 1543.58 0 0 0 0 0 0 1705.72 0 0 0 1101164019 1093779084 10 Physicians CHIOU DAVID 600302076 57 Lake 0 1 Internal Medicine 0 48 0 0 0 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 66 0 0 0 0 0 0 0 0 0 0 0 409 0 0 0 0 0 0 66 0 0 0 0 0 0 0 0 0 0 0 409 0 0 0 0 0 0 198 0 0 0 0 0 0 0 0 0 0 0 5184.16 0 0 0 0 0 0 5382.16 0 0 0 1101164024 1144261017 60 Pharmacies CVS PHARMACY 08656 612014705 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 390 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3422 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89701 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 185360.96 0 0 0 185360.96 0 0 0 1101164031 92 Waiver service provider--Disability (DHS/DRS) 63 Macon 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 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8450.05 0 0 0 0 0 0 0 0 0 0 0 0 0 8450.05 0 0 0 1101164034 1831483882 10 Physicians BOYD MOLLI 605277594 30 DuPage 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2777.75 0 0 0 0 0 0 2777.75 0 0 0 1101164048 1760750665 61 Independent Laboratories LONG TERM CARE LABORATORY LLC 600076311 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 253 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2677 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2677 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15602.9 0 0 0 0 0 0 0 0 15602.9 0 0 0 1101164049 1861466856 10 Physicians TURK REBECCA 603022361 200 Cook 0 1 Pediatrics 0 4 0 0 8 0 0 0 0 0 0 5 0 12 0 0 0 0 0 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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 9768.46 0 0 0 0 0 0 0 0 0 0 0 0 0 9768.46 0 0 0 1101164121 91 Waiver service provider--Adults (DHS/DDD) 53 Kane 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 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 0 409.2 0 0 0 0 0 0 0 0 0 0 0 0 0 409.2 0 0 0 1101164126 1114913910 10 Physicians KARLSSON TROY 605044283 30 DuPage 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 15 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65.9 0 1035.09 0 0 0 0 0 0 1100.99 0 0 0 1101164138 1750533584 16 Nurse Practitioners MOODY KAREN 625264163 63 Macon 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 14 0 0 0 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 0 537.37 0 0 0 0 0 0 537.37 0 0 0 1101164139 1922199967 10 Physicians ALBASHA MARIA 611071449 109 Winnebago 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 196 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 196 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1184.46 0 0 0 0 0 0 1184.46 0 0 0 1101164140 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18316.84 0 0 0 0 0 0 0 0 0 0 0 0 0 18316.84 0 0 0 1101164141 1295709228 13 Podiatrists LAVEAU ROBERT 600045829 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 234 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 486 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 486 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17209.27 0 0 0 0 0 0 17209.27 0 0 0 1101164143 14 Chiropractors 97 Stephenson 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 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 0 141.79 0 0 0 0 0 0 141.79 0 0 0 1101164147 1740260736 10 Physicians KUYAKANON W 612822904 89 Rock Island 0 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1101164184 1598825366 10 Physicians NEMRI MOURICE 604631149 200 Cook 0 1 Pediatrics 0 1596 0 0 951 0 0 0 0 0 0 189 0 1027 0 0 0 0 0 0 13709 0 0 3740 0 0 0 0 0 0 213 0 2574 0 0 0 0 0 0 13709 0 0 3740 0 0 0 0 0 0 213 0 2574 0 0 0 0 0 0 27419 0 0 109046.21 0 0 0 0 0 0 2532.92 0 88810.45 0 0 0 0 0 0 227808.58 0 0 0 1101164188 92 Waiver service provider--Disability (DHS/DRS) 107 Will 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 10083.32 0 0 0 0 0 0 0 0 0 0 0 0 0 10083.32 0 0 0 1101164195 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8965.73 0 0 0 0 0 0 0 0 0 0 0 0 0 8965.73 0 0 0 1101164196 1659491264 10 Physicians YOHANNA DANIEL 605275993 30 DuPage 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 890.73 0 0 0 0 0 0 890.73 0 0 0 1101164198 1205857018 16 Nurse Practitioners PFETTSCHER LADONNA M 477140556 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1025.99 0 0 0 0 0 0 1025.99 0 0 0 1101164203 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 31378.66 0 0 0 0 0 0 0 0 0 0 0 0 0 31378.66 0 0 0 1101164229 98 Waiver service provider--TBI (DHS/DRS) 69 Massac 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154.22 0 0 0 0 0 0 0 0 0 0 0 0 0 154.22 0 0 0 1101164231 1982876397 10 Physicians CONNEELY KERRY 601691019 200 Cook 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 752 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1076 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1076 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20172.21 0 1418.3 0 0 0 0 0 0 21590.51 0 0 0 1101164245 1760484042 10 Physicians CASTELINO AJITH 606101157 200 Cook 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 0 113 0 409 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 667 0 3065 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 667 0 3065 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5885.55 0 21022.06 0 0 0 0 0 0 26907.61 0 0 0 1101164248 1568461226 10 Physicians SHOULTS KEVIN 600107509 57 Lake 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2123.11 0 0 0 0 0 0 2123.11 0 0 0 1101164255 1427083062 10 Physicians WILSNACK JOEL 606031882 200 Cook 0 1 Internal Medicine 0 3 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 752.62 0 0 0 0 0 0 761.62 0 0 0 1101164291 92 Waiver service provider--Disability (DHS/DRS) 37 Fulton 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 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20512.18 0 0 0 0 0 0 0 0 0 0 0 0 0 20512.18 0 0 0 1101164293 1558560136 12 Optometrists CARTER ANTHONY 614020179 56 Knox 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 185 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 185 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2795.26 0 957.67 0 0 0 0 3752.93 0 0 0 1101164295 10 Physicians 200 Cook 0 0 Radiology 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14.8 0 0 0 0 0 0 14.8 0 0 0 1101164331 1639231731 75 Department of Alcohol and Substance Abuse Provider HERITAGE BEHAVIORAL HEALTH CTR 625231206 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 414 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2827 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4990 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 366917.56 0 0 366917.56 0 0 0 1101164335 1972578375 10 Physicians FRANGELLA BRIDGET 601082227 30 DuPage 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 4 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 202.67 0 978.37 0 0 0 0 0 0 1181.04 0 0 0 1101164342 14 Chiropractors 98 Tazewell 0 0 0 0 0 0 0 0 0 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 23 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 0 0 0 0 0 0 0 0 256.17 0 0 0 0 0 0 256.17 0 0 0 1101164353 1285846162 10 Physicians RICE CLIFFORD 602011718 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 380 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 439 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 439 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13981.77 0 0 0 0 0 0 13981.77 0 0 0 1101164354 1558304063 10 Physicians LEHMANN MICHAEL 532024809 852 Wisconsin 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 970 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1052 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1052 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33168.79 0 0 0 0 0 0 33168.79 0 0 0 1101164357 22 Physical Therapists 57 Lake 0 0 0 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 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 495.78 495.78 0 0 0 1101164371 2100154789 10 Physicians HAUGH ROBERT 420033813 818 Kentucky 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 617 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5358 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5358 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19109.82 0 0 0 0 0 0 0 0 19109.82 0 0 0 1101164379 1467688010 55 Early Intervention Services VORONA PEGGY 601953225 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 496 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 496 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45148.88 0 0 0 0 0 0 45148.88 0 0 0 1101164381 91 Waiver service provider--Adults (DHS/DDD) 11 Alexander 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 0 240 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 240 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11294.09 0 0 0 0 0 0 0 0 0 0 0 0 0 11294.09 0 0 0 1101164390 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9326.62 0 0 0 0 0 0 0 0 0 0 0 0 0 9326.62 0 0 0 1101164400 1245339944 10 Physicians HARRIS GARY B 600674531 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4166.7 0 0 0 0 0 0 4166.7 0 0 0 1101164401 1376771972 30 General Hospitals YORKVILLE DIALYSIS CENTER LLC 605605600 55 Kendall DIALYSIS Outpatient dialysis centers. 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1287 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 110245.34 0 0 0 0 0 110245.34 0 0 0 1101164418 1326226564 29 ICF/MR 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0 1101164471 1811031818 34 State-operated facility (DHS) UNIT 8172 2A FOX 604201322 61 Livingston 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 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2821 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1993006.94 0 0 0 0 0 0 0 0 0 0 1993006.94 0 0 0 1101164504 1558316117 10 Physicians NISIPEANU OANA 600615257 57 Lake 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 442 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 477 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 477 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18481.27 0 0 0 0 0 0 18481.27 0 0 0 1101164515 1043205107 10 Physicians FU YIPING 600454833 57 Lake 0 0 Pulmonary Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 512 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 512 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8961.29 0 0 0 0 0 0 8961.29 0 0 0 1101164521 1528084886 10 Physicians METROU BESS 606233501 200 Cook 0 0 Family Practice 0 0 0 0 10 0 0 0 0 0 0 2 0 175 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 2 0 255 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 2 0 255 0 0 0 0 0 0 0 0 0 353.65 0 0 0 0 0 0 19.03 0 7385.79 0 0 0 0 0 0 7758.47 0 0 0 1101164528 1730362815 94 Waiver service provider--Children's support (DHS/DDD) NORTHPOINTE RESOURCES INC 600993662 57 Lake 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 0 231 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 231 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13042.99 0 0 0 0 0 0 0 0 0 0 0 0 0 13042.99 0 0 0 1101164540 1952599482 10 Physicians KIEFER PETER J 600182110 57 Lake 0 1 Family Practice 0 41 0 0 11 0 0 0 0 0 0 1 0 65 0 0 0 0 0 0 273 0 0 23 0 0 0 0 0 0 2 0 140 0 0 0 0 0 0 273 0 0 23 0 0 0 0 0 0 2 0 140 0 0 0 0 0 0 695 0 0 1188.18 0 0 0 0 0 0 34 0 3949.98 0 0 0 0 0 0 5867.16 0 0 0 1101164547 1962414961 63 Other Providers of Medical Equipment/Supplies (Non-registered) CORTESE FOOT AND ANKLE CLINIC 617616160 72 McLean 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 769.12 0 304.97 0 0 0 0 1074.09 0 0 0 1101164559 55 Early Intervention Services 200 Cook 0 0 0 0 0 0 0 0 0 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 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2414.09 0 0 0 0 0 0 2414.09 0 0 0 1101164560 1205983871 10 Physicians KUMAR ASHOK 628390040 22 Clay 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 7 0 339 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 1852 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 1852 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9.21 0 96224.95 0 0 0 0 0 0 96234.16 0 0 0 1101164565 1457315624 10 Physicians TIERNEY SEAN 604062402 200 Cook 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 480 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 970 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 970 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6432.67 0 0 0 0 0 0 6432.67 0 0 0 1101164602 1306877451 60 Pharmacies KMART PHARMACY 4984 604772576 200 Cook 0 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 0 556 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13576 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27157.85 0 0 0 27157.85 0 0 0 1101164603 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 18757.4 0 0 0 0 0 0 0 0 0 0 0 0 0 18757.4 0 0 0 1101164607 1316087059 23 Occupational Therapists LENKE MAUREEN 600563425 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1991.4 1991.4 0 0 0 1101164609 1801806054 10 Physicians SCALZO ANTHONY 631102515 826 Missouri 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3217.48 0 0 0 0 0 0 3217.48 0 0 0 1101164619 1225202492 16 Nurse Practitioners BAUER SHELLY 600987530 71 McHenry 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 138 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 138 0 0 0 0 0 0 0 0 0 167.15 0 0 0 0 0 0 0 0 1739.86 0 0 0 0 0 0 1907.01 0 0 0 1101164621 1275570699 10 Physicians HILLMAN SHONA M 616360001 200 Cook 0 0 Family Practice 0 788 0 0 25 0 0 0 0 0 0 6 0 147 0 0 0 0 0 0 3765 0 0 62 0 0 0 0 0 0 7 0 305 0 0 0 0 0 0 3765 0 0 62 0 0 0 0 0 0 7 0 305 0 0 0 0 0 0 8973 0 0 2408.28 0 0 0 0 0 0 12.68 0 7652.81 0 0 0 0 0 0 19046.77 0 0 0 1101164639 92 Waiver service provider--Disability (DHS/DRS) 60 Lee 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 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32588 0 0 0 0 0 0 0 0 0 0 0 0 0 32588 0 0 0 1101164644 1043363708 10 Physicians GNATENCO CARMEN 604532504 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 248 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 248 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1050.45 0 0 0 0 0 0 1050.45 0 0 0 1101164647 92 Waiver service provider--Disability (DHS/DRS) 57 Lake 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 16349.84 0 0 0 0 0 0 0 0 0 0 0 0 0 16349.84 0 0 0 1101164669 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17061 0 0 0 0 0 0 0 0 0 0 0 0 0 17061 0 0 0 1101164670 13 Podiatrists 816 Iowa 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 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 0 0 0 0 0 0 0 0 0 0 0 1101164674 1003980111 60 Pharmacies MARISSA DISCOUNT PHARMACY 622571141 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 211 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2814 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75624 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100311.84 0 0 0 100311.84 0 0 0 1101164685 1538177373 36 Community mental health provider UNION COUNTY COUNSELING SVCS 629061549 99 Union 0 0 0 138 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 314 0 0 272 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3360 0 0 272 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3360 0 0 9545.17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 219480.65 0 0 229025.82 0 0 0 1101164686 1275520132 10 Physicians KIM JAMES 605131252 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 3 0 0 0 0 0 0 42 0 219 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 71 0 468 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 71 0 468 0 0 0 0 0 0 0 0 0 295.57 0 0 0 0 0 0 574.28 0 43946.01 0 0 0 0 0 0 44815.86 0 0 0 1101164691 10 Physicians 852 Wisconsin 0 0 Emergency Medicine 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 0 160.21 0 0 0 0 0 0 160.21 0 0 0 1101164692 1710971288 33 Nursing Facilities HICKORY NURSING PAVILION 604572066 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 672 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16382 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1765909.56 0 0 0 0 0 0 0 1765909.56 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 23622.95 0 0 0 1101164731 1053341248 10 Physicians SRIVASTAVA RAJNI 605252041 200 Cook 0 1 Obstetric-Gynecology 0 68 0 0 1 0 0 0 0 0 0 32 0 110 0 0 0 0 0 0 284 0 0 1 0 0 0 0 0 0 66 0 191 0 0 0 0 0 0 284 0 0 1 0 0 0 0 0 0 66 0 191 0 0 0 0 0 0 846 0 0 104.96 0 0 0 0 0 0 153.57 0 26939.22 0 0 0 0 0 0 28043.75 0 0 0 1101164736 92 Waiver service provider--Disability (DHS/DRS) 79 Ogle 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 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 0 306.75 0 0 0 0 0 0 0 0 0 0 0 0 0 306.75 0 0 0 1101164737 1235399304 10 Physicians MCHALE SARA A 946081826 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 238 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 238 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4849.77 0 0 0 0 0 0 4849.77 0 0 0 1101164741 1376530766 33 Nursing Facilities ALDEN PARK STRATHMOOR 611075110 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1663 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42995 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5381775.51 0 0 0 0 0 0 0 5381775.51 0 0 0 1101164748 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 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 7255.48 0 0 0 0 0 0 0 0 0 0 0 0 0 7255.48 0 0 0 1101164757 1467749085 55 Early Intervention Services BAULT KELLY 613504304 58 La Salle 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 417 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 417 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18715.76 0 0 0 0 0 0 18715.76 0 0 0 1101164773 1316178064 60 Pharmacies CVS PHARMACY 07017 617047117 72 McLean 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 700 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3231 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76219 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120240.11 0 0 0 120240.11 0 0 0 1101164785 1386932028 16 Nurse Practitioners WHITAKER KELLY 622697287 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 264 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3752 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3752 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1292.38 0 0 0 0 0 0 1292.38 0 0 0 1101164794 1932197134 10 Physicians AHMAD SHIREEN 606114402 200 Cook 0 0 Anesthesiology 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 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3791.12 0 0 0 0 0 0 3791.12 0 0 0 1101164811 1699978791 10 Physicians MURTHY AMISHI 602012475 200 Cook 0 0 Allergy-Immunization 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 328 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 328 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11626.1 0 0 0 0 0 0 11626.1 0 0 0 1101164824 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9504 0 0 0 0 0 0 0 0 0 0 0 0 0 9504 0 0 0 1101164828 10 Physicians 826 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4400.98 0 0 0 1101164862 1538129275 10 Physicians LESLIE WILLIAM 606751611 200 Cook 0 0 Oncology 0 0 0 0 0 0 0 0 0 0 0 0 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 364 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 364 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2999.15 0 0 0 0 0 0 2999.15 0 0 0 1101164867 92 Waiver service provider--Disability (DHS/DRS) 68 Mason 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 568.74 0 0 0 0 0 0 0 0 0 0 0 0 0 568.74 0 0 0 1101164873 2100155291 91 Waiver service provider--Adults (DHS/DDD) ROCK RIVER VALLEY SELF HELP EN 610817703 106 Whiteside 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18637 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18637 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1194712.08 0 0 0 0 0 0 0 0 0 0 0 0 0 1194712.08 0 0 0 1101164877 11 Dentists 200 Cook 0 0 General Dentistry 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 0 405.88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 405.88 0 0 0 1101164883 1457364903 10 Physicians BENNETT DAVID 606253642 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16978.92 0 0 0 0 0 0 16978.92 0 0 0 1101164891 1902832397 10 Physicians FASEHUN TAIWO 600505434 71 McHenry 0 1 Pediatrics 0 6 0 0 12 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 11 0 0 28 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 11 0 0 28 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 22 0 0 1000.37 0 0 0 0 0 0 0 0 2433.24 0 0 0 0 0 0 3455.61 0 0 0 1101164893 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 22587.66 0 0 0 0 0 0 0 0 0 0 0 0 0 22587.66 0 0 0 1101164894 1376677187 16 Nurse Practitioners FELT TRACEY R. 602011718 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 134.66 0 0 0 0 0 0 134.66 0 0 0 1101164896 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 347 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 347 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22156.2 0 0 0 0 0 0 0 0 0 0 0 0 0 22156.2 0 0 0 1101164909 1043384761 22 Physical Therapists MULVEY THOMAS 604561135 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 188 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 188 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3559.33 3559.33 0 0 0 1101164923 1427064708 16 Nurse Practitioners BAGGE MARLA J 601874069 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2337.46 0 0 0 0 0 0 2337.46 0 0 0 1101164924 1912002882 10 Physicians DELOSO DAVID 628642857 49 Jefferson 0 1 Pediatrics 0 776 0 0 511 0 0 0 0 0 0 15 0 705 0 0 0 0 0 0 7589 0 0 1880 0 0 0 0 0 0 15 0 1989 0 0 0 0 0 0 7589 0 0 1880 0 0 0 0 0 0 15 0 1989 0 0 0 0 0 0 15178 0 0 56848.25 0 0 0 0 0 0 166.95 0 75614.57 0 0 0 0 0 0 147807.77 0 0 0 1101164926 1740244151 10 Physicians DILLEY KIMBERLEY 60453 200 Cook 0 1 Family Practice 0 158 0 0 783 0 0 0 0 0 0 40 0 544 0 0 0 0 0 0 382 0 0 2379 0 0 0 0 0 0 41 0 645 0 0 0 0 0 0 382 0 0 2379 0 0 0 0 0 0 41 0 645 0 0 0 0 0 0 816 0 0 73266.6 0 0 0 0 0 0 203.97 0 26367.08 0 0 0 0 0 0 100653.65 0 0 0 1101164929 1124188081 10 Physicians SAEED MOHAMMED M 601376138 30 DuPage 0 1 Internal Medicine 0 32 0 0 4 0 0 0 0 0 0 21 0 178 0 0 0 0 0 0 105 0 0 9 0 0 0 0 0 0 45 0 810 0 0 0 0 0 0 105 0 0 9 0 0 0 0 0 0 45 0 810 0 0 0 0 0 0 236 0 0 303.13 0 0 0 0 0 0 328.34 0 9961.57 0 0 0 0 0 0 10829.04 0 0 0 1101164955 1033398482 63 Other Providers of Medical Equipment/Supplies (Non-registered) HUEYS HOME MEDICAL 618202153 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 776 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 776 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16994.36 0 0 0 0 0 0 16994.36 0 0 0 1101164956 22 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 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2307.48 2307.48 0 0 0 1101164978 1306898960 30 General Hospitals ST VINCENT HOSPITAL 462601902 815 Indiana NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 5 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 288.37 0 0 1.06 0 0 0 0 0 289.43 0 0 0 1101164983 91 Waiver service provider--Adults (DHS/DDD) 41 Hamilton 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 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10106.25 0 0 0 0 0 0 0 0 0 0 0 0 0 10106.25 0 0 0 1101164989 1366561458 10 Physicians NGUYEN DUYHUU 606118709 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 317 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 317 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4232.99 0 0 0 0 0 0 4232.99 0 0 0 1101164991 1629024013 60 Pharmacies OSCO DRUG 3721 606382743 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 447 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2057 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50655 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82240.62 0 0 0 82240.62 0 0 0 1101164996 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 19 0 0 0 0 0 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 15988.84 0 0 0 0 0 0 0 0 0 0 0 0 0 15988.84 0 0 0 1101165023 1639172026 10 Physicians KASTE SUE 381052794 844 Tennessee 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 14 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 594.56 0 26.12 0 0 0 0 0 0 620.68 0 0 0 1101165034 1285687996 63 Other Providers of Medical Equipment/Supplies (Non-registered) BONUTTI ORTHOPEDIC SERVICES LT 624011619 33 Effingham 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 138 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 408.25 0 9889.93 0 0 0 0 10298.18 0 0 0 1101165038 92 Waiver service provider--Disability (DHS/DRS) 52 Johnson 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 18426.32 0 0 0 0 0 0 0 0 0 0 0 0 0 18426.32 0 0 0 1101165048 1598899759 24 Speech Therapists BOLTZ MELISSA 606146005 200 Cook 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 0 288 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 288 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29684.98 29684.98 0 0 0 1101165051 11 Dentists 200 Cook 0 0 General Dentistry 0 0 0 1 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 30.45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30.45 0 0 0 1101165058 1720203086 10 Physicians AHMAD TANVEER 600983713 71 McHenry 0 1 Internal Medicine 0 3 0 0 0 0 0 0 0 0 0 15 0 109 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 26 0 873 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 26 0 873 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 359.46 0 2734.82 0 0 0 0 0 0 3163.28 0 0 0 1101165061 1134238728 10 Physicians LEE RICHARD 631102515 826 Missouri 0 0 Thoracic Surgery 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 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 7383.86 0 0 0 0 0 0 7383.86 0 0 0 1101165068 1912936600 63 Other Providers of Medical Equipment/Supplies (Non-registered) HEALTHCARE EQUIP AND SUPPLY 637751837 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 172 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 824 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 824 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43374.53 0 2628.12 0 0 0 0 46002.65 0 0 0 1101165072 22 Physical Therapists 58 La Salle 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 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 0 108.31 108.31 0 0 0 1101165076 91 Waiver service provider--Adults (DHS/DDD) 108 Williamson 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 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12777.24 0 0 0 0 0 0 0 0 0 0 0 0 0 12777.24 0 0 0 1101165078 1750411138 63 Other Providers of Medical Equipment/Supplies (Non-registered) FIRST LINE MEDICAL SUPPLIES 600903120 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 910 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13925 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13925 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 819519.85 0 3458.59 0 0 0 0 822978.44 0 0 0 1101165108 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 2851.2 0 0 0 0 0 0 0 0 0 0 0 0 0 2851.2 0 0 0 1101165110 1760593693 10 Physicians KHAN FARHAN 611042315 109 Winnebago 0 0 Nephrology 0 0 0 0 0 0 0 0 0 0 0 12 0 301 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 989 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 989 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51.77 0 31840.04 0 0 0 0 0 0 31891.81 0 0 0 1101165122 92 Waiver service provider--Disability (DHS/DRS) 91 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1383.5 0 0 0 0 0 0 0 0 0 0 0 0 0 1383.5 0 0 0 1101165141 47 Local Education Agencies 15 Bureau 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 384 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 384 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10437.64 0 10437.64 0 0 0 1101165146 1124033428 60 Pharmacies BOND DRUG COMPANY OF ILLINOIS 604303505 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 942 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3696 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86228 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 172964.42 0 0 0 172964.42 0 0 0 1101165147 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24233.7 0 0 0 0 0 0 0 0 0 0 0 0 0 24233.7 0 0 0 1101165149 1578570701 11 Dentists HYTEN ROBERT 622311437 23 Clinton 0 0 General Dentistry 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 347 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 347 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9361.45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9361.45 0 0 0 1101165150 92 Waiver service provider--Disability (DHS/DRS) 108 Williamson 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 7522.93 0 0 0 0 0 0 0 0 0 0 0 0 0 7522.93 0 0 0 1101165163 1669456406 10 Physicians MAMON JOHN 604532600 200 Cook 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 770 0 290 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 992 0 497 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 992 0 497 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10862.45 0 9072.68 0 0 0 0 0 0 19935.13 0 0 0 1101165171 92 Waiver service provider--Disability (DHS/DRS) 46 Iroquois 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20240.66 0 0 0 0 0 0 0 0 0 0 0 0 0 20240.66 0 0 0 1101165172 1700862331 64 Imaging Services METRO MRI CENTER LIMITED 527221656 816 Iowa 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1208.46 0 0 0 0 0 0 1208.46 0 0 0 1101165215 1245202613 16 Nurse Practitioners HANSELMAN CHRISTINA 631312329 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 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 0 706.03 0 0 0 0 0 0 706.03 0 0 0 1101165216 1588755409 10 Physicians RIAZUDDIN MOHAMMED 604904949 107 Will 0 0 General Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 77 0 0 0 0 0 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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 16359.61 0 0 0 0 0 0 0 0 0 0 0 0 0 16359.61 0 0 0 1101165833 1447366240 10 Physicians WALJI AIJAZ 604358200 107 Will 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 603 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 723 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 723 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33936.01 0 0 0 0 0 0 33936.01 0 0 0 1101165835 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 325 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 325 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11627.4 0 0 0 0 0 0 0 0 0 0 0 0 0 11627.4 0 0 0 1101165837 10 Physicians 815 Indiana 0 0 Anesthesiology 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 281.29 0 0 0 0 0 0 281.29 0 0 0 1101165840 1083819684 10 Physicians AHMED DANISH 608052701 200 Cook 0 0 Internal 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0 0 0 879408.27 0 0 0 0 0 0 0 0 0 0 0 0 0 879408.27 0 0 0 1101165868 92 Waiver service provider--Disability (DHS/DRS) 30 DuPage 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 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 5156.14 0 0 0 0 0 0 0 0 0 0 0 0 0 5156.14 0 0 0 1101165877 1003823220 10 Physicians SHAH RIAZ 616042867 80 Peoria 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 268 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 268 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4675.42 0 0 0 0 0 0 4675.42 0 0 0 1101165879 1144227737 10 Physicians BOAS STEVEN 600257645 200 Cook 0 0 Pediatrics 0 0 0 0 5 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 274 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 274 0 0 0 0 0 0 0 0 0 83.13 0 0 0 0 0 0 0 0 9767.62 0 0 0 0 0 0 9850.75 0 0 0 1101165893 1417954165 63 Other Providers of Medical Equipment/Supplies (Non-registered) ACTIVSTYLE INC 554132638 824 Minnesota 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11961 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 181345 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 181345 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10473987.63 0 0 0 0 0 0 10473987.63 0 0 0 1101165894 10 Physicians 57 Lake 0 0 Internal Medicine 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 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 50.57 0 0 0 0 0 0 50.57 0 0 0 1101165898 1629029426 10 Physicians GOSAIN ARUN 606116649 200 Cook 0 0 Plastic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40671.51 0 0 0 0 0 0 40671.51 0 0 0 1101165899 36 Community mental health provider 57 Lake 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101165916 1922150598 10 Physicians ERNST LINDA 606118709 200 Cook 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 114 0 0 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0 1861 0 0 1006.36 0 0 0 0 0 0 404.15 0 10647.11 0 0 0 0 0 0 13918.62 0 0 0 1101165966 1417059007 10 Physicians LEGURSKY CLARE 600141726 71 McHenry 0 1 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 42 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 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2562.22 0 0 0 0 0 0 2562.22 0 0 0 1101165968 1518241017 11 Dentists SHARMA VINEET 604061493 200 Cook 0 0 General Dentistry 0 0 0 1039 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4556 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4556 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 124804.65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 124804.65 0 0 0 1101165982 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11116.84 0 0 0 0 0 0 0 0 0 0 0 0 0 11116.84 0 0 0 1101165997 1316032741 10 Physicians GOYAL SAGUN 631102515 826 Missouri 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 622.28 0 0 0 0 0 0 622.28 0 0 0 1101166002 1568481919 12 Optometrists BRUCE MICHAEL 627022562 91 Sangamon 0 0 Therapeutic Pharmaceutical Agents 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 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 0 407.45 0 0 0 0 0 0 407.45 0 0 0 1101166003 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 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 14763.9 0 0 0 0 0 0 0 0 0 0 0 0 0 14763.9 0 0 0 1101166011 1669608394 16 Nurse Practitioners KOBLER JASON 616159506 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 824.41 0 0 0 0 0 0 824.41 0 0 0 1101166012 1992898258 10 Physicians STALTER LARRY 617400299 61 Livingston 0 1 Family Practice 0 176 0 0 18 0 0 0 0 0 0 34 0 171 0 0 0 0 0 0 1686 0 0 25 0 0 0 0 0 0 58 0 389 0 0 0 0 0 0 1686 0 0 25 0 0 0 0 0 0 58 0 389 0 0 0 0 0 0 4238 0 0 1457.99 0 0 0 0 0 0 541.04 0 10523.06 0 0 0 0 0 0 16760.09 0 0 0 1101166026 2100156444 90 Waiver service provider--Elderly (DOA) CARELINK INC 999999999 10 Adams 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 1260 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1260 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57012.73 0 0 0 0 0 0 0 0 0 0 0 0 0 57012.73 0 0 0 1101166028 1023072394 10 Physicians SHIMONY JOSHUA 633101016 826 Missouri 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 357 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 511 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 511 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30702.69 0 124.22 0 0 0 0 0 0 30826.91 0 0 0 1101166030 1972873271 16 Nurse Practitioners ZONFRILLI MARY JAYNE 618012500 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2967.48 0 0 0 0 0 0 2967.48 0 0 0 1101166031 2100156449 98 Waiver service provider--TBI (DHS/DRS) AMERICAN MEDICAL ALERT CORP 604433803 200 Cook 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 755 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 755 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14592.77 0 0 0 0 0 0 0 0 0 0 0 0 0 14592.77 0 0 0 1101166034 1932304789 28 Waiver service provider--Supportive living facility (HFS) CAMBRIDGE HOUSE 622691957 96 St Clair 0 0 0 0 0 0 0 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27439 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1330769.42 0 0 0 0 0 0 0 0 0 0 0 0 0 1330769.42 0 0 0 1101166043 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24078 0 0 0 0 0 0 0 0 0 0 0 0 0 24078 0 0 0 1101166064 1275799785 10 Physicians NAUMANN SHANNON 622265360 96 St Clair 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 229 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 243 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 243 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7963.66 0 0 0 0 0 0 7963.66 0 0 0 1101166071 1073522249 10 Physicians SHU NAI 622212491 96 St Clair 0 0 General Practice 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 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45.52 0 0 0 0 0 0 45.52 0 0 0 1101166101 1386914372 33 Nursing Facilities PERSHING GARDENS HC CENTER 604024168 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 355 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8758 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 848585.68 0 0 0 0 0 0 0 848585.68 0 0 0 1101166105 1831263797 63 Other Providers of Medical Equipment/Supplies (Non-registered) HANGER PROSTHETICS ORTHOTICS 627024922 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 501 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 501 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14871.41 0 109874.77 0 0 0 0 124746.18 0 0 0 1101166106 92 Waiver service provider--Disability (DHS/DRS) 826 Missouri 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 10198.66 0 0 0 0 0 0 0 0 0 0 0 0 0 10198.66 0 0 0 1101166108 1013143494 13 Podiatrists WILLIAMS MICHAEL 606545704 200 Cook 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 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 808.57 0 0 0 0 0 0 808.57 0 0 0 1101166143 1134211956 10 Physicians BHATIA MOTILAL 604292056 200 Cook 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 258 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 439 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 439 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23563.25 0 0 0 0 0 0 23563.25 0 0 0 1101166165 1770608903 11 Dentists RAMADORAI THIRUNINDRAVUR 604352926 107 Will 0 0 General Dentistry 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 212 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 212 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5145.21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5145.21 0 0 0 1101166170 92 Waiver service provider--Disability (DHS/DRS) 89 Rock Island 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 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9197.88 0 0 0 0 0 0 0 0 0 0 0 0 0 9197.88 0 0 0 1101166175 30 General Hospitals 826 Missouri NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91.67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91.67 0 0 0 1101166202 1750307997 10 Physicians ZAZULIA ALLYSON 631101010 826 Missouri 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 385.25 0 0 0 0 0 0 385.25 0 0 0 1101166226 10 Physicians 91 Sangamon 0 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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 12246.32 0 0 0 0 0 0 0 0 0 0 0 0 0 12246.32 0 0 0 1101166529 55 Early Intervention Services 96 St Clair 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 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2878.39 0 0 0 0 0 0 2878.39 0 0 0 1101166543 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 21415.93 0 0 0 0 0 0 0 0 0 0 0 0 0 21415.93 0 0 0 1101166547 1942292412 10 Physicians JONES DAVID 625214665 63 Macon 0 1 Family Practice 0 26 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 357 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 407 0 0 0 1101166559 1992735526 10 Physicians PATEL BHARAT 629600191 69 Massac 0 1 Cardiovascular Diseases 0 53 0 0 0 0 0 0 0 0 0 3 0 804 0 0 0 0 0 0 501 0 0 0 0 0 0 0 0 0 3 0 2423 0 0 0 0 0 0 501 0 0 0 0 0 0 0 0 0 3 0 2423 0 0 0 0 0 0 1587 0 0 0 0 0 0 0 0 0 19.98 0 35886.17 0 0 0 0 0 0 37493.15 0 0 0 1101166568 91 Waiver service provider--Adults (DHS/DDD) 53 Kane 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 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9411.6 0 0 0 0 0 0 0 0 0 0 0 0 0 9411.6 0 0 0 1101166575 1427032457 30 General Hospitals KEOKUK AREA HOSPITAL 526323456 816 Iowa NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 0 0 0 0 2 0 0 0 0 0 0 134 0 0 17 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 562 0 0 22 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 562 0 0 22 0 0 0 0 0 0 0 0 23.08 0 0 0 0 0 0 5728.31 0 0 465.06 0 0 0 0 0 6216.45 0 0 0 1101166584 1538187349 10 Physicians BAILEY THOMAS 631082259 826 Missouri 0 0 Internal Medicine 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 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 322.34 0 0 0 0 0 0 322.34 0 0 0 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0 0 0 0 0.77 0 0 0 0 0 0 0.77 0 0 0 1101166611 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 185 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 185 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20030.11 0 0 0 0 0 0 0 0 0 0 0 0 0 20030.11 0 0 0 1101166613 1407921448 14 Chiropractors GREENBERG RONALD 624500096 88 Richland 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 752 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 752 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4780.8 0 0 0 0 0 0 4780.8 0 0 0 1101166615 1124210570 16 Nurse Practitioners MOYER DEBORAH 605277594 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 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 0 0 0 0 0 0 0 0 0 0 0 1101166638 1114920824 10 Physicians ASIMACOPOULOS VOULA 600684230 200 Cook 0 1 Internal Medicine 0 16 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 0 0 55 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 0 0 55 0 0 0 0 0 0 299 0 0 0 0 0 0 0 0 0 0 0 1983.72 0 0 0 0 0 0 2282.72 0 0 0 1101166646 2100157064 71 Medicar Provider SOUTH CENTRAL ILL MASS TRANSIT 628013149 66 Marion 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 441 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12962 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12962 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114389.38 0 0 0 0 0 0 114389.38 0 0 0 1101166653 92 Waiver service provider--Disability (DHS/DRS) 30 DuPage 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26286.45 0 0 0 0 0 0 0 0 0 0 0 0 0 26286.45 0 0 0 1101166656 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 30334.5 0 0 0 0 0 0 0 0 0 0 0 0 0 30334.5 0 0 0 1101166659 1598730863 64 Imaging Services ADVANTAGE MRI LLC 603021033 200 Cook 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 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 170.22 0 0 0 170.22 0 0 0 1101170978 91 Waiver service provider--Adults (DHS/DDD) 107 Will 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 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16137 0 0 0 0 0 0 0 0 0 0 0 0 0 16137 0 0 0 1101171003 1760505721 10 Physicians STONE ERIN 627023749 91 Sangamon 0 0 Obstetric-Gynecology 0 0 0 0 3 0 0 0 0 0 0 29 0 69 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 41 0 156 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 41 0 156 0 0 0 0 0 0 0 0 0 255.92 0 0 0 0 0 0 2404.74 0 18115.59 0 0 0 0 0 0 20776.25 0 0 0 1101171010 1629057302 30 General Hospitals ST ELIZABETH HOSPITAL 622201915 96 St Clair DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 0 0 0 0 17 0 0 0 0 0 0 731 0 0 322 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 3177 0 0 1088 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 3177 0 0 1088 0 0 0 0 0 0 0 0 116.13 0 0 0 0 0 0 14536.75 0 0 60050.47 0 0 0 0 0 74703.35 0 0 0 1101171042 92 Waiver service 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0 3014.84 0 31808.62 0 0 0 0 0 0 69708.53 0 0 0 1101171086 1316200835 63 Other Providers of Medical Equipment/Supplies (Non-registered) ALL HOME MEDICAL SUPPLY CO 601723574 30 DuPage 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 0 671 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 671 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56560.05 0 0 0 0 0 0 56560.05 0 0 0 1101171095 1164437315 60 Pharmacies BOND DRUG COMPANY OF IL 02828 611045116 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 2079 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 9241 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 201660 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67.24 0 0 375234.83 0 0 0 375302.07 0 0 0 1101171096 1477572022 10 Physicians MEHTA SANJAY 618012530 19 Champaign 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 3 0 685 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 1036 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 1036 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5.58 0 44310.31 0 0 0 0 0 0 44315.89 0 0 0 1101171097 1699066084 10 Physicians SUHAIL JAWARIA 604611010 200 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reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 23 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 8763.19 0 0 0 0 6448.11 0 0 0 0 0 0 0 0 0 15211.3 0 0 0 1101171271 22 Physical Therapists 42 Hancock 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 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 15.64 15.64 0 0 0 1101171276 1467499715 16 Nurse Practitioners KOSTYK MEGHAN 606143363 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 261 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 261 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16196.76 0 0 0 0 0 0 16196.76 0 0 0 1101171283 1285652792 10 Physicians THOMPSON ROBERT 631600352 80 Peoria 0 0 Vascular Surgery 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 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2057.5 0 0 0 0 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Practitioners SPARGUR AMY V 606132729 200 Cook 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 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 467.85 0 0 0 0 0 0 467.85 0 0 0 1101171362 1205947983 16 Nurse Practitioners PENEGOR MARITTA 604611030 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 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 31.88 0 0 0 0 0 0 31.88 0 0 0 1101171364 94 Waiver service provider--Children's support (DHS/DDD) 54 Kankakee 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 0 240 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 240 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14992.18 0 0 0 0 0 0 0 0 0 0 0 0 0 14992.18 0 0 0 1101171374 1396790739 10 Physicians KUDIRKA ANDRIUS 604624508 200 Cook 0 1 Family Practice 0 21 0 0 10 0 0 0 0 0 0 9 0 61 0 0 0 0 0 0 35 0 0 15 0 0 0 0 0 0 9 0 139 0 0 0 0 0 0 35 0 0 15 0 0 0 0 0 0 9 0 139 0 0 0 0 0 0 88 0 0 1170.63 0 0 0 0 0 0 60.18 0 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10 Physicians MATHEW MOLY 601181416 53 Kane 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21073.99 0 0 0 0 0 0 21073.99 0 0 0 1101171795 1225257470 10 Physicians GERWE AMY 628643649 49 Jefferson 0 0 Internal Medicine 0 1161 0 0 149 0 0 0 0 0 0 172 0 884 0 0 0 0 0 0 9087 0 0 182 0 0 0 0 0 0 232 0 2395 0 0 0 0 0 0 9087 0 0 182 0 0 0 0 0 0 232 0 2395 0 0 0 0 0 0 25009 0 0 14384.65 0 0 0 0 0 0 1593.33 0 101838.49 0 0 0 0 0 0 142825.47 0 0 0 1101171810 92 Waiver service provider--Disability (DHS/DRS) 99 Union 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121.47 0 0 0 0 0 0 0 0 0 0 0 0 0 121.47 0 0 0 1101171815 16 Nurse Practitioners 72 McLean 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 99.86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99.86 0 0 0 1101171887 1154321222 10 Physicians CAPECCI PIERO 616052507 80 Peoria 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 54 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78 0 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78 0 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 844.1 0 11955.2 0 0 0 0 0 0 12799.3 0 0 0 1101171894 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 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 0 250.24 0 0 0 0 0 0 0 0 0 0 0 0 0 250.24 0 0 0 1101171902 1932102969 10 Physicians HELFER TAMARA 618203909 19 Champaign 0 0 Obstetrics 0 0 0 0 12 0 0 0 0 0 0 255 0 338 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 996 0 645 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 996 0 645 0 0 0 0 0 0 0 0 0 529.59 0 0 0 0 0 0 23408.37 0 52412.45 0 0 0 0 0 0 76350.41 0 0 0 1101171910 1841213725 10 Physicians KATZ RICHARD 600164029 200 Cook 0 0 Ophthalmology 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 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 214.51 0 0 0 0 0 0 214.51 0 0 0 1101171923 98 Waiver service provider--TBI (DHS/DRS) 80 Peoria 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 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 5006.12 0 0 0 0 0 0 0 0 0 0 0 0 0 5006.12 0 0 0 1101171934 1437180353 40 Federally Qualified Health Centers FARMWORKER HEALTH PROGRAM 629663333 47 Jackson 0 0 Homeless 0 0 91 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 371 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 371 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24254.3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24254.3 0 0 0 1101171935 1770571648 16 Nurse Practitioners SMITH LEX SANDRA 627810001 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 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provider--Disability (DHS/DRS) 200 Cook 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 40524.26 0 0 0 0 0 0 0 0 0 0 0 0 0 40524.26 0 0 0 1101171998 1972559334 10 Physicians MASON JAMES 600073309 200 Cook 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 247 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 247 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2409.58 0 0 0 0 0 0 2409.58 0 0 0 1101172001 94 Waiver service provider--Children's support (DHS/DDD) 30 DuPage 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 0 168.02 0 0 0 0 0 0 0 0 0 0 0 0 0 168.02 0 0 0 1101172002 1720061526 10 Physicians KALIS JOHN 605231806 30 DuPage 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 0 0 0 23 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 0 273.04 0 0 0 0 0 0 273.04 0 0 0 1101172008 1740346451 50 Home Health Agencies - In Home RMC HOME HEALTH CARE 604689590 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 259 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 259 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17649.18 0 0 0 0 0 0 17649.18 0 0 0 1101172011 1679506489 10 Physicians TACHAUER ALLAN 606405759 200 Cook 0 1 Internal Medicine 0 25 0 0 0 0 0 0 0 0 0 12 0 178 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 13 0 474 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 13 0 474 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 22.41 0 8271.33 0 0 0 0 0 0 8393.74 0 0 0 1101172042 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 28179.89 0 0 0 0 0 0 0 0 0 0 0 0 0 28179.89 0 0 0 1101172045 1639334667 10 Physicians GIACOMI MARK 999999999 30 DuPage 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 8 0 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0 0 0 1101172140 1790787570 10 Physicians RYAN TIMOTHY 600312603 57 Lake 0 0 Vascular Surgery 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 23 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 0 0 0 0 0 0 0 0 2423.35 0 0 0 0 0 0 2423.35 0 0 0 1101172147 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 34796.92 0 0 0 0 0 0 0 0 0 0 0 0 0 34796.92 0 0 0 1101172158 1053367201 63 Other Providers of Medical Equipment/Supplies (Non-registered) BALLERT ORTHOPEDIC 606112926 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 889.73 0 10282.14 0 0 0 0 11171.87 0 0 0 1101172160 1225211600 10 Physicians MILLICHAP JOHN 606112991 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 208 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 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0 0 0 0 134.75 0 0 0 0 0 0 134.75 0 0 0 1101172331 10 Physicians 200 Cook 0 0 Neurology 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101172335 1689627010 10 Physicians MATHUR VIRENDRA 604591561 200 Cook 0 1 Internal Medicine 0 68 0 0 2 0 0 0 0 0 0 0 0 88 0 0 0 0 0 0 496 0 0 2 0 0 0 0 0 0 0 0 331 0 0 0 0 0 0 496 0 0 2 0 0 0 0 0 0 0 0 331 0 0 0 0 0 0 1466 0 0 176.27 0 0 0 0 0 0 0 0 4677.43 0 0 0 0 0 0 6319.7 0 0 0 1101172359 1881633949 10 Physicians REDA WILLIAM 606112991 200 Cook 0 0 Neonatology 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 397 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 397 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40364.48 0 0 0 0 0 0 40364.48 0 0 0 1101172361 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4886.45 0 0 0 0 0 0 0 0 0 0 0 0 0 4886.45 0 0 0 1101172375 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 17581.63 0 0 0 0 0 0 0 0 0 0 0 0 0 17581.63 0 0 0 1101172376 1952585812 10 Physicians KANE PATRICK 631366119 826 Missouri 0 0 Emergency Medicine 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 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 0 603.44 0 0 0 0 0 0 603.44 0 0 0 1101172385 91 Waiver service provider--Adults (DHS/DDD) 72 McLean 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 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2877.23 0 0 0 0 0 0 0 0 0 0 0 0 0 2877.23 0 0 0 1101172390 1942403134 47 Local Education Agencies SOUTHEASTERN CU SCH DIST 337 623160247 42 Hancock 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 564 0 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0 3 0 0 0 0 0 0 3 0 6 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 3 0 7 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 3 0 7 0 0 0 0 0 0 0 0 0 179.6 0 0 0 0 0 0 0 0 4.4 0 0 0 0 0 0 184 0 0 0 1101172437 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 240 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 240 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11869.55 0 0 0 0 0 0 0 0 0 0 0 0 0 11869.55 0 0 0 1101172472 1265433890 10 Physicians MOODY LAURA 381123814 844 Tennessee 0 0 Pathology 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 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88.1 0 0 0 0 0 0 0 0 88.1 0 0 0 1101172474 1891807731 60 Pharmacies FARMACIA CUATRO INC 606392505 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 343 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2361 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55897 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61273.44 0 0 0 61273.44 0 0 0 1101172477 16 Nurse Practitioners 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 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KOLANDAIVELU PARASAKTHI 609360000 35 Ford 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2701.79 0 0 0 0 0 0 2701.79 0 0 0 1101172502 1982637450 10 Physicians HOEPER ERIC 600761234 200 Cook 0 1 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 204 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 404 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 404 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14626.42 0 0 0 0 0 0 14626.42 0 0 0 1101172511 2100162929 92 Waiver service provider--Disability (DHS/DRS) NORTHWEST HOME CARE INC 60004 200 Cook 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 524 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 524 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 683687.95 0 0 0 0 0 0 0 0 0 0 0 0 0 683687.95 0 0 0 1101172517 91 Waiver service provider--Adults (DHS/DDD) 19 Champaign 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 0 297 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 297 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10494 0 0 0 0 0 0 0 0 0 0 0 0 0 10494 0 0 0 1101172537 1124003124 10 Physicians THOMPSON HINGLE SUSAN 627949639 91 Sangamon 0 1 Internal Medicine 0 43 0 0 0 0 0 0 0 0 0 5 0 36 0 0 0 0 0 0 332 0 0 0 0 0 0 0 0 0 9 0 58 0 0 0 0 0 0 332 0 0 0 0 0 0 0 0 0 9 0 58 0 0 0 0 0 0 991 0 0 0 0 0 0 0 0 0 76.05 0 2884.2 0 0 0 0 0 0 3951.25 0 0 0 1101172540 1568417780 10 Physicians FIMMEL CLAUS J. 600221690 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 231 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 231 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15475.44 0 0 0 0 0 0 15475.44 0 0 0 1101172551 1740207018 60 Pharmacies WAL MART 10 1553 601082300 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 488 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2505 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81222.5 0 0 0 81222.5 0 0 0 1101172552 1275522377 10 Physicians KAHAN RANDALL 600042315 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 8 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 391.37 0 3233.01 0 0 0 0 0 0 3624.38 0 0 0 1101172555 1073628822 30 General Hospitals RENAL CARE GROUP NORTHWESTERN 606112645 200 Cook NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 589 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6740 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 243636.64 0 0 0 0 0 243636.64 0 0 0 1101172563 92 Waiver service provider--Disability (DHS/DRS) 27 Dekalb 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 12842.63 0 0 0 0 0 0 0 0 0 0 0 0 0 12842.63 0 0 0 1101172576 98 Waiver service provider--TBI (DHS/DRS) 80 Peoria 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2540.55 0 0 0 0 0 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0 0 0 0 0 1101174189 1730268426 10 Physicians MITCHELL CRAIG 616147300 65 Madison 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 3187 0 185 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5199 0 195 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5199 0 195 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76540.22 0 8570.7 0 0 0 0 0 0 85110.92 0 0 0 1101174191 1215021100 10 Physicians GILBERT GEORGE 616145021 80 Peoria 0 1 Family Practice 0 57 0 0 2 0 0 0 0 0 0 14 0 138 0 0 0 0 0 0 534 0 0 2 0 0 0 0 0 0 20 0 646 0 0 0 0 0 0 534 0 0 2 0 0 0 0 0 0 20 0 646 0 0 0 0 0 0 1541 0 0 6.4 0 0 0 0 0 0 52.47 0 13132.8 0 0 0 0 0 0 14732.67 0 0 0 1101174194 94 Waiver service provider--Children's support (DHS/DDD) 57 Lake 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 0 290 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 290 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31574.34 0 0 0 0 0 0 0 0 0 0 0 0 0 31574.34 0 0 0 1101174196 1992841480 34 State-operated facility (DHS) UNIT 0217 HOME 17 LUDEMAN 604661200 200 Cook 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 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 772 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 476951.72 0 0 0 0 0 0 0 0 0 0 476951.72 0 0 0 1101174203 1962504597 10 Physicians IGLESIAS JOSUNE 606123218 200 Cook 0 1 Internal Medicine 0 78 0 0 0 0 0 0 0 0 0 18 0 235 0 0 0 0 0 0 176 0 0 0 0 0 0 0 0 0 25 0 460 0 0 0 0 0 0 176 0 0 0 0 0 0 0 0 0 25 0 460 0 0 0 0 0 0 528 0 0 0 0 0 0 0 0 0 90.33 0 7777.74 0 0 0 0 0 0 8396.07 0 0 0 1101174214 92 Waiver service provider--Disability (DHS/DRS) 79 Ogle 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 10297.84 0 0 0 0 0 0 0 0 0 0 0 0 0 10297.84 0 0 0 1101174242 1265667117 10 Physicians BASNET EKTA 626503924 77 Morgan 0 0 Pediatrics 0 0 0 0 5 0 0 0 0 0 0 157 0 87 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 211 0 133 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 211 0 133 0 0 0 0 0 0 0 0 0 192.9 0 0 0 0 0 0 2555.66 0 3909.07 0 0 0 0 0 0 6657.63 0 0 0 1101174244 92 Waiver service provider--Disability (DHS/DRS) 107 Will 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 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 9012.01 0 0 0 0 0 0 0 0 0 0 0 0 0 9012.01 0 0 0 1101174246 2100164664 72 Taxicabs and Livery Companies HARVEST TRANSPORTATION 622218627 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117079.2 0 0 0 0 0 0 117079.2 0 0 0 1101174256 1750330668 13 Podiatrists LATHROP RALPH 624541145 25 Crawford 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 680 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 680 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7692.35 0 0 0 0 0 0 7692.35 0 0 0 1101174268 1831168962 10 Physicians BERNSTEN STEPHEN 605238723 57 Lake 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 1302 0 195 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1857 0 313 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1857 0 313 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30936.05 0 3770.97 0 0 0 0 0 0 34707.02 0 0 0 1101174273 1306048855 47 Local Education Agencies PROPHETSTOWN LYNDON TAMPICO CU 612771056 106 Whiteside 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14928.91 0 14928.91 0 0 0 1101174284 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 20415.05 0 0 0 0 0 0 0 0 0 0 0 0 0 20415.05 0 0 0 1101174300 1033132311 60 Pharmacies TARGET PHARMACY T 894 604351166 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 684 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18679 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31427.8 0 0 0 31427.8 0 0 0 1101174308 91 Waiver service provider--Adults (DHS/DDD) 54 Kankakee 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 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12469.05 0 0 0 0 0 0 0 0 0 0 0 0 0 12469.05 0 0 0 1101174309 1932377694 55 Early Intervention Services HEKTOEN INST FOR MEDICAL CFC 9 606123821 200 Cook 0 0 0 1720 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10832 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10832 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1277264.36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1277264.36 0 0 0 1101174313 1194856237 28 Waiver service provider--Supportive living facility (HFS) COLES SUPPORTIVE LIVING 606493963 200 Cook 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 538 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12621 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 875928.86 0 0 0 0 0 0 0 0 0 0 0 0 0 875928.86 0 0 0 1101174314 1689681678 60 Pharmacies WALGREEN CO 601375819 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 933 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3982 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89834 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 223557.99 0 0 0 223557.99 0 0 0 1101174322 1609837665 48 Rural Health Clinics HAMILTON MEM FAMILY CLINIC 628591213 41 Hamilton 0 1 0 871 898 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5838 5040 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5838 5040 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15126 197911.64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 213037.64 0 0 0 1101174329 1548265689 13 Podiatrists MACK THOMAS 606443939 200 Cook 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 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 959.82 0 0 0 0 0 0 959.82 0 0 0 1101174331 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 14938.17 0 0 0 0 0 0 0 0 0 0 0 0 0 14938.17 0 0 0 1101174332 1881753226 10 Physicians LEE EDWARD 600155655 57 Lake 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 62 0 214 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 110 0 748 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 110 0 748 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5785.03 0 55524.62 0 0 0 0 0 0 61309.65 0 0 0 1101174347 1376536631 63 Other Providers of Medical Equipment/Supplies (Non-registered) CARDIO RESPIRATORY ASSISTANCE 606593728 200 Cook 0 0 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 0 863 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 863 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22707.77 0 0 0 0 0 0 22707.77 0 0 0 1101174352 1639185275 10 Physicians SARANTOPOULOS JOHN 601723583 30 DuPage 0 0 Physical Medicine/Rehabilitation 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 0 229 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 229 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1370.72 0 0 0 0 0 0 1370.72 0 0 0 1101174356 1467417931 64 Imaging Services INMED DIAGNOSTIC SVS OF IL LLC 629183391 108 Williamson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 302 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 302 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21734.2 0 0 0 0 0 0 21734.2 0 0 0 1101174359 1902846215 70 Ambulance Service Providers PARK FOREST FIRE DEPT 604662044 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 259 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 742 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 742 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28581.56 0 0 0 0 0 0 28581.56 0 0 0 1101174361 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 13112.98 0 0 0 0 0 0 0 0 0 0 0 0 0 13112.98 0 0 0 1101174362 1912103060 10 Physicians BRAUER EMILY 606930623 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 1114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1222 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1222 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46301.57 0 0 0 0 0 0 46301.57 0 0 0 1101174370 1477548287 12 Optometrists DISTIN GARY D 614621755 102 Warren 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 265 0 168 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 549 0 190 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 549 0 190 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13912.34 0 4851.16 0 0 0 0 18763.5 0 0 0 1101174380 1003035122 10 Physicians CHOI HAEMI 601533328 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 316 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 407 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 407 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12010.61 0 0 0 0 0 0 12010.61 0 0 0 1101174383 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 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 1905.75 0 0 0 0 0 0 0 0 0 0 0 0 0 1905.75 0 0 0 1101174391 1932132123 10 Physicians LELCHUK BORIS 600902979 200 Cook 0 1 Pediatrics 0 1685 0 0 1233 0 0 0 0 0 0 1491 0 1895 0 0 0 0 0 0 15745 0 0 6233 0 0 0 0 0 0 3908 0 5556 0 0 0 0 0 0 15745 0 0 6233 0 0 0 0 0 0 3908 0 5556 0 0 0 0 0 0 31492 0 0 156581.44 0 0 0 0 0 0 25778.73 0 231962.08 0 0 0 0 0 0 445814.25 0 0 0 1101174392 1245286756 60 Pharmacies CORAM ALTERNATE SITE SERVICES 528065823 816 Iowa 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 772 0 0 230 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 772 0 0 1944 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101353.88 0 0 306046.36 0 0 0 407400.24 0 0 0 1101174395 92 Waiver service provider--Disability (DHS/DRS) 53 Kane 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1713.49 0 0 0 0 0 0 0 0 0 0 0 0 0 1713.49 0 0 0 1101174403 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10691.99 0 0 0 0 0 0 0 0 0 0 0 0 0 10691.99 0 0 0 1101174405 1013110816 10 Physicians SIDDIQUI SAAD 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 118 0 600 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 288 0 1419 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 288 0 1419 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6547 0 43953.22 0 0 0 0 0 0 50500.22 0 0 0 1101174422 1538119888 14 Chiropractors WEBER SCOTT 626501008 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 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 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 630.64 0 0 0 0 0 0 630.64 0 0 0 1101174424 1689786352 10 Physicians JOHNSON JEFFREY 601228942 30 DuPage 0 0 Family Practice 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 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5019.06 0 0 0 0 0 0 5019.06 0 0 0 1101174432 1720191091 63 Other Providers of Medical Equipment/Supplies (Non-registered) ORTHOPEDIC ASSOC OF KANKAKEE 609152685 54 Kankakee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 372 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61 0 448 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61 0 448 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2186.88 0 26968.6 0 0 0 0 29155.48 0 0 0 1101174445 1770666414 10 Physicians OIE CHRISTOPHER 601344200 53 Kane 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 262 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 287 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 287 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8739.17 0 0 0 0 0 0 8739.17 0 0 0 1101174450 1790771434 10 Physicians CHATSKIS EMILY 600895979 57 Lake 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 4 0 262 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 2626 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 2626 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35.45 0 14296.59 0 0 0 0 0 0 14332.04 0 0 0 1101174451 1043230303 10 Physicians SYED MALIHA 611033655 109 Winnebago 0 0 Internal Medicine 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 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1479.61 0 0 0 0 0 0 1479.61 0 0 0 1101174454 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 7891.74 0 0 0 0 0 0 0 0 0 0 0 0 0 7891.74 0 0 0 1101174455 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 40877.68 0 0 0 0 0 0 0 0 0 0 0 0 0 40877.68 0 0 0 1101174458 1881676997 10 Physicians SHAPIRO ALAN 600761260 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1943.37 0 0 0 0 0 0 1943.37 0 0 0 1101174462 92 Waiver service provider--Disability (DHS/DRS) 66 Marion 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 18373.11 0 0 0 0 0 0 0 0 0 0 0 0 0 18373.11 0 0 0 1101174466 1205822913 10 Physicians FREITAG PER 627949639 91 Sangamon 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 268 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 394 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 394 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58455.97 0 0 0 0 0 0 58455.97 0 0 0 1101174472 1538177423 30 General Hospitals CHRISTIAN HOSPITAL NE NW 631366119 826 Missouri DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 0 0 0 0 0 277 0 0 0 0 192 0 0 0 334 0 0 0 0 0 0 0 0 0 380 0 0 0 0 226 0 0 0 672 0 0 0 0 0 0 0 0 0 380 0 0 0 0 1066 0 0 0 769 0 0 0 0 0 0 0 0 0 52143.61 0 0 0 0 960410.93 0 0 0 168110.37 0 0 0 0 0 1180664.91 0 0 0 1101174480 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12693.44 0 0 0 0 0 0 0 0 0 0 0 0 0 12693.44 0 0 0 1101174499 1407845985 11 Dentists KIM YOONJUNG 601335257 200 Cook 0 0 General Dentistry 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 511 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 511 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14960.48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14960.48 0 0 0 1101174507 1225296858 28 Waiver service provider--Supportive living facility (HFS) HAWTHORNE INN OF FREEPORT 610327803 97 Stephenson 0 0 0 0 0 0 0 0 8 0 0 0 0 0 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Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 350 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 350 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7090.95 0 0 0 0 0 0 7090.95 0 0 0 1101174540 1851349831 16 Nurse Practitioners POWERS MICHELLE 601159602 27 Dekalb 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 0 0 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8748.72 0 0 0 0 0 0 8748.72 0 0 0 1101174542 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 17566.36 0 0 0 0 0 0 0 0 0 0 0 0 0 17566.36 0 0 0 1101174545 1528032430 12 Optometrists WILLIAMS ROBERT TRACY 601533304 53 Kane 0 0 Therapeutic Pharmaceutical Agents 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 14 0 0 0 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 0 115.8 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 40586.6 0 0 0 0 0 0 0 0 0 0 0 0 0 40586.6 0 0 0 1101174681 1508924267 10 Physicians KAGAN TATYANA 600073713 200 Cook 0 1 Pediatrics 0 800 0 0 536 0 0 0 0 0 0 200 0 852 0 0 0 0 0 0 5407 0 0 2726 0 0 0 0 0 0 261 0 2279 0 0 0 0 0 0 5407 0 0 2726 0 0 0 0 0 0 261 0 2279 0 0 0 0 0 0 10816 0 0 69808.24 0 0 0 0 0 0 2270.47 0 91722.29 0 0 0 0 0 0 174617 0 0 0 1101174683 1548227317 10 Physicians STUART CHARLES 535661569 47 Jackson 0 0 Nephrology 0 0 0 0 0 0 0 0 0 0 0 4 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42.89 0 5253.74 0 0 0 0 0 0 5296.63 0 0 0 1101174690 1922032424 30 General Hospitals SACRED HEART HOSPITAL 325048721 200 Cook ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1995.35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1995.35 0 0 0 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3063.48 0 0 0 1101174834 92 Waiver service provider--Disability (DHS/DRS) 27 Dekalb 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 7517.72 0 0 0 0 0 0 0 0 0 0 0 0 0 7517.72 0 0 0 1101174839 92 Waiver service provider--Disability (DHS/DRS) 58 La Salle 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3115.87 0 0 0 0 0 0 0 0 0 0 0 0 0 3115.87 0 0 0 1101174851 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3233.82 0 0 0 0 0 0 0 0 0 0 0 0 0 3233.82 0 0 0 1101174852 1376673608 22 Physical Therapists DONOHUE SUSAN 606342616 200 Cook 0 0 0 0 0 0 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 0 187 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 187 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 3 0 0 6102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 144387 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97.91 0 0 270090.84 0 0 0 270188.75 0 0 0 1101174878 1114931375 10 Physicians CARROLL META 606143363 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 242 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 259 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 259 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9885.89 0 0 0 0 0 0 9885.89 0 0 0 1101174890 1376673749 10 Physicians BOTUYAN ANDRES 606224446 200 Cook 0 0 Surgery General 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 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3363.03 0 0 0 0 0 0 3363.03 0 0 0 1101174892 1245262906 10 Physicians KULIK LAURA 606118709 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5563.78 0 0 0 0 0 0 5563.78 0 0 0 1101174900 1720039738 10 Physicians THOMPSON STEPHEN 616145927 80 Peoria 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 2 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 347.46 0 1108.2 0 0 0 0 0 0 1455.66 0 0 0 1101174902 1568478816 23 Occupational Therapists HANK KARA 616370001 80 Peoria 0 0 0 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 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8571.04 8571.04 0 0 0 1101174908 91 Waiver service provider--Adults (DHS/DDD) 852 Wisconsin 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 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3704.24 0 0 0 0 0 0 0 0 0 0 0 0 0 3704.24 0 0 0 1101174909 10 Physicians 200 Cook 0 0 Emergency Medicine 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 0 101.45 0 0 0 0 0 0 101.45 0 0 0 1101174947 1407947187 10 Physicians MORAN 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0 0 0 0 0 0 0 0 0 8505.85 0 0 0 0 0 0 0 0 0 0 0 0 0 8505.85 0 0 0 1101175244 1497747497 10 Physicians FRANKEL DANIEL A 480381125 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 336 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 456 0 186 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 456 0 186 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6100.25 0 2138.36 0 0 0 0 0 0 8238.61 0 0 0 1101175253 1942296504 10 Physicians YOUNG NANCY 606112991 200 Cook 0 0 Otorhinolaryngology 0 0 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34554.1 0 0 0 0 0 0 34554.1 0 0 0 1101175262 1285693176 10 Physicians GONZALES RONALD 606045759 200 Cook 0 0 Infectious Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 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 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62.15 0 0 0 0 0 0 62.15 0 0 0 1101175281 1295980852 28 Waiver service provider--Supportive living facility (HFS) EVERGREEN PLACE STREATOR 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Practitioners KIEFER JULIANN 631101002 826 Missouri 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 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1168.65 0 0 0 0 0 0 1168.65 0 0 0 1101175388 1003041674 60 Pharmacies WALGREENS 12744 625571404 20 Christian 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 772 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 4816 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 111521 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24.16 0 0 191993.71 0 0 0 192017.87 0 0 0 1101175392 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10694.47 0 0 0 0 0 0 0 0 0 0 0 0 0 10694.47 0 0 0 1101175399 1235265349 10 Physicians KYOUTCHOUKOVA MILENA 608042129 200 Cook 0 1 Internal Medicine 0 238 0 0 21 0 0 0 0 0 0 5 0 144 0 0 0 0 0 0 371 0 0 34 0 0 0 0 0 0 5 0 307 0 0 0 0 0 0 371 0 0 34 0 0 0 0 0 0 5 0 307 0 0 0 0 0 0 863 0 0 1326.47 0 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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 7092.47 0 0 0 0 0 0 0 0 0 0 0 0 0 7092.47 0 0 0 1101176070 1437127305 60 Pharmacies WILLIAMS BROS HLTH CARE PHARM 476701090 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 276 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 501 0 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 501 0 0 3360 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29929.55 0 0 3547.36 0 0 0 33476.91 0 0 0 1101176071 1124077714 10 Physicians GROSSE PERDEKAMP MARIA T 618012529 19 Champaign 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 3 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 308 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 308 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3.22 0 12419.24 0 0 0 0 0 0 12422.46 0 0 0 1101176072 1891705737 10 Physicians RILES WILLIAM 606121372 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 27 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 0 460.71 0 0 0 0 0 0 460.71 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0 1101176218 1285622340 10 Physicians DORAN EDWARD 613562538 15 Bureau 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 7 0 307 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 609 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 609 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70.34 0 78088.02 0 0 0 0 0 0 78158.36 0 0 0 1101176219 22 Physical Therapists 30 DuPage 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 392.31 392.31 0 0 0 1101176229 1528229861 64 Imaging Services CAL DEVON URGENT CARE INC 606455208 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 1721 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8083 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8083 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20603.22 0 0 0 0 0 0 0 0 20603.22 0 0 0 1101176243 1275526758 12 Optometrists ECKLUND WINTERS JANIS 606164201 200 Cook 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 334 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 334 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provider--Disability (DHS/DRS) 200 Cook 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 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 3166.68 0 0 0 0 0 0 0 0 0 0 0 0 0 3166.68 0 0 0 1101176588 1518055144 10 Physicians JUNDI IYAD 610811252 106 Whiteside 0 1 Internal Medicine 0 48 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 477 0 0 0 0 0 0 0 0 0 0 0 296 0 0 0 0 0 0 477 0 0 0 0 0 0 0 0 0 0 0 296 0 0 0 0 0 0 1425 0 0 0 0 0 0 0 0 0 0 0 7570.19 0 0 0 0 0 0 8995.19 0 0 0 1101176595 1972792281 36 Community mental health provider HABILITATIVE SYSTEMS INC 606512664 200 Cook 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 136 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 136 0 0 266.4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4292.71 0 0 4559.11 0 0 0 1101176608 1194833012 10 Physicians ARNOLD BRIAN 475911038 815 Indiana 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 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Cook 0 0 Pulmonary Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 389 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1051 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1051 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24068.25 0 0 0 0 0 0 24068.25 0 0 0 1101177041 11 Dentists 200 Cook 0 0 Periodontists 0 0 0 1 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 0 464.8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 464.8 0 0 0 1101177045 1023064128 60 Pharmacies PILL STAT RX LLC 462781928 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 845 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22094 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5006.47 0 0 0 5006.47 0 0 0 1101177048 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 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 26092.48 0 0 0 0 0 0 0 0 0 0 0 0 0 26092.48 0 0 0 1101177056 92 Waiver service provider--Disability 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1101177098 1194904169 10 Physicians THURTELL MATTHEW 522421007 816 Iowa 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 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 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101177103 16 Nurse Practitioners 815 Indiana 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101177142 1225084916 10 Physicians KREAMER JEFFRY 600476400 57 Lake 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 298 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 298 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8605.81 0 0 0 0 0 0 8605.81 0 0 0 1101177146 1902881170 10 Physicians GROSTERN RICHARD J 606123848 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 11 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 191.51 0 1146.5 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 243.43 0 0 0 0 0 0 243.43 0 0 0 1101177190 1003074519 10 Physicians KOLIOPOULOS ELIAS 605213625 30 DuPage 0 0 Internal Medicine 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 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 191.84 0 0 0 0 0 0 191.84 0 0 0 1101177200 92 Waiver service provider--Disability (DHS/DRS) 71 McHenry 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 19893.29 0 0 0 0 0 0 0 0 0 0 0 0 0 19893.29 0 0 0 1101177204 30 General Hospitals 852 Wisconsin NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 91.67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91.67 0 0 0 1101177224 91 Waiver service provider--Adults (DHS/DDD) 91 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 0 281 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 281 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21795.25 0 0 0 0 0 0 0 0 0 0 0 0 0 21795.25 0 0 0 1101177225 1588776884 10 Physicians OTERO WILLIAM 606392505 200 Cook 0 1 Family Practice 0 307 0 0 151 0 0 0 0 0 0 7 0 236 0 0 0 0 0 0 2362 0 0 519 0 0 0 0 0 0 7 0 720 0 0 0 0 0 0 2362 0 0 519 0 0 0 0 0 0 7 0 720 0 0 0 0 0 0 4724 0 0 16125.03 0 0 0 0 0 0 20 0 11082.07 0 0 0 0 0 0 31951.1 0 0 0 1101177226 1639361579 16 Nurse Practitioners BORKGREN BRENDA S 503061455 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 770 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 770 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11393.57 0 0 0 0 0 0 11393.57 0 0 0 1101177235 22 Physical Therapists 72 McLean 0 0 0 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 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 201.06 201.06 0 0 0 1101177236 1407801665 10 Physicians KALLAL CATHERINE 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0 3584.22 0 0 0 1101177252 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 23125.09 0 0 0 0 0 0 0 0 0 0 0 0 0 23125.09 0 0 0 1101177262 1912179250 91 Waiver service provider--Adults (DHS/DDD) YOUNG MICHELLE L 610329630 200 Cook 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 965.34 0 0 0 0 0 0 0 0 0 0 0 0 0 965.34 0 0 0 1101177265 1841376878 10 Physicians ROSSI LAWRENCE J JR 617470267 98 Tazewell 0 0 Pediatrics 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 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1118.92 0 0 0 0 0 0 1118.92 0 0 0 1101177280 1649390022 43 Encounter rate clinic OAK FOREST SPECIALTY CLINIC 604524006 200 Cook ARS-C.O.P. "JH Stroger, Oak Forest and Provident Hospitals, paid under an alternate reimbursement system" 0 1 Direct Access 0 22 1761 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 6423 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 6423 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83 1299877.36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1299960.36 0 0 0 1101177285 1538139316 10 Physicians SALEM MOHAMED 606573145 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 944 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 944 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13634.31 0 0 0 0 0 0 13634.31 0 0 0 1101177298 1447256797 10 Physicians JONES BART 622261919 96 St Clair 0 0 General Practice 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 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9804.46 0 0 0 0 0 0 9804.46 0 0 0 1101177317 30 General Hospitals 845 Texas NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 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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 14946.15 0 0 0 0 0 0 0 0 0 0 0 0 0 14946.15 0 0 0 1101177960 1457472409 55 Early Intervention Services WOOSLEY EILEEN 605045883 30 DuPage 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 0 187 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 187 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10606.1 0 0 0 0 0 0 10606.1 0 0 0 1101177964 98 Waiver service provider--TBI (DHS/DRS) 63 Macon 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 16481.28 0 0 0 0 0 0 0 0 0 0 0 0 0 16481.28 0 0 0 1101177970 1588617559 10 Physicians MAXIM ROLANDA 631041095 826 Missouri 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 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 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1008.18 0 0 0 0 0 0 1008.18 0 0 0 1101177973 1548268204 10 Physicians MCCLEAN JOHN 614012807 56 Knox 0 0 Oncology 0 0 0 0 0 0 0 0 0 0 0 35 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 251 0 462 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 251 0 462 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2062.05 0 34187.24 0 0 0 0 0 0 36249.29 0 0 0 1101177982 1730154709 12 Optometrists MOORE STEVEN 625682230 20 Christian 0 0 Therapeutic Pharmaceutical Agents 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 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 769.35 0 0 0 0 0 0 769.35 0 0 0 1101177984 91 Waiver service provider--Adults (DHS/DDD) 91 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 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3980.9 0 0 0 0 0 0 0 0 0 0 0 0 0 3980.9 0 0 0 1101178011 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 320 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 320 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24905.14 0 0 0 0 0 0 0 0 0 0 0 0 0 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118277.93 0 0 0 1101178044 92 Waiver service provider--Disability (DHS/DRS) 30 DuPage 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 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 8568 0 0 0 0 0 0 0 0 0 0 0 0 0 8568 0 0 0 1101178076 1073506101 10 Physicians GRUSZKA MARY 605461166 200 Cook 0 1 Pediatrics 0 243 0 0 134 0 0 0 0 0 0 37 0 169 0 0 0 0 0 0 753 0 0 442 0 0 0 0 0 0 43 0 245 0 0 0 0 0 0 753 0 0 442 0 0 0 0 0 0 43 0 245 0 0 0 0 0 0 1506 0 0 12954.07 0 0 0 0 0 0 202.47 0 8590.75 0 0 0 0 0 0 23253.29 0 0 0 1101178089 1053397018 10 Physicians AHMAD AHMAD 625213832 63 Macon 0 1 Internal Medicine 0 26 0 0 10 0 0 0 0 0 0 2 0 120 0 0 0 0 0 0 176 0 0 10 0 0 0 0 0 0 3 0 910 0 0 0 0 0 0 176 0 0 10 0 0 0 0 0 0 3 0 910 0 0 0 0 0 0 496 0 0 871.19 0 0 0 0 0 0 2.18 0 9061.79 0 0 0 0 0 0 10431.16 0 0 0 1101178095 1114903507 10 Physicians KICHURA GEORGE 631418253 826 Missouri 0 0 Internal Medicine 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 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1312.86 0 0 0 0 0 0 1312.86 0 0 0 1101178103 98 Waiver service provider--TBI (DHS/DRS) 72 McLean 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 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 8367.33 0 0 0 0 0 0 0 0 0 0 0 0 0 8367.33 0 0 0 1101178110 1760420392 33 Nursing Facilities MANORCARE OF ELGIN 601236429 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 622 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15723 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1510173.23 0 0 0 0 0 0 0 1510173.23 0 0 0 1101178115 1891966982 10 Physicians MCELLIGOTT DAVID 601901237 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 284 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 284 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4257.91 0 0 0 0 0 0 4257.91 0 0 0 1101178117 1982851879 36 Community mental health provider THRESHOLDS 606255416 200 Cook 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 726 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1270 0 0 726 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1270 0 0 204809.53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83279.26 0 0 288088.79 0 0 0 1101178118 1659359446 30 General Hospitals SCRIPPS MEMORIAL HOSP MERCY 921032105 805 California NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 5 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 962.96 0 0 0 0 7737.74 0 0 0 0 0 0 0 0 0 8700.7 0 0 0 1101178121 1528130150 52 Certified local public health department WASHINGTON COUNTY HEALTH DEPT 622631226 103 Washington 0 0 Family Practice 0 0 3 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 496 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 496 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56.1 0 4090.62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4146.72 0 0 0 1101178122 1912988981 10 Physicians MAJMUDAR PARAG 600355613 57 Lake 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 43 0 234 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 394 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 394 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 318.51 0 15649.39 0 0 0 0 0 0 15967.9 0 0 0 1101178132 1912099060 10 Physicians PARVEEN ZEENAT 610169362 109 Winnebago 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 138 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 363 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 363 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6031.92 0 0 0 0 0 0 6031.92 0 0 0 1101178179 30 General Hospitals 803 Arizona NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 Children's Hospital 0 0 0 0 0 3 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 358.8 0 0 0 0 3243.56 0 0 0 0 0 0 0 0 0 3602.36 0 0 0 1101178180 1396840658 16 Nurse Practitioners PALME PAMELA 622303618 23 Clinton 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 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 0 898.37 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45.37 0 0 0 0 0 0 45.37 0 0 0 1101178222 1609997964 55 Early Intervention Services LORENZ SUSAN 606182663 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 571 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 571 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32969.89 0 0 0 0 0 0 32969.89 0 0 0 1101178226 1699953711 36 Community mental health provider "PILSEN WELLNESS CENTER, INC. -" 601601723 200 Cook 0 0 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 833 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1621 0 0 833 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1621 0 0 35015.15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105278.03 0 0 140293.18 0 0 0 1101178230 1407089394 10 Physicians SUAREZ JOSE 999999999 200 Cook 0 0 0 0 0 0 1 0 0 0 0 0 0 2 0 3 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 2 0 3 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 2 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102.8 0 0 0 0 0 0 102.8 0 0 0 1101178231 1376543488 10 Physicians BAQAI SERENA 606576274 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 377 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 410 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 410 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14223.34 0 0 0 0 0 0 14223.34 0 0 0 1101178239 2100168657 16 Nurse Practitioners SVARA JACKIE 604363172 107 Will 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 61 0 0 0 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 1062.5 0 0 0 0 0 0 1062.5 0 0 0 1101178269 1831167592 16 Nurse Practitioners CONKLEN MARY 627116248 91 Sangamon 0 0 General Psychiatry Residency 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 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3128.62 0 0 0 0 0 0 3128.62 0 0 0 1101178284 1063437333 10 Physicians KIM THOMAS 618012530 19 Champaign 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 129 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 144 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 144 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8362.83 0 1513.43 0 0 0 0 0 0 9876.26 0 0 0 1101178292 1114945813 10 Physicians OSTLUND RICHARD E 631082212 826 Missouri 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 208 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 767 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 767 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6417.06 0 309.5 0 0 0 0 0 0 6726.56 0 0 0 1101178302 1649218397 10 Physicians MALOUL KATHLEEN 606593447 200 Cook 0 1 Family Practice 0 384 0 0 160 0 0 0 0 0 0 101 0 279 0 0 0 0 0 0 3261 0 0 517 0 0 0 0 0 0 286 0 777 0 0 0 0 0 0 3261 0 0 517 0 0 0 0 0 0 286 0 777 0 0 0 0 0 0 7762 0 0 18154.7 0 0 0 0 0 0 1984.22 0 46031.65 0 0 0 0 0 0 73932.57 0 0 0 1101178303 1386943306 33 Nursing Facilities THREE SPRINGS LODGE NRSG HOME 622331064 87 Randolph 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 0 411 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11522 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 844931.45 0 0 0 0 0 0 0 844931.45 0 0 0 1101178305 10 Physicians 852 Wisconsin 0 0 Surgery General 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 81.15 0 0 0 0 0 0 81.15 0 0 0 1101178321 1992963243 10 Physicians XU RONG 606252684 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3548 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3548 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63350.16 0 0 0 0 0 0 63350.16 0 0 0 1101178338 1710165279 75 Department of Alcohol and Substance Abuse Provider S E ILLINOIS COUNSELING CTRS 624504720 88 Richland 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 596 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 596 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30422.22 0 0 30422.22 0 0 0 1101178340 1003044819 10 Physicians NORBET CHRISTOPHER 999999999 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 1692 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2380 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2380 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26615.21 0 0 0 0 0 0 0 0 26615.21 0 0 0 1101178345 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 6621.79 0 0 0 0 0 0 0 0 0 0 0 0 0 6621.79 0 0 0 1101178350 98 Waiver service provider--TBI (DHS/DRS) 91 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 8482.44 0 0 0 0 0 0 0 0 0 0 0 0 0 8482.44 0 0 0 1101178368 92 Waiver service provider--Disability (DHS/DRS) 53 Kane 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 12431.85 0 0 0 0 0 0 0 0 0 0 0 0 0 12431.85 0 0 0 1101178384 91 Waiver service provider--Adults (DHS/DDD) 100 Vermilion 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 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 165 0 0 0 1101178389 1093894990 30 General Hospitals COMER CHILDRENS HOSPITAL 605615314 30 DuPage CHILDRENS Hospital designated as childrens hospitals and paid a Per Diem rate. 0 0 General Hospital - Children Section 0 0 0 0 824 0 0 0 0 0 0 2168 0 0 1751 0 0 0 0 0 0 0 0 1470 0 0 0 0 0 0 12307 0 0 4030 0 0 0 0 0 0 0 0 1470 0 0 0 0 0 0 12307 0 0 4030 0 0 0 0 0 0 0 0 12378.18 0 0 0 0 0 0 70482.94 0 0 223546.14 0 0 0 0 0 306407.26 0 0 0 1101178394 1184655243 60 Pharmacies KMART STORES OF IL LLC 3241 627044203 91 Sangamon 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 0 190 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5353 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5571.41 0 0 0 5571.41 0 0 0 1101178400 1033310024 10 Physicians PAGDALA ARUNA 605648568 107 Will 0 1 Family Practice 0 0 0 0 0 0 0 0 0 0 0 7 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 161.98 0 1067.8 0 0 0 0 0 0 1229.78 0 0 0 1101178403 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 2 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20619.55 0 0 0 0 0 0 20619.55 0 0 0 1101178679 1558387217 10 Physicians SHRUTI DAVE 618215410 19 Champaign 0 0 Endocrinology 0 0 0 0 0 0 0 0 0 0 0 5 0 167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 308 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 308 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24.04 0 9568.06 0 0 0 0 0 0 9592.1 0 0 0 1101178684 92 Waiver service provider--Disability (DHS/DRS) 69 Massac 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 1004.5 0 0 0 0 0 0 0 0 0 0 0 0 0 1004.5 0 0 0 1101178698 92 Waiver service provider--Disability (DHS/DRS) 63 Macon 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 3968.85 0 0 0 0 0 0 0 0 0 0 0 0 0 3968.85 0 0 0 1101178699 1407976202 36 Community mental health provider NO CENTRAL BEHAV HLTH SYSTEMS 614552312 70 McDonough 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 311 0 0 443 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4057 0 0 443 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4057 0 0 13179.73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 250587.88 0 0 263767.61 0 0 0 1101178717 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 22325.73 0 0 0 0 0 0 0 0 0 0 0 0 0 22325.73 0 0 0 1101178719 1093803975 10 Physicians SANTWANI KISHORE 601344209 53 Kane 0 0 Neurology 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 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 415.5 0 0 0 0 0 0 415.5 0 0 0 1101178720 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6523.5 0 0 0 0 0 0 0 0 0 0 0 0 0 6523.5 0 0 0 1101178729 91 Waiver service provider--Adults (DHS/DDD) 30 DuPage 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 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13147.2 0 0 0 0 0 0 0 0 0 0 0 0 0 13147.2 0 0 0 1101178730 1316169949 10 Physicians FISHMAN ILYA 600073362 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 956 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 956 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2425.4 0 0 0 0 0 0 2425.4 0 0 0 1101178734 1124089479 13 Podiatrists RABINOVICH ZINOVIY 600627130 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 354 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3476 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3476 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10517.58 0 0 0 0 0 0 10517.58 0 0 0 1101178739 1144276221 10 Physicians WALKER YVETTE RENE 612821804 89 Rock Island 0 0 Anesthesiology 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 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1370.92 0 0 0 0 0 0 1370.92 0 0 0 1101178749 1932155603 60 Pharmacies OSCO DRUG 3092 606174707 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 222 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1204 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31290 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71978.33 0 0 0 71978.33 0 0 0 1101178755 1710026745 55 Early Intervention Services WABASH OHIO VLY SP ED CFC 23 628690320 105 White 0 0 0 231 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1495 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1495 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180466.26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180466.26 0 0 0 1101178810 92 Waiver service provider--Disability (DHS/DRS) 98 Tazewell 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 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 18919.06 0 0 0 0 0 0 0 0 0 0 0 0 0 18919.06 0 0 0 1101178824 1730209545 30 General Hospitals J H STROGER HOSP OF COOK CTY 606123714 200 Cook ARS-C.O.P. "JH Stroger, Oak Forest and Provident Hospitals, paid under an alternate reimbursement system" 0 0 General Hospital - Adult and Child 0 0 0 0 928 0 0 0 0 0 0 12225 0 0 1576 0 0 0 0 0 0 0 0 1703 0 0 0 0 0 0 84364 0 0 7095 0 0 0 0 0 0 0 0 1703 0 0 0 0 0 0 84364 0 0 7095 0 0 0 0 0 0 0 0 16935.14 0 0 0 0 0 0 835117.19 0 0 2137425.87 0 0 0 0 0 2989478.2 0 0 0 1101178826 1679882526 24 Speech Therapists JOHNSON SARAH 606171841 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1809 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1809 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 136705.65 136705.65 0 0 0 1101178833 10 Physicians 852 Wisconsin 0 0 Clinical Pathology 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53.17 0 0 0 0 0 0 0 0 53.17 0 0 0 1101178834 1861457533 10 Physicians JAGMIN JEFFREY 601181454 53 Kane 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 3 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5813.34 0 0 0 0 0 0 5813.34 0 0 0 1101178835 1689674541 10 Physicians HOMANN SCOTT 611022112 109 Winnebago 0 0 Infectious Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 157 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 494 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 494 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5239.26 0 0 0 0 0 0 5239.26 0 0 0 1101178843 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3239.66 0 0 0 0 0 0 0 0 0 0 0 0 0 3239.66 0 0 0 1101178845 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 310 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 310 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20181.2 0 0 0 0 0 0 0 0 0 0 0 0 0 20181.2 0 0 0 1101178866 1215023916 10 Physicians KAMAL SHAISTA 606778004 200 Cook 0 1 Pediatrics 0 56 0 0 14 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2214 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34712.42 0 0 0 0 0 0 34712.42 0 0 0 1101179664 92 Waiver service provider--Disability (DHS/DRS) 34 Fayette 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15937.09 0 0 0 0 0 0 0 0 0 0 0 0 0 15937.09 0 0 0 1101179684 1295718781 10 Physicians HOLT RONALD 605173527 30 DuPage 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 448 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 478 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 478 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12430.25 0 0 0 0 0 0 12430.25 0 0 0 1101179705 1881609006 60 Pharmacies WALGREEN CO 1670 605213360 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 438 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 10846 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11.81 0 0 22750.18 0 0 0 22761.99 0 0 0 1101179710 1700921699 10 Physicians MANUS DEBORAH 603011135 200 Cook 0 1 Family Practice 0 35 0 0 16 0 0 0 0 0 0 4 0 22 0 0 0 0 0 0 73 0 0 41 0 0 0 0 0 0 4 0 38 0 0 0 0 0 0 73 0 0 41 0 0 0 0 0 0 4 0 38 0 0 0 0 0 0 166 0 0 1427.24 0 0 0 0 0 0 24.6 0 1289.41 0 0 0 0 0 0 2907.25 0 0 0 1101179716 92 Waiver service provider--Disability (DHS/DRS) 45 Henry 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 39872.83 0 0 0 0 0 0 0 0 0 0 0 0 0 39872.83 0 0 0 1101179718 1730144650 10 Physicians MUELLER JOHN 616157835 80 Peoria 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 5 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 393.34 0 2226.38 0 0 0 0 0 0 2619.72 0 0 0 1101179726 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 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 1474 0 0 0 0 0 0 0 0 0 0 0 0 0 1474 0 0 0 1101179729 1407839202 70 Ambulance Service Providers AIR EVAC EMS INC 623012834 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37199.97 0 0 0 0 0 0 37199.97 0 0 0 1101179730 10 Physicians 852 Wisconsin 0 0 General Practice 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36.56 0 0 0 0 0 0 36.56 0 0 0 1101179749 98 Waiver service provider--TBI (DHS/DRS) 98 Tazewell 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2324.2 0 0 0 0 0 0 0 0 0 0 0 0 0 2324.2 0 0 0 1101179751 1477509347 10 Physicians CREVIER WILLIAM 604265441 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 586 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 586 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1789.46 0 0 0 0 0 0 1789.46 0 0 0 1101179752 1164424487 28 Waiver service provider--Supportive living facility (HFS) MAGNOLIA TERRACE 622981598 75 Monroe 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 210 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5772 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 273970.95 0 0 0 0 0 0 0 0 0 0 0 0 0 273970.95 0 0 0 1101179756 1437134731 10 Physicians BEYER CRAIG 620341904 65 Madison 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 15 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 530.31 0 1428.81 0 0 0 0 0 0 1959.12 0 0 0 1101179792 1467612911 10 Physicians SWEET ALISON 447182545 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 11 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 153.17 0 1643.91 0 0 0 0 0 0 1797.08 0 0 0 1101179799 1699799304 10 Physicians SWOBODA ROBERT J 532152843 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 503.56 0 0 0 0 0 0 0 0 503.56 0 0 0 1101179808 34 State-operated facility (DHS) 53 Kane 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55155.74 0 0 0 0 0 0 0 0 0 55155.74 0 0 0 1101179809 94 Waiver service provider--Children's support (DHS/DDD) 62 Logan 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 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6600 0 0 0 0 0 0 0 0 0 0 0 0 0 6600 0 0 0 1101179813 1255338554 10 Physicians COULSON MICHAEL 601154939 27 Dekalb 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6985.28 0 0 0 0 0 0 6985.28 0 0 0 1101179814 1508056953 16 Nurse Practitioners BANKS LONI J 629462718 200 Cook 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 227 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 780 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 780 0 0 0 0 0 0 0 0 0 1525.18 0 0 0 0 0 0 0 0 20904.69 0 0 0 0 0 0 22429.87 0 0 0 1101179834 92 Waiver service provider--Disability (DHS/DRS) 33 Effingham 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 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 22243.88 0 0 0 0 0 0 0 0 0 0 0 0 0 22243.88 0 0 0 1101179842 1780681973 13 Podiatrists COZZI OLSON MARGARET 603051930 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 272.34 0 0 0 0 0 0 272.34 0 0 0 1101179852 1245260645 40 Federally Qualified Health Centers MURPHYSBORO HEALTH CENTER 629663333 47 Jackson 0 1 0 3856 3212 0 678 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34902 23164 0 2610 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34902 23164 0 2610 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 92801 1344197.73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1436998.73 0 0 0 1101179860 1619002458 10 Physicians BRUMBAUGH JANE 528032459 816 Iowa 0 0 Neonatology 0 0 0 0 4 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 93.73 0 0 0 0 0 0 0 0 9682.78 0 0 0 0 0 0 9776.51 0 0 0 1101179861 1194794487 30 General Hospitals MATTOON DIALYSIS 619209467 24 Coles DIALYSIS Outpatient dialysis centers. 0 0 General Hospital - Adult and Child 0 1 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 354 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 3475 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102902.32 0 0 0 0 0 102902.32 0 0 0 1101179869 1982877288 11 Dentists CARUSO DIANE 617015048 72 McLean 0 0 General Dentistry 0 0 0 1158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5567 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5567 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166955.66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166955.66 0 0 0 1101179873 1871566893 16 Nurse Practitioners CURRAN MARY ANN 606118709 200 Cook 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 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 147.4 0 0 0 0 0 0 147.4 0 0 0 1101179896 1720040264 16 Nurse Practitioners DAVIS LAURENCE 609369987 35 Ford 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 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 0 279.14 0 0 0 0 0 0 279.14 0 0 0 1101179901 92 Waiver service provider--Disability (DHS/DRS) 107 Will 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 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 4004.11 0 0 0 0 0 0 0 0 0 0 0 0 0 4004.11 0 0 0 1101179908 1215037353 33 Nursing Facilities PRAIRIE ROSE HEALTH CARE CTR 625579730 20 Christian 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 289 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7614 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 663119.5 0 0 0 0 0 0 0 663119.5 0 0 0 1101179911 1891004404 10 Physicians HODOGBEY PRINCE 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 451 0 0 0 0 0 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0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 279.65 0 0 0 0 0 0 279.65 0 0 0 1101180026 1427087030 10 Physicians STOSHAK MARCIE 606295148 200 Cook 0 0 Emergency Medicine 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 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3822.7 0 0 0 0 0 0 3822.7 0 0 0 1101180027 10 Physicians 30 DuPage 0 0 Family Practice 0 0 0 0 0 0 0 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 0 1101180030 1467414797 10 Physicians HUI ROSENNA 600693038 71 McHenry 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 6 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28.19 0 1718.44 0 0 0 0 0 0 1746.63 0 0 0 1101180031 1104081363 10 Physicians CUTUK ADNAN 631102515 826 Missouri 0 0 Orthopedic Surgery 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 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 0 457.52 0 0 0 0 0 0 457.52 0 0 0 1101180032 1750366050 10 Physicians LUSSNIG ERICH 600162359 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 614 0 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 792 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 792 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23697.38 0 1644.93 0 0 0 0 0 0 25342.31 0 0 0 1101180033 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 18185.11 0 0 0 0 0 0 0 0 0 0 0 0 0 18185.11 0 0 0 1101180043 1558334573 10 Physicians VISSA SRIRAM 631415010 826 Missouri 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 831.35 0 0 0 0 0 0 831.35 0 0 0 1101180057 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 2885.1 0 0 0 0 0 0 0 0 0 0 0 0 0 2885.1 0 0 0 1101180059 92 Waiver service provider--Disability (DHS/DRS) 39 Greene 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20389.84 0 0 0 0 0 0 0 0 0 0 0 0 0 20389.84 0 0 0 1101180060 1831115153 10 Physicians MUKHERJI ISABELLA 606112991 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 228 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 258 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 258 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50641.08 0 0 0 0 0 0 50641.08 0 0 0 1101180068 1245326156 10 Physicians CORVINO TIMOTHY 604358200 107 Will 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 1690 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1908 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1908 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63067.25 0 0 0 0 0 0 63067.25 0 0 0 1101180086 70 Ambulance Service Providers 826 Missouri 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1371.93 0 0 0 0 0 0 1371.93 0 0 0 1101180088 10 Physicians 826 Missouri 0 0 Psychiatry 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 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 0 217.2 0 0 0 0 0 0 217.2 0 0 0 1101180117 1598818395 10 Physicians LEE MICHAEL 600101901 57 Lake 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 266 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 328 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 328 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9181.7 0 0 0 0 0 0 9181.7 0 0 0 1101180118 92 Waiver service provider--Disability (DHS/DRS) 46 Iroquois 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5405.94 0 0 0 0 0 0 0 0 0 0 0 0 0 5405.94 0 0 0 1101180129 1972545358 10 Physicians PARKS BARI 606081732 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15663.36 0 0 0 0 0 0 15663.36 0 0 0 1101180130 91 Waiver service provider--Adults (DHS/DDD) 57 Lake 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 0 360 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24310 0 0 0 0 0 0 0 0 0 0 0 0 0 24310 0 0 0 1101180136 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6007.52 0 0 0 0 0 0 0 0 0 0 0 0 0 6007.52 0 0 0 1101180138 10 Physicians 816 Iowa 0 0 Endocrinology 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87.4 0 0 0 0 0 0 87.4 0 0 0 1101180149 1356378509 10 Physicians MILLARD ANTHONY 604113400 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 793 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 884 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 884 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28509.25 0 0 0 0 0 0 28509.25 0 0 0 1101180152 1538264957 10 Physicians HWANG CHRISTOPHER 605047222 30 DuPage 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 446 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 477 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 477 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15846.29 0 0 0 0 0 0 15846.29 0 0 0 1101180153 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 30917.79 0 0 0 0 0 0 0 0 0 0 0 0 0 30917.79 0 0 0 1101180159 1174651616 34 State-operated facility (DHS) UNIT 3266 HOME 16 KILEY 600856263 57 Lake 0 0 0 0 0 0 0 0 0 0 0 7 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 0 630 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 476143.7 0 0 0 0 0 0 0 0 0 0 476143.7 0 0 0 1101180180 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23769.94 0 0 0 0 0 0 0 0 0 0 0 0 0 23769.94 0 0 0 1101180188 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12438.88 0 0 0 0 0 0 0 0 0 0 0 0 0 12438.88 0 0 0 1101180190 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17292 0 0 0 0 0 0 0 0 0 0 0 0 0 17292 0 0 0 1101180208 1831348952 16 Nurse Practitioners CAPPELLA ELIZABETH 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 211.95 0 0 0 0 0 0 211.95 0 0 0 1101180220 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4469.14 0 0 0 0 0 0 0 0 0 0 0 0 0 4469.14 0 0 0 1101180221 1558358804 33 Nursing Facilities FRIENDSHIP SKILLED NSG REHAB 626261165 64 Macoupin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 309 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7529 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 622310.72 0 0 0 0 0 0 0 622310.72 0 0 0 1101180232 1164758660 63 Other Providers of Medical Equipment/Supplies (Non-registered) AIR 24 622083419 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9151.47 0 208.17 0 0 0 0 9359.64 0 0 0 1101180238 92 Waiver service provider--Disability (DHS/DRS) 34 Fayette 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 4295.18 0 0 0 0 0 0 0 0 0 0 0 0 0 4295.18 0 0 0 1101180242 94 Waiver service provider--Children's support (DHS/DDD) 105 White 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 0 233 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 233 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16366.7 0 0 0 0 0 0 0 0 0 0 0 0 0 16366.7 0 0 0 1101180252 47 Local Education Agencies 61 Livingston 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 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72.12 0 72.12 0 0 0 1101180254 1548275746 60 Pharmacies WALGREEN CO 7362 604031848 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 639 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2604 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63815 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97573.9 0 0 0 97573.9 0 0 0 1101180256 1891023164 10 Physicians IL DEPT OF PUBLIC HEALTH 627610999 91 Sangamon 0 0 General Practice 0 0 0 0 17814 0 0 0 0 0 0 2378 0 0 0 0 0 0 0 0 0 0 0 18158 0 0 0 0 0 0 5349 0 0 0 0 0 0 0 0 0 0 0 18158 0 0 0 0 0 0 5349 0 0 0 0 0 0 0 0 0 0 0 429983.55 0 0 0 0 0 0 231018.37 0 0 0 0 0 0 0 0 661001.92 0 0 0 1101180265 1356362941 30 General Hospitals NEPHRON DIALYSIS CENTER LTD 606253645 200 Cook NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 505 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61174.79 0 0 0 0 0 61174.79 0 0 0 1101180268 1497871156 10 Physicians POZZI PATRICK E 600073372 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7684.83 0 0 0 0 0 0 7684.83 0 0 0 1101180300 1578558300 33 Nursing Facilities JERSEYVILLE MANOR 620521169 50 Jersey 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1099 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28343 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2482697.93 0 0 0 0 0 0 0 2482697.93 0 0 0 1101180325 1396799961 10 Physicians GOMEZ DEL RIO MARIA 477140541 815 Indiana 0 0 Neonatal-Perinatal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8162.54 0 0 0 0 0 0 8162.54 0 0 0 1101180326 92 Waiver service provider--Disability (DHS/DRS) 81 Perry 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 30291.24 0 0 0 0 0 0 0 0 0 0 0 0 0 30291.24 0 0 0 1101180329 1891736492 10 Physicians SHAH VIJAY 605047205 30 DuPage 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 15 0 472 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 863 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 863 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 170.9 0 11314.53 0 0 0 0 0 0 11485.43 0 0 0 1101180339 22 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 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 0 174.36 174.36 0 0 0 1101180350 10 Physicians 816 Iowa 0 0 Anesthesiology 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 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 0 421.15 0 0 0 0 0 0 421.15 0 0 0 1101180359 1346273562 10 Physicians WALEGA DAVID 606118709 200 Cook 0 0 Anesthesiology 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 0 268 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 268 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5532.2 0 0 0 0 0 0 5532.2 0 0 0 1101180366 1578556692 10 Physicians RAMANA PABBISETTY 605461166 200 Cook 0 1 Pediatrics 0 204 0 0 114 0 0 0 0 0 0 40 0 183 0 0 0 0 0 0 484 0 0 346 0 0 0 0 0 0 44 0 256 0 0 0 0 0 0 484 0 0 346 0 0 0 0 0 0 44 0 256 0 0 0 0 0 0 968 0 0 10697.66 0 0 0 0 0 0 308.67 0 10382.72 0 0 0 0 0 0 22357.05 0 0 0 1101180381 1396994141 10 Physicians BEAUBIER NIKE 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 176 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 215 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 215 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3502.51 0 0 0 0 0 0 0 0 3502.51 0 0 0 1101180391 70 Ambulance Service Providers 100 Vermilion 0 0 0 0 0 0 0 0 0 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101180416 1831176338 10 Physicians TAMLYN THOMAS 463211215 815 Indiana 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 9 0 434 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 898 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 898 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 153.54 0 9127.45 0 0 0 0 0 0 9280.99 0 0 0 1101180424 1619959137 10 Physicians SHIVARAM KALUGOTLA 620024568 65 Madison 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 710.45 0 0 0 0 0 0 710.45 0 0 0 1101180433 14 Chiropractors 80 Peoria 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 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83.12 0 0 0 0 0 0 83.12 0 0 0 1101180434 1124059373 10 Physicians ROBICSEK ARI A 602031311 200 Cook 0 0 Internal Medicine 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 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 640.38 0 0 0 0 0 0 640.38 0 0 0 1101180436 92 Waiver service provider--Disability (DHS/DRS) 815 Indiana 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 40960.06 0 0 0 0 0 0 0 0 0 0 0 0 0 40960.06 0 0 0 1101180438 1326015645 10 Physicians DANKO ISTVAN 535625531 852 Wisconsin 0 0 Pediatrics 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 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2871.89 0 0 0 0 0 0 2871.89 0 0 0 1101180443 1447257258 30 General Hospitals HAMILTON MEMORIAL HOSPITAL 628590429 41 Hamilton DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 1 0 0 0 0 0 74 0 0 0 0 0 0 715 0 0 295 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 2951 0 0 1248 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 2951 0 0 1248 0 0 0 0 0 0 0 0 417.35 0 0 0 0 0 0 16631.48 0 0 107676.64 0 0 0 0 0 124725.47 0 0 0 1101180462 1760508907 36 Community mental health provider TAZWOOD MENTAL HEALTH CTR 616112560 98 Tazewell 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 281 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1196 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1196 0 0 6151.28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71862.16 0 0 78013.44 0 0 0 1101180469 1154533057 10 Physicians VEACH CASEY 612656180 89 Rock Island 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 752 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 949 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 949 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17450.45 0 1133.23 0 0 0 0 0 0 18583.68 0 0 0 1101180471 1518946912 10 Physicians HOLCOMB PAUL 637034914 826 Missouri 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2420.07 0 0 0 0 0 0 2420.07 0 0 0 1101180473 1851342810 10 Physicians BERGER PETER 606575640 200 Cook 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 2364 0 257 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3867 0 454 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3867 0 454 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72566.89 0 6160.17 0 0 0 0 0 0 78727.06 0 0 0 1101180479 91 Waiver service provider--Adults (DHS/DDD) 65 Madison 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 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6385.5 0 0 0 0 0 0 0 0 0 0 0 0 0 6385.5 0 0 0 1101180480 1912959578 10 Physicians HOLLANDER LAWRENCE 628121969 36 Franklin 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7621.75 0 0 0 0 0 0 7621.75 0 0 0 1101180487 1831136654 10 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 170 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 170 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 663.57 0 249.87 0 0 0 0 913.44 0 0 0 1101181618 1285667691 33 Nursing Facilities BUCKINGHAM PAVILION 606453109 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 914 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23701 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2216035.47 0 0 0 0 0 0 0 2216035.47 0 0 0 1101181625 10 Physicians 852 Wisconsin 0 0 Internal Medicine 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 96.91 0 0 0 0 0 0 96.91 0 0 0 1101181640 1568486165 60 Pharmacies CAINS DRUG STORE INC 624711028 34 Fayette 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 113 0 0 1833 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 234 0 0 18813 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 234 0 0 458133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8138.29 0 0 761605.56 0 0 0 769743.85 0 0 0 1101181652 1114992963 25 Audiologists BLOUNT VICTORIA 627810001 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0 0 0 0 0 0 0 0 0 0 0 0 1651.59 0 0 0 1101181662 1679636187 10 Physicians STERN TODD 603023212 200 Cook 0 1 Internal Medicine 0 13 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 196 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 196 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 0 0 3358.51 0 0 0 0 0 0 3460.51 0 0 0 1101181666 1649239740 13 Podiatrists COHEN ROBERT 606401635 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 533 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 533 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1899.85 0 0 0 0 0 0 1899.85 0 0 0 1101181675 1265465108 10 Physicians HRONCICH MARK 604022338 200 Cook 0 1 Internal Medicine 0 53 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 308 0 0 0 0 0 0 0 0 0 0 0 304 0 0 0 0 0 0 308 0 0 0 0 0 0 0 0 0 0 0 304 0 0 0 0 0 0 900 0 0 0 0 0 0 0 0 0 0 0 3827.91 0 0 0 0 0 0 4727.91 0 0 0 1101181680 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 19114.09 0 0 0 0 0 0 0 0 0 0 0 0 0 19114.09 0 0 0 1101181690 1720001647 10 Physicians APPLETON CATHERINE 631101016 826 Missouri 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 8 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 109.49 0 564.92 0 0 0 0 0 0 674.41 0 0 0 1101181691 1750334504 70 Ambulance Service Providers WOOD DALE FIRE PROT DIST 1 601911535 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4893.67 0 0 0 0 0 0 4893.67 0 0 0 1101181705 1992713309 12 Optometrists NICHOLSON MATTHEW 609142458 54 Kankakee 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 243 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 399 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 399 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5421.07 0 0 0 0 0 0 5421.07 0 0 0 1101181709 1992975619 10 Physicians MCFARLANE PAUL 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Transportation Providers ( Non-Registered) 89 Rock Island 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 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 0 189.52 0 0 0 0 0 0 189.52 0 0 0 1101181767 1295928158 24 Speech Therapists KORB LOREE 623017402 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11827.28 11827.28 0 0 0 1101181768 1417163205 10 Physicians ONEIL JONATHAN 611033600 109 Winnebago 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 171 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 255 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 255 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7766.49 0 0 0 0 0 0 7766.49 0 0 0 1101181775 92 Waiver service provider--Disability (DHS/DRS) 73 Menard 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 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 2054.95 0 0 0 0 0 0 0 0 0 0 0 0 0 2054.95 0 0 0 1101181785 93 Waiver service provider--HIV/AIDS (DHS/DRS) 815 Indiana 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12065.64 0 0 0 0 0 0 0 0 0 0 0 0 0 12065.64 0 0 0 1101181787 91 Waiver service provider--Adults (DHS/DDD) 74 Mercer 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 0 295 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 0 0 0 0 0 0 0 0 0 0 0 0 23496 0 0 0 0 0 0 0 0 0 0 0 0 0 23496 0 0 0 1101181798 1720070386 10 Physicians SABA HANNA 625265858 63 Macon 0 0 Oncology 0 0 0 0 0 0 0 0 0 0 0 39 0 188 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 374 0 2685 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 374 0 2685 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2931.91 0 294273.95 0 0 0 0 0 0 297205.86 0 0 0 1101181800 1114964673 10 Physicians ASONYE UDOCHUKWU 606930330 30 DuPage 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8417.93 0 0 0 0 0 0 8417.93 0 0 0 1101181801 1104837780 10 Physicians KENDALL AGNIESZKA 606313716 200 Cook 0 1 Pediatrics 0 457 0 0 498 0 0 0 0 0 0 129 0 650 0 0 0 0 0 0 4266 0 0 2576 0 0 0 0 0 0 148 0 1469 0 0 0 0 0 0 4266 0 0 2576 0 0 0 0 0 0 148 0 1469 0 0 0 0 0 0 8554 0 0 66803.09 0 0 0 0 0 0 2248.41 0 86392.49 0 0 0 0 0 0 163997.99 0 0 0 1101181803 1750392866 10 Physicians IGNACZEWSKI ANNA 604671982 200 Cook 0 1 Pediatrics 0 216 0 0 23 0 0 0 0 0 0 0 0 151 0 0 0 0 0 0 605 0 0 35 0 0 0 0 0 0 0 0 366 0 0 0 0 0 0 605 0 0 35 0 0 0 0 0 0 0 0 366 0 0 0 0 0 0 1212 0 0 737.27 0 0 0 0 0 0 0 0 17910.63 0 0 0 0 0 0 19859.9 0 0 0 1101181805 1316085137 24 Speech Therapists BAUER LINDA 605102478 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 700 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 700 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48353.69 48353.69 0 0 0 1101181813 1518978295 10 Physicians DALE WILLIAM 605615314 30 DuPage 0 0 Geriatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 887.3 0 0 0 0 0 0 887.3 0 0 0 1101181843 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 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 19966.66 0 0 0 0 0 0 0 0 0 0 0 0 0 19966.66 0 0 0 1101181879 1679630297 10 Physicians SWIFT JOHNSON AMY 600734905 57 Lake 0 1 Family Practice 0 1065 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4757 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4757 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11422 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11422 0 0 0 1101181884 93 Waiver service provider--HIV/AIDS (DHS/DRS) 96 St Clair 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 7939.71 0 0 0 0 0 0 0 0 0 0 0 0 0 7939.71 0 0 0 1101181892 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11234.29 0 0 0 0 0 0 0 0 0 0 0 0 0 11234.29 0 0 0 1101181909 1669595872 10 Physicians WAGGONER DARREL 605275993 30 DuPage 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1421.71 0 0 0 0 0 0 1421.71 0 0 0 1101181914 1528216629 11 Dentists SHIN HYUN 605062453 53 Kane 0 0 General Dentistry 0 0 0 244 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1833 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1833 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54770.23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54770.23 0 0 0 1101181916 1821060039 10 Physicians SMITH PAMELA 606513161 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 1 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 84.62 0 0 0 0 0 0 0 0 3413.85 0 0 0 0 0 0 3498.47 0 0 0 1101181921 1790888931 10 Physicians SHEIKH JAVED 610324864 97 Stephenson 0 0 Geriatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 259 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 803 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 803 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11693.13 0 0 0 0 0 0 11693.13 0 0 0 1101181935 1225162092 22 Physical Therapists OVERSTREET RENITA 601206822 53 Kane 0 0 0 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 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9763.74 9763.74 0 0 0 1101181938 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11895.74 0 0 0 0 0 0 0 0 0 0 0 0 0 11895.74 0 0 0 1101181940 24 Speech 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 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1959.12 1959.12 0 0 0 1101181943 1568401529 10 Physicians GUNDLAPALLI SUSHAMA 605400954 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 1 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 186 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 186 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5308.4 0 0 0 0 0 0 5308.4 0 0 0 1101181950 1265751291 11 Dentists BHATWADEKAR SAYALI 601232800 53 Kane 0 0 General Dentistry 0 0 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 337 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 337 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9838.54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9838.54 0 0 0 1101181973 1851324503 10 Physicians KHANDEKAR JANARDAN 602011718 200 Cook 0 0 Oncology 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 348.91 0 0 0 0 0 0 348.91 0 0 0 1101181985 1316077662 10 Physicians NEIL SEIF 463212901 815 Indiana 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 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rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 27 0 0 0 0 7 0 0 0 30 0 0 0 0 0 0 0 0 0 33 0 0 0 0 8 0 0 0 76 0 0 0 0 0 0 0 0 0 33 0 0 0 0 33 0 0 0 76 0 0 0 0 0 0 0 0 0 6251.98 0 0 0 0 21294.37 0 0 0 37061.15 0 0 0 0 0 64607.5 0 0 0 1101182021 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 0 270 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 270 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15665.65 0 0 0 0 0 0 0 0 0 0 0 0 0 15665.65 0 0 0 1101182022 1194708271 13 Podiatrists RIZZO THOMAS 612541344 45 Henry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 310 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 310 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2057.19 0 0 0 0 0 0 2057.19 0 0 0 1101182032 1568660009 64 Imaging Services MARAYAH DIAGNOSTIC LLC 604551821 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 168 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 922 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 922 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38502.72 0 0 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0 0 1101182178 92 Waiver service provider--Disability (DHS/DRS) 107 Will 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 2731.17 0 0 0 0 0 0 0 0 0 0 0 0 0 2731.17 0 0 0 1101182193 1972587061 10 Physicians RERRI BERNARD 999999999 49 Jefferson 0 0 0 0 0 0 0 0 0 0 0 0 0 165 0 263 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 392 0 850 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 392 0 850 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4885.05 0 99617.16 0 0 0 0 0 0 104502.21 0 0 0 1101182202 10 Physicians 852 Wisconsin 0 0 Emergency Medicine 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53.1 0 0 0 0 0 0 53.1 0 0 0 1101182209 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 1281.39 0 0 0 0 0 0 0 0 0 0 0 0 0 1281.39 0 0 0 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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 8563.38 0 0 0 0 0 0 0 0 0 0 0 0 0 8563.38 0 0 0 1101182492 10 Physicians 852 Wisconsin 0 0 Orthopedic Surgery 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 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 24.45 0 0 0 0 0 0 24.45 0 0 0 1101182498 1134358922 36 Community mental health provider LAWRENCE COUNTY HEALTH DEPT 624390516 59 Lawrence 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1470 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1470 0 0 932.4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82375.85 0 0 83308.25 0 0 0 1101182513 1275733073 10 Physicians KELLENBERGER BRYAN 627949248 91 Sangamon 0 0 Family Practice 0 3 0 0 5 0 0 0 0 0 0 1 0 58 0 0 0 0 0 0 4 0 0 5 0 0 0 0 0 0 1 0 92 0 0 0 0 0 0 4 0 0 5 0 0 0 0 0 0 1 0 92 0 0 0 0 0 0 12 0 0 160.75 0 0 0 0 0 0 2.6 0 1807.03 0 0 0 0 0 0 1982.38 0 0 0 1101182516 1215918685 10 Physicians ORZA FLORIN 606127239 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20128.73 0 0 0 0 0 0 20128.73 0 0 0 1101182517 92 Waiver service provider--Disability (DHS/DRS) 10 Adams 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 10668.57 0 0 0 0 0 0 0 0 0 0 0 0 0 10668.57 0 0 0 1101182519 94 Waiver service provider--Children's support (DHS/DDD) 63 Macon 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 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2946.07 0 0 0 0 0 0 0 0 0 0 0 0 0 2946.07 0 0 0 1101182529 92 Waiver service provider--Disability (DHS/DRS) 89 Rock Island 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 22401 0 0 0 0 0 0 0 0 0 0 0 0 0 22401 0 0 0 1101182534 30 General Hospitals 810 Florida NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 2 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 0 267.58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 267.58 0 0 0 1101182543 1538196043 10 Physicians SHAH MEHUL 606313713 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 489 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 489 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2726.66 0 0 0 0 0 0 2726.66 0 0 0 1101182544 1871760934 10 Physicians AHMAD IMRAN 601228942 200 Cook 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 226 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 226 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7413.68 0 0 0 0 0 0 7413.68 0 0 0 1101182565 1033138243 10 Physicians PURYEAR AKI 631102515 826 Missouri 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 404 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 679 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 679 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68084.77 0 0 0 0 0 0 68084.77 0 0 0 1101182567 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4342.62 0 0 0 0 0 0 0 0 0 0 0 0 0 4342.62 0 0 0 1101182580 1245313964 10 Physicians DILLON CATHERINE 600761248 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 1 0 0 0 0 0 0 6 0 29 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 6 0 44 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 6 0 44 0 0 0 0 0 0 0 0 0 104.96 0 0 0 0 0 0 81.82 0 1648.97 0 0 0 0 0 0 1835.75 0 0 0 1101182586 1851376032 10 Physicians PADOVANO VINCENZO 600483266 57 Lake 0 0 Obstetric-Gynecology 0 0 0 0 42 0 0 0 0 0 0 155 0 388 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 314 0 2797 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 314 0 2797 0 0 0 0 0 0 0 0 0 837 0 0 0 0 0 0 11214.63 0 226332.4 0 0 0 0 0 0 238384.03 0 0 0 1101182593 1356513790 29 ICF/MR GLENWOOD TERRACE SPRINGFIELD 627045010 91 Sangamon 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 0 497 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8274 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 593164.88 0 0 0 0 0 0 0 0 0 0 593164.88 0 0 0 1101182594 1104843176 10 Physicians MIKULEC ANTHONY 631102515 826 Missouri 0 0 Otorhinolaryngology 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 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3758.68 0 0 0 0 0 0 3758.68 0 0 0 1101182613 1982647707 10 Physicians CHOKSHI SAPANA 605153437 30 DuPage 0 0 Psychiatry 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 0 168 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 168 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3265.78 0 0 0 0 0 0 3265.78 0 0 0 1101182614 1841479946 60 Pharmacies HEALTHY RX INC 604551824 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 815 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8233 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 236698 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 437326.56 0 0 0 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0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 612.51 0 0 0 0 0 0 612.51 0 0 0 1101182654 92 Waiver service provider--Disability (DHS/DRS) 96 St Clair 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 39475.11 0 0 0 0 0 0 0 0 0 0 0 0 0 39475.11 0 0 0 1101182660 1598852659 70 Ambulance Service Providers RIVER FOREST FIRE DEPARTMENT 603051726 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7989.34 0 0 0 0 0 0 7989.34 0 0 0 1101182669 1073883203 10 Physicians WHITING CLYDE 628632638 101 Wabash 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 284 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 304 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 304 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10271.13 0 0 0 0 0 0 10271.13 0 0 0 1101182680 98 Waiver service provider--TBI (DHS/DRS) 80 Peoria 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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APRIA HEALTHCARE INC 618212405 19 Champaign 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 0 592 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 592 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26932.2 0 0 0 0 0 0 26932.2 0 0 0 1101182715 1427165943 10 Physicians NUSSBAUM STEVEN 606113015 200 Cook 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 0 0 0 228 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 389 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 389 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4897.9 0 0 0 0 0 0 4897.9 0 0 0 1101182719 1396712220 10 Physicians LO RAULIE 606740018 107 Will 0 1 Pediatrics 0 13 0 0 13 0 0 0 0 0 0 4 0 15 0 0 0 0 0 0 101 0 0 36 0 0 0 0 0 0 4 0 19 0 0 0 0 0 0 101 0 0 36 0 0 0 0 0 0 4 0 19 0 0 0 0 0 0 202 0 0 1308.72 0 0 0 0 0 0 68.92 0 588.91 0 0 0 0 0 0 2168.55 0 0 0 1101182727 1720200512 11 Dentists DEVAYYA CHEPPUDIRA N 608276129 200 Cook 0 0 General Dentistry 0 0 0 307 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1407 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1407 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 0 0 324 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 473 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 473 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3877.34 0 0 0 0 0 0 3877.34 0 0 0 1101182850 1356387559 10 Physicians LIN HENRY Y 606202540 200 Cook 0 0 General Practice 0 428 0 0 82 0 0 0 0 0 0 0 0 443 0 0 0 0 0 0 2593 0 0 270 0 0 0 0 0 0 0 0 1150 0 0 0 0 0 0 2593 0 0 270 0 0 0 0 0 0 0 0 1150 0 0 0 0 0 0 6534 0 0 8765.95 0 0 0 0 0 0 0 0 22864.19 0 0 0 0 0 0 38164.14 0 0 0 1101182853 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 14 0 0 0 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 0 930.6 0 0 0 0 0 0 0 0 0 0 0 0 0 930.6 0 0 0 1101182855 1396840153 33 Nursing Facilities GOOD SAMARITAN HOME OF QUINCY 623016756 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1063 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27271 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2278564.41 0 0 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0 0 0 0 0 0 0 0 348 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5646.39 0 0 0 0 0 0 0 0 0 0 0 0 0 5646.39 0 0 0 1101184799 1578821005 40 Federally Qualified Health Centers FRANCES NELSON HEALTH CENTER 999999999 19 Champaign 0 0 0 1372 2576 0 649 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8601 16167 0 2294 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8601 16167 0 2294 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22170 657370.64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 679540.64 0 0 0 1101184800 1942203914 36 Community mental health provider LIFELINKS MENTAL HEALTH 619384610 24 Coles 0 0 Childrens mental health 0 625 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1972 0 0 11764 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30064 0 0 11764 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30064 0 0 145035.94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1947460.91 0 0 2092496.85 0 0 0 1101184815 10 Physicians 852 Wisconsin 0 0 Pediatric Hematology Oncology 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 291.34 0 0 0 0 0 0 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0 0 0 0 0 0 271 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8162.94 0 0 0 0 0 0 0 0 0 0 0 0 0 8162.94 0 0 0 1101185084 1588705982 10 Physicians ULYANOVA OLGA 601542515 200 Cook 0 1 Pediatrics 0 40 0 0 89 0 0 0 0 0 0 45 0 108 0 0 0 0 0 0 152 0 0 304 0 0 0 0 0 0 88 0 178 0 0 0 0 0 0 152 0 0 304 0 0 0 0 0 0 88 0 178 0 0 0 0 0 0 304 0 0 8460.78 0 0 0 0 0 0 341.05 0 6024.59 0 0 0 0 0 0 15130.42 0 0 0 1101185097 10 Physicians 852 Wisconsin 0 0 Pathology 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 119.7 0 0 0 0 0 0 0 0 119.7 0 0 0 1101185105 1972553261 10 Physicians EKLUND HEIDI 605407430 30 DuPage 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 537 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 696 0 260 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 696 0 260 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9742.65 0 3638.91 0 0 0 0 0 0 13381.56 0 0 0 1101185110 10 Physicians 816 Iowa 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 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JINSUP 604519607 107 Will 0 1 Internal Medicine 0 44 0 0 0 0 0 0 0 0 0 0 0 61 0 0 0 0 0 0 238 0 0 0 0 0 0 0 0 0 0 0 181 0 0 0 0 0 0 238 0 0 0 0 0 0 0 0 0 0 0 181 0 0 0 0 0 0 684 0 0 0 0 0 0 0 0 0 0 0 6368.55 0 0 0 0 0 0 7052.55 0 0 0 1101185755 92 Waiver service provider--Disability (DHS/DRS) 106 Whiteside 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 27848.09 0 0 0 0 0 0 0 0 0 0 0 0 0 27848.09 0 0 0 1101185764 92 Waiver service provider--Disability (DHS/DRS) 30 DuPage 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 24372.53 0 0 0 0 0 0 0 0 0 0 0 0 0 24372.53 0 0 0 1101185767 1154363349 60 Pharmacies CVS PHARMACY 08632 625213515 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1454 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7502 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 163154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 291039.27 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 502 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16358.87 0 0 0 0 0 0 16358.87 0 0 0 1101185828 92 Waiver service provider--Disability (DHS/DRS) 66 Marion 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 2860.59 0 0 0 0 0 0 0 0 0 0 0 0 0 2860.59 0 0 0 1101185833 1629076971 10 Physicians MIGAS JOHN 617613815 72 McLean 0 0 Oncology 0 0 0 0 0 0 0 0 0 0 0 8 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 212 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 212 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 247.28 0 32180.01 0 0 0 0 0 0 32427.29 0 0 0 1101185840 1992817837 60 Pharmacies NATHAN PHARMACY 606455253 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 521 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6772 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 204861 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69508.32 0 0 0 69508.32 0 0 0 1101185844 1457698961 16 Nurse Practitioners BARA JESSICA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4743.34 0 0 0 0 0 0 4743.34 0 0 0 1101185849 1124204565 16 Nurse Practitioners SZKLINIARZ KELLY 606313222 200 Cook 0 0 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 61 0 0 0 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 0 128.8 0 0 0 0 0 0 128.8 0 0 0 1101185854 1023047842 10 Physicians UNFER SUSAN 600681110 200 Cook 0 1 Pediatrics 0 527 0 0 319 0 0 0 0 0 0 200 0 460 0 0 0 0 0 0 5098 0 0 1051 0 0 0 0 0 0 308 0 591 0 0 0 0 0 0 5098 0 0 1051 0 0 0 0 0 0 308 0 591 0 0 0 0 0 0 10198 0 0 32493.3 0 0 0 0 0 0 1868.16 0 24697.88 0 0 0 0 0 0 69257.34 0 0 0 1101185867 1336102250 10 Physicians KAMINSKI MITCHELL 607144444 200 Cook 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 227 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5808.67 0 0 0 0 0 0 5808.67 0 0 0 1101185869 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 25965.96 0 0 0 0 0 0 0 0 0 0 0 0 0 25965.96 0 0 0 1101185881 1679729644 63 Other Providers of Medical Equipment/Supplies (Non-registered) SECOND ACT LLC 606574109 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6358.3 0 0 0 0 6358.3 0 0 0 1101185893 1740306679 39 Hospice QUAD COUNTY HOSPICE 625571721 20 Christian 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 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 597 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56739.42 0 0 0 0 0 0 0 0 0 0 0 56739.42 0 0 0 1101185901 1003994443 63 Other Providers of Medical Equipment/Supplies (Non-registered) LINCARE INC 613502209 58 La Salle 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 437 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 207508.49 0 0 0 0 0 0 207508.49 0 0 0 1101185903 1427076850 10 Physicians WINDUS DAVID 631101010 826 Missouri 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 10 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12.72 0 1357.33 0 0 0 0 0 0 1370.05 0 0 0 1101185911 1316985914 10 Physicians MORGAN CHRISTOPHER 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2139.45 0 44.61 0 0 0 0 0 0 2184.06 0 0 0 1101185915 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7172.06 0 0 0 0 0 0 0 0 0 0 0 0 0 7172.06 0 0 0 1101185919 16 Nurse Practitioners 826 Missouri 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 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0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9.4 0 0 0 0 0 0 9.4 0 0 0 1101185942 63 Other Providers of Medical Equipment/Supplies (Non-registered) 80 Peoria 0 0 0 0 0 0 0 0 0 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 14 0 0 0 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 0 453.98 0 0 0 0 0 0 453.98 0 0 0 1101185952 1134125032 10 Physicians SHORT NANCY 612444287 89 Rock Island 0 1 Family Practice 0 15 0 0 3 0 0 0 0 0 0 7 0 32 0 0 0 0 0 0 150 0 0 3 0 0 0 0 0 0 7 0 110 0 0 0 0 0 0 150 0 0 3 0 0 0 0 0 0 7 0 110 0 0 0 0 0 0 591 0 0 175.71 0 0 0 0 0 0 43.48 0 3244.26 0 0 0 0 0 0 4054.45 0 0 0 1101185970 1497741508 13 Podiatrists LUCAS PAUL R 606081732 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 240 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 848 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 848 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15812.09 0 0 0 0 0 0 15812.09 0 0 0 1101185979 91 Waiver service provider--Adults (DHS/DDD) 47 Jackson 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 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8971.06 0 0 0 0 0 0 0 0 0 0 0 0 0 8971.06 0 0 0 1101185983 10 Physicians 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 259.58 0 0 0 0 0 0 259.58 0 0 0 1101185989 73 Other Transportation Providers ( Non-Registered) 88 Richland 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29.21 0 0 0 0 0 0 29.21 0 0 0 1101186015 1295883551 10 Physicians MCDERMOTT RAYMOND 606257014 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 2 0 0 0 0 0 0 4 0 169 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 4 0 393 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 4 0 393 0 0 0 0 0 0 0 0 0 39.23 0 0 0 0 0 0 9.92 0 36435.96 0 0 0 0 0 0 36485.11 0 0 0 1101186018 1396717203 24 Speech Therapists HAMILTON PAULA 605438293 55 Kendall 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1007 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1007 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76027.8 76027.8 0 0 0 1101186024 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 264 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 264 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13371.05 0 0 0 0 0 0 0 0 0 0 0 0 0 13371.05 0 0 0 1101186025 1841591393 91 Waiver service provider--Adults (DHS/DDD) VALENTINO DENA A 600047234 200 Cook 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2780 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2780 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 149883.53 0 0 0 0 0 0 0 0 0 0 0 0 0 149883.53 0 0 0 1101186030 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12235.96 0 0 0 0 0 0 0 0 0 0 0 0 0 12235.96 0 0 0 1101186034 60 Pharmacies 815 Indiana 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 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 459 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 397.49 0 0 0 397.49 0 0 0 1101186035 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 5301.26 0 0 0 0 0 0 0 0 0 0 0 0 0 5301.26 0 0 0 1101186042 1912153115 10 Physicians ALI SADIA 606123723 200 Cook 0 0 Family Practice 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 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3584.53 0 0 0 0 0 0 3584.53 0 0 0 1101186046 1174854574 23 Occupational Therapists GALLAGHER ELIZABETH 600931120 200 Cook 0 0 0 0 0 0 0 0 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 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 5739.82 5739.82 0 0 0 1101186047 1881893212 10 Physicians GARCIA XOCHITL 616031747 80 Peoria 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 2 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 143.8 0 1939.67 0 0 0 0 0 0 2083.47 0 0 0 1101186061 1265407076 10 Physicians GEANNOPOULOS CHRIS 601901237 30 DuPage 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2599.11 0 0 0 0 0 0 2599.11 0 0 0 1101186079 1245450113 11 Dentists GOLDMAN SCOTT 600483712 57 Lake 0 0 General Dentistry 0 0 0 211 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 925 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 925 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26357.59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26357.59 0 0 0 1101186082 1174829295 16 Nurse Practitioners TRAINOR KELLY 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 231 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 231 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12437.1 0 0 0 0 0 0 12437.1 0 0 0 1101186085 1720104938 47 Local Education Agencies COBDEN SCH UNIT DIST 17 629202100 99 Union 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 1589 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 1589 0 0 0 0 287.96 0 0 0 0 0 0 0 0 0 0 0 0 0 21543.8 0 21831.76 0 0 0 1101186090 1215160320 10 Physicians GALILI DORON 600052349 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 848.62 0 0 0 0 0 0 848.62 0 0 0 1101186092 1174502868 13 Podiatrists SIGLE JOHN 627045359 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 369 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 369 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3851.44 0 0 0 0 0 0 3851.44 0 0 0 1101186138 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 9744.51 0 0 0 0 0 0 0 0 0 0 0 0 0 9744.51 0 0 0 1101186148 1063672095 10 Physicians ALPERIN RISA 606143363 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 232 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 232 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8930.87 0 0 0 0 0 0 8930.87 0 0 0 1101186182 92 Waiver service provider--Disability (DHS/DRS) 30 DuPage 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 47254.38 0 0 0 0 0 0 0 0 0 0 0 0 0 47254.38 0 0 0 1101186188 1558394569 12 Optometrists HEINISCH EDWARD 605064356 53 Kane 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 759.9 0 0 0 0 0 0 759.9 0 0 0 1101186193 1396763017 10 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0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16512.31 0 0 0 0 0 0 0 0 0 0 0 0 0 16512.31 0 0 0 1101186816 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 219 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 219 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15988.06 0 0 0 0 0 0 0 0 0 0 0 0 0 15988.06 0 0 0 1101186822 1578548921 10 Physicians ARLA POLAVARAPU LATHA 604519623 107 Will 0 0 Internal Medicine 0 68 0 0 0 0 0 0 0 0 0 22 0 88 0 0 0 0 0 0 533 0 0 0 0 0 0 0 0 0 37 0 246 0 0 0 0 0 0 533 0 0 0 0 0 0 0 0 0 37 0 246 0 0 0 0 0 0 1567 0 0 0 0 0 0 0 0 0 155.91 0 8994.49 0 0 0 0 0 0 10717.4 0 0 0 1101186825 1629209853 61 Independent Laboratories HEALTH DIAGNOSTIC LABORATORY 232191441 848 Virginia 0 0 0 0 0 0 0 0 0 0 0 0 0 237 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7986 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7986 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95221.22 0 0 0 0 0 0 0 0 95221.22 0 0 0 1101186829 1639311673 36 Community mental health provider PERRY COUNTY COUNSELING CENTER 628321839 81 Perry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1366.16 0 0 1366.16 0 0 0 1101186837 1144526351 16 Nurse Practitioners STANLEY SANDRA 999999999 107 Will 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 261 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 585 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 585 0 0 0 0 0 0 0 0 0 32.15 0 0 0 0 0 0 0 0 12336.7 0 0 0 0 0 0 12368.85 0 0 0 1101186838 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 32076.93 0 0 0 0 0 0 0 0 0 0 0 0 0 32076.93 0 0 0 1101186840 1982643540 10 Physicians KALIMULLAH ZEBAA 604020715 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 497 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 552 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 552 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18955.24 0 0 0 0 0 0 18955.24 0 0 0 1101186847 46 Ambulatory Surgical Treatment Centers 200 Cook NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 739.67 0 0 0 0 0 739.67 0 0 0 1101186848 1679505242 10 Physicians HOOD DOUGLAS 627949639 91 Sangamon 0 0 Vascular Surgery 0 0 0 0 0 0 0 0 0 0 0 7 0 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 418 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 418 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90.54 0 95530.26 0 0 0 0 0 0 95620.8 0 0 0 1101186861 1730304684 47 Local Education Agencies TRI COUNTY SPECIAL EDUCATION 617047272 72 McLean 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 619 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 7226 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 7226 0 0 0 0 139.42 0 0 0 0 0 0 0 0 0 0 0 0 0 104645.62 0 104785.04 0 0 0 1101186872 1700890969 10 Physicians SIMON CHARLA E 606574228 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 15 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 243 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 243 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 838.72 0 23812.83 0 0 0 0 0 0 24651.55 0 0 0 1101186883 1174524110 16 Nurse Practitioners KUNSTMULLER RENE 637014011 826 Missouri 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 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319.8 0 0 0 0 0 0 319.8 0 0 0 1101186889 1073520516 10 Physicians BARTLETT ANDREW 618206217 19 Champaign 0 1 Internal Medicine 0 47 0 0 0 0 0 0 0 0 0 11 0 47 0 0 0 0 0 0 332 0 0 0 0 0 0 0 0 0 43 0 372 0 0 0 0 0 0 332 0 0 0 0 0 0 0 0 0 43 0 372 0 0 0 0 0 0 884 0 0 0 0 0 0 0 0 0 288.16 0 3014.95 0 0 0 0 0 0 4187.11 0 0 0 1101186892 1235290230 36 Community mental health provider DOUGLAS COUNTY MENTAL HEALTH 619531660 29 Douglas 0 0 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 302 0 0 482 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5049 0 0 482 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5049 0 0 18865.02 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 417280.68 0 0 436145.7 0 0 0 1101186899 1083623573 16 Nurse Practitioners WILLIAMSON WILLA 606123723 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159.04 0 0 0 0 0 0 159.04 0 0 0 1101186903 1750360764 10 Physicians ROBKEN JON 528032459 816 Iowa 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 2 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30.58 0 4156.18 0 0 0 0 0 0 4186.76 0 0 0 1101186905 1700177763 16 Nurse Practitioners PRUITT DAWN 628640000 49 Jefferson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1094 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1236 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1236 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43725.34 0 0 0 0 0 0 43725.34 0 0 0 1101186910 1376772327 24 Speech Therapists FISCHER ELLEN 605102478 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 493 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 493 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40804.79 40804.79 0 0 0 1101186915 1962554345 10 Physicians LEVINE JAMES 478042706 815 Indiana 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3621.61 0 0 0 0 0 0 3621.61 0 0 0 1101186921 1942339635 10 Physicians PAQUETTE KATHERINE 604532600 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 335 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 352 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 352 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13018.11 0 0 0 0 0 0 13018.11 0 0 0 1101186928 1164537825 10 Physicians KWAAN HAU C 606113141 200 Cook 0 0 Oncology 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 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 0 901.42 0 0 0 0 0 0 901.42 0 0 0 1101186934 1407852551 10 Physicians KLAZURA PAUL 611325730 109 Winnebago 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 22 0 113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 318 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 318 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 208.83 0 13809.81 0 0 0 0 0 0 14018.64 0 0 0 1101186935 1730297607 10 Physicians UNAL SHEREF 627949658 91 Sangamon 0 0 Pediatrics 0 95 0 0 121 0 0 0 0 0 0 25 0 270 0 0 0 0 0 0 698 0 0 513 0 0 0 0 0 0 25 0 416 0 0 0 0 0 0 698 0 0 513 0 0 0 0 0 0 25 0 416 0 0 0 0 0 0 1396 0 0 13354.86 0 0 0 0 0 0 239.28 0 45451.63 0 0 0 0 0 0 60441.77 0 0 0 1101186947 1871691758 11 Dentists RUBIS JOSEPH 604031881 107 Will 0 0 General Dentistry 0 0 0 341 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122111.05 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122111.05 0 0 0 1101186948 92 Waiver service provider--Disability (DHS/DRS) 71 McHenry 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 19999.98 0 0 0 0 0 0 0 0 0 0 0 0 0 19999.98 0 0 0 1101186958 1538323456 16 Nurse Practitioners THOMAS JESSY 999999999 30 DuPage 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 89.9 0 0 0 0 0 0 0 0 1399.82 0 0 0 0 0 0 1489.72 0 0 0 1101186962 1811050495 10 Physicians SINGH RAMA 604522657 200 Cook 0 1 Pediatrics 0 282 0 0 75 0 0 0 0 0 0 0 0 172 0 0 0 0 0 0 731 0 0 181 0 0 0 0 0 0 0 0 291 0 0 0 0 0 0 731 0 0 181 0 0 0 0 0 0 0 0 291 0 0 0 0 0 0 1462 0 0 3182.64 0 0 0 0 0 0 0 0 13057.77 0 0 0 0 0 0 17702.41 0 0 0 1101186975 1427054592 10 Physicians SCHAUER JEFFREY 611325730 109 Winnebago 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 13 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 1028.55 0 0 0 0 0 0 1028.55 0 0 0 1101186985 1982762720 16 Nurse Practitioners DAVIS SANDRA 605406508 30 DuPage 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 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 525.53 0 0 0 0 0 0 525.53 0 0 0 1101186986 1457373490 10 Physicians NULMAN BORIS 601181416 53 Kane 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 1 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 357.81 0 19236.45 0 0 0 0 0 0 19594.26 0 0 0 1101186989 1477664472 60 Pharmacies BECKS DRUGS 629301629 90 Saline 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1680 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21512 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 533652 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1025909.4 0 0 0 1025909.4 0 0 0 1101186992 1740236397 60 Pharmacies OSCO DRUG 3338 601853966 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 422 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 2169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 53625 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115.89 0 0 145166.57 0 0 0 145282.46 0 0 0 1101186995 92 Waiver service provider--Disability (DHS/DRS) 110 Woodford 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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28 0 0 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 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3185.65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3185.65 0 0 0 1101187033 30 General Hospitals 824 Minnesota ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 0 0 0 0 0 2 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 1802.72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1802.72 0 0 0 1101187034 1336314459 10 Physicians IRVING DANIEL 600052349 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 333 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 394 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 394 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11378.89 0 0 0 0 0 0 11378.89 0 0 0 1101187041 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 535.99 0 0 0 0 0 0 0 0 0 0 0 0 0 535.99 0 0 0 1101187042 1689788630 10 Physicians DAVIS DENNON 628961957 36 Franklin 0 0 Family Practice 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 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 511.67 0 0 0 0 0 0 511.67 0 0 0 1101187045 11 Dentists 108 Williamson 0 0 General Dentistry 0 0 0 1 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 77.4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77.4 0 0 0 1101187049 1184856825 16 Nurse Practitioners BROWN KARRI 624012099 33 Effingham 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 643 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 1157 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 1157 0 0 0 0 0 0 0 0 0 851.85 0 0 0 0 0 0 0 0 33816.97 0 0 0 0 0 0 34668.82 0 0 0 1101187051 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 273 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 273 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13382.6 0 0 0 0 0 0 0 0 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Wisconsin 0 0 Pediatrics 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42.5 0 0 0 0 0 0 42.5 0 0 0 1101190143 1407963879 10 Physicians IFTIKHAR TARIQ B 604023756 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 11 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230.63 0 3568.41 0 0 0 0 0 0 3799.04 0 0 0 1101190146 10 Physicians 107 Will 0 0 Neurology 0 0 0 0 0 0 0 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 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 69.55 0 0 0 0 0 0 69.55 0 0 0 1101190149 1013243765 10 Physicians OLPINSKI MARIAN 600073372 200 Cook 0 1 Pediatrics 0 305 0 0 257 0 0 0 0 0 0 32 0 277 0 0 0 0 0 0 1780 0 0 1141 0 0 0 0 0 0 43 0 706 0 0 0 0 0 0 1780 0 0 1141 0 0 0 0 0 0 43 0 706 0 0 0 0 0 0 3560 0 0 35473.83 0 0 0 0 0 0 568.13 0 36661.46 0 0 0 0 0 0 76263.42 0 0 0 1101190155 22 Physical Therapists 57 Lake 0 0 0 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 112.51 112.51 0 0 0 1101190168 1508948530 10 Physicians ROCHA SINGH KRISHNA 627011034 91 Sangamon 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 3 0 255 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 331 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 331 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47.63 0 4036.04 0 0 0 0 0 0 4083.67 0 0 0 1101190176 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 12506.89 0 0 0 0 0 0 0 0 0 0 0 0 0 12506.89 0 0 0 1101190184 91 Waiver service provider--Adults (DHS/DDD) 107 Will 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 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4158 0 0 0 0 0 0 0 0 0 0 0 0 0 4158 0 0 0 1101190196 24 Speech Therapists 30 DuPage 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 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 0 290.24 290.24 0 0 0 1101190225 30 General Hospitals 846 Utah ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 396.66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 396.66 0 0 0 1101190227 1669439584 10 Physicians CAVANAGH PATRICK 625214029 63 Macon 0 1 Family Practice 0 552 0 0 110 0 0 0 0 0 0 58 0 323 0 0 0 0 0 0 4354 0 0 124 0 0 0 0 0 0 67 0 643 0 0 0 0 0 0 4354 0 0 124 0 0 0 0 0 0 67 0 643 0 0 0 0 0 0 10965 0 0 9974.01 0 0 0 0 0 0 388.07 0 22353.14 0 0 0 0 0 0 43680.22 0 0 0 1101190228 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 216 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 216 0 0 0 0 0 0 0 0 0 0 0 0 0 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12092.96 0 0 0 1101190279 1477537405 10 Physicians MORTON RONALD 477140550 815 Indiana 0 0 Pediatric Pulmonary 0 0 0 0 0 0 0 0 0 0 0 0 0 7 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 0 756.56 0 0 0 0 0 0 756.56 0 0 0 1101190281 1689789372 10 Physicians PYLE JENNIFER 600052462 200 Cook 0 1 Pediatrics 0 44 0 0 31 0 0 0 0 0 0 10 0 43 0 0 0 0 0 0 112 0 0 66 0 0 0 0 0 0 10 0 80 0 0 0 0 0 0 112 0 0 66 0 0 0 0 0 0 10 0 80 0 0 0 0 0 0 224 0 0 3439.2 0 0 0 0 0 0 112.03 0 3626.75 0 0 0 0 0 0 7401.98 0 0 0 1101190301 1437214582 10 Physicians SCHULMAN SIDNEY 535461626 852 Wisconsin 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 2 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62.8 0 922.09 0 0 0 0 0 0 984.89 0 0 0 1101190309 92 Waiver service provider--Disability (DHS/DRS) 12 Bond 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 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13345.72 0 0 0 0 0 0 0 0 0 0 0 0 0 13345.72 0 0 0 1101190312 2100180730 92 Waiver service provider--Disability (DHS/DRS) HELP AT HOME INC 606024486 200 Cook 0 0 0 0 0 0 0 0 481 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3730 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3730 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4012002.43 0 0 0 0 0 0 0 0 0 0 0 0 0 4012002.43 0 0 0 1101190319 1265603369 23 Occupational Therapists KUBECK MONIQUE 605852829 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 207 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 207 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14900.97 14900.97 0 0 0 1101190323 1548246101 10 Physicians GORELIK MAXIM 535482940 852 Wisconsin 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 1 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 316.47 0 0 0 0 0 0 316.47 0 0 0 1101190334 1417965039 16 Nurse Practitioners DURASKI SYLVIA 606112654 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5509.76 0 0 0 0 0 0 5509.76 0 0 0 1101190340 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3776.4 0 0 0 0 0 0 0 0 0 0 0 0 0 3776.4 0 0 0 1101190343 1396907317 10 Physicians PARK EDWARD 999999999 72 McLean 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 283 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 283 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3820.11 0 0 0 0 0 0 3820.11 0 0 0 1101190344 1275631426 10 Physicians MILIK ADAM 604498988 107 Will 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 489 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 489 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3512.27 0 0 0 0 0 0 3512.27 0 0 0 1101190348 1821067737 70 Ambulance Service Providers WAYNE COUNTY AMBULANCE SERV 628371470 104 Wayne 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 267 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1060 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1060 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55315.51 0 0 0 0 0 0 55315.51 0 0 0 1101190352 1750543179 10 Physicians MALLIK NAMRATA 999999999 89 Rock Island 0 0 0 37 0 0 2 0 0 0 0 0 0 2 0 116 0 0 0 0 0 0 299 0 0 3 0 0 0 0 0 0 3 0 344 0 0 0 0 0 0 299 0 0 3 0 0 0 0 0 0 3 0 344 0 0 0 0 0 0 923 0 0 275.23 0 0 0 0 0 0 20.47 0 8077.79 0 0 0 0 0 0 9296.49 0 0 0 1101190361 94 Waiver service provider--Children's support (DHS/DDD) 53 Kane 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 0 167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9906.6 0 0 0 0 0 0 0 0 0 0 0 0 0 9906.6 0 0 0 1101190363 1679598742 10 Physicians LEIKIN JERROLD 600251314 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5094.01 0 0 0 0 0 0 5094.01 0 0 0 1101190402 91 Waiver service provider--Adults (DHS/DDD) 50 Jersey 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 0 270 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 270 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15363.5 0 0 0 0 0 0 0 0 0 0 0 0 0 15363.5 0 0 0 1101190408 1457573347 10 Physicians WURZELBACHER ALAN 601901237 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2436.64 0 0 0 0 0 0 2436.64 0 0 0 1101190411 10 Physicians 53 Kane 0 0 Physical Medicine/Rehabilitation 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35.05 0 0 0 0 0 0 35.05 0 0 0 1101190428 1629015490 10 Physicians GRAHAM ROBERT 606107011 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 5 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 303 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 303 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49.8 0 7384.09 0 0 0 0 0 0 7433.89 0 0 0 1101190442 92 Waiver service provider--Disability (DHS/DRS) 72 McLean 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 523.54 0 0 0 0 0 0 0 0 0 0 0 0 0 523.54 0 0 0 1101190453 1790846525 10 Physicians JACOBS RENEE 604532656 200 Cook 0 0 Hematology 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 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9077.56 0 0 0 0 0 0 9077.56 0 0 0 1101190458 92 Waiver service provider--Disability (DHS/DRS) 106 Whiteside 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 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4913.73 0 0 0 0 0 0 0 0 0 0 0 0 0 4913.73 0 0 0 1101190465 1740288737 10 Physicians BARONKUHN ELIZABETH 606127313 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 5 0 0 0 0 0 0 11 0 382 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 12 0 487 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 12 0 487 0 0 0 0 0 0 0 0 0 137.82 0 0 0 0 0 0 361.01 0 71163.82 0 0 0 0 0 0 71662.65 0 0 0 1101190470 1679775647 10 Physicians GALAN AILEEN 629037647 47 Jackson 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 468 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 493 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 493 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85007.67 0 0 0 0 0 0 85007.67 0 0 0 1101190471 92 Waiver service provider--Disability (DHS/DRS) 64 Macoupin 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10565.34 0 0 0 0 0 0 0 0 0 0 0 0 0 10565.34 0 0 0 1101190476 1457425514 10 Physicians SENKO THOMAS 605275993 30 DuPage 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 399 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 412 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 412 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14837.29 0 0 0 0 0 0 14837.29 0 0 0 1101190477 1386932911 16 Nurse Practitioners DUDLEY CORRIE 641843225 53 Kane 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 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 0 627.14 0 0 0 0 0 0 627.14 0 0 0 1101190480 1366457566 60 Pharmacies BOND DRUG COMPANY OF IL 5543 600401313 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 485 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53344 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81143.85 0 0 0 81143.85 0 0 0 1101190483 1396853008 10 Physicians JERABEK JASON 622741034 81 Perry 0 1 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1959.2 0 0 0 0 0 0 1959.2 0 0 0 1101190487 92 Waiver service provider--Disability (DHS/DRS) 96 St Clair 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 15209.2 0 0 0 0 0 0 0 0 0 0 0 0 0 15209.2 0 0 0 1101190495 1427111046 30 General Hospitals TOUCHETTE REGIONAL HOSPITAL 622072326 96 St Clair DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 0 0 60 0 0 1814 0 0 0 0 687 0 0 0 788 0 0 0 0 0 0 139 0 0 2554 0 0 0 0 751 0 0 0 1242 0 0 0 0 0 0 832 0 0 2578 0 0 0 0 2772 0 0 0 1664 0 0 0 0 0 0 134647.82 0 0 334461.41 0 0 0 0 1602338.34 0 0 0 220861.67 0 0 0 0 0 2292309.24 0 0 0 1101190500 1427236157 36 Community mental health provider ECKER CENTER FOR MENTAL HEALTH 601231865 53 Kane 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 735 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 448 0 0 735 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 448 0 0 12468.49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8531.35 0 0 20999.84 0 0 0 1101190512 30 General Hospitals 815 Indiana DIALYSIS Outpatient dialysis centers. 0 0 General Hospital - Adult and Child 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 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 555 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4435.48 0 0 0 0 0 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0 344 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9092.3 0 1529.43 0 0 0 0 10621.73 0 0 0 1101191115 1629119607 11 Dentists HUSSAIN UZMA 604356515 72 McLean 0 0 General Dentistry 0 0 0 196 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 729 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 729 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23501.92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23501.92 0 0 0 1101191116 1336169432 10 Physicians PERRY PATRICIA 606123833 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31651.84 0 0 0 0 0 0 31651.84 0 0 0 1101191125 1942326970 30 General Hospitals PANA COMMUNITY HOSPITAL 625571716 20 Christian DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 1 0 0 0 0 0 0 0 0 0 0 0 0 412 0 0 461 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2323 0 0 989 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2323 0 0 989 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11136.55 0 0 93605.06 0 0 0 0 0 104741.61 0 0 0 1101191127 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47251.42 0 0 0 0 0 0 47251.42 0 0 0 1101191156 1700064268 36 Community mental health provider ARBORS NORTH 624541710 25 Crawford 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 195 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 195 0 0 349.98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14392.3 0 0 14742.28 0 0 0 1101191157 1235289869 60 Pharmacies J AND S COMM PHARMACY INC 606244059 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 697 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 4295 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 76599 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1394.56 0 0 156760.67 0 0 0 158155.23 0 0 0 1101191166 98 Waiver service provider--TBI (DHS/DRS) 91 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 1889.26 0 0 0 0 0 0 0 0 0 0 0 0 0 1889.26 0 0 0 1101191176 1730104183 16 Nurse Practitioners HELFRICH DAWN C 631600352 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 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(DHS/DDD) 200 Cook 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 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24816 0 0 0 0 0 0 0 0 0 0 0 0 0 24816 0 0 0 1101191712 1356395313 10 Physicians BLOCH ARTHUR H 600354649 57 Lake 0 0 Psychiatry 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 0 219 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 219 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1508.66 0 0 0 0 0 0 1508.66 0 0 0 1101191718 1487639811 10 Physicians BEAL CATHERINE 631282702 826 Missouri 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 50 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1691.8 0 6.01 0 0 0 0 0 0 1697.81 0 0 0 1101191735 91 Waiver service provider--Adults (DHS/DDD) 71 McHenry 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 0 246 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 246 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18480 0 0 0 0 0 0 0 0 0 0 0 0 0 18480 0 0 0 1101191736 98 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0 0 0 0 0 0 11774.37 0 0 0 1101191767 1518017763 10 Physicians COELHO RONALD 298413862 80 Peoria 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20051.09 0 0 0 0 0 0 20051.09 0 0 0 1101191769 30 General Hospitals 844 Tennessee NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 87.97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87.97 0 0 0 1101191772 10 Physicians 30 DuPage 0 0 Radiology Therapeutic 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 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37.7 0 0 0 0 0 0 37.7 0 0 0 1101191774 1134178056 10 Physicians YI JONG YOON 604355487 107 Will 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 0 0 454 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11826.65 0 0 0 0 0 0 11826.65 0 0 0 1101191778 1669641643 47 Local Education Agencies MENDOTA TWP H S DIST 280 613422700 58 La Salle 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 334 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 334 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5423.74 0 5423.74 0 0 0 1101191798 1861624579 10 Physicians BURNS BRIAN 628121969 36 Franklin 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 571 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 989 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 989 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25737.57 0 0 0 0 0 0 25737.57 0 0 0 1101191799 10 Physicians 816 Iowa 0 0 Pulmonary Diseases 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40.72 0 0 0 0 0 0 40.72 0 0 0 1101191804 1346333077 16 Nurse Practitioners BURTON ANITA 625264163 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 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0 0 0 0 0 0 0 0 0 0 1377.63 0 44063.09 0 0 0 0 0 0 45440.72 0 0 0 1101192809 1639198237 10 Physicians WUNDERINK RICHARD 606118709 200 Cook 0 0 Pulmonary Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 233 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 233 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7529.94 0 0 0 0 0 0 7529.94 0 0 0 1101192810 1851337604 63 Other Providers of Medical Equipment/Supplies (Non-registered) CARE CONNECTION PLUS 480151227 823 Michigan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5235.37 0 0 0 0 0 0 5235.37 0 0 0 1101192821 91 Waiver service provider--Adults (DHS/DDD) 31 Edgar 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 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1356.3 0 0 0 0 0 0 0 0 0 0 0 0 0 1356.3 0 0 0 1101192829 2100183247 10 Physicians BROWNE ROSANNE 601873112 30 DuPage 0 1 Family Practice 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 19 0 0 0 0 0 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 0 321.83 0 0 0 0 0 0 321.83 0 0 0 1101192830 92 Waiver service provider--Disability (DHS/DRS) 99 Union 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 24592.81 0 0 0 0 0 0 0 0 0 0 0 0 0 24592.81 0 0 0 1101192834 98 Waiver service provider--TBI (DHS/DRS) 76 Montgomery 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11453.48 0 0 0 0 0 0 0 0 0 0 0 0 0 11453.48 0 0 0 1101192835 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4554.09 0 0 0 0 0 0 0 0 0 0 0 0 0 4554.09 0 0 0 1101192841 1952615809 39 Hospice COVENANTCARE HOSPICE 601742409 53 Kane 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 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 693 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80454.72 0 0 0 0 0 0 0 0 0 0 0 80454.72 0 0 0 1101192842 1801834049 60 Pharmacies OSCO DRUG 3331 601743561 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 337 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2351 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60825 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94339.38 0 0 0 94339.38 0 0 0 1101192843 1679599518 10 Physicians GUTIERREZ GERARDO 630318014 826 Missouri 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1613.08 0 0 0 0 0 0 1613.08 0 0 0 1101192847 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 19 0 0 0 0 0 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 23018.3 0 0 0 0 0 0 0 0 0 0 0 0 0 23018.3 0 0 0 1101192853 2100183271 91 Waiver service provider--Adults (DHS/DDD) "HABILITATIVE SYSTEMS, INC." 606444923 200 Cook 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24286 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24286 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1637200.41 0 0 0 0 0 0 0 0 0 0 0 0 0 1637200.41 0 0 0 1101192859 91 Waiver service provider--Adults (DHS/DDD) 30 DuPage 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 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13851.45 0 0 0 0 0 0 0 0 0 0 0 0 0 13851.45 0 0 0 1101192869 1376582999 10 Physicians NAIR SUDEEP 628646293 49 Jefferson 0 1 Internal Medicine 0 523 0 0 261 0 0 0 0 0 0 910 0 2904 0 0 0 0 0 0 4224 0 0 280 0 0 0 0 0 0 1244 0 4833 0 0 0 0 0 0 4224 0 0 280 0 0 0 0 0 0 1244 0 4833 0 0 0 0 0 0 12791 0 0 23579.84 0 0 0 0 0 0 10820.05 0 174737.64 0 0 0 0 0 0 221928.53 0 0 0 1101192890 30 General Hospitals 810 Florida NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 742.63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 742.63 0 0 0 1101192891 1467554089 10 Physicians EKPENYONG ANDEM 606123218 200 Cook 0 1 Internal Medicine 0 60 0 0 0 0 0 0 0 0 0 10 0 113 0 0 0 0 0 0 142 0 0 0 0 0 0 0 0 0 15 0 208 0 0 0 0 0 0 142 0 0 0 0 0 0 0 0 0 15 0 208 0 0 0 0 0 0 427 0 0 0 0 0 0 0 0 0 46.87 0 3954.21 0 0 0 0 0 0 4428.08 0 0 0 1101192900 11 Dentists 200 Cook 0 0 Oral Surgery 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101192909 91 Waiver service provider--Adults (DHS/DDD) 72 McLean 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 0 204 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 204 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22299.75 0 0 0 0 0 0 0 0 0 0 0 0 0 22299.75 0 0 0 1101192915 1033435433 60 Pharmacies RASHID LONG TERM CARE PHARMACY 999999999 816 Iowa 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 367 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8609 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2901.16 0 0 0 2901.16 0 0 0 1101192919 1801193206 16 Nurse Practitioners HALL JAMIE 629037647 47 Jackson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 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 0 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1321.5 0 0 0 0 0 0 1321.5 0 0 0 1101192922 98 Waiver service provider--TBI (DHS/DRS) 96 St Clair 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 2701.56 0 0 0 0 0 0 0 0 0 0 0 0 0 2701.56 0 0 0 1101192923 92 Waiver service provider--Disability (DHS/DRS) 99 Union 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 755.83 0 0 0 0 0 0 0 0 0 0 0 0 0 755.83 0 0 0 1101192929 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 868.64 0 0 0 0 0 0 0 0 0 0 0 0 0 868.64 0 0 0 1101192948 1881924702 10 Physicians ZAIDI FAWWAD 627695324 91 Sangamon 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 444 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 444 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6819.19 0 0 0 0 0 0 6819.19 0 0 0 1101192990 1942260278 10 Physicians AHN CHARLES 605151001 30 DuPage 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4604.28 0 0 0 0 0 0 4604.28 0 0 0 1101192994 1497003065 16 Nurse Practitioners STRUBHAR ASHLEY 605277594 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5726.97 0 0 0 0 0 0 5726.97 0 0 0 1101192999 1700041167 10 Physicians HARRIS BEN 601604000 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 171 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6825.54 0 0 0 0 0 0 6825.54 0 0 0 1101193001 1982639621 10 Physicians DAVIS JASON 617042101 72 McLean 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 528 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 825 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 825 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12333.9 0 2296.28 0 0 0 0 0 0 14630.18 0 0 0 1101193017 1558636555 60 Pharmacies WALGREENS 15283 618203909 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 264 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 633 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27016 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81072.98 0 0 0 81072.98 0 0 0 1101193020 92 Waiver service provider--Disability (DHS/DRS) 54 Kankakee 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 29 0 0 0 0 0 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 17392.11 0 0 0 0 0 0 0 0 0 0 0 0 0 17392.11 0 0 0 1101193021 1396847216 11 Dentists MOORE KELLY 611075905 109 Winnebago 0 0 General Dentistry 0 0 0 7 0 0 0 0 0 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 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 601.35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 601.35 0 0 0 1101193029 16 Nurse Practitioners 826 Missouri 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64.31 0 0 0 0 0 0 64.31 0 0 0 1101193030 92 Waiver service provider--Disability (DHS/DRS) 100 Vermilion 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 7452.63 0 0 0 0 0 0 0 0 0 0 0 0 0 7452.63 0 0 0 1101193033 1225241979 10 Physicians JABIR BUTHAINA 605061449 53 Kane 0 0 Obstetric-Gynecology 0 0 0 0 3 0 0 0 0 0 0 30 0 50 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 93 0 126 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 93 0 126 0 0 0 0 0 0 0 0 0 85.65 0 0 0 0 0 0 1145.14 0 10270.91 0 0 0 0 0 0 11501.7 0 0 0 1101193034 1356527451 47 Local Education Agencies LINCOLNWOOD SCH DIST 74 606452520 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1097 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1097 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27173.32 0 27173.32 0 0 0 1101193038 1467478693 10 Physicians BENZINGER GEORGE 631101010 826 Missouri 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 22 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 6358.2 0 0 0 0 0 0 6358.2 0 0 0 1101193040 1396844189 10 Physicians KOLB JEAN 617043750 72 McLean 0 1 Pediatrics 0 85 0 0 116 0 0 0 0 0 0 31 0 158 0 0 0 0 0 0 681 0 0 410 0 0 0 0 0 0 36 0 235 0 0 0 0 0 0 681 0 0 410 0 0 0 0 0 0 36 0 235 0 0 0 0 0 0 1370 0 0 13736.72 0 0 0 0 0 0 464.97 0 9842.33 0 0 0 0 0 0 25414.02 0 0 0 1101193048 1871587691 13 Podiatrists WALTERS LORNA V 606196107 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 184 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 744 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 744 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6766.36 0 0 0 0 0 0 6766.36 0 0 0 1101193062 91 Waiver service provider--Adults (DHS/DDD) 55 Kendall 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 0 249 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 249 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14913.25 0 0 0 0 0 0 0 0 0 0 0 0 0 14913.25 0 0 0 1101193065 92 Waiver service provider--Disability (DHS/DRS) 37 Fulton 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 17508.52 0 0 0 0 0 0 0 0 0 0 0 0 0 17508.52 0 0 0 1101193072 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 344 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 344 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23177 0 0 0 0 0 0 0 0 0 0 0 0 0 23177 0 0 0 1101193078 1245245414 60 Pharmacies BOND DRUG COMPANY OF IL 4148 604625038 200 Cook 0 0 0 0 0 0 0 0 0 0 0 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Ambulance Service Providers WINNEBAGO CO FPD 1 610240185 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 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 1787.65 0 0 0 0 0 0 1787.65 0 0 0 1101193118 1487684080 10 Physicians MOSS ROBERT 600681005 200 Cook 0 0 Admitting Privileges 0 0 0 0 0 0 0 0 0 0 0 1 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 362 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 362 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 759.44 0 0 0 0 0 0 759.44 0 0 0 1101193122 1730103201 10 Physicians BELLAFIORE FRANK 618012500 19 Champaign 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 385 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 546 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 546 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11086.15 0 41.46 0 0 0 0 0 0 11127.61 0 0 0 1101193125 1841286929 63 Other Providers of Medical Equipment/Supplies (Non-registered) XMED OXYGEN AND MED EQUIP LP 750014338 845 Texas 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 242 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1562 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1562 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26211.26 0 0 0 0 0 0 26211.26 0 0 0 1101193130 1194749580 30 General Hospitals MCKAY DEE HOSPITAL 844033195 846 Utah NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1336.95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1336.95 0 0 0 1101193136 1053311126 10 Physicians PHILLIPS JOHN 600681343 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 849 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1152 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1152 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23248.98 0 2000.91 0 0 0 0 0 0 25249.89 0 0 0 1101193139 1417088931 11 Dentists ARNOUS AMNEH 606304312 200 Cook 0 0 General Dentistry 0 0 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 339 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 339 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8935.44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8935.44 0 0 0 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0 0 365733.35 0 0 0 0 23526.82 0 0 0 285514.12 0 0 0 0 0 674774.29 0 0 0 1101194707 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1880.43 0 0 0 0 0 0 0 0 0 0 0 0 0 1880.43 0 0 0 1101194718 1821064585 10 Physicians ALTER ROBERT 606162419 200 Cook 0 1 Internal Medicine 0 22 0 0 0 0 0 0 0 0 0 17 0 75 0 0 0 0 0 0 106 0 0 0 0 0 0 0 0 0 32 0 176 0 0 0 0 0 0 106 0 0 0 0 0 0 0 0 0 32 0 176 0 0 0 0 0 0 303 0 0 0 0 0 0 0 0 0 81.58 0 2954.26 0 0 0 0 0 0 3338.84 0 0 0 1101194724 1013287853 60 Pharmacies MEIJER PHARMACY 176 627117962 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 944 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24782 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41488.23 0 0 0 41488.23 0 0 0 1101194744 92 Waiver service provider--Disability (DHS/DRS) 33 Effingham 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 21602.33 0 0 0 0 0 0 0 0 0 0 0 0 0 21602.33 0 0 0 1101194749 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 230 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17721.5 0 0 0 0 0 0 0 0 0 0 0 0 0 17721.5 0 0 0 1101194750 10 Physicians 107 Will 0 1 Family Practice 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 1101194758 1154579811 61 Independent Laboratories FERTILITY AND CRYOGENIC SERV 605164805 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 371 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 371 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2321.2 0 0 0 0 0 0 0 0 2321.2 0 0 0 1101194763 1508880469 10 Physicians WOOD CHRISTOPHER 600043906 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 2 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1209.86 0 0 0 0 0 0 1209.86 0 0 0 1101194771 1972732246 16 Nurse Practitioners RUNYON JENNIFER 999999999 56 Knox 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 262 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 277 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 277 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9605.12 0 0 0 0 0 0 9605.12 0 0 0 1101194789 1760441976 30 General Hospitals LINCOLN DIALYSIS 626569115 62 Logan DIALYSIS Outpatient dialysis centers. 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 772 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22802.66 0 0 0 0 0 22802.66 0 0 0 1101194792 1225084585 10 Physicians HAYES SHARPLEY CAROL 606432392 200 Cook 0 1 Family Practice 0 63 0 0 1 0 0 0 0 0 0 36 0 144 0 0 0 0 0 0 356 0 0 1 0 0 0 0 0 0 49 0 274 0 0 0 0 0 0 356 0 0 1 0 0 0 0 0 0 49 0 274 0 0 0 0 0 0 1049 0 0 71.31 0 0 0 0 0 0 293.3 0 8587.39 0 0 0 0 0 0 10001 0 0 0 1101194797 1689660995 10 Physicians IMDAD ZARQA 601335356 30 DuPage 0 0 Infectious Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 187 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 769 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 769 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69820.69 0 0 0 0 0 0 69820.69 0 0 0 1101194803 1114264462 16 Nurse Practitioners RYAN JEFFREY 999999999 107 Will 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 206.35 0 0 0 0 0 0 206.35 0 0 0 1101194808 22 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 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1187.62 1187.62 0 0 0 1101194810 1598864654 33 Nursing Facilities SWANSEA REHAB HEALTH CARE CENT 622264213 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 830 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18355 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1392916.1 0 0 0 0 0 0 0 1392916.1 0 0 0 1101194822 92 Waiver service provider--Disability (DHS/DRS) 19 Champaign 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 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14128.3 0 0 0 0 0 0 0 0 0 0 0 0 0 14128.3 0 0 0 1101194829 30 General Hospitals 848 Virginia NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 162.69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 162.69 0 0 0 1101194855 1053341297 10 Physicians EGOFSKE PETER 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 107 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6865.7 0 1342.34 0 0 0 0 0 0 8208.04 0 0 0 1101194856 1639146111 10 Physicians WU SUSAN 625264169 63 Macon 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 0 4 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 136.32 0 1557.22 0 0 0 0 0 0 1693.54 0 0 0 1101194857 60 Pharmacies 824 Minnesota 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116.41 0 0 0 116.41 0 0 0 1101194871 1700033719 10 Physicians SANDIFORD PENELOPE 616033133 80 Peoria 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 623 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 623 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 293857.8 0 0 0 0 0 0 293857.8 0 0 0 1101194874 1972638484 28 Waiver service provider--Supportive living facility (HFS) BARTON SENIOR RESIDENCES ZION 600994371 57 Lake 0 0 0 0 0 0 0 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1253 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31886 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2015744.16 0 0 0 0 0 0 0 0 0 0 0 0 0 2015744.16 0 0 0 1101194877 1881731255 10 Physicians POLAVARAPU NAGENDRA 604532699 200 Cook 0 0 Neonatology 0 0 0 0 0 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 249 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 249 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26459.99 0 0 0 0 0 0 26459.99 0 0 0 1101194878 1508865338 10 Physicians KHAN MUHAMMAD 601232300 53 Kane 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 604 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 694 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 694 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19128.19 0 0 0 0 0 0 19128.19 0 0 0 1101194885 10 Physicians 30 DuPage 0 0 Emergency Medicine 0 0 0 0 0 0 0 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133.65 0 0 0 0 0 0 133.65 0 0 0 1101194887 92 Waiver service provider--Disability (DHS/DRS) 72 McLean 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 6345.89 0 0 0 0 0 0 0 0 0 0 0 0 0 6345.89 0 0 0 1101194894 1932285509 13 Podiatrists EKBAL MOEED 606592003 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 474 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 474 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1700.22 0 0 0 0 0 0 1700.22 0 0 0 1101194902 92 Waiver service provider--Disability (DHS/DRS) 17 Carroll 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 32602.43 0 0 0 0 0 0 0 0 0 0 0 0 0 32602.43 0 0 0 1101194903 92 Waiver service provider--Disability (DHS/DRS) 97 Stephenson 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 8626.81 0 0 0 0 0 0 0 0 0 0 0 0 0 8626.81 0 0 0 1101194908 1568482214 10 Physicians BERGER ISRAEL 600761226 200 Cook 0 0 Urological Surgery 0 0 0 0 0 0 0 0 0 0 0 332 0 377 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 876 0 2060 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 876 0 2060 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10752.87 0 58263.61 0 0 0 0 0 0 69016.48 0 0 0 1101194912 91 Waiver service provider--Adults (DHS/DDD) 109 Winnebago 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 0 304 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 304 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14097.6 0 0 0 0 0 0 0 0 0 0 0 0 0 14097.6 0 0 0 1101194917 1982779765 10 Physicians SACLARIDES THEODORE 601533328 200 Cook 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 2 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14.08 0 10768.91 0 0 0 0 0 0 10782.99 0 0 0 1101194921 1346233590 10 Physicians MERRICK ROBERT 520017320 816 Iowa 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 37 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1069.57 0 28.15 0 0 0 0 0 0 1097.72 0 0 0 1101194932 1427210319 10 Physicians KELLENBERGER NEAL 610081702 13 Boone 0 1 Family Practice 0 10 0 0 4 0 0 0 0 0 0 6 0 69 0 0 0 0 0 0 51 0 0 7 0 0 0 0 0 0 8 0 170 0 0 0 0 0 0 51 0 0 7 0 0 0 0 0 0 8 0 170 0 0 0 0 0 0 151 0 0 261.17 0 0 0 0 0 0 33.45 0 2405.02 0 0 0 0 0 0 2850.64 0 0 0 1101194933 1922062538 10 Physicians BRESLIN TARA 606118709 200 Cook 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 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 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 223.68 0 0 0 0 0 0 223.68 0 0 0 1101194940 1699921684 10 Physicians CHIRANJEEV SAHA 606123833 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 3 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15335.38 0 0 0 0 0 0 15335.38 0 0 0 1101194952 1235362815 11 Dentists VARUGHESE DAISY 606322846 200 Cook 0 0 General Dentistry 0 0 0 167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 750 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 750 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21592.57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21592.57 0 0 0 1101194958 1386675809 10 Physicians ZISHOLTZ TODD 999999999 87 Randolph 0 0 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 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3146.61 0 0 0 0 0 0 3146.61 0 0 0 1101194964 1730256470 12 Optometrists EPSTEIN PETER J 600475219 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 323 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 323 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9632.72 0 0 0 0 0 0 9632.72 0 0 0 1101194973 1922144286 16 Nurse Practitioners PATTERSON LISA 631101010 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 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 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 174.25 0 0 0 0 0 0 174.25 0 0 0 1101194975 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 16736.17 0 0 0 0 0 0 0 0 0 0 0 0 0 16736.17 0 0 0 1101194976 91 Waiver service provider--Adults (DHS/DDD) 89 Rock Island 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 0 312 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 312 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5720 0 0 0 0 0 0 0 0 0 0 0 0 0 5720 0 0 0 1101194982 1053613323 70 Ambulance Service Providers SURVIVAL FLIGHT INC 999999999 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22785.83 0 0 0 0 0 0 22785.83 0 0 0 1101194991 93 Waiver service provider--HIV/AIDS (DHS/DRS) 53 Kane 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 21775.15 0 0 0 0 0 0 0 0 0 0 0 0 0 21775.15 0 0 0 1101194996 1750584918 47 Local Education Agencies FULTON COUNTY COMM DIST 3 614270079 37 Fulton 0 0 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 2050 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2050 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31748.41 0 31748.41 0 0 0 1101195016 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17948.15 0 0 0 0 0 0 0 0 0 0 0 0 0 17948.15 0 0 0 1101195034 1730107376 16 Nurse Practitioners SPARKMAN JAYME 630175229 826 Missouri 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 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 598.62 0 0 0 0 0 0 598.62 0 0 0 1101195040 1255396511 10 Physicians JONES CICILY 605638951 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 589 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 589 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1283.11 0 0 0 0 0 0 1283.11 0 0 0 1101195049 1659691715 40 Federally Qualified Health Centers ACCESS AT GARY COMER YOUTH 606191254 200 Cook 0 1 0 325 294 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1712 906 0 266 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1712 906 0 266 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3425 55161.18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58586.18 0 0 0 1101195064 1275512964 10 Physicians ROSENBERG AARON 606123836 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 16 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116.4 0 1612.12 0 0 0 0 0 0 1728.52 0 0 0 1101195068 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 350 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 350 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15386.17 0 0 0 0 0 0 0 0 0 0 0 0 0 15386.17 0 0 0 1101195070 1013032499 10 Physicians CHAPPIDI PRASAD 606344485 200 Cook 0 0 Neurology 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 0 0 0 0 0 1969 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1969 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25638.43 0 0 0 0 0 0 25638.43 0 0 0 1101195098 10 Physicians 30 DuPage 0 0 Allergy-Immunization 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 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 169.98 0 0 0 0 0 0 169.98 0 0 0 1101195104 1477613743 60 Pharmacies PEACE PHARMACY INC 606162014 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 580 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2494 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64549 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 150146.05 0 0 0 150146.05 0 0 0 1101195105 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12262.29 0 0 0 0 0 0 0 0 0 0 0 0 0 12262.29 0 0 0 1101195113 1518914431 10 Physicians HAMPTON ALFREDA 606161768 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 7 0 0 0 0 0 0 22 0 285 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 25 0 661 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 25 0 661 0 0 0 0 0 0 0 0 0 277.7 0 0 0 0 0 0 890.72 0 99544.92 0 0 0 0 0 0 100713.34 0 0 0 1101195117 1700814225 10 Physicians HILL GREGORY 631416820 826 Missouri 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 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 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5444.76 0 0 0 0 0 0 5444.76 0 0 0 1101195122 1568638989 10 Physicians TREMB RYAN 605865007 107 Will 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 103 0 408 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 153 0 1148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 153 0 1148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 389.85 0 45017.91 0 0 0 0 0 0 45407.76 0 0 0 1101195128 93 Waiver service provider--HIV/AIDS (DHS/DRS) 96 St Clair 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 30630.03 0 0 0 0 0 0 0 0 0 0 0 0 0 30630.03 0 0 0 1101195136 1720183437 10 Physicians HASANAIN S J 601601634 200 Cook 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1441.2 0 0 0 0 0 0 1441.2 0 0 0 1101195148 1861428583 10 Physicians NARULA SUNIL 605277594 30 DuPage 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3345.02 0 0 0 0 0 0 3345.02 0 0 0 1101195163 92 Waiver service provider--Disability (DHS/DRS) 57 Lake 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 10245.33 0 0 0 0 0 0 0 0 0 0 0 0 0 10245.33 0 0 0 1101195167 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 1197.04 0 0 0 0 0 0 0 0 0 0 0 0 0 1197.04 0 0 0 1101195181 1326037433 10 Physicians LUPO SUSAN 600042338 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 5 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 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0 0 0 0 0 146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1876.24 0 0 0 0 0 0 1876.24 0 0 0 1101195241 1013946433 16 Nurse Practitioners SCHWARTZ ALLEN 631102500 826 Missouri 0 0 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 347.61 0 0 0 0 0 0 347.61 0 0 0 1101195242 1801996368 10 Physicians FRY MARY 606576159 200 Cook 0 1 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2069.59 0 0 0 0 0 0 2069.59 0 0 0 1101195249 91 Waiver service provider--Adults (DHS/DDD) 57 Lake 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 0 358 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 358 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13569.6 0 0 0 0 0 0 0 0 0 0 0 0 0 13569.6 0 0 0 1101195258 92 Waiver service provider--Disability (DHS/DRS) 91 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 20084.95 0 0 0 0 0 0 0 0 0 0 0 0 0 20084.95 0 0 0 1101195268 94 Waiver service provider--Children's support (DHS/DDD) 72 McLean 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 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14124 0 0 0 0 0 0 0 0 0 0 0 0 0 14124 0 0 0 1101195293 1205887684 10 Physicians KACHAR SERGEY 604532862 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 184 0 236 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 605 0 1465 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 605 0 1465 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4354.8 0 10107.72 0 0 0 0 0 0 14462.52 0 0 0 1101195297 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 19 0 0 0 0 0 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 14556.81 0 0 0 0 0 0 0 0 0 0 0 0 0 14556.81 0 0 0 1101195306 1992962146 10 Physicians MUNOZ VICTOR 606414332 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(Non-registered) NATURALLY YOURS 605277561 30 DuPage 0 0 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 23 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 0 0 0 0 0 0 0 0 1773.64 0 0 0 0 1773.64 0 0 0 1101195391 1982684197 10 Physicians CONNOR CLINT G 629482468 108 Williamson 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 282 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 825 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 825 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14149.73 0 0 0 0 0 0 14149.73 0 0 0 1101195400 92 Waiver service provider--Disability (DHS/DRS) 54 Kankakee 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 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 1590.9 0 0 0 0 0 0 0 0 0 0 0 0 0 1590.9 0 0 0 1101195410 10 Physicians 816 Iowa 0 0 Internal Medicine 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101195417 1518979137 14 Chiropractors VELOS CHRISTA 613609414 58 La Salle 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 188.58 0 0 0 0 0 0 188.58 0 0 0 1101195433 1568457554 10 Physicians FONDRIEST DIANE 600451688 57 Lake 0 1 Pediatrics 0 17 0 0 8 0 0 0 0 0 0 5 0 15 0 0 0 0 0 0 66 0 0 17 0 0 0 0 0 0 6 0 20 0 0 0 0 0 0 66 0 0 17 0 0 0 0 0 0 6 0 20 0 0 0 0 0 0 132 0 0 480.84 0 0 0 0 0 0 53.77 0 885.34 0 0 0 0 0 0 1551.95 0 0 0 1101195435 92 Waiver service provider--Disability (DHS/DRS) 98 Tazewell 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 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 15925.6 0 0 0 0 0 0 0 0 0 0 0 0 0 15925.6 0 0 0 1101195438 91 Waiver service provider--Adults (DHS/DDD) 64 Macoupin 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 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 1131.48 0 0 0 0 0 0 0 0 0 0 0 0 0 1131.48 0 0 0 1101195458 1043219322 10 Physicians MEYER MICHAEL 600564240 200 Cook 0 0 Family Practice 0 0 0 0 1 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 6.4 0 0 0 0 0 0 0 0 243.97 0 0 0 0 0 0 250.37 0 0 0 1101195481 1609032598 10 Physicians SARGSYAN NARINE 620026722 65 Madison 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 546 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 546 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5529.06 0 0 0 0 0 0 5529.06 0 0 0 1101195485 92 Waiver service provider--Disability (DHS/DRS) 81 Perry 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 12231.29 0 0 0 0 0 0 0 0 0 0 0 0 0 12231.29 0 0 0 1101195493 92 Waiver service provider--Disability (DHS/DRS) 37 Fulton 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 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 1261.05 0 0 0 0 0 0 0 0 0 0 0 0 0 1261.05 0 0 0 1101195496 1760753859 25 Audiologists MUELLER SAMANTHA 617049500 72 McLean 0 0 0 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 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7213.56 7213.56 0 0 0 1101195502 1477570828 10 Physicians LO JEANNE 618036002 19 Champaign 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 375 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 375 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6231.12 0 0 0 0 0 0 0 0 6231.12 0 0 0 1101195505 1609816719 10 Physicians HALL JOHN 637034997 826 Missouri 0 0 Urological Surgery 0 0 0 0 0 0 0 0 0 0 0 13 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93.49 0 1560.31 0 0 0 0 0 0 1653.8 0 0 0 1101195510 1306048632 40 Federally Qualified Health Centers HOWARD BROWN HEALTH CENTER 606132010 200 Cook 0 1 0 229 1408 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1627 6841 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1627 6841 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5275 352571.35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 357846.35 0 0 0 1101195516 1477703189 10 Physicians BISHU SHREENATH 600451659 57 Lake 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 57 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1090.39 0 0 0 0 0 0 0 0 1090.39 0 0 0 1101195517 30 General Hospitals 848 Virginia ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 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 0 412.37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 412.37 0 0 0 1101195522 1629208129 10 Physicians PANARKER ISHVARI 601601626 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 4 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27.8 0 764.1 0 0 0 0 0 0 791.9 0 0 0 1101195532 1801807722 10 Physicians HE MING 452132664 836 Ohio 0 0 Nuclear Medicine 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 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 1122.52 0 0 0 0 0 0 0 0 1122.52 0 0 0 1101195539 23 Occupational Therapists 30 DuPage 0 0 0 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 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7510.41 7510.41 0 0 0 1101195555 1205037595 10 Physicians RANDHAWA JYOTI 617613558 72 McLean 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 926.73 0 0 0 0 0 0 926.73 0 0 0 1101195559 1629340096 24 Speech Therapists VANSELOW LISA 600677743 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4896.52 4896.52 0 0 0 1101195601 1427269737 10 Physicians HILDEBRAND JAY 606223734 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2026.29 0 0 0 0 0 0 2026.29 0 0 0 1101195603 1588650246 10 Physicians SCHOLZ THOMAS 612311258 74 Mercer 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 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 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 291.11 0 0 0 0 0 0 291.11 0 0 0 1101195605 1760409056 60 Pharmacies SAM'S CLUB PHARMACY 10-6384 605254137 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 401 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13350.98 0 0 0 13350.98 0 0 0 1101195612 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 24579.23 0 0 0 0 0 0 0 0 0 0 0 0 0 24579.23 0 0 0 1101195613 1023005519 63 Other Providers of Medical Equipment/Supplies (Non-registered) ALDEN TERRACE OF MCHENRY 600504209 71 McHenry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9930 0 0 0 0 0 0 9930 0 0 0 1101195622 1548212764 10 Physicians CALFEE RYAN 631101010 826 Missouri 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 9 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56.12 0 2403.03 0 0 0 0 0 0 2459.15 0 0 0 1101195638 1134142953 10 Physicians TANDON SHASHI 600442203 57 Lake 0 0 Anesthesiology 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 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2429.91 0 0 0 0 0 0 2429.91 0 0 0 1101195646 1154494193 55 Early Intervention Services MARCUM VICKI 611036921 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14119.5 0 0 0 0 0 0 14119.5 0 0 0 1101195649 1265652762 10 Physicians SCHUE JEREMY 999999999 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 333.44 0 5096.17 0 0 0 0 0 0 5429.61 0 0 0 1101195654 92 Waiver service provider--Disability (DHS/DRS) 63 Macon 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 0 299.34 0 0 0 0 0 0 0 0 0 0 0 0 0 299.34 0 0 0 1101195655 16 Nurse Practitioners 30 DuPage 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 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59.63 0 0 0 0 0 0 59.63 0 0 0 1101195663 1205998754 10 Physicians LANG ROBERTO 605276686 30 DuPage 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 0 0 598 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 757 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 757 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10635.09 0 0 0 0 0 0 10635.09 0 0 0 1101195674 1083716476 10 Physicians HARRIS MICHAEL 604611939 200 Cook 0 1 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 423 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 423 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2915.26 0 0 0 0 0 0 2915.26 0 0 0 1101195680 92 Waiver service provider--Disability (DHS/DRS) 54 Kankakee 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 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10915.15 0 0 0 0 0 0 0 0 0 0 0 0 0 10915.15 0 0 0 1101195700 1861526899 11 Dentists LEZERKIEWICZ BEATA 605406670 30 DuPage 0 0 General Dentistry 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2275.07 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2275.07 0 0 0 1101195703 94 Waiver 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0 0 0 0 1076 0 1324 0 0 0 0 0 0 13807 0 0 5491 0 0 0 0 0 0 3589 0 3914 0 0 0 0 0 0 13807 0 0 5491 0 0 0 0 0 0 3589 0 3914 0 0 0 0 0 0 27614 0 0 139041.89 0 0 0 0 0 0 9124.69 0 134270.58 0 0 0 0 0 0 310051.16 0 0 0 1101197189 1043232846 10 Physicians AHMAD MASHOOD 611075089 109 Winnebago 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 6 0 173 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 577 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 577 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14.74 0 5378.22 0 0 0 0 0 0 5392.96 0 0 0 1101197213 1912169780 10 Physicians BENJAMIN JASON 600854980 57 Lake 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 1950 0 225 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2858 0 344 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2858 0 344 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68182.39 0 5168.45 0 0 0 0 0 0 73350.84 0 0 0 1101197214 1619921665 36 Community mental health provider CHESTNUT HEALTH SYSTEMS INC 620601420 65 Madison 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1134 0 0 112 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23626.12 0 0 0 0 0 0 23626.12 0 0 0 1101197978 1609105527 16 Nurse Practitioners LLOYD MARY 601782750 27 Dekalb 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 318 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 516 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 516 0 0 0 0 0 0 0 0 0 12.04 0 0 0 0 0 0 0 0 12929.87 0 0 0 0 0 0 12941.91 0 0 0 1101197981 2100188399 28 Waiver service provider--Supportive living facility (HFS) GLENWOOD OF MT ZION 625491086 63 Macon 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 432 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13353.14 0 0 0 0 0 0 0 0 0 0 0 0 0 13353.14 0 0 0 1101197988 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 19 0 0 0 0 0 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 17297.36 0 0 0 0 0 0 0 0 0 0 0 0 0 17297.36 0 0 0 1101198005 1043363617 10 Physicians SHAH BIMAL 600442203 57 Lake 0 0 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0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 244.25 0 0 0 0 0 0 244.25 0 0 0 1101198125 1023036506 16 Nurse Practitioners ZUECK JASON 631101010 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2980.66 0 0 0 0 0 0 2980.66 0 0 0 1101198129 1245299775 16 Nurse Practitioners RHODES SANDRA 627810001 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 185.32 0 0 0 0 0 0 185.32 0 0 0 1101198144 1891955233 10 Physicians WILL THOMAS 605256539 200 Cook 0 0 Urology 0 0 0 0 0 0 0 0 0 0 0 7 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48.77 0 2067.18 0 0 0 0 0 0 2115.95 0 0 0 1101198146 10 Physicians 816 Iowa 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 258.18 0 0 0 0 0 0 258.18 0 0 0 1101198168 1366555740 10 Physicians ROSENCRANZ HOLLY 606124325 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 147.49 0 0 0 0 0 0 147.49 0 0 0 1101198181 1861650152 11 Dentists WHITESMAN LOUIS 606391108 200 Cook 0 0 Orthodontist 0 0 0 954 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1907 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1907 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365690.75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365690.75 0 0 0 1101198188 1841404373 10 Physicians SRIVASTAVA PAVAN 606127323 200 Cook 0 1 Internal Medicine 0 0 0 0 456 0 0 0 0 0 0 0 0 590 0 0 0 0 0 0 0 0 0 731 0 0 0 0 0 0 0 0 831 0 0 0 0 0 0 0 0 0 731 0 0 0 0 0 0 0 0 831 0 0 0 0 0 0 0 0 0 41485.87 0 0 0 0 0 0 0 0 69454.04 0 0 0 0 0 0 110939.91 0 0 0 1101198195 92 Waiver service provider--Disability (DHS/DRS) 11 Alexander 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12721.04 0 0 0 0 0 0 0 0 0 0 0 0 0 12721.04 0 0 0 1101198201 1326144676 10 Physicians DARBANDI SAEED 604621989 200 Cook 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 3 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28.79 0 87.1 0 0 0 0 0 0 115.89 0 0 0 1101198205 1780657270 10 Physicians BENNETT BRIAN 610326942 97 Stephenson 0 1 Family Practice 0 319 0 0 85 0 0 0 0 0 0 62 0 352 0 0 0 0 0 0 3089 0 0 272 0 0 0 0 0 0 88 0 681 0 0 0 0 0 0 3089 0 0 272 0 0 0 0 0 0 88 0 681 0 0 0 0 0 0 7598 0 0 10298.73 0 0 0 0 0 0 475.52 0 31061.48 0 0 0 0 0 0 49433.73 0 0 0 1101198220 1871551184 10 Physicians KASTURI JAYA 601602042 200 Cook 0 1 General Practice 0 1 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 222.8 0 0 0 0 0 0 228.8 0 0 0 1101198238 1649448846 47 Local Education Agencies COMMUNITY CONSOLIDATED SD 93 601880093 30 DuPage 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 259 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 8549 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 8549 0 0 0 0 3.78 0 0 0 0 0 0 0 0 0 0 0 0 0 180177.93 0 180181.71 0 0 0 1101198242 1275503211 10 Physicians AHUJA SATYA P 606362410 30 DuPage 0 0 Nephrology 0 0 0 0 0 0 0 0 0 0 0 0 0 249 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13830.17 0 0 0 0 0 0 13830.17 0 0 0 1101198243 1083660658 32 Rehabilitation Hospitals MARIANJOY REHABILITATION HOSP 601876078 30 DuPage REHAB Rehabilitation hospitals paid a Per Diem rate. 0 0 0 0 117 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 0 235 0 0 0 0 0 0 0 92 0 0 0 0 0 0 0 0 0 0 236 0 0 0 0 0 0 0 1466 0 0 0 0 0 0 0 0 0 0 14486.4 0 0 0 0 0 0 0 1049380.72 0 0 0 0 0 0 0 0 0 1063867.12 0 0 0 1101198259 1871583245 11 Dentists DINKHA NAHRAIN 606263221 200 Cook 0 0 General Dentistry 0 0 0 459 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1839 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1839 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60470.6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60470.6 0 0 0 1101198261 1912163650 10 Physicians RYDBERG LESLIE 606112654 200 Cook 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 344 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 344 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 306.2 0 0 0 0 0 0 306.2 0 0 0 1101198269 1720291990 55 Early Intervention Services MORAN GLORIA 606085710 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1229 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1229 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71491.15 0 0 0 0 0 0 71491.15 0 0 0 1101198270 1871603068 10 Physicians ESCARZA ROBERT 611033655 109 Winnebago 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 501 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 619 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 619 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16972.29 0 0 0 0 0 0 16972.29 0 0 0 1101198273 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18587.8 0 0 0 0 0 0 0 0 0 0 0 0 0 18587.8 0 0 0 1101198287 1447266176 10 Physicians GORDON COLETTE 606576159 200 Cook 0 1 Internal Medicine 0 22 0 0 1 0 0 0 0 0 0 1 0 118 0 0 0 0 0 0 118 0 0 1 0 0 0 0 0 0 1 0 481 0 0 0 0 0 0 118 0 0 1 0 0 0 0 0 0 1 0 481 0 0 0 0 0 0 334 0 0 96.6 0 0 0 0 0 0 4 0 8162.44 0 0 0 0 0 0 8597.04 0 0 0 1101198288 1902853450 60 Pharmacies OSCO DRUG 3490 600451738 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 208 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8034.93 0 0 0 8034.93 0 0 0 1101198294 1790968147 10 Physicians GUNDETI MOHAN 605276686 30 DuPage 0 0 Urological Surgery 0 0 0 0 0 0 0 0 0 0 0 5 0 213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 433 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 433 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64.94 0 59060.27 0 0 0 0 0 0 59125.21 0 0 0 1101198303 94 Waiver service provider--Children's support (DHS/DDD) 63 Macon 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 0 163.6 0 0 0 0 0 0 0 0 0 0 0 0 0 163.6 0 0 0 1101198309 92 Waiver service provider--Disability (DHS/DRS) 53 Kane 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 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 11660.77 0 0 0 0 0 0 0 0 0 0 0 0 0 11660.77 0 0 0 1101198328 1033105093 10 Physicians RICHARDSON ROBERT R 604524000 200 Cook 0 0 Neurology Surgery 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 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 957.58 0 0 0 0 0 0 957.58 0 0 0 1101198329 1497752703 10 Physicians MANAM SATYA 601154939 27 Dekalb 0 0 Anesthesiology 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 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12604.61 0 0 0 0 0 0 12604.61 0 0 0 1101198334 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 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 13366.98 0 0 0 0 0 0 0 0 0 0 0 0 0 13366.98 0 0 0 1101198340 1316149875 47 Local Education Agencies GALVA COMMUNITY UNIT 224 614341090 45 Henry 0 0 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 0 288 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 288 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6106.69 0 6106.69 0 0 0 1101198348 1205847613 10 Physicians MARZEC MICHAEL 605064355 53 Kane 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 6 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115.29 0 523.86 0 0 0 0 0 0 639.15 0 0 0 1101198349 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 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 9944.07 0 0 0 0 0 0 0 0 0 0 0 0 0 9944.07 0 0 0 1101198352 92 Waiver service provider--Disability (DHS/DRS) 63 Macon 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 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 9972.76 0 0 0 0 0 0 0 0 0 0 0 0 0 9972.76 0 0 0 1101198356 1235452996 63 Other Providers of Medical Equipment/Supplies (Non-registered) CARLE PHYSICIAN GROUP 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 186 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 186 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43798.47 0 0 0 0 0 0 43798.47 0 0 0 1101198358 1346324423 10 Physicians MORELAND CONNIE 606081732 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12732.82 0 0 0 0 0 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Therapists OLOUGHLIN MICHELLE 601159621 27 Dekalb 0 0 0 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 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5071.7 5071.7 0 0 0 1101200092 1912054933 14 Chiropractors STEWARD BRIC 629319708 43 Hardin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 552.65 0 0 0 0 0 0 552.65 0 0 0 1101200096 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4125 0 0 0 0 0 0 0 0 0 0 0 0 0 4125 0 0 0 1101200100 1770573305 10 Physicians LEVITSKY JOSH 602014720 200 Cook 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5069.55 0 0 0 0 0 0 5069.55 0 0 0 1101200101 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0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 1 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9.21 0 4762.15 0 0 0 0 0 0 4771.36 0 0 0 1101200160 91 Waiver service provider--Adults (DHS/DDD) 57 Lake 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 0 145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13851.75 0 0 0 0 0 0 0 0 0 0 0 0 0 13851.75 0 0 0 1101200163 1548365646 10 Physicians LASH JAMES 606743462 200 Cook 0 0 Nephrology 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8487.64 0 0 0 0 0 0 8487.64 0 0 0 1101200164 1588614218 16 Nurse Practitioners LOCKE ROSENBERG FRANCES 606261707 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10260.09 0 0 0 0 0 0 10260.09 0 0 0 1101200165 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provider--TBI (DHS/DRS) 200 Cook 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 30323.28 0 0 0 0 0 0 0 0 0 0 0 0 0 30323.28 0 0 0 1101200282 1811981640 33 Nursing Facilities LEXINGTON OF LAKE ZURICH 600472450 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 185 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1516 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39599 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3827143.18 0 0 0 0 0 0 0 3827143.18 0 0 0 1101200283 92 Waiver service provider--Disability (DHS/DRS) 53 Kane 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 27369.47 0 0 0 0 0 0 0 0 0 0 0 0 0 27369.47 0 0 0 1101200284 1043202500 10 Physicians HAACKE LINDA 339012699 107 Will 0 0 Pulmonary Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 665 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 665 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4346.31 0 0 0 0 0 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0 0 1101200390 92 Waiver service provider--Disability (DHS/DRS) 50 Jersey 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 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 1120.12 0 0 0 0 0 0 0 0 0 0 0 0 0 1120.12 0 0 0 1101200397 2100190815 90 Waiver service provider--Elderly (DOA) FAMILY SERVICE OF CHAMPAIGN CO 618205129 19 Champaign 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3527 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3527 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 140739.46 0 0 0 0 0 0 0 0 0 0 0 0 0 140739.46 0 0 0 1101200403 1093833725 29 ICF/MR CHAMPAIGN TERRACE 618739221 19 Champaign 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 379 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47341.63 0 0 0 0 0 0 0 0 0 0 47341.63 0 0 0 1101200411 1083842868 10 Physicians QAZI SAMEER 999999999 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 301 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 301 0 0 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0 0 0 0 0 0 0 0 0 0 0 7 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27.43 0 1084.35 0 0 0 0 0 0 1111.78 0 0 0 1101200511 1982725651 55 Early Intervention Services STONE KATHY 605632541 30 DuPage 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 1306 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1306 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71521.98 0 0 0 0 0 0 71521.98 0 0 0 1101200522 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 1733.92 0 0 0 0 0 0 0 0 0 0 0 0 0 1733.92 0 0 0 1101200536 1861409013 10 Physicians HAYNES F P 618203909 19 Champaign 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 21 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 695.94 0 12632.62 0 0 0 0 0 0 13328.56 0 0 0 1101200551 1063453876 10 Physicians CHANDRA SANDEEP 604591403 200 Cook 0 1 Internal Medicine 0 94 0 0 0 0 0 0 0 0 0 15 0 185 0 0 0 0 0 0 763 0 0 0 0 0 0 0 0 0 45 0 972 0 0 0 0 0 0 763 0 0 0 0 0 0 0 0 0 45 0 972 0 0 0 0 0 0 2289 0 0 0 0 0 0 0 0 0 161.78 0 17024.61 0 0 0 0 0 0 19475.39 0 0 0 1101200591 1811247604 36 Community mental health provider CHILDSERV 605321219 30 DuPage 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1340 0 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1340 0 0 9781.39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65012.4 0 0 74793.79 0 0 0 1101200595 1528051422 10 Physicians LUTAN ROBERT 620026723 65 Madison 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 0 0 462 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 885 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 885 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11031.95 0 0 0 0 0 0 11031.95 0 0 0 1101200602 92 Waiver service provider--Disability (DHS/DRS) 90 Saline 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4910.95 0 0 0 0 0 0 0 0 0 0 0 0 0 4910.95 0 0 0 1101200609 1962489526 33 Nursing Facilities WINDMILL NURSING PAVILION LTD 604731464 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1433 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36452 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3461352.99 0 0 0 0 0 0 0 3461352.99 0 0 0 1101200620 1073574547 63 Other Providers of Medical Equipment/Supplies (Non-registered) TRINITY HOME MEDICAL EQUIPMENT 617049485 72 McLean 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 1140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24480.33 0 0 0 0 0 0 24480.33 0 0 0 1101200623 1477744886 10 Physicians SIMS MARIAMOU 602011718 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 3 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 3202.47 0 0 0 0 0 0 3210.47 0 0 0 1101200625 1184846693 23 Occupational Therapists RICE ANNA 622986064 75 Monroe 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12423 12423 0 0 0 1101200626 10 Physicians 200 Cook 0 0 Hematology 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 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 0 129 0 0 0 0 0 0 129 0 0 0 1101200650 1922026673 10 Physicians JUERGENS PAUL B 629460428 53 Kane 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 11 0 242 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 863 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 863 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121.07 0 24734.77 0 0 0 0 0 0 24855.84 0 0 0 1101200657 91 Waiver service provider--Adults (DHS/DDD) 34 Fayette 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 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4503 0 0 0 0 0 0 0 0 0 0 0 0 0 4503 0 0 0 1101200664 1376561720 10 Physicians GROSSETT ROBERT 604267886 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 1872 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2942 0 172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2942 0 172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40074.6 0 1375.94 0 0 0 0 0 0 41450.54 0 0 0 1101200679 1831174317 10 Physicians PICKEN JOHN 606162454 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 64 0 190 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 293 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 293 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2472.22 0 68519.17 0 0 0 0 0 0 70991.39 0 0 0 1101200680 1205934122 10 Physicians HARTH CATHERINE 605276686 200 Cook 0 0 Obstetric-Gynecology 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 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26162.93 0 0 0 0 0 0 26162.93 0 0 0 1101200683 92 Waiver service provider--Disability (DHS/DRS) 97 Stephenson 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 17034.11 0 0 0 0 0 0 0 0 0 0 0 0 0 17034.11 0 0 0 1101200691 1780887612 10 Physicians DAWSON LAUREN 604023429 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5018.34 0 0 0 0 0 0 5018.34 0 0 0 1101200696 1104844885 16 Nurse Practitioners STOUT VALERIE 605011816 200 Cook 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 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7369.95 0 0 0 0 0 0 7369.95 0 0 0 1101200700 23 Occupational Therapists 109 Winnebago 0 0 0 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 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 0 125.52 125.52 0 0 0 1101200702 1922299858 28 Waiver service provider--Supportive living facility (HFS) HERITAGE WOODS OF MT VERNON 628646560 49 Jefferson 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 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826 Missouri 0 0 Neurology 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 47 0 0 0 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 0 654.79 0 0 0 0 0 0 654.79 0 0 0 1101200736 1285606038 63 Other Providers of Medical Equipment/Supplies (Non-registered) AMERICAN HOMEPATIENT INC 622345816 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2093 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2093 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32832.4 0 0 0 0 0 0 32832.4 0 0 0 1101200739 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 17709.9 0 0 0 0 0 0 0 0 0 0 0 0 0 17709.9 0 0 0 1101200748 92 Waiver service provider--Disability (DHS/DRS) 53 Kane 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 17038.15 0 0 0 0 0 0 0 0 0 0 0 0 0 17038.15 0 0 0 1101200749 2100191167 90 Waiver service provider--Elderly (DOA) FOX VALLEY OLDER ADULT SERVICE 605481459 27 Dekalb 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 596 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 596 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21536.14 0 0 0 0 0 0 0 0 0 0 0 0 0 21536.14 0 0 0 1101200751 1568432094 13 Podiatrists DONETS SIMON 600902979 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 757 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4793 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4793 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33169.94 0 0 0 0 0 0 33169.94 0 0 0 1101200768 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 8401.09 0 0 0 0 0 0 0 0 0 0 0 0 0 8401.09 0 0 0 1101200777 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 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 3157.72 0 0 0 0 0 0 0 0 0 0 0 0 0 3157.72 0 0 0 1101200787 1962590729 23 Occupational Therapists KUPCZYK SUSAN 601263754 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 373 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 373 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28902.79 28902.79 0 0 0 1101200792 98 Waiver service provider--TBI (DHS/DRS) 98 Tazewell 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 26482.03 0 0 0 0 0 0 0 0 0 0 0 0 0 26482.03 0 0 0 1101200800 1831280536 46 Ambulatory Surgical Treatment Centers EFFINGHAM SURGICAL PARTNERS 624012178 33 Effingham ARS-LS Long-term stay hospitals paid under an ARS 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 389 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 517 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 517 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45304.51 156158.02 0 0 0 0 0 201462.53 0 0 0 1101200806 10 Physicians 109 Winnebago 0 0 Internal 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STEPHEN 622261919 96 St Clair 0 0 Ophthalmology 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 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 616.68 0 0 0 0 0 0 616.68 0 0 0 1101201454 1548534688 36 Community mental health provider TRANSITIONS OF WESTERN ILL 999999999 10 Adams 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 152 0 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1011 0 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1011 0 0 4539.11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67778.28 0 0 72317.39 0 0 0 1101201459 1043263171 13 Podiatrists NOXON BRUCE 600251324 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2250.8 0 0 0 0 0 0 2250.8 0 0 0 1101201460 1790841724 60 Pharmacies FARMACIA SAN JUDAS 606478415 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 843 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20995 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47485.67 0 0 0 47485.67 0 0 0 1101201462 92 Waiver service provider--Disability (DHS/DRS) 72 McLean 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21423.43 0 0 0 0 0 0 0 0 0 0 0 0 0 21423.43 0 0 0 1101201476 1831124494 10 Physicians YAP RENEE 606114402 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 667 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 947 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 947 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15804.68 0 223.07 0 0 0 0 0 0 16027.75 0 0 0 1101201492 1720297203 12 Optometrists CASPER DAVID 617649695 61 Livingston 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 1016 0 987 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1994 0 1061 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1994 0 1061 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58054.2 0 30316.38 0 0 0 0 88370.58 0 0 0 1101201504 10 Physicians 826 Missouri 0 0 Cardiovascular Diseases 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 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0 0 0 0 0 0 0 0 0 0 0 0 0 1898.29 0 0 0 0 0 0 1898.29 0 0 0 1101201577 1972806883 55 Early Intervention Services GONZALEZ JENNIFER 609144602 54 Kankakee 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 66 0 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 3586.82 0 0 0 0 0 0 3586.82 0 0 0 1101201578 1467594747 24 Speech Therapists LEGEREIT PEGGY 629603119 69 Massac 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14730.31 14730.31 0 0 0 1101201580 1366400327 10 Physicians ANCHETA OLIVER 527325032 816 Iowa 0 0 Neurology 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 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 221.93 0 0 0 0 0 0 221.93 0 0 0 1101201582 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 8759.13 0 0 0 0 0 0 0 0 0 0 0 0 0 8759.13 0 0 0 1101201590 1992768311 36 Community mental health provider LCFS LUTHERBROOK CHILDRENS CTR 601012584 30 DuPage 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 4375 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16178 0 0 4375 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16178 0 0 169620.42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 602026.75 0 0 771647.17 0 0 0 1101201593 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 1320.66 0 0 0 0 0 0 0 0 0 0 0 0 0 1320.66 0 0 0 1101201598 1184798175 16 Nurse Practitioners MAHMOOD REGINA 601262823 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101201609 92 Waiver service provider--Disability (DHS/DRS) 58 La Salle 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 1515.47 0 0 0 0 0 0 0 0 0 0 0 0 0 1515.47 0 0 0 1101201618 1407906449 10 Physicians MOEL DONALD 601533328 200 Cook 0 0 Pediatric Nephrology 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2930.99 0 0 0 0 0 0 2930.99 0 0 0 1101201626 92 Waiver service provider--Disability (DHS/DRS) 13 Boone 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34478.12 0 0 0 0 0 0 0 0 0 0 0 0 0 34478.12 0 0 0 1101201634 1679560031 33 Nursing Facilities ALDEN ESTATES OF NAPERVILLE 605651511 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 919 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23234 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2889742.34 0 0 0 0 0 0 0 2889742.34 0 0 0 1101201640 23 Occupational 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0 0 0 0 0 0 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8075.81 0 0 0 0 0 0 8075.81 0 0 0 1101203324 30 General Hospitals 824 Minnesota NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 527.06 0 0 0 0 0 0 0 0 0 0 0 0 0 0 527.06 0 0 0 1101203337 1396882205 30 General Hospitals VANDERBILT UNIVERSITY MEDICAL 372322102 844 Tennessee ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 0 0 0 0 0 7 0 0 0 0 3 0 0 0 3 0 0 0 0 0 0 0 0 0 9 0 0 0 0 3 0 0 0 4 0 0 0 0 0 0 0 0 0 9 0 0 0 0 18 0 0 0 4 0 0 0 0 0 0 0 0 0 3322.73 0 0 0 0 11606.61 0 0 0 1597.13 0 0 0 0 0 16526.47 0 0 0 1101203341 1932174000 33 Nursing Facilities MANOR COURT OF PERU 613541419 58 La Salle 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 274 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7101 0 0 0 0 0 0 0 0 0 0 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0 0 18631.27 0 0 0 1101203885 10 Physicians 53 Kane 0 0 Psychiatry 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 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 0 100.58 0 0 0 0 0 0 100.58 0 0 0 1101203892 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4212.45 0 0 0 0 0 0 0 0 0 0 0 0 0 4212.45 0 0 0 1101203907 1811061567 10 Physicians TOOMGANTI PRASUNA 606575640 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2771.25 0 0 0 0 0 0 2771.25 0 0 0 1101203908 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 2257.03 0 0 0 0 0 0 0 0 0 0 0 0 0 2257.03 0 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(DHS/DRS) 200 Cook 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 28127.62 0 0 0 0 0 0 0 0 0 0 0 0 0 28127.62 0 0 0 1101204068 1144247685 10 Physicians SCHLAGGAR BRADLEY 631101010 826 Missouri 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3210.92 0 0 0 0 0 0 3210.92 0 0 0 1101204071 1679680797 63 Other Providers of Medical Equipment/Supplies (Non-registered) A TO Z MOBILITY AND MEDICAL 605858516 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 224 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 224 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 149214.4 0 0 0 0 0 0 149214.4 0 0 0 1101204075 1396722815 10 Physicians BERKI ZAFEER 600051069 200 Cook 0 0 General Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 0 0 0 0 0 0 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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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14346.19 0 0 0 0 0 0 0 0 0 0 0 0 0 14346.19 0 0 0 1101205336 94 Waiver service provider--Children's support (DHS/DDD) 55 Kendall 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 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8474.4 0 0 0 0 0 0 0 0 0 0 0 0 0 8474.4 0 0 0 1101205342 1285641217 60 Pharmacies BOND DRUG COMPANY OF ILLINOIS 604771754 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 860 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 4328 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 102754 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17.72 0 0 214987.2 0 0 0 215004.92 0 0 0 1101205343 1346268844 10 Physicians VACCARO ANTHONY 606573419 200 Cook 0 1 Internal Medicine 0 3 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 2269.3 0 0 0 0 0 0 2281.3 0 0 0 1101205345 1487605143 10 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3872 0 440 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3872 0 440 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60365.81 0 5123.36 0 0 0 0 0 0 65489.17 0 0 0 1101208183 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 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 0 158.95 0 0 0 0 0 0 0 0 0 0 0 0 0 158.95 0 0 0 1101208189 1528172772 10 Physicians KELLERMEIER JENS 606780001 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 1 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10386.86 0 0 0 0 0 0 10386.86 0 0 0 1101208200 1871554097 10 Physicians FRANK BENJAMIN S 535475081 57 Lake 0 0 Rheumatology 0 0 0 0 0 0 0 0 0 0 0 7 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18.37 0 283.71 0 0 0 0 0 0 302.08 0 0 0 1101208206 91 Waiver service provider--Adults (DHS/DDD) 96 St Clair 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 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5783.22 0 0 0 0 0 0 0 0 0 0 0 0 0 5783.22 0 0 0 1101208211 1992711006 10 Physicians GATES MARK 637034928 826 Missouri 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 661 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 822 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 822 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18402.16 0 1423.13 0 0 0 0 0 0 19825.29 0 0 0 1101208223 30 General Hospitals 844 Tennessee NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 595.66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 595.66 0 0 0 1101208226 1669672465 28 Waiver service provider--Supportive living facility (HFS) HERITAGE WOODS OF FLORA 628391296 22 Clay 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 459 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10710 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 572293.86 0 0 0 0 0 0 0 0 0 0 0 0 0 572293.86 0 0 0 1101208227 91 Waiver service provider--Adults (DHS/DDD) 57 Lake 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 0 230 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22141 0 0 0 0 0 0 0 0 0 0 0 0 0 22141 0 0 0 1101208228 10 Physicians 836 Ohio 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 1 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95.25 0 65.05 0 0 0 0 0 0 160.3 0 0 0 1101208231 91 Waiver service provider--Adults (DHS/DDD) 107 Will 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 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 924.16 0 0 0 0 0 0 0 0 0 0 0 0 0 924.16 0 0 0 1101208240 92 Waiver service provider--Disability (DHS/DRS) 79 Ogle 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20121.03 0 0 0 0 0 0 0 0 0 0 0 0 0 20121.03 0 0 0 1101208254 1205165222 16 Nurse Practitioners ATWOOD TEIA 606243308 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 430 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 430 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1270.96 0 0 0 0 0 0 1270.96 0 0 0 1101208276 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6291.45 0 0 0 0 0 0 0 0 0 0 0 0 0 6291.45 0 0 0 1101208289 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 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 5930.32 0 0 0 0 0 0 0 0 0 0 0 0 0 5930.32 0 0 0 1101208307 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8279.98 0 0 0 0 0 0 0 0 0 0 0 0 0 8279.98 0 0 0 1101208316 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 17242.5 0 0 0 0 0 0 0 0 0 0 0 0 0 17242.5 0 0 0 1101208332 1730258047 10 Physicians JIDO EBBY 601181416 53 Kane 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15696.65 0 0 0 0 0 0 15696.65 0 0 0 1101208334 1447311444 10 Physicians TALATI ARVINDKUMAR 606233939 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 0 0 677 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1313 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1313 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29539.5 0 0 0 0 0 0 29539.5 0 0 0 1101208381 1225162506 47 Local Education Agencies MUNDELEIN CONSOL HS DIST 120 600601504 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 354 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 354 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6405.64 0 6405.64 0 0 0 1101208385 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21145.68 0 0 0 0 0 0 0 0 0 0 0 0 0 21145.68 0 0 0 1101208392 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20794.88 0 0 0 0 0 0 0 0 0 0 0 0 0 20794.88 0 0 0 1101208394 1710977939 11 Dentists MIRZA MUZAFFAR 606093758 200 Cook 0 0 General Dentistry 0 0 0 926 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 4738 0 0 0 0 0 0 0 0 0 0 0 111 0 0 0 0 0 0 4738 0 0 0 0 0 0 0 0 0 0 0 111 0 0 0 0 0 0 164817.82 0 0 0 0 0 0 0 0 0 0 0 39213.86 0 0 0 0 204031.68 0 0 0 1101208402 98 Waiver service provider--TBI (DHS/DRS) 80 Peoria 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 24493.99 0 0 0 0 0 0 0 0 0 0 0 0 0 24493.99 0 0 0 1101208404 92 Waiver service provider--Disability (DHS/DRS) 13 Boone 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 22412.31 0 0 0 0 0 0 0 0 0 0 0 0 0 22412.31 0 0 0 1101208412 1215042049 10 Physicians TENG HONGYU 600442203 57 Lake 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 1 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3025.61 0 0 0 0 0 0 3025.61 0 0 0 1101208425 1912993858 10 Physicians VICARI JOSEPH J 611075075 109 Winnebago 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 6 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 294 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 294 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26.29 0 10583.08 0 0 0 0 0 0 10609.37 0 0 0 1101208430 1962401364 10 Physicians ROSE CHRISTOPHER G 606731250 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 237 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 237 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5739.54 0 0 0 0 0 0 5739.54 0 0 0 1101208431 16 Nurse Practitioners 815 Indiana 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 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116.98 0 0 0 0 0 0 116.98 0 0 0 1101208434 1417983487 10 Physicians KINSINGER LEE 615712170 98 Tazewell 0 1 Family Practice 0 31 0 0 8 0 0 0 0 0 0 9 0 23 0 0 0 0 0 0 305 0 0 9 0 0 0 0 0 0 11 0 58 0 0 0 0 0 0 305 0 0 9 0 0 0 0 0 0 11 0 58 0 0 0 0 0 0 732 0 0 510.42 0 0 0 0 0 0 94.86 0 2886.82 0 0 0 0 0 0 4224.1 0 0 0 1101208436 1720216930 10 Physicians ULMER MEREDITH 611033619 109 Winnebago 0 1 Family Practice 0 261 0 0 35 0 0 0 0 0 0 9 0 217 0 0 0 0 0 0 1598 0 0 83 0 0 0 0 0 0 10 0 444 0 0 0 0 0 0 1598 0 0 83 0 0 0 0 0 0 10 0 444 0 0 0 0 0 0 4276 0 0 2936.8 0 0 0 0 0 0 22.62 0 12051.47 0 0 0 0 0 0 19286.89 0 0 0 1101208445 10 Physicians 852 Wisconsin 0 0 Anesthesiology 0 0 0 0 0 0 0 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1405.52 0 0 0 0 0 0 1405.52 0 0 0 1101208463 1649387838 60 Pharmacies PECATONICA PHARMACY 610630550 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 235 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2237 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56947 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 147277.43 0 0 0 147277.43 0 0 0 1101208485 1508854597 10 Physicians BASNET SANGITA 627031944 91 Sangamon 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 350 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 350 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114597.59 0 0 0 0 0 0 114597.59 0 0 0 1101208487 1407886385 30 General Hospitals DES PERES HOSPITAL 631223313 826 Missouri NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 5 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 203.49 0 0 66.3 0 0 0 0 0 269.79 0 0 0 1101208491 1417070327 10 Physicians SARIKONDA MOLLY 630442436 826 Missouri 0 0 Infectious Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 806.93 0 0 0 0 0 0 806.93 0 0 0 1101208496 1801816517 10 Physicians CHAVEZ LORITZ 532152843 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 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 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42.5 0 0 0 0 0 0 42.5 0 0 0 1101208502 1679549356 10 Physicians HASAN SIDDIQ SYED 606321849 816 Iowa 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 189 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 189 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15344.21 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 12952.07 0 0 0 1101208539 1891723730 10 Physicians RUBIN CINDY 606910263 200 Cook 0 1 Pediatrics 0 394 0 0 353 0 0 0 0 0 0 0 0 449 0 0 0 0 0 0 3290 0 0 638 0 0 0 0 0 0 0 0 642 0 0 0 0 0 0 3290 0 0 638 0 0 0 0 0 0 0 0 642 0 0 0 0 0 0 6580 0 0 41647.99 0 0 0 0 0 0 0 0 31587.92 0 0 0 0 0 0 79815.91 0 0 0 1101208540 1326279068 75 Department of Alcohol and Substance Abuse Provider HUMAN SERVICE CENTER 616141219 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2563 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2563 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230174.57 0 0 230174.57 0 0 0 1101208544 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14342.82 0 0 0 0 0 0 0 0 0 0 0 0 0 14342.82 0 0 0 1101208558 91 Waiver service provider--Adults (DHS/DDD) 65 Madison 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 0 345 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 345 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23689.77 0 0 0 0 0 0 0 0 0 0 0 0 0 23689.77 0 0 0 1101208566 24 Speech 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 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 0 145.12 145.12 0 0 0 1101208568 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 20182.04 0 0 0 0 0 0 0 0 0 0 0 0 0 20182.04 0 0 0 1101208581 1942282322 10 Physicians MCCALL BRIAN 606303745 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 60 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132 0 213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132 0 213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1223.94 0 7517.24 0 0 0 0 0 0 8741.18 0 0 0 1101208592 1083759633 30 General Hospitals COMMUNITY METHODIST HOSPITAL 424200048 818 Kentucky NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 11 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 1055.11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1055.11 0 0 0 1101208603 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 16307.81 0 0 0 0 0 0 0 0 0 0 0 0 0 16307.81 0 0 0 1101208604 1003091042 55 Early Intervention Services SWANK ANNETTE 600852013 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 422 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 422 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26873.42 0 0 0 0 0 0 26873.42 0 0 0 1101208622 98 Waiver service provider--TBI (DHS/DRS) 19 Champaign 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 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 0 895.65 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 529.44 0 0 0 0 0 0 0 0 0 0 0 0 0 529.44 0 0 0 1101208938 1891830402 16 Nurse Practitioners GRISSOM BRADLEY 618321735 100 Vermilion 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1166.58 0 0 0 0 0 0 1166.58 0 0 0 1101208945 1215996301 10 Physicians JAIN PANKAJ 605233808 30 DuPage 0 0 Pulmonary Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 381 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1461 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1461 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18443.11 0 0 0 0 0 0 18443.11 0 0 0 1101208948 1316942915 63 Other Providers of Medical Equipment/Supplies (Non-registered) KELLYS MEDICAL EQUIP SUPPLY 612654551 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2929.66 0 0 0 0 0 0 2929.66 0 0 0 1101208956 1972884062 16 Nurse 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(DHS/DRS) NEXT LEVEL HEALTHCARE OUTREACH 604222085 200 Cook 0 0 0 0 0 0 0 0 8 0 0 0 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 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86883.65 0 0 0 0 0 0 0 0 0 0 0 0 0 86883.65 0 0 0 1101210116 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22629.99 0 0 0 0 0 0 0 0 0 0 0 0 0 22629.99 0 0 0 1101210126 1477587954 10 Physicians SATTOVIA SCOTT 627810001 91 Sangamon 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 1 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14364.25 0 0 0 0 0 0 14364.25 0 0 0 1101210129 91 Waiver service provider--Adults (DHS/DDD) 53 Kane 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 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2868.25 0 0 0 0 0 0 0 0 0 0 0 0 0 2868.25 0 0 0 1101210141 1245204577 10 Physicians TELFER MARGARET 606163557 200 Cook 0 0 Hematology 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 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 0 0 0 0 0 0 0 0 0 0 0 1101210169 1083633663 10 Physicians PIAZZA LEONARD 605406540 30 DuPage 0 0 Otorhinolaryngology 0 0 0 0 2 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 162 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 162 0 0 0 0 0 0 0 0 0 27.86 0 0 0 0 0 0 0 0 3620 0 0 0 0 0 0 3647.86 0 0 0 1101210170 1053328831 10 Physicians WHEELER RONALD 614553313 70 McDonough 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 274 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 620 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 620 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30132.59 0 0 0 0 0 0 30132.59 0 0 0 1101210172 1861663270 10 Physicians FINLAYSON CRAIG 606116649 30 DuPage 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 211 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 404 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 404 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51173.38 0 0 0 0 0 0 51173.38 0 0 0 1101210173 1114987161 33 Nursing Facilities FAIRVIEW HAVEN NURSING HOME 617391210 61 Livingston 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 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1768 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 174118.73 0 0 0 0 0 0 0 174118.73 0 0 0 1101210181 1548276991 10 Physicians MAZZEI JOE 535482940 852 Wisconsin 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 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 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2426.59 0 0 0 0 0 0 2426.59 0 0 0 1101210185 1508076522 10 Physicians MARTINI JOHN 606930623 109 Winnebago 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 1051 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1305 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1305 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39650.76 0 0 0 0 0 0 39650.76 0 0 0 1101210205 10 Physicians 30 DuPage 0 0 Obstetric-Gynecology 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104.96 0 0 0 0 0 0 104.96 0 0 0 1101210207 92 Waiver service provider--Disability (DHS/DRS) 10 Adams 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 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 6332.5 0 0 0 0 0 0 0 0 0 0 0 0 0 6332.5 0 0 0 1101210222 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23188 0 0 0 0 0 0 0 0 0 0 0 0 0 23188 0 0 0 1101210223 16 Nurse Practitioners 30 DuPage 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 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132.26 0 0 0 0 0 0 132.26 0 0 0 1101210224 92 Waiver service provider--Disability (DHS/DRS) 94 Shelby 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 2632.22 0 0 0 0 0 0 0 0 0 0 0 0 0 2632.22 0 0 0 1101210225 63 Other Providers of Medical Equipment/Supplies (Non-registered) 91 Sangamon 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 170.42 0 0 0 0 170.42 0 0 0 1101210235 36 Community mental health provider 815 Indiana 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 246 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 246 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135654.24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135654.24 0 0 0 1101210243 10 Physicians 852 Wisconsin 0 0 Internal Medicine 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 192.55 0 0 0 0 0 0 192.55 0 0 0 1101210249 92 Waiver service provider--Disability (DHS/DRS) 37 Fulton 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11884.55 0 0 0 0 0 0 0 0 0 0 0 0 0 11884.55 0 0 0 1101210270 1194900258 11 Dentists SANDHU VARINDER 606146730 200 Cook 0 0 General Dentistry 0 0 0 1311 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4931 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4931 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114250 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114250 0 0 0 1101210272 1336154566 60 Pharmacies BOND DRUG COMPANY OF IL 03995 601641645 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 3554 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 14119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 324617 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40.52 0 0 708400.75 0 0 0 708441.27 0 0 0 1101210276 1023289444 10 Physicians LEE HONG 604405125 30 DuPage 0 0 Endocrinology 0 0 0 0 0 0 0 0 0 0 0 24 0 194 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 930 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 930 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 377.25 0 8990.87 0 0 0 0 0 0 9368.12 0 0 0 1101210279 1538194154 10 Physicians RAZBADOUSKI LINDA M 610888738 109 Winnebago 0 1 Internal Medicine 0 2 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 119.62 0 0 0 0 0 0 125.62 0 0 0 1101210292 1619963816 63 Other Providers of Medical Equipment/Supplies (Non-registered) ALDEN ALMA NELSON MANOR INC 611082599 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 188 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 188 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29719.7 0 0 0 0 0 0 29719.7 0 0 0 1101210309 93 Waiver service provider--HIV/AIDS (DHS/DRS) 56 Knox 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 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 18018.5 0 0 0 0 0 0 0 0 0 0 0 0 0 18018.5 0 0 0 1101210311 92 Waiver service provider--Disability (DHS/DRS) 45 Henry 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 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 0 252.61 0 0 0 0 0 0 0 0 0 0 0 0 0 252.61 0 0 0 1101210314 1033275276 10 Physicians OH THOMAS 600852161 57 Lake 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 4 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6.31 0 616.02 0 0 0 0 0 0 622.33 0 0 0 1101210315 1982832119 10 Physicians MONACO MICHAEL 631101010 826 Missouri 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1123.65 0 0 0 0 0 0 1123.65 0 0 0 1101210317 1770797359 10 Physicians SHARMA RAJIV 477140556 815 Indiana 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8813.96 0 0 0 0 0 0 8813.96 0 0 0 1101210322 1699776039 13 Podiatrists WILCZYNSKI RICHARD 600842424 200 Cook 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 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 498.84 0 0 0 0 0 0 498.84 0 0 0 1101210325 94 Waiver service provider--Children's support (DHS/DDD) 91 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 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2035 0 0 0 0 0 0 0 0 0 0 0 0 0 2035 0 0 0 1101210328 91 Waiver service provider--Adults (DHS/DDD) 91 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 0 168 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 168 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13133.4 0 0 0 0 0 0 0 0 0 0 0 0 0 13133.4 0 0 0 1101210341 1841456217 10 Physicians ADHIKARI SEETAL 600681110 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 1 0 0 0 0 0 0 207 0 192 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 557 0 506 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 557 0 506 0 0 0 0 0 0 0 0 0 85.65 0 0 0 0 0 0 15532.1 0 40149.64 0 0 0 0 0 0 55767.39 0 0 0 1101210353 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18656.83 0 0 0 0 0 0 0 0 0 0 0 0 0 18656.83 0 0 0 1101210368 1013025097 10 Physicians JORDAN WAGNER DIANE 478044002 815 Indiana 0 0 Allergy-Immunization 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 217 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 217 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6821.28 0 0 0 0 0 0 6821.28 0 0 0 1101210374 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 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 20437.86 0 0 0 0 0 0 0 0 0 0 0 0 0 20437.86 0 0 0 1101210378 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22392.67 0 0 0 0 0 0 0 0 0 0 0 0 0 22392.67 0 0 0 1101210379 91 Waiver service provider--Adults (DHS/DDD) 66 Marion 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 0 255 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 255 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12405.98 0 0 0 0 0 0 0 0 0 0 0 0 0 12405.98 0 0 0 1101210394 1073560900 10 Physicians SETHI ASHWANI 531435031 852 Wisconsin 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 8 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 0 410.65 0 0 0 0 0 0 410.65 0 0 0 1101210395 1932127651 10 Physicians HAMLIN KIM 631101002 826 Missouri 0 0 Pediatrics 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 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2107.83 0 0 0 0 0 0 2107.83 0 0 0 1101210396 94 Waiver service provider--Children's support (DHS/DDD) 91 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 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2792.62 0 0 0 0 0 0 0 0 0 0 0 0 0 2792.62 0 0 0 1101210403 1689786204 10 Physicians SOHN AUGUSTINE 606743461 200 Cook 0 1 Family Practice 0 1242 0 0 82 0 0 0 0 0 0 37 0 342 0 0 0 0 0 0 4050 0 0 219 0 0 0 0 0 0 57 0 549 0 0 0 0 0 0 4050 0 0 219 0 0 0 0 0 0 57 0 549 0 0 0 0 0 0 9904 0 0 8049.68 0 0 0 0 0 0 224.72 0 44358.91 0 0 0 0 0 0 62537.31 0 0 0 1101210404 92 Waiver service provider--Disability (DHS/DRS) 53 Kane 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 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 2750.07 0 0 0 0 0 0 0 0 0 0 0 0 0 2750.07 0 0 0 1101210405 10 Physicians 816 Iowa 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43.92 0 73.35 0 0 0 0 0 0 117.27 0 0 0 1101210412 1548373053 10 Physicians CHMELL MICHAEL 611075090 109 Winnebago 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 76 0 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132 0 201 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132 0 201 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1535.67 0 17096.95 0 0 0 0 0 0 18632.62 0 0 0 1101210419 1619925021 10 Physicians SHIH CHRISTINE 604404921 107 Will 0 1 Family Practice 0 4 0 0 3 0 0 0 0 0 0 4 0 34 0 0 0 0 0 0 16 0 0 14 0 0 0 0 0 0 4 0 73 0 0 0 0 0 0 16 0 0 14 0 0 0 0 0 0 4 0 73 0 0 0 0 0 0 40 0 0 475.64 0 0 0 0 0 0 16.05 0 1629.5 0 0 0 0 0 0 2161.19 0 0 0 1101210421 98 Waiver service provider--TBI (DHS/DRS) 815 Indiana 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 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 5491.87 0 0 0 0 0 0 0 0 0 0 0 0 0 5491.87 0 0 0 1101210427 1760446256 30 General Hospitals ABBOTT NORTHWESTERN HOSP 554073723 824 Minnesota NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 7 0 0 0 0 4 0 0 0 2 0 0 0 0 0 0 0 0 0 7 0 0 0 0 4 0 0 0 2 0 0 0 0 0 0 0 0 0 7 0 0 0 0 11 0 0 0 2 0 0 0 0 0 0 0 0 0 1788.08 0 0 0 0 4513.68 0 0 0 1081.02 0 0 0 0 0 7382.78 0 0 0 1101210448 1760579346 10 Physicians CHETKOVICH DANE 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40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2200 0 0 0 0 0 0 0 0 0 0 0 0 0 2200 0 0 0 1101211330 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 2057.6 0 0 0 0 0 0 0 0 0 0 0 0 0 2057.6 0 0 0 1101211331 1376504365 10 Physicians STRAYER SUE A 625218439 63 Macon 0 0 Pathology 0 0 0 0 21 0 0 0 0 0 0 3476 0 368 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 30598 0 908 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 30598 0 908 0 0 0 0 0 0 0 0 0 158.13 0 0 0 0 0 0 134443.4 0 5091.73 0 0 0 0 0 0 139693.26 0 0 0 1101211382 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1890.9 0 0 0 0 0 0 0 0 0 0 0 0 0 1890.9 0 0 0 1101211385 1043358914 10 Physicians SUSEDIK CYNTHIA 604403411 107 Will 0 0 Emergency 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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 19839.17 0 0 0 0 0 0 0 0 0 0 0 0 0 19839.17 0 0 0 1101211464 1508886409 10 Physicians DIAZ HAROLD 606133077 200 Cook 0 1 Internal Medicine 0 17 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 145 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 145 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 1322.21 0 0 0 0 0 0 1396.21 0 0 0 1101211469 1972647139 10 Physicians BERRY DANNY 999999999 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2443.5 0 0 0 0 0 0 2443.5 0 0 0 1101211471 1932386984 10 Physicians HUBBARD MARK 477101781 815 Indiana 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 139 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 236 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 236 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8824.84 0 885.54 0 0 0 0 0 0 9710.38 0 0 0 1101211503 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 189172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 344414.99 0 0 0 344414.99 0 0 0 1101212067 1356356166 10 Physicians NYE ELIZABETH 606113162 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 2 0 0 0 0 0 0 5 0 11 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 11 0 29 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 11 0 29 0 0 0 0 0 0 0 0 0 170.27 0 0 0 0 0 0 247.57 0 1153.16 0 0 0 0 0 0 1571 0 0 0 1101212075 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 12705.22 0 0 0 0 0 0 0 0 0 0 0 0 0 12705.22 0 0 0 1101212078 91 Waiver service provider--Adults (DHS/DDD) 55 Kendall 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 0 324 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 324 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19194 0 0 0 0 0 0 0 0 0 0 0 0 0 19194 0 0 0 1101212084 1154415024 30 General Hospitals LAKEVIEW MEDICAL CENTER 548681238 852 Wisconsin NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 651.41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 651.41 0 0 0 1101212108 1821074600 10 Physicians ROLAND DONALD E 609013673 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 33 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 676 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 676 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 140.53 0 3050.47 0 0 0 0 0 0 3191 0 0 0 1101212110 1255458055 10 Physicians LEVISAY JUSTIN 602011718 200 Cook 0 0 Internal Medicine 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 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5895.75 0 0 0 0 0 0 5895.75 0 0 0 1101212112 92 Waiver service provider--Disability (DHS/DRS) 62 Logan 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11618.51 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0 0 0 0 0 0 0 0 2255 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59149.75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59149.75 0 0 0 1101212150 1043261555 10 Physicians MALIK KHALID 605231956 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 1537 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2340 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2340 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44556.05 0 0 0 0 0 0 44556.05 0 0 0 1101212152 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 22810.05 0 0 0 0 0 0 0 0 0 0 0 0 0 22810.05 0 0 0 1101212154 10 Physicians 826 Missouri 0 0 Internal Medicine 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 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 0 0 0 0 0 0 0 0 0 0 0 1101212155 1093732414 60 Pharmacies WAL MART STORES EAST LP 100431 420030337 818 Kentucky 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 276 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4077.07 0 0 0 4077.07 0 0 0 1101212157 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15573.81 0 0 0 0 0 0 0 0 0 0 0 0 0 15573.81 0 0 0 1101212168 1760480750 13 Podiatrists SHOUDEL JOHN 627949679 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 153 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 482 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 482 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13188.58 0 0 0 0 0 0 13188.58 0 0 0 1101212176 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 16329.5 0 0 0 0 0 0 0 0 0 0 0 0 0 16329.5 0 0 0 1101212213 10 Physicians 200 Cook 0 0 Obstetric-Gynecology 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86.9 0 0 0 0 0 0 86.9 0 0 0 1101212215 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 11678.83 0 0 0 0 0 0 0 0 0 0 0 0 0 11678.83 0 0 0 1101212225 1598910192 11 Dentists HAMPER STEPHANIE 613690674 200 Cook 0 0 General Dentistry 0 0 0 345 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1745 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1745 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58487.71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58487.71 0 0 0 1101212228 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 1190.44 0 0 0 0 0 0 0 0 0 0 0 0 0 1190.44 0 0 0 1101212230 1124228622 10 Physicians PUNNOOSE JENNIFER 999999999 200 Cook 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 261.04 0 0 0 0 0 0 261.04 0 0 0 1101212234 92 Waiver service provider--Disability (DHS/DRS) 50 Jersey 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 0 120 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 0 0 0 0 0 0 0 0 0 0 0 0 40538.64 0 0 0 0 0 0 0 0 0 0 0 0 0 40538.64 0 0 0 1101212257 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5836.55 0 0 0 0 0 0 0 0 0 0 0 0 0 5836.55 0 0 0 1101212266 1811953532 33 Nursing Facilities WATSEKA REHAB HEALTH CARE CTR 609709730 46 Iroquois 0 0 0 0 0 0 0 0 0 0 0 0 0 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1054 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23471 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1622926.06 0 0 0 0 0 0 0 1622926.06 0 0 0 1101212268 1578563904 10 Physicians PUTTERMAN ALLEN M 606743460 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 0 0 6 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 0 522.21 0 0 0 0 0 0 522.21 0 0 0 1101212294 1043273915 10 Physicians JERCINOVIC BRUNO 604047301 107 Will 0 0 Pediatrics 0 14 0 0 5 0 0 0 0 0 0 4 0 12 0 0 0 0 0 0 110 0 0 10 0 0 0 0 0 0 7 0 32 0 0 0 0 0 0 110 0 0 10 0 0 0 0 0 0 7 0 32 0 0 0 0 0 0 220 0 0 485.2 0 0 0 0 0 0 107.23 0 1636.07 0 0 0 0 0 0 2448.5 0 0 0 1101212296 1578886669 16 Nurse Practitioners GRIGGS MICHELLE 622861820 87 Randolph 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20490.87 0 0 0 0 0 0 20490.87 0 0 0 1101212307 1609889914 33 Nursing Facilities APOSTOLIC CHRISTIAN HOME 615300128 110 Woodford 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 0 173 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4931 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 380589.52 0 0 0 0 0 0 0 380589.52 0 0 0 1101212313 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 19 0 0 0 0 0 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 21501.03 0 0 0 0 0 0 0 0 0 0 0 0 0 21501.03 0 0 0 1101212321 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10678.8 0 0 0 0 0 0 0 0 0 0 0 0 0 10678.8 0 0 0 1101212327 14 Chiropractors 200 Cook 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21.75 0 0 0 0 0 0 21.75 0 0 0 1101212335 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14066.65 0 0 0 0 0 0 0 0 0 0 0 0 0 14066.65 0 0 0 1101212352 1457462558 10 Physicians WESTERN GARY 627023719 91 Sangamon 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 173 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 393 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 393 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12722.64 0 0 0 0 0 0 12722.64 0 0 0 1101212355 2100202773 90 Waiver service provider--Elderly (DOA) CASA CENTRAL SOCIAL SVCS CORP 606222803 200 Cook 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17528 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17528 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 633672.45 0 0 0 0 0 0 0 0 0 0 0 0 0 633672.45 0 0 0 1101212370 1669541728 10 Physicians GOWDAR KUSUMA 625264163 30 DuPage 0 1 Neonatal-Perinatal Medicine 0 26 0 0 10 0 0 0 0 0 0 8 0 17 0 0 0 0 0 0 149 0 0 32 0 0 0 0 0 0 11 0 24 0 0 0 0 0 0 149 0 0 32 0 0 0 0 0 0 11 0 24 0 0 0 0 0 0 298 0 0 1232.4 0 0 0 0 0 0 48.94 0 829.71 0 0 0 0 0 0 2409.05 0 0 0 1101212380 92 Waiver service provider--Disability (DHS/DRS) 79 Ogle 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 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7491.85 0 0 0 0 0 0 0 0 0 0 0 0 0 7491.85 0 0 0 1101212381 1437361722 10 Physicians JOSHI ATUL 605231956 30 DuPage 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 1159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1247 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1247 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43401.24 0 0 0 0 0 0 43401.24 0 0 0 1101212383 1417928714 10 Physicians BRODSKY GEORGE 600532102 200 Cook 0 1 Emergency Medicine 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 0 819 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 819 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4833.44 0 0 0 0 0 0 4833.44 0 0 0 1101212395 1790789139 63 Other Providers of Medical Equipment/Supplies (Non-registered) ANDERSON MEDICAL PRODUCTS 478024359 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 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 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1415.81 0 0 0 0 0 0 1415.81 0 0 0 1101212421 1063423655 10 Physicians THOMAS ABRAHAM 609270068 46 Iroquois 0 1 Internal Medicine 0 136 0 0 0 0 0 0 0 0 0 1 0 270 0 0 0 0 0 0 1234 0 0 0 0 0 0 0 0 0 1 0 919 0 0 0 0 0 0 1234 0 0 0 0 0 0 0 0 0 1 0 919 0 0 0 0 0 0 3735 0 0 0 0 0 0 0 0 0 4 0 15994.48 0 0 0 0 0 0 19733.48 0 0 0 1101212435 16 Nurse Practitioners 30 DuPage 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 204.5 0 0 0 0 0 0 204.5 0 0 0 1101212447 1457468019 10 Physicians IKEDIONWU CHUKWUELOKA 626284247 77 Morgan 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 157 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 157 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8463.4 0 0 0 0 0 0 8463.4 0 0 0 1101212461 16 Nurse Practitioners 19 Champaign 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82.31 0 0 0 0 0 0 82.31 0 0 0 1101212462 1134358567 10 Physicians CONKLIN PATRICK 999999999 24 Coles 0 0 0 0 0 0 0 0 0 0 0 0 0 724 0 169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 896 0 293 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 896 0 293 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16243.84 0 7705.27 0 0 0 0 0 0 23949.11 0 0 0 1101212477 1194887646 10 Physicians ODENIKE OLATOYOSI 605276686 30 DuPage 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2800.63 0 0 0 0 0 0 2800.63 0 0 0 1101212481 1538378047 55 Early Intervention Services THOMAS DEBRA 600142906 71 McHenry 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 0 287 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 287 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20360.81 0 0 0 0 0 0 20360.81 0 0 0 1101212492 1235116088 10 Physicians HANCOCK JAMES 617013514 72 McLean 0 1 Internal Medicine 0 81 0 0 47 0 0 0 0 0 0 29 0 78 0 0 0 0 0 0 737 0 0 51 0 0 0 0 0 0 96 0 174 0 0 0 0 0 0 737 0 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Waiver service provider--Adults (DHS/DDD) 57 Lake 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 0 274 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 274 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20352.42 0 0 0 0 0 0 0 0 0 0 0 0 0 20352.42 0 0 0 1101213221 1609876077 10 Physicians GREEN PAULA 608052701 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 635 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 660 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 660 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22842.02 0 0 0 0 0 0 22842.02 0 0 0 1101213225 1851351472 10 Physicians BAILEY KENNETH 604264267 200 Cook 0 0 Radiology Diagnosis 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 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 0 464.96 0 0 0 0 0 0 0 0 464.96 0 0 0 1101213235 92 Waiver service provider--Disability (DHS/DRS) 31 Edgar 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 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13151.09 0 0 0 0 0 0 0 0 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Madison 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 267.17 0 0 0 0 0 0 267.17 0 0 0 1101213710 1548306343 30 General Hospitals ELMHURST MEMORIAL HOSPITAL 601265658 30 DuPage DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 0 0 0 0 391 0 0 0 0 0 0 2472 0 0 1698 0 0 0 0 0 0 0 0 518 0 0 0 0 0 0 9900 0 0 3791 0 0 0 0 0 0 0 0 518 0 0 0 0 0 0 9900 0 0 3791 0 0 0 0 0 0 0 0 2254.21 0 0 0 0 0 0 76382.98 0 0 450056.03 0 0 0 0 0 528693.22 0 0 0 1101213715 1215184759 33 Nursing Facilities BRENTWOOD NORTH HC REHAB CTR 600153540 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 567 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14054 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1680424.02 0 0 0 0 0 0 0 1680424.02 0 0 0 1101213723 1699752485 10 Physicians MENENDEZ CESAR 606292014 200 Cook 0 1 Pediatrics 0 1210 0 0 386 0 0 0 0 0 0 196 0 393 0 0 0 0 0 0 2511 0 0 1388 0 0 0 0 0 0 269 0 524 0 0 0 0 0 0 2511 0 0 1388 0 0 0 0 0 0 269 0 524 0 0 0 0 0 0 5032 0 0 36665.36 0 0 0 0 0 0 1103.28 0 19948.44 0 0 0 0 0 0 62749.08 0 0 0 1101213724 1437195161 60 Pharmacies HY VEE PHARMACY 1416 612654544 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1680 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43321 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105601.67 0 0 0 105601.67 0 0 0 1101213728 1730131152 22 Physical Therapists GIDLEY JENNIFER 628646262 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1037.42 1037.42 0 0 0 1101213734 1235307471 47 Local Education Agencies WEST CARROLL CUSD 314 612857500 17 Carroll 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 2594 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2594 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37554.23 0 37554.23 0 0 0 1101213739 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 4152.59 0 0 0 0 0 0 0 0 0 0 0 0 0 4152.59 0 0 0 1101213743 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5870.69 0 0 0 0 0 0 0 0 0 0 0 0 0 5870.69 0 0 0 1101213746 91 Waiver service provider--Adults (DHS/DDD) 57 Lake 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 0 185 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 185 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24791.13 0 0 0 0 0 0 0 0 0 0 0 0 0 24791.13 0 0 0 1101213756 10 Physicians 57 Lake 0 0 Pediatrics 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 152.67 0 0 0 0 0 0 152.67 0 0 0 1101213762 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 14209.78 0 0 0 0 0 0 0 0 0 0 0 0 0 14209.78 0 0 0 1101213772 1922265701 10 Physicians JAHEDI SOGOL 600681110 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 1 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 14.6 0 0 0 0 0 0 0 0 1310.07 0 0 0 0 0 0 1324.67 0 0 0 1101213791 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 396 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 396 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35135.04 0 0 0 0 0 0 0 0 0 0 0 0 0 35135.04 0 0 0 1101213808 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 19 0 0 0 0 0 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 16987.92 0 0 0 0 0 0 0 0 0 0 0 0 0 16987.92 0 0 0 1101213847 1558378588 60 Pharmacies BOND DRUG COMPANY OF IL 03729 601033301 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 2322 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 10471 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 245076 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62.65 0 0 680235.31 0 0 0 680297.96 0 0 0 1101213848 1154437853 13 Podiatrists STEPLETON CHRISTIAN 601037831 200 Cook 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 77 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 0 0 0 432.85 0 0 0 0 0 0 432.85 0 0 0 1101213863 1386860534 10 Physicians DATTA SWATI 606118709 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 574.51 0 0 0 0 0 0 574.51 0 0 0 1101213869 1609969880 60 Pharmacies CARDINAL GLENNON CHILDREN 631041003 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 621 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1892 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34098 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 291794.13 0 0 0 291794.13 0 0 0 1101213870 1922137546 11 Dentists CONNOLLY CAROLINE 629596382 108 Williamson 0 0 General Dentistry 0 0 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 670 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 670 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18190.95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18190.95 0 0 0 1101213907 1558475996 10 Physicians PEREZ WALTER 606234456 200 Cook 0 1 Pediatrics 0 1096 0 0 705 0 0 0 0 0 0 502 0 926 0 0 0 0 0 0 3498 0 0 3364 0 0 0 0 0 0 624 0 1924 0 0 0 0 0 0 3498 0 0 3364 0 0 0 0 0 0 624 0 1924 0 0 0 0 0 0 7001 0 0 84594.26 0 0 0 0 0 0 2551.86 0 89184.45 0 0 0 0 0 0 183331.57 0 0 0 1101213910 92 Waiver service provider--Disability (DHS/DRS) 49 Jefferson 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 13140.47 0 0 0 0 0 0 0 0 0 0 0 0 0 13140.47 0 0 0 1101213915 1255388286 10 Physicians AHDAB WADDAH 463222909 815 Indiana 0 1 Internal Medicine 0 3 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 66 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 66 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 2225.54 0 0 0 0 0 0 2237.54 0 0 0 1101213922 1861638546 16 Nurse Practitioners LEFLORE KAYCI D 627115653 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 474.04 0 0 0 0 0 0 474.04 0 0 0 1101213924 92 Waiver service provider--Disability (DHS/DRS) 816 Iowa 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 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 10394.67 0 0 0 0 0 0 0 0 0 0 0 0 0 10394.67 0 0 0 1101213927 1235397068 60 Pharmacies WALGREENS 10885 605381027 55 Kendall 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1458 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 8572 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 213722 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1.73 0 0 449175.61 0 0 0 449177.34 0 0 0 1101213935 1639259740 10 Physicians RAUF ANIS 600073361 200 Cook 0 0 Nephrology 0 0 0 0 0 0 0 0 0 0 0 0 0 223 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 703 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 703 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7775.56 0 0 0 0 0 0 7775.56 0 0 0 1101213942 1740491190 23 Occupational Therapists JOHNSON DANETTE 606576992 200 Cook 0 0 0 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 23 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 0 0 0 0 0 0 0 0 139.3 139.3 0 0 0 1101213948 1598768152 10 Physicians ADEN MARILYN 606575640 200 Cook 0 1 Internal Medicine 0 26 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 112 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 112 0 0 0 0 0 0 272 0 0 0 0 0 0 0 0 0 0 0 2529.46 0 0 0 0 0 0 2801.46 0 0 0 1101213971 92 Waiver service provider--Disability (DHS/DRS) 49 Jefferson 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 0 303.68 0 0 0 0 0 0 0 0 0 0 0 0 0 303.68 0 0 0 1101213974 91 Waiver service provider--Adults (DHS/DDD) 60 Lee 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 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10771.2 0 0 0 0 0 0 0 0 0 0 0 0 0 10771.2 0 0 0 1101213978 1043448111 10 Physicians SHANMUGAM RAJU 999999999 72 McLean 0 0 0 120 0 0 9 0 0 0 0 0 0 15 0 71 0 0 0 0 0 0 788 0 0 11 0 0 0 0 0 0 22 0 155 0 0 0 0 0 0 788 0 0 11 0 0 0 0 0 0 22 0 155 0 0 0 0 0 0 1929 0 0 833.43 0 0 0 0 0 0 136.05 0 5038.04 0 0 0 0 0 0 7936.52 0 0 0 1101213982 1225082761 10 Physicians SLIVNICK DAVID 600485265 57 Lake 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 7 0 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 324 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 324 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137.74 0 10297.7 0 0 0 0 0 0 10435.44 0 0 0 1101213994 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 1680.33 0 0 0 0 0 0 0 0 0 0 0 0 0 1680.33 0 0 0 1101214002 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 4593.7 0 0 0 0 0 0 0 0 0 0 0 0 0 4593.7 0 0 0 1101214007 1871600858 30 General Hospitals FERRELL HOSPITAL COMM FOUND 629301634 90 Saline DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 1 0 General Hospital - Adult and Child 0 0 0 0 1 0 0 0 0 0 0 1304 0 0 364 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 6047 0 0 1206 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 6047 0 0 1206 0 0 0 0 0 0 0 0 11.54 0 0 0 0 0 0 47892.3 0 0 208380.25 0 0 0 0 0 256284.09 0 0 0 1101214012 1952399842 16 Nurse Practitioners WILMERT KAYE 999999999 72 McLean 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2360.02 0 0 0 0 0 0 2360.02 0 0 0 1101214033 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 2284.6 0 0 0 0 0 0 0 0 0 0 0 0 0 2284.6 0 0 0 1101214039 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 17264.6 0 0 0 0 0 0 0 0 0 0 0 0 0 17264.6 0 0 0 1101214041 1396876439 28 Waiver service provider--Supportive living facility (HFS) JACKSON PARK SUPPORTIVE LIVING 606192109 200 Cook 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 587 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13028 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 979060.21 0 0 0 0 0 0 0 0 0 0 0 0 0 979060.21 0 0 0 1101214045 1164433884 30 General Hospitals GREAT RIVER MEDICAL CENTER 526551679 816 Iowa DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 0 0 0 0 1 0 0 0 0 0 0 35 0 0 18 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 247 0 0 53 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 247 0 0 53 0 0 0 0 0 0 0 0 11.54 0 0 0 0 0 0 3192.86 0 0 2838.78 0 0 0 0 0 6043.18 0 0 0 1101214053 1962415513 10 Physicians MARTIN MICHAEL 627949639 91 Sangamon 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 456 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 456 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4019.37 0 0 0 0 0 0 4019.37 0 0 0 1101214054 1881781813 10 Physicians EXNER JOHN 610811252 106 Whiteside 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 0 32 0 511 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 1257 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 1257 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 172.6 0 45074.32 0 0 0 0 0 0 45246.92 0 0 0 1101214056 1922114115 36 Community mental health provider SINNISSIPPI CENTERS INC 610811608 106 Whiteside 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 2795 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7824 0 0 2795 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7824 0 0 4157.5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 285459.49 0 0 289616.99 0 0 0 1101214068 1164448734 10 Physicians AGULNIK MARK 606118709 200 Cook 0 0 Oncology 0 0 0 0 0 0 0 0 0 0 0 15 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151 0 701 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151 0 701 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 896.58 0 87725.43 0 0 0 0 0 0 88622.01 0 0 0 1101214083 1437203528 10 Physicians BRANTMAN BRUCE 609013675 54 Kankakee 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 889 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26443.19 0 0 0 0 0 0 26443.19 0 0 0 1101214100 91 Waiver service provider--Adults (DHS/DDD) 852 Wisconsin 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 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 1791.9 0 0 0 0 0 0 0 0 0 0 0 0 0 1791.9 0 0 0 1101214102 1548275860 60 Pharmacies BOND DRUG COMPANY OF IL 03833 607071637 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 2061 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 9106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 209939 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34.67 0 0 501358.04 0 0 0 501392.71 0 0 0 1101214112 1942424486 10 Physicians SUNDAR KANNAN 604532658 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 8 0 0 0 0 0 0 66 0 413 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 93 0 778 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 93 0 778 0 0 0 0 0 0 0 0 0 256.84 0 0 0 0 0 0 141.53 0 96565.12 0 0 0 0 0 0 96963.49 0 0 0 1101214117 91 Waiver service provider--Adults (DHS/DDD) 57 Lake 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 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22408.1 0 0 0 0 0 0 0 0 0 0 0 0 0 22408.1 0 0 0 1101214124 1528231354 13 Podiatrists HOFFMAN HEATH 611072201 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 454 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 454 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6276.64 0 0 0 0 0 0 6276.64 0 0 0 1101214126 1043217870 33 Nursing Facilities HELIA HEALTHCARE OF ENERGY 629333568 108 Williamson 0 0 0 0 0 0 0 0 0 0 0 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1101215230 92 Waiver service provider--Disability (DHS/DRS) 96 St Clair 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 21096.98 0 0 0 0 0 0 0 0 0 0 0 0 0 21096.98 0 0 0 1101215232 1588694343 10 Physicians MAY PERCY CONRAD 606242342 200 Cook 0 1 Internal Medicine 0 227 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1699 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1699 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4359 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4359 0 0 0 1101215252 1790767721 16 Nurse Practitioners AKINS SUSAN 631183907 826 Missouri 0 0 General Psychiatry Residency 0 0 0 0 0 0 0 0 0 0 0 0 0 22 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 15.75 0 0 0 0 0 0 15.75 0 0 0 1101215259 10 Physicians 200 Cook 0 0 Thoracic Surgery 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 110 0 842 0 0 0 0 0 0 9700 0 0 40646.47 0 0 0 0 0 0 1304.84 0 49071.87 0 0 0 0 0 0 100723.18 0 0 0 1101215277 1154388791 10 Physicians MCCORMACK ANTHONY 625264382 63 Macon 0 1 Family Practice 0 65 0 0 5 0 0 0 0 0 0 1 0 74 0 0 0 0 0 0 541 0 0 5 0 0 0 0 0 0 1 0 160 0 0 0 0 0 0 541 0 0 5 0 0 0 0 0 0 1 0 160 0 0 0 0 0 0 1374 0 0 408.57 0 0 0 0 0 0 31.3 0 3277.56 0 0 0 0 0 0 5091.43 0 0 0 1101215280 92 Waiver service provider--Disability (DHS/DRS) 25 Crawford 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 6820.65 0 0 0 0 0 0 0 0 0 0 0 0 0 6820.65 0 0 0 1101215284 1649471434 16 Nurse Practitioners SMITH SARA 535661569 50 Jersey 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 292 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 728 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 728 0 0 0 0 0 0 0 0 0 834.85 0 0 0 0 0 0 0 0 27829.85 0 0 0 0 0 0 28664.7 0 0 0 1101215295 1134254824 10 Physicians CREIGHTON DERRICK 528032459 816 Iowa 0 0 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0 1101215324 1053462739 12 Optometrists STAUDER MICHAEL F 625264280 63 Macon 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 758 0 519 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2848 0 616 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2848 0 616 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76728.25 0 17477.88 0 0 0 0 94206.13 0 0 0 1101215339 1194981100 10 Physicians KOTHARI AMI 600532127 200 Cook 0 0 Rheumatology 0 0 0 0 0 0 0 0 0 0 0 34 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 313 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 313 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 239.88 0 15619.55 0 0 0 0 0 0 15859.43 0 0 0 1101215345 92 Waiver service provider--Disability (DHS/DRS) 49 Jefferson 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 15882.76 0 0 0 0 0 0 0 0 0 0 0 0 0 15882.76 0 0 0 1101215351 1215139779 47 Local Education Agencies ROCK ISLAND SCHOOL DISTRICT 41 612018116 89 Rock Island 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 525 0 0 0 0 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DuPage 0 1 Pediatrics 0 12 0 0 20 0 0 0 0 0 0 17 0 23 0 0 0 0 0 0 61 0 0 35 0 0 0 0 0 0 34 0 35 0 0 0 0 0 0 61 0 0 35 0 0 0 0 0 0 34 0 35 0 0 0 0 0 0 122 0 0 1865.34 0 0 0 0 0 0 116.9 0 1645.74 0 0 0 0 0 0 3749.98 0 0 0 1101215391 1780650135 10 Physicians WOOD BRADLEY 628121969 36 Franklin 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 214 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 214 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6953.29 0 0 0 0 0 0 6953.29 0 0 0 1101215394 30 General Hospitals 815 Indiana ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 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 0 660.54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 660.54 0 0 0 1101215404 1477537090 10 Physicians MAKHECHA SANJIV 476309225 815 Indiana 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 169 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 247 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 247 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5091.91 0 378.45 0 0 0 0 0 0 5470.36 0 0 0 1101215422 1750559258 16 Nurse Practitioners JONES GILBERT 631101010 826 Missouri 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 329.41 0 0 0 0 0 0 329.41 0 0 0 1101215423 92 Waiver service provider--Disability (DHS/DRS) 91 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 12421.78 0 0 0 0 0 0 0 0 0 0 0 0 0 12421.78 0 0 0 1101215447 1811955636 10 Physicians HASAN YASMEEN 600987530 71 McHenry 0 1 Family Practice 0 1 0 0 2 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 1 0 0 6 0 0 0 0 0 0 0 0 273 0 0 0 0 0 0 1 0 0 6 0 0 0 0 0 0 0 0 273 0 0 0 0 0 0 2 0 0 242.86 0 0 0 0 0 0 0 0 4403.11 0 0 0 0 0 0 4647.97 0 0 0 1101215448 1881643948 10 Physicians ROSBOROUGH BRIAN 613501614 58 La Salle 0 1 Family Practice 0 474 0 0 86 0 0 0 0 0 0 13 0 241 0 0 0 0 0 0 4287 0 0 249 0 0 0 0 0 0 16 0 497 0 0 0 0 0 0 4287 0 0 249 0 0 0 0 0 0 16 0 497 0 0 0 0 0 0 10631 0 0 8247.97 0 0 0 0 0 0 88.83 0 20726.67 0 0 0 0 0 0 39694.47 0 0 0 1101215450 94 Waiver service provider--Children's support (DHS/DDD) 852 Wisconsin 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 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6217.2 0 0 0 0 0 0 0 0 0 0 0 0 0 6217.2 0 0 0 1101215462 1497876825 36 Community mental health provider SOUTHWEST COMMUNITY SERVICES 604774789 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 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 0 575.96 0 0 575.96 0 0 0 1101215467 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 13723.17 0 0 0 0 0 0 0 0 0 0 0 0 0 13723.17 0 0 0 1101215469 1245332543 10 Physicians KORY CHRISTOPHER 631366119 826 Missouri 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1568.51 0 0 0 0 0 0 1568.51 0 0 0 1101215470 1649368523 30 General Hospitals GENESIS MEDICAL CENTER DEWITT 527421353 816 Iowa ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 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 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 606.37 0 0 0 0 0 606.37 0 0 0 1101215478 1326030735 10 Physicians SUBLETTE GERARD 601265371 30 DuPage 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 341 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 341 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19179.71 0 0 0 0 0 0 19179.71 0 0 0 1101215486 1427261635 30 General Hospitals TAYLORVILLE MEMORIAL HOSPITAL 625681562 20 Christian DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 1 0 General Hospital - Adult and Child 0 0 0 0 2 0 0 0 0 0 0 258 0 0 118 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 1064 0 0 600 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 1064 0 0 600 0 0 0 0 0 0 0 0 11.54 0 0 0 0 0 0 4523.35 0 0 55748.98 0 0 0 0 0 60283.87 0 0 0 1101215513 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 10946.79 0 0 0 0 0 0 0 0 0 0 0 0 0 10946.79 0 0 0 1101215525 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 1271.11 0 0 0 0 0 0 0 0 0 0 0 0 0 1271.11 0 0 0 1101215534 1154327526 10 Physicians ARNOLD JOHN M 614221346 70 McDonough 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 269 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 269 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3863.45 0 0 0 0 0 0 3863.45 0 0 0 1101215541 1538294483 36 Community mental health provider HEARTLAND HEALTH OUTREACH 606405034 200 Cook 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 4098 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2824 0 0 4098 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2824 0 0 59762.42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66764.12 0 0 126526.54 0 0 0 1101215542 1669649554 10 Physicians JENNINGS AMY 475911038 815 Indiana 0 0 Anesthesiology 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 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 1555.19 0 0 0 0 0 0 1555.19 0 0 0 1101215558 1811004179 10 Physicians ROGGIN KEVIN 606149398 200 Cook 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7942.97 0 0 0 0 0 0 7942.97 0 0 0 1101215563 91 Waiver service provider--Adults (DHS/DDD) 45 Henry 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 0 152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12672 0 0 0 0 0 0 0 0 0 0 0 0 0 12672 0 0 0 1101215569 1932157294 16 Nurse Practitioners ODUEYUNGBO FOLARIN 606222743 200 Cook 0 0 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 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2313.49 0 0 0 0 0 0 2313.49 0 0 0 1101215571 1912932484 10 Physicians RAMAPRASAD CHILAKAPATI 618323716 100 Vermilion 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 1821 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3247 0 186 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3247 0 186 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61810.89 0 4373.82 0 0 0 0 0 0 66184.71 0 0 0 1101215573 98 Waiver service provider--TBI (DHS/DRS) 30 DuPage 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 16924.49 0 0 0 0 0 0 0 0 0 0 0 0 0 16924.49 0 0 0 1101215584 1003912601 10 Physicians BLOUNT MORRIS 606162333 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 320 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1243 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1243 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20940.56 0 0 0 0 0 0 20940.56 0 0 0 1101215587 1225189293 10 Physicians ROSENBLUM JORDAN 601533328 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 892 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1284 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1284 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64065.04 0 161.1 0 0 0 0 0 0 64226.14 0 0 0 1101215620 92 Waiver service provider--Disability (DHS/DRS) 37 Fulton 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 25458.68 0 0 0 0 0 0 0 0 0 0 0 0 0 25458.68 0 0 0 1101215630 1871635078 10 Physicians MIANOWSKI ANNA 606345116 200 Cook 0 1 General Practice 0 134 0 0 6 0 0 0 0 0 0 58 0 134 0 0 0 0 0 0 193 0 0 6 0 0 0 0 0 0 210 0 2881 0 0 0 0 0 0 193 0 0 6 0 0 0 0 0 0 210 0 2881 0 0 0 0 0 0 535 0 0 467.88 0 0 0 0 0 0 3203.55 0 7680.34 0 0 0 0 0 0 11886.77 0 0 0 1101215640 1770559312 10 Physicians BECKER FRANK 606114402 200 Cook 0 0 Pulmonary Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3555.6 0 0 0 0 0 0 3555.6 0 0 0 1101215656 1750477212 22 Physical Therapists SOLAVA DORENE 617612192 72 McLean 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 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 0 0 0 0 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11024.29 11024.29 0 0 0 1101215676 1265451603 10 Physicians GOLDBERG KENNETH 600257657 200 Cook 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 520 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 669 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 669 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26838.2 0 187.61 0 0 0 0 0 0 27025.81 0 0 0 1101215680 1225048804 10 Physicians ERICKSON ROBERT 600483266 57 Lake 0 0 Neurology Surgery 0 0 0 0 0 0 0 0 0 0 0 10 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 136.45 0 17410.03 0 0 0 0 0 0 17546.48 0 0 0 1101215687 1245306752 24 Speech Therapists RAAD SUSAN 605151774 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1056 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1056 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66089.57 66089.57 0 0 0 1101215688 92 Waiver service provider--Disability (DHS/DRS) 61 Livingston 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 16161.27 0 0 0 0 0 0 0 0 0 0 0 0 0 16161.27 0 0 0 1101215690 10 Physicians 815 Indiana 0 0 Pediatrics 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 749.2 0 0 0 0 0 0 749.2 0 0 0 1101215699 91 Waiver service provider--Adults (DHS/DDD) 41 Hamilton 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 0 172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5515.01 0 0 0 0 0 0 0 0 0 0 0 0 0 5515.01 0 0 0 1101215746 1396785291 10 Physicians PATEL SEJAL 601695020 53 Kane 0 0 Nephrology 0 0 0 0 0 0 0 0 0 0 0 83 0 230 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 119 0 978 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 119 0 978 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 191.22 0 11318.71 0 0 0 0 0 0 11509.93 0 0 0 1101215749 1336237296 10 Physicians FIOR CARLOS 625263259 63 Macon 0 1 Internal Medicine 0 7 0 0 0 0 0 0 0 0 0 4 0 35 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 7 0 276 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 7 0 276 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 19.23 0 2703.67 0 0 0 0 0 0 2806.9 0 0 0 1101215754 1124021308 30 General Hospitals PERRY MEMORIAL HOSPITAL 613563901 15 Bureau DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 1 0 Government Owned 0 0 0 0 0 1796 0 0 0 0 65 0 0 0 627 0 0 0 0 0 0 0 0 0 3544 0 0 0 0 75 0 0 0 1203 0 0 0 0 0 0 0 0 0 3544 0 0 0 0 193 0 0 0 1830 0 0 0 0 0 0 0 0 0 715548.91 0 0 0 0 161186.89 0 0 0 580864.99 0 0 0 0 0 1457600.79 0 0 0 1101215760 1942252697 10 Physicians BELLO ALFONSO MD 600257645 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 127.13 0 3282.83 0 0 0 0 0 0 3409.96 0 0 0 1101215763 24 Speech Therapists 109 Winnebago 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 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 0 711.97 711.97 0 0 0 1101215766 2100206184 90 Waiver service provider--Elderly (DOA) EUROPEAN SERVICE AT HOME INC 600670415 200 Cook 0 0 0 0 0 0 0 0 636 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64862 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64862 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4182769.95 0 0 0 0 0 0 0 0 0 0 0 0 0 4182769.95 0 0 0 1101215772 1639370083 10 Physicians MORSTADT KIMBERLY 600468563 57 Lake 0 1 Family Practice 0 1090 0 0 37 0 0 0 0 0 0 23 0 156 0 0 0 0 0 0 6657 0 0 62 0 0 0 0 0 0 26 0 365 0 0 0 0 0 0 6657 0 0 62 0 0 0 0 0 0 26 0 365 0 0 0 0 0 0 17280 0 0 3369.72 0 0 0 0 0 0 102.81 0 17689.75 0 0 0 0 0 0 38442.28 0 0 0 1101215773 92 Waiver service provider--Disability (DHS/DRS) 64 Macoupin 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 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16211.22 0 0 0 0 0 0 0 0 0 0 0 0 0 16211.22 0 0 0 1101215791 1861431751 30 General Hospitals UNIVERSITY OF ILLINOIS HOSP 606127232 200 Cook ARS-U.I. "University of Illinois Hospital, paid under an ARS." 0 0 Government Owned 0 5 710 0 0 8677 0 0 0 0 4361 0 0 30 12605 0 0 0 0 0 17 2432 0 0 13264 0 0 0 0 5512 0 0 30 44205 0 0 0 0 0 17 3037 0 0 13928 0 0 0 0 30199 0 0 39 54344 0 0 0 0 0 367.48 351395.45 0 0 5615422.16 0 0 0 0 80023911.69 0 0 130320.13 14747335.66 0 0 0 0 0 100868752.6 0 0 0 1101215809 1821067588 10 Physicians BELICH PAUL D 601533328 30 DuPage 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 219 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 400 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 400 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9242.06 0 0 0 0 0 0 9242.06 0 0 0 1101215813 1023033578 10 Physicians HANKO RODGER 622631534 103 Washington 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 579 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 823 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 823 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16420.13 0 0 0 0 0 0 16420.13 0 0 0 1101215822 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 10460.36 0 0 0 0 0 0 0 0 0 0 0 0 0 10460.36 0 0 0 1101215826 92 Waiver service provider--Disability (DHS/DRS) 98 Tazewell 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 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 10497.98 0 0 0 0 0 0 0 0 0 0 0 0 0 10497.98 0 0 0 1101215828 92 Waiver service provider--Disability (DHS/DRS) 108 Williamson 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55.98 0 0 0 0 0 0 0 0 0 0 0 0 0 55.98 0 0 0 1101215829 1912944703 48 Rural Health Clinics HYGIENIC INSTITUTE 613011097 58 La Salle 0 1 0 2784 1774 0 944 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26911 10447 0 5115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26911 10447 0 5115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65070 472807.81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 537877.81 0 0 0 1101215832 1972665438 10 Physicians DECARA JEANNE 605276686 30 DuPage 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 0 0 860 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10691.79 0 0 0 0 0 0 10691.79 0 0 0 1101215838 1972518140 60 Pharmacies BOND DRUG COMPANY OF ILLINOIS 601773304 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 724 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 3092 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 69730 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40.52 0 0 120408.78 0 0 0 120449.3 0 0 0 1101215840 1023002383 10 Physicians KRUCKMEYER WARREN 600841702 57 Lake 0 1 Family Practice 0 86 0 0 20 0 0 0 0 0 0 3 0 91 0 0 0 0 0 0 666 0 0 29 0 0 0 0 0 0 5 0 186 0 0 0 0 0 0 666 0 0 29 0 0 0 0 0 0 5 0 186 0 0 0 0 0 0 1666 0 0 2009.34 0 0 0 0 0 0 10.6 0 7550.26 0 0 0 0 0 0 11236.2 0 0 0 1101215844 1386662880 10 Physicians BRODY STEVEN 631082212 826 Missouri 0 0 Pulmonary Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1974.86 0 0 0 0 0 0 1974.86 0 0 0 1101215864 1700992179 10 Physicians CALTRY JOHN 605596142 30 DuPage 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 1145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1323 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1323 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45237.97 0 0 0 0 0 0 45237.97 0 0 0 1101215877 1023008174 11 Dentists KWON JAMES I 600673550 200 Cook 0 0 General Dentistry 0 0 0 204 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1501 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1501 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48798.44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48798.44 0 0 0 1101215879 1598849895 10 Physicians MAHMOOD TAHIR 62859 41 Hamilton 0 1 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1553.41 0 0 0 0 0 0 1553.41 0 0 0 1101215900 92 Waiver service provider--Disability (DHS/DRS) 83 Pike 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 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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 14439.66 0 0 0 0 0 0 0 0 0 0 0 0 0 14439.66 0 0 0 1101216447 91 Waiver service provider--Adults (DHS/DDD) 55 Kendall 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 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23014 0 0 0 0 0 0 0 0 0 0 0 0 0 23014 0 0 0 1101216451 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15557.85 0 0 0 0 0 0 0 0 0 0 0 0 0 15557.85 0 0 0 1101216457 10 Physicians 826 Missouri 0 0 Dermatology 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101216467 1497918247 64 Imaging Services CARE DIAGNOSTIC SERVICES LLC 606451735 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 298 0 430 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 361 0 1122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 361 0 1122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1679.7 0 0 0 0 0 0 1679.7 0 0 0 1101216471 1194995357 10 Physicians JAGARLAMUDI KUPPUSWAMY 619389253 24 Coles 0 0 Oncology 0 0 0 0 0 0 0 0 0 0 0 0 0 185 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 591 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 591 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13933.3 0 0 0 0 0 0 13933.3 0 0 0 1101216476 98 Waiver service provider--TBI (DHS/DRS) 57 Lake 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 34300.92 0 0 0 0 0 0 0 0 0 0 0 0 0 34300.92 0 0 0 1101216489 1780687640 10 Physicians ALVARADO ALEJANDRO 622491658 65 Madison 0 0 Internal Medicine 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 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 552.97 0 0 0 0 0 0 552.97 0 0 0 1101216494 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 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Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3491.65 0 0 0 0 0 0 3491.65 0 0 0 1101216530 1003028150 10 Physicians WIRTH JILL 616151410 80 Peoria 0 1 Family Practice 0 30 0 0 11 0 0 0 0 0 0 16 0 76 0 0 0 0 0 0 215 0 0 15 0 0 0 0 0 0 23 0 214 0 0 0 0 0 0 215 0 0 15 0 0 0 0 0 0 23 0 214 0 0 0 0 0 0 533 0 0 1197 0 0 0 0 0 0 183.31 0 5861.57 0 0 0 0 0 0 7774.88 0 0 0 1101216535 1417137092 24 Speech Therapists DAVEY TERRY 620253138 65 Madison 0 0 0 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 0 0 0 244 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 244 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26323.18 26323.18 0 0 0 1101216538 1861426132 10 Physicians MATSUMURA JON 535625531 852 Wisconsin 0 0 Vascular Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2952.05 0 0 0 0 0 0 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provider--Disability (DHS/DRS) 58 La Salle 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69.97 0 0 0 0 0 0 0 0 0 0 0 0 0 69.97 0 0 0 1101216624 1629194543 10 Physicians HASHMI NASHIB 609012934 54 Kankakee 0 0 Nephrology 0 0 0 0 0 0 0 0 0 0 0 0 0 175 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 902 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 902 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6609.28 0 0 0 0 0 0 6609.28 0 0 0 1101216637 1851330203 50 Home Health Agencies - In Home OSF HOME HEALTH EASTERN REGION 617616107 72 McLean 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 153 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1622 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1622 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114062.9 0 0 0 0 0 0 114062.9 0 0 0 1101216643 1851465702 63 Other Providers of Medical Equipment/Supplies (Non-registered) HANGER PROSTHETICS ORTHOTICS 604354902 845 Texas 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 227 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 491 0 0 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0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2376 0 0 0 0 0 0 0 0 0 0 0 0 0 2376 0 0 0 1101216695 92 Waiver service provider--Disability (DHS/DRS) 27 Dekalb 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 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15135.22 0 0 0 0 0 0 0 0 0 0 0 0 0 15135.22 0 0 0 1101216700 1538233705 16 Nurse Practitioners VANDERHOEK SANDRA 600531313 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 294.8 0 0 0 0 0 0 294.8 0 0 0 1101216717 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 20676.63 0 0 0 0 0 0 0 0 0 0 0 0 0 20676.63 0 0 0 1101216737 1265432090 10 Physicians PATEL ISHWAR K 601695026 200 Cook 0 1 Obstetric-Gynecology 0 2 0 0 0 0 0 0 0 0 0 6 0 33 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 6 0 165 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 6 0 165 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 15.05 0 9750.72 0 0 0 0 0 0 9780.77 0 0 0 1101216748 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25792.84 0 0 0 0 0 0 0 0 0 0 0 0 0 25792.84 0 0 0 1101216752 10 Physicians 30 DuPage 0 0 Obstetric-Gynecology 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 1723.5 0 0 0 0 0 0 1723.5 0 0 0 1101216756 1871609016 10 Physicians SKURKA JEROME 605434355 55 Kendall 0 0 Pediatrics 0 0 0 0 5 0 0 0 0 0 0 9 0 47 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 12 0 67 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 12 0 67 0 0 0 0 0 0 0 0 0 165.56 0 0 0 0 0 0 106.91 0 877.31 0 0 0 0 0 0 1149.78 0 0 0 1101216762 1336160076 10 Physicians HENDERSON CYNTHIA 606431791 200 Cook 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5275.56 0 0 0 0 0 0 5275.56 0 0 0 1101216767 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23809.5 0 0 0 0 0 0 0 0 0 0 0 0 0 23809.5 0 0 0 1101216776 47 Local Education Agencies 15 Bureau 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 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 450.36 0 450.36 0 0 0 1101216803 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 3461.44 0 0 0 0 0 0 0 0 0 0 0 0 0 3461.44 0 0 0 1101216807 1417970724 13 Podiatrists BROGADIR ROBERT 600896826 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 217 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 799 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 799 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 350.06 0 0 0 0 0 0 350.06 0 0 0 1101216817 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 33843.89 0 0 0 0 0 0 0 0 0 0 0 0 0 33843.89 0 0 0 1101216819 91 Waiver service provider--Adults (DHS/DDD) 107 Will 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 0 358 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 358 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22268.4 0 0 0 0 0 0 0 0 0 0 0 0 0 22268.4 0 0 0 1101216824 1770594723 10 Physicians CANNON SARA 620024580 65 Madison 0 0 Obstetric-Gynecology 0 0 0 0 23 0 0 0 0 0 0 136 0 238 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 383 0 821 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 383 0 821 0 0 0 0 0 0 0 0 0 1649.72 0 0 0 0 0 0 8272.81 0 82155.77 0 0 0 0 0 0 92078.3 0 0 0 1101216840 33 Nursing 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46 Ambulatory Surgical Treatment Centers TRI CITIES SURGERY CENTER LLC 601344220 53 Kane ASTC Ambulatory Surgical Treatment Center. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7049.93 0 0 0 0 0 7049.93 0 0 0 1101217215 1497051239 10 Physicians SOROKIN YEVGENIYA 999999999 852 Wisconsin 0 0 0 0 0 0 4 0 0 0 0 0 0 84 0 205 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 111 0 478 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 111 0 478 0 0 0 0 0 0 0 0 0 110.52 0 0 0 0 0 0 5759.21 0 53756.8 0 0 0 0 0 0 59626.53 0 0 0 1101217217 1144235557 10 Physicians OLOLADE OMIYOSOYE 604358200 107 Will 0 0 Pediatrics 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 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5125.31 0 0 0 0 0 0 5125.31 0 0 0 1101217228 94 Waiver service provider--Children's support (DHS/DDD) 40 Grundy 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 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provider--Disability (DHS/DRS) 107 Will 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6022.11 0 0 0 0 0 0 0 0 0 0 0 0 0 6022.11 0 0 0 1101218299 1225098031 10 Physicians SMITH CRAIG 601901222 30 DuPage 0 0 Urology 0 0 0 0 0 0 0 0 0 0 0 29 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 804.72 0 10588.34 0 0 0 0 0 0 11393.06 0 0 0 1101218318 1871589382 10 Physicians HUNT HALLER KELLY 624011788 33 Effingham 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 87 0 281 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122 0 650 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122 0 650 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18.08 0 73331.49 0 0 0 0 0 0 73349.57 0 0 0 1101218322 1306042999 10 Physicians BAMROLIA SHILPA 600313376 57 Lake 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 4 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 455.99 0 0 0 0 0 0 455.99 0 0 0 1101218326 1811997711 61 Independent Laboratories SPECIALTY LABORATORIES INC 913555386 805 California 0 0 0 0 0 0 0 0 0 0 0 0 0 6702 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25272 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25272 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1228016.46 0 0 0 0 0 0 0 0 1228016.46 0 0 0 1101218343 1275650897 34 State-operated facility (DHS) UNIT 4593 BLDG 514A SHAPIRO 609015018 54 Kankakee 0 0 0 0 0 0 0 0 0 0 0 25 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 0 0 0 2128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1440125.57 0 0 0 0 0 0 0 0 0 0 1440125.57 0 0 0 1101218344 91 Waiver service provider--Adults (DHS/DDD) 65 Madison 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 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9603 0 0 0 0 0 0 0 0 0 0 0 0 0 9603 0 0 0 1101218357 92 Waiver service provider--Disability (DHS/DRS) 91 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 19447.19 0 0 0 0 0 0 0 0 0 0 0 0 0 19447.19 0 0 0 1101218368 92 Waiver service provider--Disability (DHS/DRS) 63 Macon 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 20993.31 0 0 0 0 0 0 0 0 0 0 0 0 0 20993.31 0 0 0 1101218371 1336456367 10 Physicians GARZA CAVAZOS ARTURO 627949640 91 Sangamon 0 0 Obstetric-Gynecology 0 0 0 0 8 0 0 0 0 0 0 146 0 358 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 396 0 667 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 396 0 667 0 0 0 0 0 0 0 0 0 782.45 0 0 0 0 0 0 12674.39 0 138178.81 0 0 0 0 0 0 151635.65 0 0 0 1101218383 1699865568 10 Physicians VANDENBERG DANIEL 604264265 200 Cook 0 1 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 615 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 615 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2566.03 0 0 0 0 0 0 2566.03 0 0 0 1101218407 1184875072 10 Physicians KAUR AMANDEEP 611042231 109 Winnebago 0 1 Family Practice 0 203 0 0 40 0 0 0 0 0 0 21 0 273 0 0 0 0 0 0 1601 0 0 86 0 0 0 0 0 0 23 0 456 0 0 0 0 0 0 1601 0 0 86 0 0 0 0 0 0 23 0 456 0 0 0 0 0 0 3810 0 0 2646.74 0 0 0 0 0 0 116.7 0 25068.96 0 0 0 0 0 0 31642.4 0 0 0 1101218410 92 Waiver service provider--Disability (DHS/DRS) 107 Will 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 22795.24 0 0 0 0 0 0 0 0 0 0 0 0 0 22795.24 0 0 0 1101218417 1417144577 10 Physicians TAKATAROSSI JANICE 615503401 98 Tazewell 0 0 Internal Medicine 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 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 198.97 0 0 0 0 0 0 198.97 0 0 0 1101218419 92 Waiver service provider--Disability (DHS/DRS) 24 Coles 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 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18704.72 0 0 0 0 0 0 0 0 0 0 0 0 0 18704.72 0 0 0 1101218420 1467450577 10 Physicians FLURY KIRK 631102515 826 Missouri 0 0 Pulmonary Diseases 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 684.98 0 0 0 0 0 0 684.98 0 0 0 1101218441 1275543456 10 Physicians ARELLANO VILLARREAL KIM 616147300 80 Peoria 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 1997 0 273 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3747 0 378 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3747 0 378 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74335.78 0 6208.07 0 0 0 0 0 0 80543.85 0 0 0 1101218453 92 Waiver service provider--Disability (DHS/DRS) 98 Tazewell 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 22535.06 0 0 0 0 0 0 0 0 0 0 0 0 0 22535.06 0 0 0 1101218459 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 26509.71 0 0 0 0 0 0 0 0 0 0 0 0 0 26509.71 0 0 0 1101218463 1093825283 10 Physicians RHODES SHARON 611072574 109 Winnebago 0 1 Pediatrics 0 71 0 0 125 0 0 0 0 0 0 0 0 167 0 0 0 0 0 0 609 0 0 381 0 0 0 0 0 0 0 0 263 0 0 0 0 0 0 609 0 0 381 0 0 0 0 0 0 0 0 263 0 0 0 0 0 0 1218 0 0 11326.3 0 0 0 0 0 0 0 0 10261.42 0 0 0 0 0 0 22805.72 0 0 0 1101218467 1265654735 10 Physicians CHANG PHYLLIS 601896462 30 DuPage 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 2 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20.59 0 982.85 0 0 0 0 0 0 1003.44 0 0 0 1101218468 1720039407 10 Physicians COLLINS MICHAEL 999999999 852 Wisconsin 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 23 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 0 0 0 0 0 0 0 0 3485.49 0 0 0 0 0 0 3485.49 0 0 0 1101218472 1609879279 10 Physicians KLOR GROSS ELIZABETH 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provider--Disability (DHS/DRS) 200 Cook 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 20119.64 0 0 0 0 0 0 0 0 0 0 0 0 0 20119.64 0 0 0 1101218515 1265467195 48 Rural Health Clinics SALEM TOWNSHIP HOSPITAL RHC 628814263 66 Marion 0 1 Direct Access 0 428 2700 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2800 9819 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2800 9819 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7725 370415.43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 378140.43 0 0 0 1101218520 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 5950.88 0 0 0 0 0 0 0 0 0 0 0 0 0 5950.88 0 0 0 1101218526 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 879.41 0 0 0 0 0 0 0 0 0 0 0 0 0 879.41 0 0 0 1101218548 1437388337 22 Physical Therapists RATNER DONNA C 607142051 110 Woodford 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2808 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2808 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15482.01 15482.01 0 0 0 1101218554 1154556413 91 Waiver service provider--Adults (DHS/DDD) SAENZ ABRAHAM 606324628 200 Cook 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 1375 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1375 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120122.13 0 0 0 0 0 0 0 0 0 0 0 0 0 120122.13 0 0 0 1101218571 1609079896 47 Local Education Agencies FRANKLIN C U SCHOOL DISTRICT 1 626380188 77 Morgan 0 0 0 0 0 0 0 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 0 554 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 554 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3895.86 0 3895.86 0 0 0 1101218573 1417147588 10 Physicians BUCKHOLD FRED 631102515 826 Missouri 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1169.69 0 0 0 0 0 0 1169.69 0 0 0 1101218581 1548269228 10 Physicians FABI NANETTE 604383921 200 Cook 0 0 Internal Medicine 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 0 159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 581.7 0 0 0 0 0 0 581.7 0 0 0 1101218584 1619052776 63 Other Providers of Medical Equipment/Supplies (Non-registered) LINCARE INC 478024140 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 852 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 852 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40550.5 0 0 0 0 0 0 40550.5 0 0 0 1101218586 1528046893 11 Dentists BECKERMAN YULIYA 600604433 57 Lake 0 0 General Dentistry 0 0 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 367 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 367 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53458.83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53458.83 0 0 0 1101218588 1841308335 10 Physicians NAGARKATTE PREETI 605273963 30 DuPage 0 0 Nephrology 0 0 0 0 0 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 546 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 546 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3570.85 0 0 0 0 0 0 3570.85 0 0 0 1101218596 91 Waiver service provider--Adults (DHS/DDD) 815 Indiana 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 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 0 395.92 0 0 0 0 0 0 0 0 0 0 0 0 0 395.92 0 0 0 1101218602 92 Waiver service provider--Disability (DHS/DRS) 97 Stephenson 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 20728.79 0 0 0 0 0 0 0 0 0 0 0 0 0 20728.79 0 0 0 1101218606 92 Waiver service provider--Disability (DHS/DRS) 66 Marion 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 18392.83 0 0 0 0 0 0 0 0 0 0 0 0 0 18392.83 0 0 0 1101218612 2100209030 71 Medicar Provider VANDALIA REHAB HLTH CENTER 624712535 34 Fayette 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1024 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1024 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10373.97 0 0 0 0 0 0 10373.97 0 0 0 1101218616 1386659522 60 Pharmacies WALGREENS #03305 631416333 100 Vermilion 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 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 655 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1055.62 0 0 0 1055.62 0 0 0 1101218631 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6127 0 0 0 0 0 0 0 0 0 0 0 0 0 6127 0 0 0 1101218633 91 Waiver service provider--Adults (DHS/DDD) 77 Morgan 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 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2710.4 0 0 0 0 0 0 0 0 0 0 0 0 0 2710.4 0 0 0 1101218637 1811964679 10 Physicians FARDON DAVID 606124861 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 57 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111 0 113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111 0 113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 995.87 0 670.98 0 0 0 0 0 0 1666.85 0 0 0 1101218645 10 Physicians 815 Indiana 0 0 Neonatology 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 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12607.04 0 0 0 0 0 0 12607.04 0 0 0 1101218658 1376543520 36 Community mental health provider HEARTLAND HUMAN SERVICES 624011635 33 Effingham 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 734 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1497 0 0 734 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1497 0 0 246.63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61814 0 0 62060.63 0 0 0 1101218659 1033397369 75 Department of Alcohol and Substance Abuse Provider HRDI PROFESSIONAL COUNSELING 606153509 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1783 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1783 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117928.86 0 0 117928.86 0 0 0 1101218662 1023025889 10 Physicians VOGELZANG ROBERT 606112914 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 57 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85 0 203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85 0 203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 405.41 0 9686.03 0 0 0 0 0 0 10091.44 0 0 0 1101218684 1689838138 10 Physicians DEPALMA LEANNE 631101002 826 Missouri 0 0 Pediatrics 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 29 0 0 0 0 0 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 0 963.34 0 0 0 0 0 0 963.34 0 0 0 1101218687 34 State-operated facility (DHS) 200 Cook 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93527.88 0 0 0 0 0 0 0 0 0 93527.88 0 0 0 1101218704 92 Waiver service provider--Disability (DHS/DRS) 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HANSON GEORGE 618012530 19 Champaign 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 14 0 0 0 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 0 216.86 0 0 0 0 0 0 216.86 0 0 0 1101218735 1982702387 24 Speech Therapists LEE AMANDA 600041450 200 Cook 0 0 0 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 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4063.36 4063.36 0 0 0 1101218739 10 Physicians 200 Cook 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 297.2 0 0 0 0 0 0 297.2 0 0 0 1101218744 1881739753 10 Physicians SASSETTI MARIAN 603011135 200 Cook 0 1 Family Practice 0 19 0 0 7 0 0 0 0 0 0 5 0 20 0 0 0 0 0 0 33 0 0 26 0 0 0 0 0 0 11 0 69 0 0 0 0 0 0 33 0 0 26 0 0 0 0 0 0 11 0 69 0 0 0 0 0 0 82 0 0 769.84 0 0 0 0 0 0 53.34 0 2874.51 0 0 0 0 0 0 3779.69 0 0 0 1101218752 1639158728 10 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0 670 0 0 181 0 0 0 0 0 0 29 0 129 0 0 0 0 0 0 670 0 0 181 0 0 0 0 0 0 29 0 129 0 0 0 0 0 0 1340 0 0 5798.38 0 0 0 0 0 0 344.49 0 8179.11 0 0 0 0 0 0 15661.98 0 0 0 1101219368 92 Waiver service provider--Disability (DHS/DRS) 63 Macon 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 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 2537.34 0 0 0 0 0 0 0 0 0 0 0 0 0 2537.34 0 0 0 1101219381 1497748438 10 Physicians DRAY PHILIP 606081732 200 Cook 0 0 Ophthalmology 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 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3482.81 0 0 0 0 0 0 3482.81 0 0 0 1101219383 1447279237 10 Physicians SCHAER GARY 606123828 200 Cook 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 757 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14029.32 0 0 0 0 0 0 14029.32 0 0 0 1101219398 1619096583 10 Physicians KO BENJAMIN 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Iowa 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 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 0 329.15 0 0 0 0 0 0 329.15 0 0 0 1101219566 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23585.91 0 0 0 0 0 0 0 0 0 0 0 0 0 23585.91 0 0 0 1101219567 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7311.7 0 0 0 0 0 0 0 0 0 0 0 0 0 7311.7 0 0 0 1101219568 1770740565 11 Dentists DITOLA GEORGE D 601602825 49 Jefferson 0 0 General Dentistry 0 0 0 492 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2406 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2406 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75389.18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75389.18 0 0 0 1101219574 1477660876 10 Physicians FLASTER MURRAY 601533328 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 275 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 492 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 492 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11874.53 0 0 0 0 0 0 11874.53 0 0 0 1101219577 1285739151 16 Nurse Practitioners VIPOND PAMELA 612657159 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3297.33 0 0 0 0 0 0 3297.33 0 0 0 1101219586 1386715423 14 Chiropractors LARUE CASSANDRA 601682321 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 222 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 222 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1184.41 0 0 0 0 0 0 1184.41 0 0 0 1101219605 1063767424 60 Pharmacies WEBER MEDICAL CLINIC PHARMACY 624502432 88 Richland 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 393 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3539 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82433 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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service provider--Disability (DHS/DRS) 63 Macon 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 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 10823.47 0 0 0 0 0 0 0 0 0 0 0 0 0 10823.47 0 0 0 1101219941 10 Physicians 200 Cook 0 1 Internal Medicine 0 0 0 0 0 0 0 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 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 49.58 0 0 0 0 0 0 49.58 0 0 0 1101219943 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 29293.98 0 0 0 0 0 0 0 0 0 0 0 0 0 29293.98 0 0 0 1101219944 92 Waiver service provider--Disability (DHS/DRS) 49 Jefferson 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101219954 1003800830 33 Nursing Facilities LEXINGTON 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1101220114 1013291434 16 Nurse Practitioners LANGE SUZANNE 606123841 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 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 0 168.45 0 0 0 0 0 0 168.45 0 0 0 1101220127 1518091784 47 Local Education Agencies WOODRIDGE ELEM SCH DIST 68 605173821 30 DuPage 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 219 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 15087 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 15087 0 0 0 0 114.12 0 0 0 0 0 0 0 0 0 0 0 0 0 406220.55 0 406334.67 0 0 0 1101220132 1427217918 11 Dentists DOMENELLA DAVID 600719253 71 McHenry 0 0 General Dentistry 0 0 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 194 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 194 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5901.24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5901.24 0 0 0 1101220150 1255522652 16 Nurse Practitioners ALCAIN CHARINA 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108 0 0 0 0 0 0 0 0 0 0 0 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1689660763 10 Physicians RAHIM AMINA 601941329 200 Cook 0 1 Internal Medicine 0 15 0 0 5 0 0 0 0 0 0 0 0 136 0 0 0 0 0 0 51 0 0 6 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 51 0 0 6 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 132 0 0 549.43 0 0 0 0 0 0 0 0 6411.48 0 0 0 0 0 0 7092.91 0 0 0 1101222980 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24584.17 0 0 0 0 0 0 0 0 0 0 0 0 0 24584.17 0 0 0 1101222983 1972823631 48 Rural Health Clinics MARSHALL CLINIC EFFINGHAM SC 624111135 33 Effingham 0 1 0 359 599 0 210 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3092 4003 0 360 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3092 4003 0 360 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7344 168238.61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 175582.61 0 0 0 1101222991 1558411561 22 Physical Therapists DOMAGALA PIOTR 600563444 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 650 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 650 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5149.68 5149.68 0 0 0 1101222998 92 Waiver service provider--Disability (DHS/DRS) 107 Will 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 6559.09 0 0 0 0 0 0 0 0 0 0 0 0 0 6559.09 0 0 0 1101223007 98 Waiver service provider--TBI (DHS/DRS) 72 McLean 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 7144.12 0 0 0 0 0 0 0 0 0 0 0 0 0 7144.12 0 0 0 1101223010 1285684126 10 Physicians DAYA SOL 600147996 71 McHenry 0 1 Surgery General 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 138 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 138 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 408 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 408 0 0 0 1101223012 1639284862 10 Physicians SARAVANAN PATHANJALI 618012334 19 Champaign 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4789.72 0 0 0 0 0 0 4789.72 0 0 0 1101223013 1477655488 10 Physicians TAMBAR SIDDHARTH 606576183 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 13 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10.21 0 8121.54 0 0 0 0 0 0 8131.75 0 0 0 1101223015 1215980321 10 Physicians CHAMBERLIN JACK 600073309 200 Cook 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 12 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 198.8 0 7397.36 0 0 0 0 0 0 7596.16 0 0 0 1101223019 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 23634.77 0 0 0 0 0 0 0 0 0 0 0 0 0 23634.77 0 0 0 1101223041 30 General Hospitals 826 Missouri ARS-LS Long-term stay hospitals paid 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1101223075 1124134879 10 Physicians RICCARDO NICK 601691066 200 Cook 0 0 Internal Medicine 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 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 126.39 0 0 0 0 0 0 126.39 0 0 0 1101223076 10 Physicians 836 Ohio 0 0 Pediatrics 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 48 0 0 0 1101223083 98 Waiver service provider--TBI (DHS/DRS) 77 Morgan 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 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 1304.29 0 0 0 0 0 0 0 0 0 0 0 0 0 1304.29 0 0 0 1101223089 1376564898 10 Physicians CATES ROBERT 535661546 852 Wisconsin 0 1 Family Practice 0 42 0 0 3 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 331 0 0 19 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 331 0 0 19 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 984 0 0 462.25 0 0 0 0 0 0 0 0 1279.04 0 0 0 0 0 0 2725.29 0 0 0 1101223103 92 Waiver service provider--Disability (DHS/DRS) 66 Marion 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22.27 0 0 0 0 0 0 0 0 0 0 0 0 0 22.27 0 0 0 1101223109 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 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 19 0 0 0 0 0 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 8563.08 0 0 0 0 0 0 0 0 0 0 0 0 0 8563.08 0 0 0 1101223114 10 Physicians 107 Will 0 0 Family Practice 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 0 160.31 0 0 0 0 0 0 160.31 0 0 0 1101223121 1467467910 10 Physicians TEICH JEFFREY C 602014508 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 378 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 378 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24057.72 0 0 0 0 0 0 24057.72 0 0 0 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0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12114.32 0 0 0 0 0 0 0 0 0 0 0 0 0 12114.32 0 0 0 1101223161 1699063248 16 Nurse Practitioners STEWART KRISTAL R 478074214 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 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 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 886.77 0 0 0 0 0 0 886.77 0 0 0 1101223162 1154312684 10 Physicians SIDDA LINGAN 478042706 815 Indiana 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 25 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 0 784.07 0 0 0 0 0 0 0 0 784.07 0 0 0 1101223168 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20883.45 0 0 0 0 0 0 0 0 0 0 0 0 0 20883.45 0 0 0 1101223169 1154426559 10 Physicians BROWN RUSSELL D. 606777007 200 Cook 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 228 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 228 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23208.53 0 0 0 0 0 0 23208.53 0 0 0 1101223190 1164593406 10 Physicians SEMENKOVICH JANICE 631600352 826 Missouri 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 230 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 453 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 453 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3704.4 0 0 0 0 0 0 0 0 3704.4 0 0 0 1101223197 1326246356 10 Physicians VLADIMIRSKIY NATALYA 606575640 200 Cook 0 1 Internal Medicine 0 3 0 0 0 0 0 0 0 0 0 0 0 145 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 659 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 659 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 1738.78 0 0 0 0 0 0 1759.78 0 0 0 1101223202 1447370531 10 Physicians TARJAN GABOR 606123723 200 Cook 0 0 Pathology 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 513.45 0 0 0 0 0 0 0 0 513.45 0 0 0 1101223214 1265484307 10 Physicians OLIVER LYNETTE 478042706 815 Indiana 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2937.24 0 0 0 0 0 0 2937.24 0 0 0 1101223219 1659473650 10 Physicians ABRAMS RICHARD 606751611 200 Cook 0 1 Internal Medicine 0 39 0 0 0 0 0 0 0 0 0 7 0 199 0 0 0 0 0 0 82 0 0 0 0 0 0 0 0 0 12 0 403 0 0 0 0 0 0 82 0 0 0 0 0 0 0 0 0 12 0 403 0 0 0 0 0 0 250 0 0 0 0 0 0 0 0 0 45.11 0 3790.27 0 0 0 0 0 0 4085.38 0 0 0 1101223220 1730222126 10 Physicians CONRAD GREGORY 628013056 66 Marion 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 858 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 981 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 981 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26113.94 0 0 0 0 0 0 26113.94 0 0 0 1101223229 10 Physicians 852 Wisconsin 0 0 Urology 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20.73 0 0 0 0 0 0 20.73 0 0 0 1101223232 94 Waiver service provider--Children's support (DHS/DDD) 107 Will 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 14 0 0 0 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 0 944.34 0 0 0 0 0 0 0 0 0 0 0 0 0 944.34 0 0 0 1101223234 1174537039 10 Physicians BOODRAM MITRA 631366119 826 Missouri 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1835.77 0 0 0 0 0 0 0 0 1835.77 0 0 0 1101223249 1033146675 10 Physicians BERGQUIST DAVID 601181454 53 Kane 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3811.08 0 0 0 0 0 0 3811.08 0 0 0 1101223274 1285628982 10 Physicians JAFFE CHARLES E 600485360 57 Lake 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 518 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1049 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1049 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12765.92 0 0 0 0 0 0 12765.92 0 0 0 1101223289 1598721508 10 Physicians MASSIMILIAN JOHN 601150487 27 Dekalb 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 996 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1218 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1218 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46535.66 0 0 0 0 0 0 46535.66 0 0 0 1101223296 30 General Hospitals 815 Indiana NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 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 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 1101223305 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4884.35 0 0 0 0 0 0 0 0 0 0 0 0 0 4884.35 0 0 0 1101223327 1679549299 10 Physicians HATOUM NAWAR 606149268 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 145 0 146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 430 0 256 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 430 0 256 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23715.86 0 18055.74 0 0 0 0 0 0 41771.6 0 0 0 1101223332 1487645412 12 Optometrists PORTNOY KENNETH 600896824 57 Lake 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 150 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 300 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 300 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8352.29 0 4415.9 0 0 0 0 12768.19 0 0 0 1101223337 92 Waiver service provider--Disability (DHS/DRS) 47 Jackson 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 37812.3 0 0 0 0 0 0 0 0 0 0 0 0 0 37812.3 0 0 0 1101223339 1679665160 10 Physicians ZINDRICK MICHAEL 605213177 30 DuPage 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 6 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 231.2 0 382.57 0 0 0 0 0 0 613.77 0 0 0 1101223361 1437142759 10 Physicians ROQUE KEREKES ERLINDA 463123049 815 Indiana 0 0 Nuclear Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 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 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 592.24 0 0 0 0 0 0 592.24 0 0 0 1101223362 1447268362 10 Physicians NEUBERGER STEPHEN 600681110 200 Cook 0 0 Pediatric Cardiology 0 0 0 0 0 0 0 0 0 0 0 0 0 858 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2299 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2299 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73033.64 0 0 0 0 0 0 73033.64 0 0 0 1101223374 1235333956 10 Physicians CHANDRAHASEGOWDA SHASHINATH 612656867 89 Rock Island 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7025.43 0 0 0 0 0 0 7025.43 0 0 0 1101223388 1891853123 16 Nurse Practitioners RIVERA ADRIANA 606234036 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 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 3931.54 0 0 0 0 0 0 3931.54 0 0 0 1101223391 1790941581 10 Physicians SASSO LISA 624012191 33 Effingham 0 0 Surgery Hand 0 0 0 0 0 0 0 0 0 0 0 8 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 278.8 0 3396.26 0 0 0 0 0 0 3675.06 0 0 0 1101223394 1265498463 10 Physicians LAKSHMANAN SHANMUGAM 628812902 66 Marion 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17662.33 0 0 0 0 0 0 17662.33 0 0 0 1101223399 1770579922 10 Physicians SRINIVASAN KRISHNAN 604611183 200 Cook 0 0 Oncology 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 353 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 353 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5684.55 0 0 0 0 0 0 5684.55 0 0 0 1101223402 1154310365 10 Physicians GIMRE MATTHEW 605553846 53 Kane 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 17 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1104.84 0 1001.36 0 0 0 0 0 0 2106.2 0 0 0 1101223403 98 Waiver service provider--TBI (DHS/DRS) 72 McLean 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 31051.67 0 0 0 0 0 0 0 0 0 0 0 0 0 31051.67 0 0 0 1101223406 1750361325 10 Physicians GRAZIANO HANK 601533304 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 321 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 336 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 336 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8549.81 0 0 0 0 0 0 8549.81 0 0 0 1101223424 1578749164 10 Physicians DYNDA MICHAL 627949670 91 Sangamon 0 1 Emergency Medicine 0 0 0 0 1 0 0 0 0 0 0 4 0 98 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 5 0 231 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 5 0 231 0 0 0 0 0 0 0 0 0 0.02 0 0 0 0 0 0 103.2 0 15142.07 0 0 0 0 0 0 15245.29 0 0 0 1101223430 1134105018 16 Nurse Practitioners SANDERS TIMOTHY 629595884 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17079.26 0 0 0 0 0 0 17079.26 0 0 0 1101223433 1336194315 10 Physicians BANCEREK STENGELE JUSTYNA 604413234 107 Will 0 1 Family Practice 0 150 0 0 21 0 0 0 0 0 0 13 0 89 0 0 0 0 0 0 967 0 0 45 0 0 0 0 0 0 21 0 248 0 0 0 0 0 0 967 0 0 45 0 0 0 0 0 0 21 0 248 0 0 0 0 0 0 2436 0 0 1924.28 0 0 0 0 0 0 79.58 0 6983.36 0 0 0 0 0 0 11423.22 0 0 0 1101223465 94 Waiver service provider--Children's support (DHS/DDD) 77 Morgan 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 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15752.97 0 0 0 0 0 0 0 0 0 0 0 0 0 15752.97 0 0 0 1101223467 1700804408 10 Physicians CONSTANTINO JOHN 631081301 826 Missouri 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 8 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 0 416.41 0 0 0 0 0 0 416.41 0 0 0 1101223486 1073508800 10 Physicians AZODO MICHAEL 464107035 815 Indiana 0 0 Radiology Diagnosis 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 29 0 0 0 0 0 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 0 465.35 0 0 0 0 0 0 0 0 465.35 0 0 0 1101223492 1790988053 10 Physicians ANSSTAS GEORGE 631101010 826 Missouri 0 0 Internal Medicine 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 0 377 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 377 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132574.59 0 0 0 0 0 0 132574.59 0 0 0 1101223496 1447250253 30 General Hospitals BAYLOR UNIVERSITY MEDICAL CTR 752462017 845 Texas NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2222.14 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 5457.85 0 0 0 0 0 0 5457.85 0 0 0 1101223519 1902850829 10 Physicians DONOGHUE JOANN 606740018 200 Cook 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 696 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1077 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1077 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8401.09 0 0 0 0 0 0 8401.09 0 0 0 1101223539 1114951274 24 Speech Therapists MELTZER BONNIE 600627619 200 Cook 0 0 0 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 0 262 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 262 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18856.03 18856.03 0 0 0 1101223547 1841208568 10 Physicians REDDY SAVITHA 616370001 80 Peoria 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2913.17 0 0 0 0 0 0 2913.17 0 0 0 1101223556 1497859649 30 General Hospitals NORTHWESTERN MEMORIAL HOSP 606112908 200 Cook DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 0 0 0 0 6 0 0 0 0 0 0 2159 0 0 682 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 11856 0 0 944 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 11856 0 0 944 0 0 0 0 0 0 0 0 23.94 0 0 0 0 0 0 85643.59 0 0 37620.35 0 0 0 0 0 123287.88 0 0 0 1101223574 10 Physicians 852 Wisconsin 0 0 Pediatrics 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 69 0 0 0 1101223591 1386682698 60 Pharmacies OSCO DRUG 3176 606205121 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 199 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1193 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30500 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58615.78 0 0 0 58615.78 0 0 0 1101223602 92 Waiver service provider--Disability (DHS/DRS) 91 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 7538.68 0 0 0 0 0 0 0 0 0 0 0 0 0 7538.68 0 0 0 1101223620 1912032988 10 Physicians LIAO FRANK 600052364 200 Cook 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 1 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 259 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 259 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10935.86 0 0 0 0 0 0 10935.86 0 0 0 1101223623 1104833664 25 Audiologists BROWN MICHAEL 618203909 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 195 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 477 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 477 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16051.92 16051.92 0 0 0 1101223625 1205892973 11 Dentists OCHELTREE THOMAS 617013515 72 McLean 0 0 Maxillofacial Surgery 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2358.06 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2358.06 0 0 0 1101223633 10 Physicians 852 Wisconsin 0 0 Surgery General 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23.61 0 0 0 0 0 0 23.61 0 0 0 1101223634 1255306767 10 Physicians CASTLE CARL 624713228 34 Fayette 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 1 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 420.6 0 0 0 0 0 0 424.6 0 0 0 1101223642 1093884900 12 Optometrists BROWN TIMOTHY 628631465 101 Wabash 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 866 0 759 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1671 0 798 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1671 0 798 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43977.88 0 20462.59 0 0 0 0 64440.47 0 0 0 1101223658 1538270467 63 Other Providers of Medical Equipment/Supplies (Non-registered) APRIA HEALTHCARE INC 600858213 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1209 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1209 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27108.6 0 0 0 0 0 0 27108.6 0 0 0 1101223669 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2717.52 0 0 0 0 0 0 0 0 0 0 0 0 0 2717.52 0 0 0 1101223671 1487684361 16 Nurse Practitioners PRIES ELIZABETH 606143363 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 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 1725.42 0 0 0 0 0 0 1725.42 0 0 0 1101223673 1730238874 10 Physicians AGARWAL MAHESH 600313398 57 Lake 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 163 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 591 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 591 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5074.58 0 0 0 0 0 0 5074.58 0 0 0 1101223678 1265450738 10 Physicians DEHNER LOUIS 631101003 826 Missouri 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 267 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 267 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6069.54 0 0 0 0 0 0 0 0 6069.54 0 0 0 1101223683 1386826014 60 Pharmacies WAL MART PHARMACY 10 4323 609017207 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Providers of Medical Equipment/Supplies (Non-registered) FOSTER G MCGAW HOSPITAL 601533328 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 53 0 0 0 0 0 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 2 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111.49 0 4428.11 0 0 0 0 4539.6 0 0 0 1101223725 1861584542 10 Physicians FRENKEL ABRAHAM 600475008 57 Lake 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 221 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 221 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7566.17 0 0 0 0 0 0 7566.17 0 0 0 1101223726 1629011630 10 Physicians HAN SANG 600896591 57 Lake 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 395 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 454 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 454 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12000.79 0 0 0 0 0 0 12000.79 0 0 0 1101223736 1801838586 12 Optometrists MACKAY WILLIAM 606283140 200 Cook 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 395.8 0 229.34 0 0 0 0 625.14 0 0 0 1101223740 91 Waiver service provider--Adults (DHS/DDD) 19 Champaign 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 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4612 0 0 0 0 0 0 0 0 0 0 0 0 0 4612 0 0 0 1101223741 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 6786.22 0 0 0 0 0 0 0 0 0 0 0 0 0 6786.22 0 0 0 1101223752 1609940139 13 Podiatrists HOBERMAN GARY 606562161 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 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 0 251.39 0 0 0 0 0 0 251.39 0 0 0 1101223754 1538262308 60 Pharmacies CVS PHARMACY 6845 627024628 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 341 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 2106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 51646 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 558.86 0 0 88095.37 0 0 0 88654.23 0 0 0 1101223756 1083699573 10 Physicians MURCHISON ALLISON 604397461 30 DuPage 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 4 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13.16 0 2299.27 0 0 0 0 0 0 2312.43 0 0 0 1101223757 91 Waiver service provider--Adults (DHS/DDD) 107 Will 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 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24868.8 0 0 0 0 0 0 0 0 0 0 0 0 0 24868.8 0 0 0 1101223767 1851441893 10 Physicians PATEL ANGIRA 606116649 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 5 0 304 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 751 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 751 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 323.52 0 17415.75 0 0 0 0 0 0 17739.27 0 0 0 1101223781 1760409031 60 Pharmacies WAL MART 10 0334 626269223 64 Macoupin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1488 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15577 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 395769 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 641407.98 0 0 0 641407.98 0 0 0 1101223787 1467553701 60 Pharmacies AURORA PHARMACY CO 605053010 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 380 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 1700 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 33238 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 282.06 0 0 49783.22 0 0 0 50065.28 0 0 0 1101223800 1295067247 29 ICF/MR OTTAWA GROUP HOME 610211632 60 Lee 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2796 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 347222.44 0 0 0 0 0 0 0 0 0 0 347222.44 0 0 0 1101223804 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 0 252 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 252 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12804 0 0 0 0 0 0 0 0 0 0 0 0 0 12804 0 0 0 1101223825 1972592004 10 Physicians STARNER TIMOTHY D 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0 0 0 0 0 74 0 317 0 0 0 0 0 0 0 0 0 156.96 0 0 0 0 0 0 4052.4 0 23315.5 0 0 0 0 0 0 27524.86 0 0 0 1101224605 92 Waiver service provider--Disability (DHS/DRS) 37 Fulton 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8189.15 0 0 0 0 0 0 0 0 0 0 0 0 0 8189.15 0 0 0 1101224616 92 Waiver service provider--Disability (DHS/DRS) 57 Lake 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21226.01 0 0 0 0 0 0 0 0 0 0 0 0 0 21226.01 0 0 0 1101224623 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14406.38 0 0 0 0 0 0 0 0 0 0 0 0 0 14406.38 0 0 0 1101224631 91 Waiver service provider--Adults (DHS/DDD) 71 McHenry 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 0 248 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 248 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 818.4 0 0 0 0 0 0 0 0 0 0 0 0 0 818.4 0 0 0 1101224648 1750370144 10 Physicians SHIKARI HAIDARI 606579270 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 230 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 396 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 396 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10425.35 0 0 0 0 0 0 10425.35 0 0 0 1101224657 1033149901 10 Physicians ROMANO VICTOR 603022510 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 49 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 226 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 226 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1751.1 0 21302.13 0 0 0 0 0 0 23053.23 0 0 0 1101224666 1194817817 10 Physicians COLLINS MICHAEL 605213177 30 DuPage 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 4 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51.03 0 430.9 0 0 0 0 0 0 481.93 0 0 0 1101224683 13 Podiatrists 852 Wisconsin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6091.18 0 0 0 0 0 0 6091.18 0 0 0 1101227003 92 Waiver service provider--Disability (DHS/DRS) 71 McHenry 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 976.4 0 0 0 0 0 0 0 0 0 0 0 0 0 976.4 0 0 0 1101227011 1376521575 30 General Hospitals FOSTER G MCGAW HOSPITAL 601533304 200 Cook DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 0 0 0 0 2006 0 0 0 0 0 0 14887 0 0 7364 0 0 0 0 0 0 0 0 2516 0 0 0 0 0 0 86608 0 0 24382 0 0 0 0 0 0 0 0 2516 0 0 0 0 0 0 86608 0 0 24382 0 0 0 0 0 0 0 0 17457.35 0 0 0 0 0 0 527230.61 0 0 1749482.22 0 0 0 0 0 2294170.18 0 0 0 1101227033 1952570152 10 Physicians SHAKOFSKY RACHEL 631101002 826 Missouri 0 0 Pediatrics 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 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 0 822.55 0 0 0 0 0 0 822.55 0 0 0 1101227036 1841242328 16 Nurse Practitioners SCHOONOVER YVONNE 611075089 109 Winnebago 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 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1972.49 0 0 0 0 0 0 1972.49 0 0 0 1101227037 1982710216 10 Physicians SIDDIQUI NOMAN 606127331 200 Cook 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 346 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 619 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 619 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5428.65 0 35.4 0 0 0 0 0 0 5464.05 0 0 0 1101227038 1336362235 25 Audiologists HAYDEN CHERYL 600026410 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1734.03 1734.03 0 0 0 1101227042 1194927608 47 Local Education Agencies ILLINI BLUFFS CU SCH DIST 327 615339801 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1219 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1219 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75.16 0 0 0 0 0 0 0 0 75.16 0 0 0 1101227081 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2710.4 0 0 0 0 0 0 0 0 0 0 0 0 0 2710.4 0 0 0 1101227097 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 4969.59 0 0 0 0 0 0 0 0 0 0 0 0 0 4969.59 0 0 0 1101227103 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 422.91 0 0 0 0 0 0 0 0 0 0 0 0 0 422.91 0 0 0 1101227106 1295767366 10 Physicians OLIVO JACQUELINE 606473155 200 Cook 0 1 Family Practice 0 471 0 0 268 0 0 0 0 0 0 355 0 482 0 0 0 0 0 0 3569 0 0 989 0 0 0 0 0 0 656 0 3837 0 0 0 0 0 0 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provider--Adults (DHS/DDD) 57 Lake 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 0 299 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 299 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24729.32 0 0 0 0 0 0 0 0 0 0 0 0 0 24729.32 0 0 0 1101227133 91 Waiver service provider--Adults (DHS/DDD) 57 Lake 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 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23760 0 0 0 0 0 0 0 0 0 0 0 0 0 23760 0 0 0 1101227135 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 346 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 346 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11299.75 0 0 0 0 0 0 0 0 0 0 0 0 0 11299.75 0 0 0 1101227155 1720015514 29 ICF/MR RICE HOUSE 606601017 200 Cook 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 0 346 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6943 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 868291.85 0 0 0 0 0 0 0 0 0 0 868291.85 0 0 0 1101227158 1871673079 60 Pharmacies PROFESSIONAL BUILDING PHARMACY 606123841 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 199 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2752 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13432 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3403232.64 0 0 0 3403232.64 0 0 0 1101227161 1710900980 10 Physicians LEVINSKY HOWARD 606412719 200 Cook 0 1 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 178 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 569 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 569 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13751.2 0 0 0 0 0 0 13751.2 0 0 0 1101227187 91 Waiver service provider--Adults (DHS/DDD) 96 St Clair 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 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22796.4 0 0 0 0 0 0 0 0 0 0 0 0 0 22796.4 0 0 0 1101227200 1588643670 10 Physicians MROZOWICZPICKEN MARIA 601533304 200 Cook 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 301 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 579 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 579 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6539.37 0 0 0 0 0 0 0 0 6539.37 0 0 0 1101227206 1437291085 11 Dentists RAZDOLSKY LEONID 600851899 57 Lake 0 0 General Dentistry 0 0 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 479 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 479 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16680.49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16680.49 0 0 0 1101227214 1356602320 16 Nurse Practitioners MANOGURA SANDRA 606576710 62 Logan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 170 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 262 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 262 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6215.04 0 0 0 0 0 0 6215.04 0 0 0 1101227217 1407181266 11 Dentists PATEL SIVAN 605461409 200 Cook 0 0 General Dentistry 0 0 0 189 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 995 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 995 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24042.06 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24042.06 0 0 0 1101227218 1609862507 10 Physicians BARBATO TOBIA A 606313713 54 Kankakee 0 1 General Practice 0 73 0 0 2 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 101 0 0 4 0 0 0 0 0 0 0 0 264 0 0 0 0 0 0 101 0 0 4 0 0 0 0 0 0 0 0 264 0 0 0 0 0 0 267 0 0 160.19 0 0 0 0 0 0 0 0 2375.67 0 0 0 0 0 0 2802.86 0 0 0 1101227221 16 Nurse Practitioners 826 Missouri 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105.5 0 0 0 0 0 0 105.5 0 0 0 1101227235 1043510241 40 Federally Qualified Health Centers UIC MSHC HOPE ACADEMY HEALTH 606122613 200 Cook 0 1 0 1466 269 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8176 702 0 391 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8176 702 0 391 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20643 58452.97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79095.97 0 0 0 1101227240 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 8671.41 0 0 0 0 0 0 0 0 0 0 0 0 0 8671.41 0 0 0 1101227241 1174548911 10 Physicians JIMENEZ JUAN 618012529 19 Champaign 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 1215 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1498 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1498 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28542.31 0 1768.22 0 0 0 0 0 0 30310.53 0 0 0 1101227273 1629245709 10 Physicians ANDREATTA BROCK 601533328 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 1 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6207.31 0 0 0 0 0 0 6207.31 0 0 0 1101227289 10 Physicians 816 Iowa 0 0 Physical Medicine/Rehabilitation 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24.25 0 0 0 0 0 0 24.25 0 0 0 1101227298 1316915101 10 Physicians KAUFMAN GARY 600353109 57 Lake 0 1 Internal Medicine 0 51 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 289 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 289 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 860 0 0 0 0 0 0 0 0 0 0 0 1448.33 0 0 0 0 0 0 2308.33 0 0 0 1101227299 1619119849 91 Waiver service provider--Adults (DHS/DDD) DAVILA SALENA 600052410 200 Cook 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3968 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3968 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137983.1 0 0 0 0 0 0 0 0 0 0 0 0 0 137983.1 0 0 0 1101227300 1114103520 10 Physicians JOSEPH SINDHU 605462320 200 Cook 0 1 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3767.49 0 0 0 0 0 0 3767.49 0 0 0 1101227308 92 Waiver service provider--Disability (DHS/DRS) 18 Cass 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 16461.3 0 0 0 0 0 0 0 0 0 0 0 0 0 16461.3 0 0 0 1101227317 1588680722 10 Physicians BACHARIER LEONARD B. 631600352 63 Macon 0 0 Pediatric Pulmonary 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3515.93 0 0 0 0 0 0 3515.93 0 0 0 1101227328 98 Waiver service provider--TBI (DHS/DRS) 107 Will 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30809.18 0 0 0 0 0 0 0 0 0 0 0 0 0 30809.18 0 0 0 1101227344 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 10491.53 0 0 0 0 0 0 0 0 0 0 0 0 0 10491.53 0 0 0 1101227345 91 Waiver service provider--Adults (DHS/DDD) 46 Iroquois 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 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4372.4 0 0 0 0 0 0 0 0 0 0 0 0 0 4372.4 0 0 0 1101227358 1508198706 16 Nurse Practitioners HARRIS SHAWNA 628392030 22 Clay 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 549.21 0 0 0 0 0 0 549.21 0 0 0 1101227363 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17377 0 0 0 0 0 0 0 0 0 0 0 0 0 17377 0 0 0 1101227364 1548366263 10 Physicians MUDDASANI NARSIMHA 622012989 96 St Clair 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 227 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 798 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 798 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12441.25 0 0 0 0 0 0 12441.25 0 0 0 1101227372 1811053275 10 Physicians BREY STEVEN 600442203 57 Lake 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5686.74 0 0 0 0 0 0 5686.74 0 0 0 1101227397 2100217815 90 Waiver service provider--Elderly (DOA) "HELP AT HOME, LLC" 606023312 200 Cook 0 0 0 0 0 0 0 0 584 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54355 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54355 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2574112.58 0 0 0 0 0 0 0 0 0 0 0 0 0 2574112.58 0 0 0 1101227403 1053567214 11 Dentists FIELDS KAREN 600852372 57 Lake 0 0 General Dentistry 0 0 0 214 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1298 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1298 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54650.1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54650.1 0 0 0 1101227406 1477743342 48 Rural Health Clinics MT OLIVE FAMILY PRACTICE CTR 620691613 64 Macoupin 0 1 0 368 416 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2958 1873 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2958 1873 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8005 74354.14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82359.14 0 0 0 1101227408 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15763.69 0 0 0 0 0 0 0 0 0 0 0 0 0 15763.69 0 0 0 1101227412 1164480505 10 Physicians VACEK ROBERT 605461443 200 Cook 0 1 Internal Medicine 0 14 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 281 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 281 0 0 0 0 0 0 66 0 0 0 0 0 0 0 0 0 0 0 4036.86 0 0 0 0 0 0 4102.86 0 0 0 1101227414 93 Waiver service provider--HIV/AIDS (DHS/DRS) 80 Peoria 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 23 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 0 0 0 0 0 0 0 0 13982.18 0 0 0 0 0 0 0 0 0 0 0 0 0 13982.18 0 0 0 1101227417 1912016783 10 Physicians DESCH LARRY 604532600 200 Cook 0 0 Pediatrics 0 0 0 0 75 0 0 0 0 0 0 0 0 159 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 169 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 169 0 0 0 0 0 0 0 0 0 1127.51 0 0 0 0 0 0 0 0 17369.04 0 0 0 0 0 0 18496.55 0 0 0 1101227420 30 General Hospitals 818 Kentucky ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2044.26 0 0 0 0 0 0 0 0 2044.26 0 0 0 1101227463 1033351804 23 Occupational Therapists STONECIPHER LINDSAY 600761242 200 Cook 0 0 0 0 0 0 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 0 224 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 224 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16483.48 16483.48 0 0 0 1101227469 92 Waiver service provider--Disability (DHS/DRS) 19 Champaign 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1794.1 0 0 0 0 0 0 0 0 0 0 0 0 0 1794.1 0 0 0 1101227496 91 Waiver service provider--Adults (DHS/DDD) 826 Missouri 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 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7622.25 0 0 0 0 0 0 0 0 0 0 0 0 0 7622.25 0 0 0 1101227508 1356365175 10 Physicians MANLEY STEVEN 605638669 30 DuPage 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3863.06 0 0 0 0 0 0 3863.06 0 0 0 1101227509 1790828952 11 Dentists SEHY CHRISTOPHER 624111101 33 Effingham 0 0 General Dentistry 0 0 0 216 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 927 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 927 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26912.17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26912.17 0 0 0 1101227515 1396956801 16 Nurse Practitioners PATEL BANSARI 605276686 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 205 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 205 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3735.17 0 0 0 0 0 0 3735.17 0 0 0 1101227518 94 Waiver service provider--Children's support (DHS/DDD) 30 DuPage 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 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31579.2 0 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0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15211.79 0 0 0 0 0 0 0 0 0 0 0 0 0 15211.79 0 0 0 1101227597 1487788311 29 ICF/MR SOUTHSIDE MANOR 625212672 63 Macon 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 0 146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2947 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 238290 0 0 0 0 0 0 0 0 0 0 238290 0 0 0 1101227598 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 3446.16 0 0 0 0 0 0 0 0 0 0 0 0 0 3446.16 0 0 0 1101227599 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 10649.06 0 0 0 0 0 0 0 0 0 0 0 0 0 10649.06 0 0 0 1101227600 1023082153 10 Physicians TIDOW KEBRITCHI SUSANNE 601533304 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 10 0 213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 353 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 353 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 148.03 0 9812.04 0 0 0 0 0 0 9960.07 0 0 0 1101227604 1861520876 34 State-operated facility (DHS) UNIT 3561 HOME 41 KILEY 600856263 57 Lake 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 720 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 541981.39 0 0 0 0 0 0 0 0 0 0 541981.39 0 0 0 1101227620 1932378916 47 Local Education Agencies LELAND COMM UNIT SCH DIST 1 605319516 58 La Salle 0 0 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 0 173 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 173 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2158.16 0 2158.16 0 0 0 1101227626 94 Waiver service provider--Children's support (DHS/DDD) 107 Will 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 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8222.5 0 0 0 0 0 0 0 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0 0 0 0 0 26650.07 0 0 0 0 0 0 26650.07 0 0 0 1101227684 92 Waiver service provider--Disability (DHS/DRS) 69 Massac 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 7310.73 0 0 0 0 0 0 0 0 0 0 0 0 0 7310.73 0 0 0 1101227687 1831254234 40 Federally Qualified Health Centers SIHF ESLHS SCHOOL BASED CTR 622042448 96 St Clair 0 1 School-based 0 0 33 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4447.47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4447.47 0 0 0 1101227695 1285649509 60 Pharmacies WALGREEN CO 06580 604623233 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1328 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108775 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 264277.64 0 0 0 264277.64 0 0 0 1101227696 92 Waiver service provider--Disability (DHS/DRS) 76 Montgomery 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 25329.5 0 0 0 0 0 0 0 0 0 0 0 0 0 25329.5 0 0 0 1101227698 92 Waiver service provider--Disability (DHS/DRS) 33 Effingham 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 5249.54 0 0 0 0 0 0 0 0 0 0 0 0 0 5249.54 0 0 0 1101227703 1790726495 10 Physicians MOHAZAB HAMID 480381125 53 Kane 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 644 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 771 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 771 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17849.56 0 192.29 0 0 0 0 0 0 18041.85 0 0 0 1101227743 1306869284 10 Physicians MONO JEFFREY 600164029 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1223.01 0 0 0 0 0 0 1223.01 0 0 0 1101227752 1194723999 30 General Hospitals ST ANTHONY HOSPITAL 606233501 200 Cook DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 0 0 0 0 1129 0 0 0 0 0 0 3077 0 0 2248 0 0 0 0 0 0 0 0 1638 0 0 0 0 0 0 12162 0 0 8446 0 0 0 0 0 0 0 0 1638 0 0 0 0 0 0 12162 0 0 8446 0 0 0 0 0 0 0 0 6991.74 0 0 0 0 0 0 80513.15 0 0 538857.95 0 0 0 0 0 626362.84 0 0 0 1101227759 1497990147 16 Nurse Practitioners MATHEW MINY 606222743 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 343.86 0 0 0 0 0 0 343.86 0 0 0 1101227777 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 23733.11 0 0 0 0 0 0 0 0 0 0 0 0 0 23733.11 0 0 0 1101227790 36 Community mental health provider 54 Kankakee 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230 0 0 723.09 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14332.14 0 0 15055.23 0 0 0 1101227792 1982643235 10 Physicians KAPLINSKY ROBERT 607143164 30 DuPage 0 0 Urology 0 0 0 0 0 0 0 0 0 0 0 28 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 427 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 427 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 140.03 0 9989.41 0 0 0 0 0 0 10129.44 0 0 0 1101227794 1790812212 34 State-operated facility (DHS) UNIT 3262 HOME 12 KILEY 600856263 57 Lake 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 540 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 404859.63 0 0 0 0 0 0 0 0 0 0 404859.63 0 0 0 1101227812 16 Nurse Practitioners 826 Missouri 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 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 139.88 0 0 0 0 0 0 139.88 0 0 0 1101227817 1770593071 10 Physicians RAYNER LORIS 608052441 200 Cook 0 1 Pediatrics 0 735 0 0 601 0 0 0 0 0 0 51 0 534 0 0 0 0 0 0 6651 0 0 1961 0 0 0 0 0 0 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0 11187.51 0 0 0 1101229330 91 Waiver service provider--Adults (DHS/DDD) 89 Rock Island 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 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3193.34 0 0 0 0 0 0 0 0 0 0 0 0 0 3193.34 0 0 0 1101229338 10 Physicians 200 Cook 0 0 Pediatrics 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11.05 0 0 0 0 0 0 11.05 0 0 0 1101229340 1538251582 10 Physicians FAMILY PLANNING SERVICE 614014834 56 Knox 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 140 0 444 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 188 0 1847 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 188 0 1847 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 552.3 0 75680.93 0 0 0 0 0 0 76233.23 0 0 0 1101229344 94 Waiver service provider--Children's support (DHS/DDD) 107 Will 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 61 0 0 0 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 10197 0 0 0 0 0 0 0 0 0 0 0 0 0 10197 0 0 0 1101229352 91 Waiver service provider--Adults (DHS/DDD) 41 Hamilton 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 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10069.56 0 0 0 0 0 0 0 0 0 0 0 0 0 10069.56 0 0 0 1101229354 1922026434 60 Pharmacies WAL MART PHARMACY 10 0352 622331142 87 Randolph 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1233 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10292 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 240276 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 370618.15 0 0 0 370618.15 0 0 0 1101229363 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 4231.37 0 0 0 0 0 0 0 0 0 0 0 0 0 4231.37 0 0 0 1101229365 92 Waiver service provider--Disability (DHS/DRS) 10 Adams 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 4274.79 0 0 0 0 0 0 0 0 0 0 0 0 0 4274.79 0 0 0 1101229368 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 19121.93 0 0 0 0 0 0 0 0 0 0 0 0 0 19121.93 0 0 0 1101229376 1306025853 24 Speech Therapists STRELCHIN ESTHER 600900507 200 Cook 0 0 0 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 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6864.32 6864.32 0 0 0 1101229383 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 1864.91 0 0 0 0 0 0 0 0 0 0 0 0 0 1864.91 0 0 0 1101229399 1568497311 10 Physicians SHENFELD RONALD 600992676 57 Lake 0 0 Emergency Medicine 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 14 0 0 0 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 0 623.86 0 0 0 0 0 0 623.86 0 0 0 1101229411 92 Waiver service provider--Disability (DHS/DRS) 89 Rock Island 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 890.9 0 0 0 0 0 0 0 0 0 0 0 0 0 890.9 0 0 0 1101229421 1598873622 10 Physicians MCKAY MAURA 601901222 30 DuPage 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 8 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 40.22 0 0 0 0 0 0 40.22 0 0 0 1101229436 1689662710 10 Physicians DRAKE MARIA 626501136 77 Morgan 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1875.8 0 0 0 0 0 0 1875.8 0 0 0 1101229440 1164455507 10 Physicians ASKARI RUHI 600081842 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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"Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1080 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34431.99 0 0 0 0 0 34431.99 0 0 0 1101229485 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28865.42 0 0 0 0 0 0 0 0 0 0 0 0 0 28865.42 0 0 0 1101229494 92 Waiver service provider--Disability (DHS/DRS) 77 Morgan 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 0 469.38 0 0 0 0 0 0 0 0 0 0 0 0 0 469.38 0 0 0 1101229499 1093768962 30 General Hospitals MERCY HOSP OF JANESVILLE INC 535475003 852 Wisconsin NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 51 0 0 0 0 15 0 0 0 28 0 0 0 0 0 0 0 0 0 65 0 0 0 0 15 0 0 0 30 0 0 0 0 0 0 0 0 0 65 0 0 0 0 41 0 0 0 30 0 0 0 0 0 0 0 0 0 9821.11 0 0 0 0 21317.76 0 0 0 7369.21 0 0 0 0 0 38508.08 0 0 0 1101229511 1871731430 11 Dentists CHO HENRY 600852372 57 Lake 0 0 General Dentistry 0 0 0 1454 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8984 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8984 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 234665.29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 234665.29 0 0 0 1101229517 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 1622.38 0 0 0 0 0 0 0 0 0 0 0 0 0 1622.38 0 0 0 1101229522 1275695892 55 Early Intervention Services LEPARSKI CYNTHIA 600081241 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 544 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 544 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53854.84 0 0 0 0 0 0 53854.84 0 0 0 1101229533 1427191089 55 Early Intervention Services HATCHETT GRETCHEN 601203847 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9676.77 0 0 0 0 0 0 9676.77 0 0 0 1101229557 75 Department of Alcohol and Substance Abuse Provider 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 110.88 0 0 110.88 0 0 0 1101229558 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 2566.18 0 0 0 0 0 0 0 0 0 0 0 0 0 2566.18 0 0 0 1101229562 1366629230 16 Nurse Practitioners ZEKAS LINDA 606143363 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1350.55 0 0 0 0 0 0 1350.55 0 0 0 1101229571 1982698940 16 Nurse Practitioners RUBISON PAULA 622860378 87 Randolph 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11486.46 0 0 0 0 0 0 11486.46 0 0 0 1101229572 1639179179 10 Physicians BENUCK IRWIN 602023784 200 Cook 0 1 Pediatrics 0 25 0 0 14 0 0 0 0 0 0 7 0 137 0 0 0 0 0 0 94 0 0 49 0 0 0 0 0 0 23 0 170 0 0 0 0 0 0 94 0 0 49 0 0 0 0 0 0 23 0 170 0 0 0 0 0 0 188 0 0 1422.9 0 0 0 0 0 0 152.37 0 13387.5 0 0 0 0 0 0 15150.77 0 0 0 1101229574 91 Waiver service provider--Adults (DHS/DDD) 27 Dekalb 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 952.87 0 0 0 0 0 0 0 0 0 0 0 0 0 952.87 0 0 0 1101229577 1508956459 33 Nursing Facilities CHARLESTON REHAB HEALTH CARE 619202382 24 Coles 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 686 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15496 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1355947.31 0 0 0 0 0 0 0 1355947.31 0 0 0 1101229597 1053562355 10 Physicians BONAKDARPOUR BORNA 606118709 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 361.03 0 0 0 0 0 0 361.03 0 0 0 1101229599 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 8626.92 0 0 0 0 0 0 0 0 0 0 0 0 0 8626.92 0 0 0 1101229600 1841463486 16 Nurse Practitioners RILEY GLORIA 616157822 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 217 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 217 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25754.19 0 0 0 0 0 0 25754.19 0 0 0 1101229615 1104866805 10 Physicians ECANOW JACOB S. 605276686 30 DuPage 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 779 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1007 0 204 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1007 0 204 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7532.77 0 1667.11 0 0 0 0 0 0 9199.88 0 0 0 1101229651 1174529556 10 Physicians EAKIN K MAX 620342916 65 Madison 0 1 Family Practice 0 12 0 0 3 0 0 0 0 0 0 5 0 26 0 0 0 0 0 0 126 0 0 12 0 0 0 0 0 0 5 0 52 0 0 0 0 0 0 126 0 0 12 0 0 0 0 0 0 5 0 52 0 0 0 0 0 0 319 0 0 575.06 0 0 0 0 0 0 39.24 0 2765.13 0 0 0 0 0 0 3698.43 0 0 0 1101229652 91 Waiver service provider--Adults (DHS/DDD) 17 Carroll 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 0 762.3 0 0 0 0 0 0 0 0 0 0 0 0 0 762.3 0 0 0 1101229656 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 14531.06 0 0 0 0 0 0 0 0 0 0 0 0 0 14531.06 0 0 0 1101229670 92 Waiver service provider--Disability (DHS/DRS) 108 Williamson 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 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10436.94 0 0 0 0 0 0 0 0 0 0 0 0 0 10436.94 0 0 0 1101229673 1285638262 16 Nurse Practitioners MILLER KIM 625491511 63 Macon 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 153 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 280 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 280 0 0 0 0 0 0 0 0 0 450.1 0 0 0 0 0 0 0 0 6151.21 0 0 0 0 0 0 6601.31 0 0 0 1101229683 1164496865 10 Physicians LEON EDWARD 625264163 63 Macon 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 736 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 880 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 880 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32702.31 0 0 0 0 0 0 32702.31 0 0 0 1101229687 1174647929 34 State-operated facility (DHS) UNIT 4485 HINTON ELGIN 601237692 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66680.82 0 0 0 0 0 0 0 0 0 66680.82 0 0 0 1101229691 1699793232 10 Physicians BRADLEY JEFFREY D 631418573 826 Missouri 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1379.69 0 0 0 0 0 0 1379.69 0 0 0 1101229694 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2865.5 0 0 0 0 0 0 0 0 0 0 0 0 0 2865.5 0 0 0 1101229708 1023294642 10 Physicians TURBAY RAFAEL 606123723 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 482.11 0 0 0 0 0 0 482.11 0 0 0 1101229770 1023044419 10 Physicians WALVOORD EMILY C 462025109 815 Indiana 0 0 Pediatric Endocrinology 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180.81 0 0 0 0 0 0 180.81 0 0 0 1101229772 1598782880 60 Pharmacies WALMART PHARMACY 10 0256 620344323 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 385 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1794 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45696 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66795.29 0 0 0 66795.29 0 0 0 1101229774 30 General Hospitals 805 California NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 504.25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 504.25 0 0 0 1101229781 1508924093 48 Rural Health Clinics SIU CARE A VAN 629011474 47 Jackson 0 0 School-based 0 0 96 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 616 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 616 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24588.47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24588.47 0 0 0 1101229782 1003108135 60 Pharmacies WALGREENS 15169 618532754 19 Champaign 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148.04 0 0 0 1101229825 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11638 0 0 0 0 0 0 0 0 0 0 0 0 0 11638 0 0 0 1101229842 1770897431 11 Dentists KIM HOJUNG 601012513 30 DuPage 0 0 General Dentistry 0 0 0 284 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1769 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1769 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46583.76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46583.76 0 0 0 1101229852 91 Waiver service provider--Adults (DHS/DDD) 34 Fayette 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 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5163 0 0 0 0 0 0 0 0 0 0 0 0 0 5163 0 0 0 1101229856 1972788925 36 Community mental health provider BEN GORDON CENTER 601154117 27 Dekalb 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 214 0 0 1310 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3583 0 0 1310 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3583 0 0 48160.18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122092.62 0 0 170252.8 0 0 0 1101229874 1629053459 10 Physicians BISHOP CHARLES 620404701 65 Madison 0 0 Anesthesiology 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 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2755.56 0 0 0 0 0 0 2755.56 0 0 0 1101229889 92 Waiver service provider--Disability (DHS/DRS) 30 DuPage 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5542.91 0 0 0 0 0 0 0 0 0 0 0 0 0 5542.91 0 0 0 1101229897 1679710545 10 Physicians STAHULAK MEGHAN 606223086 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 396 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 441 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 441 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13685.84 0 0 0 0 0 0 13685.84 0 0 0 1101229911 1730104142 10 Physicians JOSHIPURA PREMAL 600315257 57 Lake 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 66 0 0 0 0 0 0 0 0 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McLean 0 0 Urology 0 0 0 0 0 0 0 0 0 0 0 25 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 215 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 215 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107.22 0 7012.75 0 0 0 0 0 0 7119.97 0 0 0 1101229957 1841202462 10 Physicians JUDGE JOSEPH 604264267 200 Cook 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 3693 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5601 0 196 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5601 0 196 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100239.79 0 1358.33 0 0 0 0 0 0 101598.12 0 0 0 1101229963 1861543985 10 Physicians AHSAN AZEEM 604350959 107 Will 0 1 Family Practice 0 71 0 0 2 0 0 0 0 0 0 55 0 228 0 0 0 0 0 0 474 0 0 2 0 0 0 0 0 0 76 0 1378 0 0 0 0 0 0 474 0 0 2 0 0 0 0 0 0 76 0 1378 0 0 0 0 0 0 1350 0 0 161.46 0 0 0 0 0 0 605.72 0 18429.02 0 0 0 0 0 0 20546.2 0 0 0 1101229967 1902097538 10 Physicians MENDI RESHAM 452132664 836 Ohio 0 0 Radiology Diagnosis 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 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4290.47 0 0 0 0 0 0 0 0 0 0 0 0 0 4290.47 0 0 0 1101230017 1285614867 40 Federally Qualified Health Centers SHAWNEETOWN HEALTH CARE CLINIC 629843659 38 Gallatin 0 1 0 441 621 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3766 5189 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3766 5189 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9677 203892.74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 213569.74 0 0 0 1101230031 1396930590 10 Physicians RABACAL RANILO 612541095 45 Henry 0 1 Family Practice 0 7 0 0 5 0 0 0 0 0 0 9 0 112 0 0 0 0 0 0 37 0 0 5 0 0 0 0 0 0 14 0 238 0 0 0 0 0 0 37 0 0 5 0 0 0 0 0 0 14 0 238 0 0 0 0 0 0 124 0 0 315.14 0 0 0 0 0 0 52.05 0 4887.84 0 0 0 0 0 0 5379.03 0 0 0 1101230032 1184732851 30 General Hospitals ST JOSEPH MEDICAL CENTER 617014364 72 McLean DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 0 0 0 0 26 0 0 0 0 0 0 2663 0 0 493 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 10826 0 0 1259 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 10826 0 0 1259 0 0 0 0 0 0 0 0 252.37 0 0 0 0 0 0 61565.22 0 0 93742.04 0 0 0 0 0 155559.63 0 0 0 1101230044 1891790242 38 Specialized Mental Health Rehabilitation Facilities (SMHRF) BRYN MAWR CARE INC 606401515 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1563 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34039 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2519128.32 0 0 0 0 0 0 0 2519128.32 0 0 0 1101230049 2100220467 91 Waiver service provider--Adults (DHS/DDD) PIATT COUNTY MENTAL HEALTH CEN 618568144 82 Piatt 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12485 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12485 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 619803.68 0 0 0 0 0 0 0 0 0 0 0 0 0 619803.68 0 0 0 1101230067 10 Physicians 80 Peoria 0 0 Internal Medicine 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 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 0 214.7 0 0 0 0 0 0 214.7 0 0 0 1101230079 1184615866 11 Dentists COTNER DANNA 629012583 47 Jackson 0 0 General Dentistry 0 0 0 681 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2563 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2563 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60669 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60669 0 0 0 1101230094 1588791578 12 Optometrists CRAWFORD JAMES 600315708 57 Lake 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1010.06 0 0 0 0 0 0 1010.06 0 0 0 1101230114 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 348 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 348 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12104.4 0 0 0 0 0 0 0 0 0 0 0 0 0 12104.4 0 0 0 1101230119 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 4772.13 0 0 0 0 0 0 0 0 0 0 0 0 0 4772.13 0 0 0 1101230132 1619922721 10 Physicians MIKAITIS WILLIAM 604413234 107 Will 0 0 Family Practice 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 463.75 0 0 0 0 0 0 463.75 0 0 0 1101230142 1699714360 10 Physicians BRENNAN JAMES 631283480 826 Missouri 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 29 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77 0 288 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77 0 288 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4923.45 0 25059.17 0 0 0 0 0 0 29982.62 0 0 0 1101230175 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17193.7 0 0 0 0 0 0 0 0 0 0 0 0 0 17193.7 0 0 0 1101230201 1033147848 10 Physicians SCHOENIG KENNETH 617613595 72 McLean 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 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Waiver service provider--Disability (DHS/DRS) 53 Kane 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 30792.63 0 0 0 0 0 0 0 0 0 0 0 0 0 30792.63 0 0 0 1101230281 1073579397 10 Physicians JOHNSON ROBERT 600483266 57 Lake 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 321 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 546 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 546 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5837.69 0 0 0 0 0 0 5837.69 0 0 0 1101230289 1932107208 10 Physicians KELLY JODY 616031747 80 Peoria 0 0 Obstetric-Gynecology 0 0 0 0 8 0 0 0 0 0 0 169 0 231 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 359 0 459 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 359 0 459 0 0 0 0 0 0 0 0 0 562.13 0 0 0 0 0 0 14120.13 0 38629.72 0 0 0 0 0 0 53311.98 0 0 0 1101230290 1982868840 10 Physicians AHN JONATHAN 600761267 200 Cook 0 1 Pediatrics 0 722 0 0 238 0 0 0 0 0 0 24 0 252 0 0 0 0 0 0 4267 0 0 951 0 0 0 0 0 0 33 0 438 0 0 0 0 0 0 4267 0 0 951 0 0 0 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736.54 0 0 0 0 0 0 736.54 0 0 0 1101230490 1255359899 10 Physicians BRANDES STEVEN 631082810 826 Missouri 0 0 Urological Surgery 0 0 0 0 0 0 0 0 0 0 0 5 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11.95 0 4700.18 0 0 0 0 0 0 4712.13 0 0 0 1101230491 1689667347 10 Physicians CASTILLO DIAZ FIDEL 606127323 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 288.23 0 0 0 0 0 0 288.23 0 0 0 1101230496 1942282215 10 Physicians AHMAD FAHEEM 604611185 200 Cook 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 6 0 656 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 1112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 1112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 113.82 0 6462.36 0 0 0 0 0 0 6576.18 0 0 0 1101230498 92 Waiver service provider--Disability (DHS/DRS) 30 DuPage 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21.41 0 0 0 0 0 0 0 0 0 0 0 0 0 21.41 0 0 0 1101230501 1174796478 10 Physicians KLEIN JEFFREY 537151830 852 Wisconsin 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 30 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1320.42 0 26.59 0 0 0 0 0 0 1347.01 0 0 0 1101230503 34 State-operated facility (DHS) 200 Cook 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 5 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 0 0 0 90524.28 0 0 0 0 0 0 0 0 0 90524.28 0 0 0 1101230508 1316916885 10 Physicians FISCHER ANN 603041888 200 Cook 0 1 Pediatrics 0 44 0 0 11 0 0 0 0 0 0 8 0 25 0 0 0 0 0 0 115 0 0 66 0 0 0 0 0 0 13 0 40 0 0 0 0 0 0 115 0 0 66 0 0 0 0 0 0 13 0 40 0 0 0 0 0 0 230 0 0 1513.45 0 0 0 0 0 0 51.92 0 1740.11 0 0 0 0 0 0 3535.48 0 0 0 1101230509 1275562092 60 Pharmacies HY VEE PHARMACY #1 1533 623016706 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1885 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 556635 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1039846.55 0 0 0 1039846.55 0 0 0 1101230512 1306045919 10 Physicians LU LIN 600611344 57 Lake 0 0 Psychiatry 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 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2495.91 0 0 0 0 0 0 2495.91 0 0 0 1101230521 92 Waiver service provider--Disability (DHS/DRS) 91 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 2753.97 0 0 0 0 0 0 0 0 0 0 0 0 0 2753.97 0 0 0 1101230525 1114056363 10 Physicians CUNNINGTON LAURIE 625571716 20 Christian 0 1 Family Practice 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 587 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 587 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1438 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1438 0 0 0 1101230529 92 Waiver service provider--Disability (DHS/DRS) 53 Kane 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 1071.14 0 0 0 0 0 0 0 0 0 0 0 0 0 1071.14 0 0 0 1101230534 10 Physicians 200 Cook 0 0 Obstetric-Gynecology 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101230537 1053337378 10 Physicians RATNARAJ JEBADURAI 631600352 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 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 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5909.53 0 0 0 0 0 0 5909.53 0 0 0 1101230539 1760487078 63 Other Providers of Medical Equipment/Supplies (Non-registered) ALLIED HOME MEDICAL INC 385067466 844 Tennessee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 720.23 0 0 0 0 720.23 0 0 0 1101230548 10 Physicians 200 Cook 0 0 Internal Medicine 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 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 62.12 0 0 0 0 0 0 62.12 0 0 0 1101230557 1679699250 23 Occupational Therapists TOOHILL VERONICA 616033201 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3651.46 3651.46 0 0 0 1101230566 1811084254 10 Physicians DE OLIVEIRA GILDASIO 606118709 200 Cook 0 0 Anesthesiology 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 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4016.32 0 0 0 0 0 0 4016.32 0 0 0 1101230575 1245295245 10 Physicians BARNETT SEAN 600052369 200 Cook 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 1 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26.1 0 3345.96 0 0 0 0 0 0 3372.06 0 0 0 1101230584 1780622746 10 Physicians NICOLA TERRY 606127307 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 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5868.68 0 0 0 0 0 0 5868.68 0 0 0 1101230588 1588854269 10 Physicians MAGAS ELLEN 600771270 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 194 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6268.46 0 0 0 0 0 0 6268.46 0 0 0 1101230597 1558314302 33 Nursing Facilities EVENGLOW LODGE 617642011 61 Livingston 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 207 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5331 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 481583.57 0 0 0 0 0 0 0 481583.57 0 0 0 1101230608 1831186964 10 Physicians ODONNELL PATRICK 605408137 30 DuPage 0 1 Family Practice 0 9 0 0 2 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 96 0 0 2 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 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provider--Disability (DHS/DRS) 109 Winnebago 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 10987.53 0 0 0 0 0 0 0 0 0 0 0 0 0 10987.53 0 0 0 1101230657 1235124777 10 Physicians GORDON GREGORY 464026099 815 Indiana 0 0 Emergency Medicine 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 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1944.55 0 0 0 0 0 0 1944.55 0 0 0 1101230669 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 19 0 0 0 0 0 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 9952.57 0 0 0 0 0 0 0 0 0 0 0 0 0 9952.57 0 0 0 1101230708 2100221126 92 Waiver service provider--Disability (DHS/DRS) FAMILY CHOICE HOME HEALTH CARE 606465419 200 Cook 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 237 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 237 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 313387.32 0 0 0 0 0 0 0 0 0 0 0 0 0 313387.32 0 0 0 1101230715 1821316647 60 Pharmacies LIFE SOURCE PHARMACY INC 606434116 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 520 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7446 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 198674 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 210522.52 0 0 0 210522.52 0 0 0 1101230717 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11027.53 0 0 0 0 0 0 0 0 0 0 0 0 0 11027.53 0 0 0 1101230726 1215155601 10 Physicians MARTIN MOLLY 606127324 200 Cook 0 1 Pediatrics 0 0 0 0 93 0 0 0 0 0 0 0 0 66 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 7706.98 0 0 0 0 0 0 0 0 6360.7 0 0 0 0 0 0 14067.68 0 0 0 1101230729 92 Waiver service provider--Disability (DHS/DRS) 97 Stephenson 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 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2927.77 0 0 0 0 0 0 0 0 0 0 0 0 0 2927.77 0 0 0 1101230736 55 Early Intervention Services 98 Tazewell 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 739.62 0 0 0 0 0 0 739.62 0 0 0 1101230768 1982921912 10 Physicians GLADISH JAMES 629483631 108 Williamson 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 1451 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1593 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1593 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55152.49 0 0 0 0 0 0 55152.49 0 0 0 1101230780 1588871388 10 Physicians BERTOGLIO BRYAN 600073361 200 Cook 0 0 Neurology Surgery 0 0 0 0 0 0 0 0 0 0 0 1 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 189 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 189 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21721.36 0 0 0 0 0 0 21721.36 0 0 0 1101230784 91 Waiver service provider--Adults (DHS/DDD) 96 St Clair 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 733 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 733 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32876.68 0 0 0 0 0 0 0 0 0 0 0 0 0 32876.68 0 0 0 1101235735 1629018528 10 Physicians WILLIAMSON TUWANDA 606391450 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 338 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 480 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 480 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20275 0 0 0 0 0 0 20275 0 0 0 1101235740 1972586857 10 Physicians WELFORD CHARLES R 611075161 109 Winnebago 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 356.36 0 0 0 0 0 0 356.36 0 0 0 1101235745 1619109329 12 Optometrists KWAN KATHERINE 600261324 200 Cook 0 0 Therapeutic Pharmaceutical Agents 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 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 0 303.86 0 0 0 0 0 0 303.86 0 0 0 1101235748 11 Dentists 12 Bond 0 0 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0 1101235777 92 Waiver service provider--Disability (DHS/DRS) 57 Lake 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 22187 0 0 0 0 0 0 0 0 0 0 0 0 0 22187 0 0 0 1101235792 1558580852 10 Physicians DIANATI BEHFAR 946081844 89 Rock Island 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 512 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 512 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4728.15 0 0 0 0 0 0 4728.15 0 0 0 1101235799 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 10271.25 0 0 0 0 0 0 0 0 0 0 0 0 0 10271.25 0 0 0 1101235800 1457335838 39 Hospice MIDWEST PALLIATIVE HOSPICE CTR 600257636 200 Cook 0 0 0 0 0 0 0 0 0 0 265 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 798 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18268 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 226676.43 0 0 0 226676.43 0 0 0 1101235847 1295702314 10 Physicians FELDENBERG LOUIS 631102515 826 Missouri 0 0 Pediatric Nephrology 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7110.76 0 0 0 0 0 0 7110.76 0 0 0 1101235851 1962483784 12 Optometrists BISHOP DEAN 620521838 50 Jersey 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 752 0 548 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1431 0 552 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1431 0 552 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38096.85 0 15790.16 0 0 0 0 53887.01 0 0 0 1101235852 1801806039 10 Physicians COX ELIZABETH 628643565 49 Jefferson 0 1 Family Practice 0 67 0 0 11 0 0 0 0 0 0 1 0 96 0 0 0 0 0 0 547 0 0 13 0 0 0 0 0 0 1 0 370 0 0 0 0 0 0 547 0 0 13 0 0 0 0 0 0 1 0 370 0 0 0 0 0 0 1445 0 0 1071 0 0 0 0 0 0 2.6 0 8910.27 0 0 0 0 0 0 11428.87 0 0 0 1101235860 1609828292 10 Physicians KULKARNI PRADEEP 627024926 91 Sangamon 0 0 Pulmonary Diseases 0 0 0 0 0 0 0 0 0 0 0 24 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 574 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 574 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 223.03 0 3802.71 0 0 0 0 0 0 4025.74 0 0 0 1101235871 30 General Hospitals 824 Minnesota NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 128.21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 128.21 0 0 0 1101235872 92 Waiver service provider--Disability (DHS/DRS) 107 Will 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 570.56 0 0 0 0 0 0 0 0 0 0 0 0 0 570.56 0 0 0 1101235884 1093723413 10 Physicians ANDALEON DAISY 600992608 57 Lake 0 1 Family Practice 0 2378 0 0 273 0 0 0 0 0 0 153 0 701 0 0 0 0 0 0 15477 0 0 689 0 0 0 0 0 0 184 0 1871 0 0 0 0 0 0 15477 0 0 689 0 0 0 0 0 0 184 0 1871 0 0 0 0 0 0 37870 0 0 24773.3 0 0 0 0 0 0 547.49 0 52647.29 0 0 0 0 0 0 115838.08 0 0 0 1101235903 24 Speech Therapists 58 La Salle 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 475.34 475.34 0 0 0 1101235912 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 29008.78 0 0 0 0 0 0 0 0 0 0 0 0 0 29008.78 0 0 0 1101235915 1154346013 10 Physicians MORSO EMANUELE 601533328 30 DuPage 0 1 Internal Medicine 0 164 0 0 3 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 795 0 0 3 0 0 0 0 0 0 0 0 118 0 0 0 0 0 0 795 0 0 3 0 0 0 0 0 0 0 0 118 0 0 0 0 0 0 2295 0 0 314.88 0 0 0 0 0 0 0 0 2763.96 0 0 0 0 0 0 5373.84 0 0 0 1101235945 1518123389 10 Physicians LOZOVATSKY MARGARET 600352433 57 Lake 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1436.36 0 0 0 0 0 0 1436.36 0 0 0 1101235949 1639175599 39 Hospice BEACON OF HOPE HOSPICE INC 528065827 816 Iowa 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3224 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 385054.47 0 0 0 0 0 0 0 0 0 0 0 385054.47 0 0 0 1101235951 92 Waiver service provider--Disability (DHS/DRS) 29 Douglas 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 11799.55 0 0 0 0 0 0 0 0 0 0 0 0 0 11799.55 0 0 0 1101235953 1588689285 10 Physicians ANDERSON DANIELE 601952433 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 5 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64.92 0 9807.4 0 0 0 0 0 0 9872.32 0 0 0 1101235978 1922012608 63 Other Providers of Medical Equipment/Supplies (Non-registered) NATIONAL WOUND CARE LLC 618228810 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 762 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 762 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56129.47 0 0 0 0 0 0 56129.47 0 0 0 1101235982 1831134436 10 Physicians LAWRINENKO VICTOR 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10721.89 0 0 0 0 0 0 10721.89 0 0 0 1101235984 91 Waiver service provider--Adults (DHS/DDD) 13 Boone 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 0 339 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 339 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16368 0 0 0 0 0 0 0 0 0 0 0 0 0 16368 0 0 0 1101236005 1689903726 10 Physicians GARG NATASHA 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 316 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 316 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3531.4 0 0 0 0 0 0 3531.4 0 0 0 1101236023 92 Waiver service provider--Disability (DHS/DRS) 54 Kankakee 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 0 635.35 0 0 0 0 0 0 0 0 0 0 0 0 0 635.35 0 0 0 1101236024 1457518474 16 Nurse Practitioners PERTILE JOY 604501463 40 Grundy 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 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 348.49 0 0 0 0 0 0 348.49 0 0 0 1101236027 10 Physicians 826 Missouri 0 0 Emergency Medicine 0 0 0 0 0 0 0 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 113.36 0 0 0 0 0 0 113.36 0 0 0 1101236028 1124020532 10 Physicians ROY MARC 600052392 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 644 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 875 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 875 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13349.6 0 1780.07 0 0 0 0 0 0 15129.67 0 0 0 1101236029 1548251432 10 Physicians HALL KENDRA 611145632 109 Winnebago 0 1 Pediatrics 0 16 0 0 74 0 0 0 0 0 0 29 0 104 0 0 0 0 0 0 112 0 0 411 0 0 0 0 0 0 51 0 228 0 0 0 0 0 0 112 0 0 411 0 0 0 0 0 0 51 0 228 0 0 0 0 0 0 224 0 0 12163.42 0 0 0 0 0 0 392.42 0 7874.14 0 0 0 0 0 0 20653.98 0 0 0 1101236045 1154311355 11 Dentists KIA NAVID 606186423 66 Marion 0 0 General Dentistry 0 0 0 442 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1408 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1408 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137857.95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137857.95 0 0 0 1101236049 1366559072 10 Physicians BUTTERLY MARK 604532600 200 Cook 0 1 Pediatrics 0 255 0 0 158 0 0 0 0 0 0 0 0 185 0 0 0 0 0 0 715 0 0 428 0 0 0 0 0 0 0 0 270 0 0 0 0 0 0 715 0 0 428 0 0 0 0 0 0 0 0 270 0 0 0 0 0 0 1430 0 0 13998.04 0 0 0 0 0 0 0 0 10281.74 0 0 0 0 0 0 25709.78 0 0 0 1101236051 1306876594 10 Physicians ALZONA EMMANUEL 600763946 200 Cook 0 1 Internal Medicine 0 37 0 0 0 0 0 0 0 0 0 0 0 198 0 0 0 0 0 0 190 0 0 0 0 0 0 0 0 0 0 0 739 0 0 0 0 0 0 190 0 0 0 0 0 0 0 0 0 0 0 739 0 0 0 0 0 0 576 0 0 0 0 0 0 0 0 0 0 0 5543.97 0 0 0 0 0 0 6119.97 0 0 0 1101236052 1043210750 10 Physicians ORTH DAVID H 604264259 200 Cook 0 0 Ophthalmology 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 47 0 0 0 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 0 675.05 0 0 0 0 0 0 675.05 0 0 0 1101236058 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 21161.67 0 0 0 0 0 0 0 0 0 0 0 0 0 21161.67 0 0 0 1101236074 1780601237 10 Physicians BREDENKAMP JASON 531472655 852 Wisconsin 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 597 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 717 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 717 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21008.68 0 0 0 0 0 0 21008.68 0 0 0 1101236096 92 Waiver service provider--Disability (DHS/DRS) 66 Marion 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 19 0 0 0 0 0 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 10272.65 0 0 0 0 0 0 0 0 0 0 0 0 0 10272.65 0 0 0 1101236097 1700868379 10 Physicians MILLARD DAN 616360002 80 Peoria 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 63 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 0 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8385.92 0 0 0 0 0 0 8385.92 0 0 0 1101236121 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 6200.12 0 0 0 0 0 0 0 0 0 0 0 0 0 6200.12 0 0 0 1101236133 1104854470 16 Nurse Practitioners SCHWIND DIANE 999999999 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1207.67 0 0 0 0 0 0 1207.67 0 0 0 1101236137 1851311450 10 Physicians SHOWNKEEN HARISH 601901295 30 DuPage 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 6 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57.88 0 1859.23 0 0 0 0 0 0 1917.11 0 0 0 1101236145 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 11632.28 0 0 0 0 0 0 0 0 0 0 0 0 0 11632.28 0 0 0 1101236146 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10669.76 0 0 0 0 0 0 0 0 0 0 0 0 0 10669.76 0 0 0 1101236159 1033392857 16 Nurse Practitioners DUTCHER JOSETTE 600731217 57 Lake 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 57.66 0 0 0 0 0 0 0 0 1490.48 0 0 0 0 0 0 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0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2755.33 0 0 0 0 0 0 2755.33 0 0 0 1101236184 1437306396 10 Physicians ROSENBERG SHARON 606118709 200 Cook 0 0 Pulmonary Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 306 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 306 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3750.32 0 0 0 0 0 0 3750.32 0 0 0 1101236196 92 Waiver service provider--Disability (DHS/DRS) 96 St Clair 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16572.99 0 0 0 0 0 0 0 0 0 0 0 0 0 16572.99 0 0 0 1101236197 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10006.43 0 0 0 0 0 0 0 0 0 0 0 0 0 10006.43 0 0 0 1101236218 93 Waiver service provider--HIV/AIDS (DHS/DRS) 23 Clinton 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 12 0 0 0 0 0 0 0 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0 0 0 1101236283 1114081270 63 Other Providers of Medical Equipment/Supplies (Non-registered) MED FOUR HOME INC 641531228 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1080 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18976 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18976 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 170875.62 0 0 0 0 0 0 170875.62 0 0 0 1101236286 1861486250 10 Physicians KUMAR GIRIJA 606081610 200 Cook 0 1 Internal Medicine 0 34 0 0 7 0 0 0 0 0 0 31 0 290 0 0 0 0 0 0 53 0 0 18 0 0 0 0 0 0 41 0 799 0 0 0 0 0 0 53 0 0 18 0 0 0 0 0 0 41 0 799 0 0 0 0 0 0 164 0 0 748.23 0 0 0 0 0 0 83.78 0 29220.82 0 0 0 0 0 0 30216.83 0 0 0 1101236287 1083620587 60 Pharmacies BOND DRUG COMPANY OF IL 04464 600473201 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 285 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1483 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 35562 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.32 0 0 130257.62 0 0 0 130257.94 0 0 0 1101236288 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 0 190 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11749.1 0 0 0 0 0 0 0 0 0 0 0 0 0 11749.1 0 0 0 1101236296 1851389761 13 Podiatrists ELIPAS JAMES 606463614 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 803 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17048.78 0 0 0 0 0 0 17048.78 0 0 0 1101236305 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 29071.61 0 0 0 0 0 0 0 0 0 0 0 0 0 29071.61 0 0 0 1101236306 10 Physicians 852 Wisconsin 0 0 Rheumatology 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55.28 0 0 0 0 0 0 55.28 0 0 0 1101236311 1760593719 10 Physicians DESHPANDE LINA 601202198 53 Kane 0 0 Anesthesiology 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 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15586.77 0 0 0 0 0 0 15586.77 0 0 0 1101236315 1285701714 10 Physicians OCZKO DANGUILAN AGATA 600733809 57 Lake 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78.2 0 0 0 0 0 0 78.2 0 0 0 1101236337 1174829626 22 Physical Therapists LAETHEM JOANNA 999999999 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5844.78 5844.78 0 0 0 1101236344 1477653111 10 Physicians FREGIA ADRIENNE 604432319 200 Cook 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2629.61 0 0 0 0 0 0 2629.61 0 0 0 1101236353 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9797.27 0 0 0 0 0 0 0 0 0 0 0 0 0 9797.27 0 0 0 1101236361 92 Waiver service provider--Disability (DHS/DRS) 30 DuPage 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 26989.09 0 0 0 0 0 0 0 0 0 0 0 0 0 26989.09 0 0 0 1101236364 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 22027.75 0 0 0 0 0 0 0 0 0 0 0 0 0 22027.75 0 0 0 1101236372 92 Waiver service provider--Disability (DHS/DRS) 28 De Witt 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 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 0 677.62 0 0 0 0 0 0 0 0 0 0 0 0 0 677.62 0 0 0 1101236384 1780728220 12 Optometrists HONG KYUNG 600533110 200 Cook 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 249 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 462 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 462 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13182.23 0 1138.32 0 0 0 0 14320.55 0 0 0 1101236402 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 66 0 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 7375.5 0 0 0 0 0 0 0 0 0 0 0 0 0 7375.5 0 0 0 1101236421 1912912221 60 Pharmacies WALGREENS 15197 60660 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 933 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4931 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 127615 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 392212.04 0 0 0 392212.04 0 0 0 1101236426 1568455467 10 Physicians SHEARON ELISABETH 609013664 54 Kankakee 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 235 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 235 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1276.88 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0 0 0 0 0 0 0 14520.16 0 0 0 0 0 0 14520.16 0 0 0 1101236512 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 26140.77 0 0 0 0 0 0 0 0 0 0 0 0 0 26140.77 0 0 0 1101236513 1215040464 46 Ambulatory Surgical Treatment Centers DEERPATH ORTHOPEDIC SURGICAL 604503349 40 Grundy ASTC Ambulatory Surgical Treatment Center. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 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 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26112.41 0 0 0 0 0 26112.41 0 0 0 1101236515 1508925041 10 Physicians ZANETTI CLAUDE 606311983 200 Cook 0 0 Pulmonary Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 423 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1340 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1340 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8892.2 0 0 0 0 0 0 8892.2 0 0 0 1101236523 1194970020 16 Nurse Practitioners OGUNBUYIDE MOJISOLA 600442203 57 Lake 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 13 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 0 116.67 0 0 0 0 0 0 116.67 0 0 0 1101236555 1215057773 10 Physicians LASLO KATHLEEN 606225646 200 Cook 0 0 Pediatrics 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 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1023.89 0 0 0 0 0 0 1023.89 0 0 0 1101236557 92 Waiver service provider--Disability (DHS/DRS) 10 Adams 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 19508.87 0 0 0 0 0 0 0 0 0 0 0 0 0 19508.87 0 0 0 1101236558 16 Nurse Practitioners 844 Tennessee 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 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 0 479.22 0 0 0 0 0 0 479.22 0 0 0 1101236562 1427005347 70 Ambulance Service Providers VANDENBERG AMBULANCE 604879205 107 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0 0 0 0 0 503 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 503 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32045.64 0 0 0 0 0 0 32045.64 0 0 0 1101237107 1356646673 10 Physicians SCHLEICHER BETH ANN 611076807 109 Winnebago 0 0 Gynecology 0 0 0 0 0 0 0 0 0 0 0 116 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 218 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 218 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36811.52 0 23879.47 0 0 0 0 0 0 60690.99 0 0 0 1101237110 16 Nurse Practitioners 57 Lake 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 337.7 0 0 0 0 0 0 337.7 0 0 0 1101237112 1326026030 10 Physicians RHODE CLARISSA 616147300 80 Peoria 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 1527 0 153 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2047 0 214 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2047 0 214 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33051.22 0 2307.09 0 0 0 0 0 0 35358.31 0 0 0 1101237117 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 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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 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 0 128.53 0 0 0 0 0 0 128.53 0 0 0 1101237185 1265452940 10 Physicians SONENTHAL KATHY 600148043 71 McHenry 0 0 Allergy-Immunization 0 0 0 0 0 0 0 0 0 0 0 0 0 25 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 0 952.36 0 0 0 0 0 0 952.36 0 0 0 1101237186 1407147572 16 Nurse Practitioners SLOAN SHELLE 625651749 94 Shelby 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 220 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 339 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 339 0 0 0 0 0 0 0 0 0 372.85 0 0 0 0 0 0 0 0 6322.62 0 0 0 0 0 0 6695.47 0 0 0 1101237191 1063673515 10 Physicians THOMPSON DAVID G 605435222 55 Kendall 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 637 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1051 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1051 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16047.92 0 0 0 0 0 0 16047.92 0 0 0 1101237201 1013159276 55 Early Intervention Services HARKLESS SEREDA 606523904 200 Cook 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 0 503 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 503 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30156.58 0 0 0 0 0 0 30156.58 0 0 0 1101237207 1538162151 10 Physicians WILSON JOHN F 604532504 200 Cook 0 0 Ophthalmology 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 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 507.06 0 0 0 0 0 0 507.06 0 0 0 1101237218 1972783801 10 Physicians SINGH RANJAN 600442203 57 Lake 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20227.92 0 0 0 0 0 0 20227.92 0 0 0 1101237219 1609041565 10 Physicians LIPNICK SHERYL 601695019 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 27 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 212 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 212 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 677.21 0 8885.53 0 0 0 0 0 0 9562.74 0 0 0 1101237220 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 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 30188.54 0 0 0 0 0 0 0 0 0 0 0 0 0 30188.54 0 0 0 1101237222 1871576264 10 Physicians COATES LAKIMERLY 611075291 109 Winnebago 0 0 Dermatology 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 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 236.18 0 0 0 0 0 0 236.18 0 0 0 1101237224 1275517138 13 Podiatrists SCOTT TODD 601312567 200 Cook 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 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 598.83 0 0 0 0 0 0 598.83 0 0 0 1101237238 1366420531 30 General Hospitals OCONOMOWOC MEMORIAL HOSPITAL 530663844 852 Wisconsin NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 8 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 10 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 10 0 0 0 0 6 0 0 0 1 0 0 0 0 0 0 0 0 0 1993.05 0 0 0 0 3892.27 0 0 0 96.11 0 0 0 0 0 5981.43 0 0 0 1101237241 1700952140 10 Physicians SHAH DEVENDRA U 601203829 53 Kane 0 1 Family Practice 0 35 0 0 0 0 0 0 0 0 0 0 0 92 0 0 0 0 0 0 190 0 0 0 0 0 0 0 0 0 0 0 373 0 0 0 0 0 0 190 0 0 0 0 0 0 0 0 0 0 0 373 0 0 0 0 0 0 546 0 0 0 0 0 0 0 0 0 0 0 3911.37 0 0 0 0 0 0 4457.37 0 0 0 1101237255 1386820413 10 Physicians DANDAMUDI PRAVEEN 602023445 200 Cook 0 0 Internal Medicine 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 82 0 0 0 0 0 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 5745.7 0 0 0 0 0 0 5745.7 0 0 0 1101237264 1376575332 10 Physicians BRUNNER PATRICIA 600912666 200 Cook 0 1 Pediatrics 0 21 0 0 11 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 61 0 0 26 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 61 0 0 26 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 122 0 0 927.52 0 0 0 0 0 0 0 0 1037.23 0 0 0 0 0 0 2086.75 0 0 0 1101237276 2100227694 92 Waiver service provider--Disability (DHS/DRS) PRAIRIE COUNCIL ON AGING 626502012 77 Morgan 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 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9460 0 0 0 0 0 0 0 0 0 0 0 0 0 9460 0 0 0 1101237296 11 Dentists 200 Cook 0 0 0 0 0 1 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 18.8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18.8 0 0 0 1101237304 1295952455 10 Physicians NEWMAN BRIANNE M 631102539 200 Cook 0 0 Psychiatry 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 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 0 207.3 0 0 0 0 0 0 207.3 0 0 0 1101237311 92 Waiver service provider--Disability (DHS/DRS) 13 Boone 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 41972.46 0 0 0 0 0 0 0 0 0 0 0 0 0 41972.46 0 0 0 1101237324 1922069574 10 Physicians WEINBERG KENNETH 601901295 30 DuPage 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 1 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 223 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 223 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3.82 0 4282.92 0 0 0 0 0 0 4286.74 0 0 0 1101237327 1457675233 10 Physicians GONG EDWARD 606116649 200 Cook 0 0 Pediatric Surgery 0 0 0 0 0 0 0 0 0 0 0 6 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 275 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 275 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83.7 0 30319.61 0 0 0 0 0 0 30403.31 0 0 0 1101237329 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 22056.9 0 0 0 0 0 0 0 0 0 0 0 0 0 22056.9 0 0 0 1101237332 1508876160 70 Ambulance Service Providers NORTHLAKE FIRE PROTECTION DIST 601642239 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 338 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 338 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9372.16 0 0 0 0 0 0 9372.16 0 0 0 1101237351 1093974792 10 Physicians CHEN LINDA 603042893 200 Cook 0 1 Family Practice 0 25 0 0 15 0 0 0 0 0 0 6 0 45 0 0 0 0 0 0 70 0 0 27 0 0 0 0 0 0 7 0 80 0 0 0 0 0 0 70 0 0 27 0 0 0 0 0 0 7 0 80 0 0 0 0 0 0 159 0 0 1312.44 0 0 0 0 0 0 83.68 0 2485.46 0 0 0 0 0 0 4040.58 0 0 0 1101237378 1588766646 10 Physicians CAY NILUARDO 606221778 200 Cook 0 1 Emergency Medicine 0 15 0 0 0 0 0 0 0 0 0 0 0 168 0 0 0 0 0 0 96 0 0 0 0 0 0 0 0 0 0 0 1384 0 0 0 0 0 0 96 0 0 0 0 0 0 0 0 0 0 0 1384 0 0 0 0 0 0 288 0 0 0 0 0 0 0 0 0 0 0 6949.92 0 0 0 0 0 0 7237.92 0 0 0 1101237384 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 29055.78 0 0 0 0 0 0 0 0 0 0 0 0 0 29055.78 0 0 0 1101237386 1265613657 70 Ambulance Service Providers LOVINGTON COMMUNITY AMBULANCE 619370592 78 Moultrie 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 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5222.24 0 0 0 0 0 0 5222.24 0 0 0 1101237389 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 4793.64 0 0 0 0 0 0 0 0 0 0 0 0 0 4793.64 0 0 0 1101237404 1598884629 43 Encounter rate clinic AUSTIN COOK COUNTY COMM HC 606513223 200 Cook ARS-C.O.P. "JH Stroger, Oak Forest and Provident Hospitals, paid under an alternate reimbursement system" 0 1 Direct Access 0 295 815 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 788 2272 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 788 2272 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1900 470662.97 0 15800.85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 488363.82 0 0 0 1101237406 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32978.18 0 0 0 0 0 0 0 0 0 0 0 0 0 32978.18 0 0 0 1101237425 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 2830 0 0 0 0 0 0 0 0 0 0 0 0 0 2830 0 0 0 1101237442 1205191806 10 Physicians KIRVASSILIS GEORGIOS 535625531 852 Wisconsin 0 0 Anesthesiology 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 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2728.9 0 0 0 0 0 0 2728.9 0 0 0 1101237443 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 30346.82 0 0 0 0 0 0 0 0 0 0 0 0 0 30346.82 0 0 0 1101237457 1619932068 10 Physicians COLLINGS JAMIE 606118702 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4390.78 0 0 0 0 0 0 4390.78 0 0 0 1101237465 92 Waiver service provider--Disability (DHS/DRS) 88 Richland 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 4595 0 0 0 0 0 0 0 0 0 0 0 0 0 4595 0 0 0 1101237469 1568498939 10 Physicians ARTEAGA WALDO 606093844 200 Cook 0 1 General Practice 0 354 0 0 2 0 0 0 0 0 0 32 0 333 0 0 0 0 0 0 1891 0 0 2 0 0 0 0 0 0 43 0 853 0 0 0 0 0 0 1891 0 0 2 0 0 0 0 0 0 43 0 853 0 0 0 0 0 0 5069 0 0 171.3 0 0 0 0 0 0 109.07 0 28139.53 0 0 0 0 0 0 33488.9 0 0 0 1101237470 1528103207 10 Physicians WILLIAMS FREAGER 606910263 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 1 0 0 0 0 0 0 3 0 326 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 3 0 483 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 3 0 483 0 0 0 0 0 0 0 0 0 32.15 0 0 0 0 0 0 71.9 0 62291.13 0 0 0 0 0 0 62395.18 0 0 0 1101237495 91 Waiver service provider--Adults (DHS/DDD) 57 Lake 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 0 250 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 250 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6204 0 0 0 0 0 0 0 0 0 0 0 0 0 6204 0 0 0 1101237512 1861495194 10 Physicians RITZ SHERWIN 604503122 40 Grundy 0 0 Otorhinolaryngology 0 0 0 0 0 0 0 0 0 0 0 0 0 324 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1566 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1566 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67076.82 0 0 0 0 0 0 67076.82 0 0 0 1101237523 1578542882 10 Physicians LEVINE BRETT 606124861 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 163 0 188 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 376 0 427 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 376 0 427 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1200.95 0 17264.01 0 0 0 0 0 0 18464.96 0 0 0 1101237525 92 Waiver service provider--Disability (DHS/DRS) 106 Whiteside 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 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 1731.68 0 0 0 0 0 0 0 0 0 0 0 0 0 1731.68 0 0 0 1101237530 1447470869 55 Early Intervention Services LANIER TRACIE 606282305 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29588.06 0 0 0 0 0 0 29588.06 0 0 0 1101237536 1245217520 30 General Hospitals FAIRVIEW RIDGES HOSPITAL 553375714 824 Minnesota NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 13 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 2693.63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2693.63 0 0 0 1101237540 1902838345 10 Physicians CABANA EMILIO 604403493 107 Will 0 1 Pediatrics 0 52 0 0 16 0 0 0 0 0 0 3 0 12 0 0 0 0 0 0 195 0 0 31 0 0 0 0 0 0 3 0 13 0 0 0 0 0 0 195 0 0 31 0 0 0 0 0 0 3 0 13 0 0 0 0 0 0 390 0 0 935.96 0 0 0 0 0 0 47.1 0 588.73 0 0 0 0 0 0 1961.79 0 0 0 1101237548 1982839585 11 Dentists SIDDIQUI FARIHA 605321976 30 DuPage 0 0 General Dentistry 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 564 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 564 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15710.82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15710.82 0 0 0 1101237549 1326271255 22 Physical Therapists COLVIN DANIELLE 618207553 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2002.41 2002.41 0 0 0 1101237555 1891739355 10 Physicians PROCENTO GEORGE 600601438 57 Lake 0 1 Emergency Medicine 0 176 0 0 15 0 0 0 0 0 0 6 0 106 0 0 0 0 0 0 902 0 0 17 0 0 0 0 0 0 6 0 172 0 0 0 0 0 0 902 0 0 17 0 0 0 0 0 0 6 0 172 0 0 0 0 0 0 2181 0 0 1513.01 0 0 0 0 0 0 40.97 0 9379.36 0 0 0 0 0 0 13114.34 0 0 0 1101237556 1295745909 10 Physicians HAYANI KAREN 606123445 200 Cook 0 1 Pediatrics 0 93 0 0 6 0 0 0 0 0 0 0 0 129 0 0 0 0 0 0 285 0 0 7 0 0 0 0 0 0 0 0 404 0 0 0 0 0 0 285 0 0 7 0 0 0 0 0 0 0 0 404 0 0 0 0 0 0 580 0 0 420.46 0 0 0 0 0 0 0 0 52537.57 0 0 0 0 0 0 53538.03 0 0 0 1101237573 1053349639 16 Nurse Practitioners TOIA JACQUIE 606112991 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 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 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 656.93 0 0 0 0 0 0 656.93 0 0 0 1101237574 1255451803 10 Physicians CONKLIN DARREN 616112095 98 Tazewell 0 1 Family Practice 0 19 0 0 16 0 0 0 0 0 0 14 0 74 0 0 0 0 0 0 140 0 0 48 0 0 0 0 0 0 18 0 178 0 0 0 0 0 0 140 0 0 48 0 0 0 0 0 0 18 0 178 0 0 0 0 0 0 345 0 0 1735.68 0 0 0 0 0 0 69.41 0 3738.86 0 0 0 0 0 0 5888.95 0 0 0 1101237583 10 Physicians 816 Iowa 0 0 Infectious Diseases 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101237585 1487638953 10 Physicians FRIEDMAN MICHAEL 606221797 200 Cook 0 0 Family Practice 0 0 0 0 7 0 0 0 0 0 0 5 0 100 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 5 0 209 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 5 0 209 0 0 0 0 0 0 0 0 0 428.54 0 0 0 0 0 0 2.17 0 2757.29 0 0 0 0 0 0 3188 0 0 0 1101237591 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 41879.12 0 0 0 0 0 0 0 0 0 0 0 0 0 41879.12 0 0 0 1101237598 1275679755 10 Physicians KHOLOKI M SAMER 605261968 200 Cook 0 0 Internal Medicine 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 0 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2355.73 0 0 0 0 0 0 2355.73 0 0 0 1101237603 1255312450 10 Physicians PAGAN MARIN HERIBERTO 464107035 815 Indiana 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1493.6 0 0 0 0 0 0 0 0 1493.6 0 0 0 1101237604 1124073838 10 Physicians NEMICKAS TOMAS 600315709 57 Lake 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 72 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 153 0 380 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 153 0 380 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1345.47 0 13592.84 0 0 0 0 0 0 14938.31 0 0 0 1101237605 55 Early Intervention Services 200 Cook 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 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1606.91 0 0 0 0 0 0 1606.91 0 0 0 1101237607 1912218272 10 Physicians ZAKARIA MHD 604877581 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 909 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 909 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3642.9 0 0 0 0 0 0 3642.9 0 0 0 1101237610 1881654325 30 General Hospitals CHICAGO HEIGHTS DIALYSIS 604111733 200 Cook DIALYSIS Outpatient dialysis centers. 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 226 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1952 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24164.25 0 0 0 0 0 24164.25 0 0 0 1101237612 1275558660 10 Physicians THUMME ROBERT 606740023 57 Lake 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1393.92 0 0 0 0 0 0 1393.92 0 0 0 1101237625 98 Waiver service provider--TBI (DHS/DRS) 97 Stephenson 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 3906.07 0 0 0 0 0 0 0 0 0 0 0 0 0 3906.07 0 0 0 1101237631 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 26765.08 0 0 0 0 0 0 0 0 0 0 0 0 0 26765.08 0 0 0 1101237637 1326147802 24 Speech Therapists BARNARD KYMBERLY 620351070 65 Madison 0 0 0 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 0 0 0 0 0 0 0 0 337 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 337 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26092.72 26092.72 0 0 0 1101237641 92 Waiver service provider--Disability (DHS/DRS) 77 Morgan 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 442.79 0 0 0 0 0 0 0 0 0 0 0 0 0 442.79 0 0 0 1101237653 10 Physicians 852 Wisconsin 0 0 Cardiology 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101237660 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5666.25 0 0 0 0 0 0 0 0 0 0 0 0 0 5666.25 0 0 0 1101237664 1942294897 10 Physicians AKHTAR MOHAMMAD 601691065 200 Cook 0 0 Pediatrics 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 0 263 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 263 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32773.22 0 0 0 0 0 0 32773.22 0 0 0 1101237668 94 Waiver service provider--Children's support (DHS/DDD) 99 Union 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 0 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15565.82 0 0 0 0 0 0 0 0 0 0 0 0 0 15565.82 0 0 0 1101237677 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 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 0 769.84 0 0 0 0 0 0 0 0 0 0 0 0 0 769.84 0 0 0 1101237688 1265772743 16 Nurse Practitioners DUYSER BETHANY 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 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 1.8 0 0 0 0 0 0 1.8 0 0 0 1101237696 1912997933 10 Physicians AKHTAR NAVEED 604401872 107 Will 0 0 Internal Medicine 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 0 0 0 518 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 518 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10731.49 0 0 0 0 0 0 10731.49 0 0 0 1101237700 1659374056 63 Other Providers of Medical Equipment/Supplies (Non-registered) VONO MEDICAL SUPPLIES 627025114 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 384 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2401 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2401 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 124963.01 0 4058.21 0 0 0 0 129021.22 0 0 0 1101237701 2100228119 71 Medicar Provider JO DAVIESS COUNTY 601366087 53 Kane 0 0 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 1011 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1011 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17217.81 0 0 0 0 0 0 17217.81 0 0 0 1101237710 1932114063 60 Pharmacies WALGREENS 10719 46403 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2359 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3963.62 0 0 0 3963.62 0 0 0 1101237712 1447452941 47 Local Education Agencies RACCOON C S D 1 628019621 66 Marion 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2971.08 0 2971.08 0 0 0 1101237721 1457568859 10 Physicians BACH STEVEN 999999999 71 McHenry 0 0 0 0 0 0 0 0 0 0 0 0 0 2170 0 172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3306 0 259 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3306 0 259 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80519.94 0 3616.89 0 0 0 0 0 0 84136.83 0 0 0 1101237725 1801941968 74 Hospital-Based Transportation Providers MASSAC MEMORIAL HOSPITAL 629602467 69 Massac 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 391 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1224 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1224 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79296.3 0 0 0 0 0 0 79296.3 0 0 0 1101237738 1447278254 10 Physicians RUOFF BRENT 631292555 826 Missouri 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1295.81 0 0 0 0 0 0 1295.81 0 0 0 1101237750 1639513963 28 Waiver service provider--Supportive living facility (HFS) HERITAGE WOODS OF CHARLESTON 619203291 24 Coles 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 688 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17662 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 963042.95 0 0 0 0 0 0 0 0 0 0 0 0 0 963042.95 0 0 0 1101237755 1811976988 10 Physicians MICHELFELDER AARON 601533304 200 Cook 0 1 Family Practice 0 42 0 0 1 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 313 0 0 1 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 313 0 0 1 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 697 0 0 77.87 0 0 0 0 0 0 0 0 825.98 0 0 0 0 0 0 1600.85 0 0 0 1101237758 1356301667 10 Physicians SHI FEINAN 606123723 200 Cook 0 0 Pathology 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 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 364.8 0 0 0 0 0 0 0 0 364.8 0 0 0 1101237771 1821169483 22 Physical Therapists LYONS KATHLEEN 606222712 200 Cook 0 0 0 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 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7670.15 7670.15 0 0 0 1101237776 1780789750 10 Physicians GULLO GREGORY 601691019 200 Cook 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 882 0 128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1307 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1307 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24468.26 0 1644.53 0 0 0 0 0 0 26112.79 0 0 0 1101237783 30 General Hospitals 852 Wisconsin NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 4 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 0 669.76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 669.76 0 0 0 1101237787 1902977903 63 Other Providers of Medical Equipment/Supplies (Non-registered) LINCARE INC 600072483 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 423 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3744 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3744 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51544.46 0 0 0 0 0 0 51544.46 0 0 0 1101237812 10 Physicians 57 Lake 0 0 Internal Medicine 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101237816 1932392099 10 Physicians MOORE HENRY 619389388 24 Coles 0 0 Traumatic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 246 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 417 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 417 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26725.09 0 0 0 0 0 0 26725.09 0 0 0 1101237832 1710266903 16 Nurse Practitioners BOCKMAN SUSAN 600903012 200 Cook 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 132.5 0 0 0 0 0 0 0 0 593.72 0 0 0 0 0 0 726.22 0 0 0 1101237851 1508056987 10 Physicians MULLANGI PRAVEEN 627011041 91 Sangamon 0 0 Infectious Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 560 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 560 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6641.48 0 0 0 0 0 0 6641.48 0 0 0 1101237853 1588705651 16 Nurse Practitioners STRAZAR JEAN 620406805 65 Madison 0 0 General Psychiatry Residency 0 0 0 0 0 0 0 0 0 0 0 0 0 224 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 767 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 767 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19318.3 0 0 0 0 0 0 19318.3 0 0 0 1101237855 92 Waiver service provider--Disability (DHS/DRS) 89 Rock Island 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 39500.16 0 0 0 0 0 0 0 0 0 0 0 0 0 39500.16 0 0 0 1101237861 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10824.62 0 0 0 0 0 0 0 0 0 0 0 0 0 10824.62 0 0 0 1101237864 1346276656 10 Physicians ZINGER EDUARD 606576254 200 Cook 0 1 Internal Medicine 0 88 0 0 15 0 0 0 0 0 0 10 0 565 0 0 0 0 0 0 505 0 0 16 0 0 0 0 0 0 27 0 10874 0 0 0 0 0 0 505 0 0 16 0 0 0 0 0 0 27 0 10874 0 0 0 0 0 0 1359 0 0 1430.01 0 0 0 0 0 0 43.12 0 34219.86 0 0 0 0 0 0 37051.99 0 0 0 1101237877 1609068386 10 Physicians HAMMING DAVID 600315709 57 Lake 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 92 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 192 0 437 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 192 0 437 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1815.24 0 23696.44 0 0 0 0 0 0 25511.68 0 0 0 1101237900 93 Waiver service provider--HIV/AIDS (DHS/DRS) 65 Madison 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 15417.78 0 0 0 0 0 0 0 0 0 0 0 0 0 15417.78 0 0 0 1101237905 1194725705 60 Pharmacies GABECARE DIRECT RX INC 480845515 823 Michigan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 1914 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 54859 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97.66 0 0 123395.8 0 0 0 123493.46 0 0 0 1101237908 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 27559.71 0 0 0 0 0 0 0 0 0 0 0 0 0 27559.71 0 0 0 1101237913 91 Waiver service provider--Adults (DHS/DDD) 51 Jo Daviess 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 0 339 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 339 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23354.5 0 0 0 0 0 0 0 0 0 0 0 0 0 23354.5 0 0 0 1101237924 1811959992 10 Physicians TOLITANO DOMINIC 601911574 30 DuPage 0 0 Thoracic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1721.32 0 0 0 0 0 0 1721.32 0 0 0 1101237931 1154563914 10 Physicians TRABOLSI MAIS 999999999 200 Cook 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 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 392.32 0 0 0 0 0 0 392.32 0 0 0 1101237940 1467550772 10 Physicians KNOX JUDITH 627032403 91 Sangamon 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 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 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1350.77 0 0 0 0 0 0 1350.77 0 0 0 1101237943 1356400782 46 Ambulatory Surgical Treatment Centers CHAMPAIGN SURGICENTER LLC 618215469 19 Champaign ASTC Ambulatory Surgical Treatment Center. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 470 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 525 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 525 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 321848.74 0 0 0 0 0 321848.74 0 0 0 1101237944 1003004565 38 Specialized Mental Health Rehabilitation Facilities (SMHRF) SKOKIE MEADOWS NURSING CTR II 600761210 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 481 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13556 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1069408.9 0 0 0 0 0 0 0 1069408.9 0 0 0 1101237946 1548204035 10 Physicians SHAPIRO DAVID 606123841 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 6 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57.04 0 9679.07 0 0 0 0 0 0 9736.11 0 0 0 1101237949 2100228367 91 Waiver service provider--Adults (DHS/DDD) CILA CORPORATION 628810728 66 Marion 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25456 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25456 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3408344.56 0 0 0 0 0 0 0 0 0 0 0 0 0 3408344.56 0 0 0 1101237967 1902952609 16 Nurse Practitioners SCHNEIDER KARI 601533328 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 66 0 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 0 850.29 0 0 0 0 0 0 850.29 0 0 0 1101237968 98 Waiver service provider--TBI (DHS/DRS) 37 Fulton 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 27166.64 0 0 0 0 0 0 0 0 0 0 0 0 0 27166.64 0 0 0 1101237980 1528058567 10 Physicians KAEGI CHARLES 606465738 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 381 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 381 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1883.69 0 0 0 0 0 0 1883.69 0 0 0 1101237982 1578516290 39 Hospice HEARTLAND HOSPICE SERVICES 611076671 109 Winnebago 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 0 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7059 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 752341.2 0 0 0 0 0 0 0 0 0 0 0 752341.2 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Iroquois 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 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 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1347.04 0 0 1347.04 0 0 0 1101238129 1356604268 16 Nurse Practitioners DILLON SARA 476307918 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2169.65 0 0 0 0 0 0 2169.65 0 0 0 1101238152 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 15411.02 0 0 0 0 0 0 0 0 0 0 0 0 0 15411.02 0 0 0 1101238168 1760501605 40 Federally Qualified Health Centers GREATER ELGIN FAMILY CARE CTR 601208145 53 Kane 0 0 0 0 4 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 506.78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 506.78 0 0 0 1101238178 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20801.13 0 0 0 0 0 0 0 0 0 0 0 0 0 20801.13 0 0 0 1101238213 92 Waiver service provider--Disability (DHS/DRS) 88 Richland 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101238217 1275655292 10 Physicians SMULKSTYS LINAS 601265658 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 301 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 301 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4543.85 0 0 0 0 0 0 4543.85 0 0 0 1101238227 1255387643 60 Pharmacies OSCO DRUG 3178 604512944 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 30284 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39.14 0 0 43753.49 0 0 0 43792.63 0 0 0 1101238236 92 Waiver service provider--Disability (DHS/DRS) 30 DuPage 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 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0 0 0 0 317 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18393.02 0 0 0 0 0 0 18393.02 0 0 0 1101238529 92 Waiver service provider--Disability (DHS/DRS) 91 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 20431.26 0 0 0 0 0 0 0 0 0 0 0 0 0 20431.26 0 0 0 1101238547 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14172.89 0 0 0 0 0 0 0 0 0 0 0 0 0 14172.89 0 0 0 1101238559 1043382302 60 Pharmacies CVS/SPECIALTY 151462213 839 Pennsylvania 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1705 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12983 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 368069 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13879974.7 0 0 0 13879974.7 0 0 0 1101238571 25 Audiologists 54 Kankakee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 10 0 0 0 0 0 0 0 0 0 0 0 0 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Waiver service provider--Disability (DHS/DRS) 200 Cook 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 22041.92 0 0 0 0 0 0 0 0 0 0 0 0 0 22041.92 0 0 0 1101238678 1225168859 22 Physical Therapists EHLENFELDT JOYCE 606163116 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 264 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 264 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21395.54 21395.54 0 0 0 1101238686 1477536647 70 Ambulance Service Providers AIR EVAC EMS INC 638018221 826 Missouri 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 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13003.04 0 0 0 0 0 0 13003.04 0 0 0 1101238691 91 Waiver service provider--Adults (DHS/DDD) 15 Bureau 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 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4089.8 0 0 0 0 0 0 0 0 0 0 0 0 0 4089.8 0 0 0 1101238695 1598817314 47 Local Education Agencies TAYLORVILLE CUSD 3 625681849 20 Christian 0 0 0 0 0 0 534 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 1057 0 0 0 0 0 0 0 0 0 0 0 0 0 4982 0 0 0 0 1057 0 0 0 0 0 0 0 0 0 0 0 0 0 4982 0 0 0 0 6310.56 0 0 0 0 0 0 0 0 0 0 0 0 0 38637.5 0 44948.06 0 0 0 1101238716 1437292356 12 Optometrists ADKINS LINDA J 604221267 200 Cook 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104.17 0 0 0 0 0 0 104.17 0 0 0 1101238730 1306854179 74 Hospital-Based Transportation Providers GIBSON COMMUNITY HOSPITAL 609361076 35 Ford 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 328 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 328 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35052.36 0 0 0 0 0 0 35052.36 0 0 0 1101238747 1316964695 60 Pharmacies WALMART PHARMACY 10-1779 604552401 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 607 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2768 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78223 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100598.34 0 0 0 100598.34 0 0 0 1101238750 1497868962 13 Podiatrists SILVA EYMARD 760633580 845 Texas 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 0 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2168.56 0 0 0 0 0 0 2168.56 0 0 0 1101238762 98 Waiver service provider--TBI (DHS/DRS) 98 Tazewell 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 25134.94 0 0 0 0 0 0 0 0 0 0 0 0 0 25134.94 0 0 0 1101238776 92 Waiver service provider--Disability (DHS/DRS) 55 Kendall 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 19 0 0 0 0 0 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 16155.8 0 0 0 0 0 0 0 0 0 0 0 0 0 16155.8 0 0 0 1101238781 1710947387 70 Ambulance Service Providers LOCKPORT TWP FIRE AND AMB DIST 604419807 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 332 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 920 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 920 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48258.37 0 0 0 0 0 0 48258.37 0 0 0 1101238800 92 Waiver service provider--Disability (DHS/DRS) 15 Bureau 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 19 0 0 0 0 0 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 14637.59 0 0 0 0 0 0 0 0 0 0 0 0 0 14637.59 0 0 0 1101238811 1023233921 47 Local Education Agencies RAMSEY CUSD NO 204 620800010 34 Fayette 0 0 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 0 0 0 0 0 0 0 0 1995 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1995 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18043.39 0 18043.39 0 0 0 1101238815 1235140658 10 Physicians SCOTT KRISTIN 606422607 200 Cook 0 1 Family Practice 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 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 1101238822 1538111935 10 Physicians MCADOO EFREM 604404906 107 Will 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 377 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 410 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 410 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12170.77 0 0 0 0 0 0 12170.77 0 0 0 1101238828 1841453958 10 Physicians MIRZA KHURRAM 631101010 826 Missouri 0 0 Internal Medicine 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 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 210.3 0 0 0 0 0 0 210.3 0 0 0 1101238840 94 Waiver service provider--Children's support (DHS/DDD) 72 McLean 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 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1878.25 0 0 0 0 0 0 0 0 0 0 0 0 0 1878.25 0 0 0 1101238842 1023091790 24 Speech Therapists BAROWSKI DEANNA 622491077 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 740 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 393.66 0 0 0 0 0 0 393.66 0 0 0 1101238878 1992926307 10 Physicians QUADRI SYED 606127232 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 203841.14 0 0 0 0 0 0 203841.14 0 0 0 1101238888 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4091.82 0 0 0 0 0 0 0 0 0 0 0 0 0 4091.82 0 0 0 1101238931 1194794917 40 Federally Qualified Health Centers COMM HEALTH IMPROVEMENT CTR 625264274 63 Macon 0 1 0 1465 4299 0 1781 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9240 18420 0 7755 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9240 18420 0 7755 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27138 1089912.43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1117050.43 0 0 0 1101238934 1831227941 10 Physicians LEUNG SAMUEL D 606161514 200 Cook 0 1 Family Practice 0 803 0 0 4 0 0 0 0 0 0 17 0 291 0 0 0 0 0 0 1780 0 0 18 0 0 0 0 0 0 18 0 434 0 0 0 0 0 0 1780 0 0 18 0 0 0 0 0 0 18 0 434 0 0 0 0 0 0 4448 0 0 525.39 0 0 0 0 0 0 44.04 0 11498.98 0 0 0 0 0 0 16516.41 0 0 0 1101238938 1760454979 10 Physicians VEGA SANDRA 605462320 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 4 0 0 0 0 0 0 106 0 224 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 217 0 425 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 217 0 425 0 0 0 0 0 0 0 0 0 50.2 0 0 0 0 0 0 1105.98 0 43770.13 0 0 0 0 0 0 44926.31 0 0 0 1101238941 1902958259 10 Physicians MENDI CHANDA 606493014 200 Cook 0 1 Pediatrics 0 1194 0 0 542 0 0 0 0 0 0 51 0 700 0 0 0 0 0 0 7105 0 0 1633 0 0 0 0 0 0 51 0 2130 0 0 0 0 0 0 7105 0 0 1633 0 0 0 0 0 0 51 0 2130 0 0 0 0 0 0 15545 0 0 56745.59 0 0 0 0 0 0 201.32 0 51330.52 0 0 0 0 0 0 123822.43 0 0 0 1101238946 1215935663 10 Physicians LERTRATANAKUL YONGSUK 606576211 200 Cook 0 0 Rheumatology 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 256 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 256 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1291.73 0 0 0 0 0 0 1291.73 0 0 0 1101238948 1184616864 10 Physicians HORTON MICHAEL 605141154 30 DuPage 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 261 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 369 0 186 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 369 0 186 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5504.88 0 1787.97 0 0 0 0 0 0 7292.85 0 0 0 1101238971 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27297.35 0 0 0 0 0 0 0 0 0 0 0 0 0 27297.35 0 0 0 1101238979 1376655571 10 Physicians PATEL RASHMI 606531917 200 Cook 0 1 Pediatrics 0 387 0 0 43 0 0 0 0 0 0 31 0 339 0 0 0 0 0 0 977 0 0 149 0 0 0 0 0 0 40 0 942 0 0 0 0 0 0 977 0 0 149 0 0 0 0 0 0 40 0 942 0 0 0 0 0 0 2284 0 0 4526.77 0 0 0 0 0 0 125.31 0 21872.55 0 0 0 0 0 0 28808.63 0 0 0 1101238990 1972580843 10 Physicians CLARK JOSEPH 601533304 200 Cook 0 0 Hematology 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 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4062.58 0 0 0 0 0 0 4062.58 0 0 0 1101238996 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 19 0 0 0 0 0 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 17635.31 0 0 0 0 0 0 0 0 0 0 0 0 0 17635.31 0 0 0 1101239002 1225347388 36 Community mental health provider CHILDRENS HOME ASSOCIATION OF 616032540 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1627 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1627 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91044.36 0 0 91044.36 0 0 0 1101239028 1033129788 10 Physicians DURNAS CHESTER 611148055 109 Winnebago 0 0 Geriatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1873 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1873 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2804.97 0 0 0 0 0 0 2804.97 0 0 0 1101239035 1457394595 10 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0 0 0 0 0 0 43 0 244 0 0 0 0 0 0 1774 0 0 442.98 0 0 0 0 0 0 256.55 0 3801.97 0 0 0 0 0 0 6275.5 0 0 0 1101242378 91 Waiver service provider--Adults (DHS/DDD) 58 La Salle 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 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14783.78 0 0 0 0 0 0 0 0 0 0 0 0 0 14783.78 0 0 0 1101242386 1710254131 60 Pharmacies WALGREENS 15196 606013609 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 501 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1377 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36306 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 138357.45 0 0 0 138357.45 0 0 0 1101242413 1922046101 16 Nurse Practitioners WALTER MEREDITH 620522004 50 Jersey 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 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80.38 0 0 0 0 0 0 80.38 0 0 0 1101242420 1609085273 10 Physicians SISON GENEROSO 615544936 98 Tazewell 0 1 Family Practice 0 57 0 0 12 0 0 0 0 0 0 6 0 136 0 0 0 0 0 0 286 0 0 13 0 0 0 0 0 0 8 0 254 0 0 0 0 0 0 286 0 0 13 0 0 0 0 0 0 8 0 254 0 0 0 0 0 0 806 0 0 1075.7 0 0 0 0 0 0 13.02 0 7481.29 0 0 0 0 0 0 9376.01 0 0 0 1101242423 25 Audiologists 30 DuPage 0 0 0 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 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 0 132.05 132.05 0 0 0 1101242427 1033106596 63 Other Providers of Medical Equipment/Supplies (Non-registered) ALDEN NURSING CENTER LAKELAND 606404213 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 235 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 235 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28122.39 0 0 0 0 0 0 28122.39 0 0 0 1101242430 1356378384 10 Physicians KAPLAN RICHARD 600624267 200 Cook 0 0 Pediatrics 0 0 0 0 2 0 0 0 0 0 0 143 0 296 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 183 0 863 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 183 0 863 0 0 0 0 0 0 0 0 0 12.8 0 0 0 0 0 0 451.21 0 42502.91 0 0 0 0 0 0 42966.92 0 0 0 1101242436 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0 0 0 0 0 0 258.3 0 0 0 1101242484 1902885460 10 Physicians NICHOLS LAWRENCE 634010311 826 Missouri 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 9 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 189.66 0 653.6 0 0 0 0 0 0 843.26 0 0 0 1101242487 92 Waiver service provider--Disability (DHS/DRS) 15 Bureau 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 12171.3 0 0 0 0 0 0 0 0 0 0 0 0 0 12171.3 0 0 0 1101242492 1669448973 10 Physicians ALLEN DAVID 535625531 852 Wisconsin 0 0 Pediatrics 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 724.85 0 0 0 0 0 0 724.85 0 0 0 1101242534 92 Waiver service provider--Disability (DHS/DRS) 30 DuPage 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 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Physicians KEANE DENNIS 601876078 30 DuPage 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 0 0 0 236 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 965 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 965 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11006.81 0 0 0 0 0 0 11006.81 0 0 0 1101242572 1710165279 36 Community mental health provider SOUTHEASTERN IL COUNSELING CTR 624504720 88 Richland 0 0 Childrens mental health 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 306 0 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1419 0 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1419 0 0 2991.07 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 175002.13 0 0 177993.2 0 0 0 1101242585 1972567261 36 Community mental health provider COMMUNITY RESOURCE COUNSELING 609574090 35 Ford 0 0 0 174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 626 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4211 0 0 626 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4211 0 0 14903.88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 256210.59 0 0 271114.47 0 0 0 1101242588 1619085206 10 Physicians FRY THOMAS 601901295 30 DuPage 0 0 Family Practice 0 0 0 0 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Other Providers of Medical Equipment/Supplies (Non-registered) DIABETIC EXPERTS OF AMERICA 641531228 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 376 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3359 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3359 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9584.81 0 0 0 0 0 0 9584.81 0 0 0 1101242651 10 Physicians 57 Lake 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 142.02 0 0 0 0 0 0 142.02 0 0 0 1101242652 1235225236 48 Rural Health Clinics COMMUNITY MEDICAL CLINIC PANA 625571716 20 Christian 0 0 0 0 530 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2231 0 281 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2231 0 281 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76389.99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76389.99 0 0 0 1101242655 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 255 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 255 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17604.88 0 0 0 0 0 0 0 0 0 0 0 0 0 17604.88 0 0 0 1101242659 91 Waiver service provider--Adults (DHS/DDD) 107 Will 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 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 11068.72 0 0 0 0 0 0 0 0 0 0 0 0 0 11068.72 0 0 0 1101242664 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26065.74 0 0 0 0 0 0 0 0 0 0 0 0 0 26065.74 0 0 0 1101242665 63 Other Providers of Medical Equipment/Supplies (Non-registered) 852 Wisconsin 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 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 43.85 0 0 0 0 0 0 43.85 0 0 0 1101242684 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 14 0 0 0 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 6188.08 0 0 0 0 0 0 0 0 0 0 0 0 0 6188.08 0 0 0 1101242706 1104810761 10 Physicians DAVIS MARK 214016477 821 Maryland 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 533.73 0 0 0 0 0 0 0 0 533.73 0 0 0 1101242710 2100233128 90 Waiver service provider--Elderly (DOA) ADDUS HEALTHCARE INC 600677486 200 Cook 0 0 0 0 0 0 0 0 465 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2142289.11 0 0 0 0 0 0 0 0 0 0 0 0 0 2142289.11 0 0 0 1101242712 1124028022 10 Physicians CHEN HELEN 604631256 200 Cook 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 152 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 0 0 0 0 0 0 0 0 0 0 0 0 295 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1562.7 0 0 0 0 0 0 0 0 1562.7 0 0 0 1101242714 1487678652 10 Physicians MCFADDEN JEFFREY 601783192 27 Dekalb 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 3 0 153 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33.26 0 3445 0 0 0 0 0 0 3478.26 0 0 0 1101242728 1578537973 10 Physicians SANDERS JAMES 601745799 53 Kane 0 0 Family Practice 0 27 0 0 9 0 0 0 0 0 0 4 0 47 0 0 0 0 0 0 151 0 0 16 0 0 0 0 0 0 5 0 129 0 0 0 0 0 0 151 0 0 16 0 0 0 0 0 0 5 0 129 0 0 0 0 0 0 382 0 0 1185.14 0 0 0 0 0 0 38.34 0 3092.51 0 0 0 0 0 0 4697.99 0 0 0 1101242729 1306855259 13 Podiatrists HELMER DANIEL 604355264 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 449 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 449 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5221.42 0 0 0 0 0 0 5221.42 0 0 0 1101242730 10 Physicians 852 Wisconsin 0 0 Internal Medicine 0 0 0 0 0 0 0 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 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 0 545.23 0 0 0 0 0 0 545.23 0 0 0 1101242731 1053680561 16 Nurse Practitioners PHILLIPS RACHEAL 298413862 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1166 0 0 0 0 0 0 1166 0 0 0 1101242756 1528005352 63 Other Providers of Medical Equipment/Supplies (Non-registered) SUPERIOR HEALTHCARE SUPPLY 602016511 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 517 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1040 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1040 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25266.8 0 0 0 0 0 0 25266.8 0 0 0 1101242760 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3036 0 0 0 0 0 0 0 0 0 0 0 0 0 3036 0 0 0 1101242763 1033162425 10 Physicians HALDEMAN TRAVIS 608052703 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 3 0 0 0 0 0 0 21 0 85 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 27 0 207 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 27 0 207 0 0 0 0 0 0 0 0 0 43.8 0 0 0 0 0 0 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0 0 0 0 0 0 13160.34 0 0 0 1101242804 92 Waiver service provider--Disability (DHS/DRS) 96 St Clair 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 14524.27 0 0 0 0 0 0 0 0 0 0 0 0 0 14524.27 0 0 0 1101242806 1407985047 10 Physicians CHIANG CHRISTOPHER 606124348 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 32 0 187 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 212 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 212 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 229.96 0 57307.45 0 0 0 0 0 0 57537.41 0 0 0 1101242807 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 15592.82 0 0 0 0 0 0 0 0 0 0 0 0 0 15592.82 0 0 0 1101242812 1124044318 75 Department of Alcohol and Substance Abuse Provider NORTH CENTRAL BEHAVIORAL HLTH 613562046 15 Bureau 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 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RX INCORPORATED 60085 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 1543 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 36428 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 188.04 0 0 58122.14 0 0 0 58310.18 0 0 0 1101242874 1528074028 60 Pharmacies BOND DRUG COMPANY OF IL 05147 600771317 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 1572 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 8220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 206802 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64.71 0 0 319582.61 0 0 0 319647.32 0 0 0 1101242877 1609964568 10 Physicians PIAZZA DANIEL 600054134 200 Cook 0 0 Urological Surgery 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98.85 0 0 0 0 0 0 98.85 0 0 0 1101242883 92 Waiver service provider--Disability (DHS/DRS) 57 Lake 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 2620.75 0 0 0 0 0 0 0 0 0 0 0 0 0 2620.75 0 0 0 1101242894 30 General Hospitals 848 Virginia NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 167.44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 167.44 0 0 0 1101242910 91 Waiver service provider--Adults (DHS/DDD) 57 Lake 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 0 215 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 215 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13295.93 0 0 0 0 0 0 0 0 0 0 0 0 0 13295.93 0 0 0 1101242943 1154356434 10 Physicians POLATNICK LOIS 601533328 200 Cook 0 0 Ophthalmology 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 0 420.42 0 0 0 0 0 0 420.42 0 0 0 1101242944 91 Waiver service provider--Adults (DHS/DDD) 107 Will 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 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18917 0 0 0 0 0 0 0 0 0 0 0 0 0 18917 0 0 0 1101242945 1194766832 10 Physicians MOORE WILLIAM 627044183 91 Sangamon 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 3453 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4631 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4631 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82669.63 0 1897.98 0 0 0 0 0 0 84567.61 0 0 0 1101242983 1750403408 55 Early Intervention Services NICHOLSON ELIZABETH 601034674 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 613 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 613 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43262.25 0 0 0 0 0 0 43262.25 0 0 0 1101242986 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 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 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6455.18 0 0 0 0 0 0 0 0 0 0 0 0 0 6455.18 0 0 0 1101242994 1508191750 16 Nurse Practitioners ROSE ALLISON 999999999 200 Cook 0 0 0 0 0 0 0 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0 0 0 0 0 0 168 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3755.93 0 0 0 0 0 0 3755.93 0 0 0 1101244176 1174632368 63 Other Providers of Medical Equipment/Supplies (Non-registered) TIDEWATER MEDICAL INC 294648337 842 South Carolina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 498 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 498 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20258.65 0 0 0 0 0 0 20258.65 0 0 0 1101244189 1649270117 70 Ambulance Service Providers LEXINGTON AMBULANCE ASSOC 617530172 72 McLean 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 971.15 0 0 0 0 0 0 971.15 0 0 0 1101244220 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 11680.39 0 0 0 0 0 0 0 0 0 0 0 0 0 11680.39 0 0 0 1101244248 10 Physicians 826 Missouri 0 0 Otorhinolaryngology 0 0 0 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200 Cook 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 18490.62 0 0 0 0 0 0 0 0 0 0 0 0 0 18490.62 0 0 0 1101244486 1225170889 39 Hospice VITAS HEALTHCARE CORPORATION 604873702 200 Cook 0 0 0 0 0 0 0 0 0 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 634 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15217 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2188440.2 0 0 0 0 0 0 0 0 0 0 0 2188440.2 0 0 0 1101244488 1013133396 10 Physicians NEWBERG JOSEPH 600155239 57 Lake 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 9 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 172.65 0 1208.94 0 0 0 0 0 0 1381.59 0 0 0 1101244493 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11903.96 0 0 0 0 0 0 0 0 0 0 0 0 0 11903.96 0 0 0 1101244503 1275543969 10 Physicians MEYER RAYMOND J 604503370 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 58 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 139 0 414 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 139 0 414 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2124.76 0 20862.84 0 0 0 0 0 0 22987.6 0 0 0 1101244504 1851322929 10 Physicians KORENBLIT ALLEN 606124325 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 163 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 163 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7078.37 0 0 0 0 0 0 7078.37 0 0 0 1101244509 1306841861 50 Home Health Agencies - In Home ALTERNA CARE INC 627011048 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 208 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 208 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14607.2 0 0 0 0 0 0 14607.2 0 0 0 1101244511 24 Speech Therapists 71 McHenry 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 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 0 682.19 682.19 0 0 0 1101244525 98 Waiver service provider--TBI (DHS/DRS) 110 Woodford 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 2004.3 0 0 0 0 0 0 0 0 0 0 0 0 0 2004.3 0 0 0 1101244543 1790809093 47 Local Education Agencies EVERGREEN PARK SCH DIST 124 608052328 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1635 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1635 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27091.87 0 27091.87 0 0 0 1101244547 1912981366 10 Physicians BAHUGUNA BULBUL 600354460 57 Lake 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4372.38 0 0 0 0 0 0 4372.38 0 0 0 1101244548 1962497735 63 Other Providers of Medical Equipment/Supplies (Non-registered) NORTHERN IL HOME MED SUPPLY 610211060 60 Lee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 354 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1717 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1717 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79347.56 0 183.01 0 0 0 0 79530.57 0 0 0 1101244552 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 13100.26 0 0 0 0 0 0 0 0 0 0 0 0 0 13100.26 0 0 0 1101244588 92 Waiver service provider--Disability (DHS/DRS) 97 Stephenson 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 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 1316.6 0 0 0 0 0 0 0 0 0 0 0 0 0 1316.6 0 0 0 1101244589 1831182369 10 Physicians WAITCHES LISA 463201931 815 Indiana 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 272 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 282 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 282 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7752.87 0 0 0 0 0 0 7752.87 0 0 0 1101244596 1639152655 10 Physicians BUB LAWRENCE 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 119 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 149 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 149 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2184.75 0 62.36 0 0 0 0 0 0 2247.11 0 0 0 1101244599 1598972127 25 Audiologists LAMBIN STACY 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 310 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 310 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4827.42 4827.42 0 0 0 1101244626 10 Physicians 30 DuPage 0 0 Family Practice 0 0 0 0 0 0 0 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 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 42.5 0 0 0 0 0 0 42.5 0 0 0 1101244631 91 Waiver service provider--Adults (DHS/DDD) 30 DuPage 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 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23492.85 0 0 0 0 0 0 0 0 0 0 0 0 0 23492.85 0 0 0 1101244633 92 Waiver service provider--Disability (DHS/DRS) 107 Will 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 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 0 861.37 0 0 0 0 0 0 0 0 0 0 0 0 0 861.37 0 0 0 1101244641 1700812732 13 Podiatrists WARHEIT MICHAEL 600622322 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 35.24 0 0 0 0 0 0 35.24 0 0 0 1101244648 1689881518 16 Nurse Practitioners ESCARILLA KATRINA 600681005 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42.31 0 0 0 0 0 0 42.31 0 0 0 1101244658 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 11990.86 0 0 0 0 0 0 0 0 0 0 0 0 0 11990.86 0 0 0 1101244667 1942407200 28 Waiver service provider--Supportive living facility (HFS) CAMBRIDGE HOUSE OF MARYVILLE 620620269 65 Madison 0 0 0 0 0 0 0 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31429 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1553132.26 0 0 0 0 0 0 0 0 0 0 0 0 0 1553132.26 0 0 0 1101244675 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 201 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 201 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24378.75 0 0 0 0 0 0 0 0 0 0 0 0 0 24378.75 0 0 0 1101244687 98 Waiver service provider--TBI (DHS/DRS) 47 Jackson 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 35037.79 0 0 0 0 0 0 0 0 0 0 0 0 0 35037.79 0 0 0 1101244694 1073657474 10 Physicians RAO RUMYA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 1487 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 1487 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 315.81 0 60801.09 0 0 0 0 0 0 61116.9 0 0 0 1101244695 1679517221 11 Dentists GOEL MEENAL 600565402 200 Cook 0 0 General Dentistry 0 0 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 356 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 356 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11137.03 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11137.03 0 0 0 1101244707 1821052416 10 Physicians KHOKHER TAHIR 604292409 200 Cook 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 2 0 329 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 937 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 937 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11.46 0 9275.84 0 0 0 0 0 0 9287.3 0 0 0 1101244716 1104885466 10 Physicians IRABAGON NENITA 606382639 200 Cook 0 0 Internal Medicine 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 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 423.34 0 0 0 0 0 0 423.34 0 0 0 1101244729 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 23 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 0 0 0 0 0 0 0 0 14222.21 0 0 0 0 0 0 0 0 0 0 0 0 0 14222.21 0 0 0 1101244733 92 Waiver service provider--Disability (DHS/DRS) 56 Knox 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 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 1367.13 0 0 0 0 0 0 0 0 0 0 0 0 0 1367.13 0 0 0 1101244748 1952354250 10 Physicians WALINSKI LISA 604401518 107 Will 0 0 Family Practice 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 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 224.19 0 0 0 0 0 0 224.19 0 0 0 1101244759 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11656.98 0 0 0 0 0 0 0 0 0 0 0 0 0 11656.98 0 0 0 1101244766 63 Other Providers of Medical Equipment/Supplies (Non-registered) 200 Cook 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165.5 0 0 0 0 0 0 165.5 0 0 0 1101244778 1568458776 10 Physicians GROSS MARK 600109998 57 Lake 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 7 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 92.4 0 2000.47 0 0 0 0 0 0 2092.87 0 0 0 1101244786 1871643817 10 Physicians MEADOW WILLIAM L 605233808 200 Cook 0 0 Neonatal-Perinatal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1399 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1399 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 199893.03 0 0 0 0 0 0 199893.03 0 0 0 1101244788 1346221553 40 Federally Qualified Health Centers NEAR NORTH HEALTH SERV KOMED 606533030 200 Cook 0 1 0 5516 4497 0 1706 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39550 19313 0 5125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39550 19313 0 5125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94828 1236296.05 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1331124.05 0 0 0 1101244805 1144362567 60 Pharmacies JOLIET PROFESSIONAL PHCY CORP 604355662 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 757 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19958 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101626.99 0 0 0 101626.99 0 0 0 1101244811 1346251436 10 Physicians GARDNER ROBERT 637035095 826 Missouri 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 26 0 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 367 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 367 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2373.31 0 21913.94 0 0 0 0 0 0 24287.25 0 0 0 1101244814 1295932689 10 Physicians CHENNA PRAVEEN R 631600352 200 Cook 0 0 Pulmonary Diseases 0 0 0 0 0 0 0 0 0 0 0 4 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70.72 0 5197.18 0 0 0 0 0 0 5267.9 0 0 0 1101244815 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 12928.54 0 0 0 0 0 0 0 0 0 0 0 0 0 12928.54 0 0 0 1101244847 1053384099 16 Nurse Practitioners MCCLURE KRIS 601151389 27 Dekalb 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 99 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 99 0 0 0 0 0 0 0 0 0 51.97 0 0 0 0 0 0 0 0 4637.72 0 0 0 0 0 0 4689.69 0 0 0 1101244853 2100235271 90 Waiver service provider--Elderly (DOA) KELLY HOME HEALTHCARE INC. 604222013 200 Cook 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 1121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60247.45 0 0 0 0 0 0 0 0 0 0 0 0 0 60247.45 0 0 0 1101244859 1255365797 10 Physicians BECK DONNA 618012529 19 Champaign 0 1 Pediatrics 0 188 0 0 172 0 0 0 0 0 0 0 0 229 0 0 0 0 0 0 1418 0 0 266 0 0 0 0 0 0 0 0 327 0 0 0 0 0 0 1418 0 0 266 0 0 0 0 0 0 0 0 327 0 0 0 0 0 0 2836 0 0 3752.62 0 0 0 0 0 0 0 0 15154.18 0 0 0 0 0 0 21742.8 0 0 0 1101244891 1235157264 60 Pharmacies MACKINAW PHARMACY 617551007 98 Tazewell 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 514 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30180.78 0 0 0 30180.78 0 0 0 1101244893 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5448.72 0 0 0 0 0 0 0 0 0 0 0 0 0 5448.72 0 0 0 1101244899 1962594606 10 Physicians DURKIN MICHAEL 604358431 107 Will 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 14 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 209.11 0 2113.69 0 0 0 0 0 0 2322.8 0 0 0 1101244900 1083821037 10 Physicians BUTLER DAVID 606082405 200 Cook 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 385 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 868 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 868 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53176.95 0 0 0 0 0 0 53176.95 0 0 0 1101244904 1528097474 10 Physicians ARORA ANITA 604534718 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 5 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 589 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 589 0 0 0 0 0 0 0 0 0 70.56 0 0 0 0 0 0 0 0 65096.43 0 0 0 0 0 0 65166.99 0 0 0 1101244906 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11493.58 0 0 0 0 0 0 0 0 0 0 0 0 0 11493.58 0 0 0 1101244909 10 Physicians 826 Missouri 0 0 Internal Medicine 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 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 0 0 0 0 0 0 0 0 0 0 0 1101244912 1750473443 14 Chiropractors HERRON KENT 628962537 36 Franklin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 301 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 301 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1105.87 0 0 0 0 0 0 1105.87 0 0 0 1101244915 94 Waiver service provider--Children's support (DHS/DDD) 96 St Clair 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 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5365.8 0 0 0 0 0 0 0 0 0 0 0 0 0 5365.8 0 0 0 1101244934 92 Waiver service provider--Disability (DHS/DRS) 96 St Clair 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 15462.11 0 0 0 0 0 0 0 0 0 0 0 0 0 15462.11 0 0 0 1101244935 1366628349 10 Physicians BASZIS KEVIN 631101002 826 Missouri 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3162.5 0 0 0 0 0 0 3162.5 0 0 0 1101244943 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 248 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 248 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22456.5 0 0 0 0 0 0 0 0 0 0 0 0 0 22456.5 0 0 0 1101244951 1548321250 36 Community mental health provider ADAPT OF ILLINOIS INC 622201150 96 St Clair 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 568 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2380 0 0 568 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2380 0 0 1009.64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182550.4 0 0 183560.04 0 0 0 1101244953 1992757439 14 Chiropractors PELLETIER NATHALIE 618321159 100 Vermilion 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 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103.9 0 0 0 0 0 0 103.9 0 0 0 1101244962 1992989933 10 Physicians PINCAVAGE AMBER 605276686 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 6 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 0 436.67 0 0 0 0 0 0 436.67 0 0 0 1101244963 1740475037 25 Audiologists HALL MICHELLE 606118709 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1743.38 1743.38 0 0 0 1101244969 1467565069 10 Physicians SCHWING LOUIS 619389388 24 Coles 0 1 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 227 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 662 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 662 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15266 0 0 0 0 0 0 15266 0 0 0 1101244973 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6516.36 0 0 0 0 0 0 0 0 0 0 0 0 0 6516.36 0 0 0 1101244975 1235114661 10 Physicians LAMOND NADINE 605063814 53 Kane 0 1 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 2 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30.22 0 4026.78 0 0 0 0 0 0 4057 0 0 0 1101244984 92 Waiver service provider--Disability (DHS/DRS) 12 Bond 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 40 0 0 0 0 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Cook 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 17246.54 0 0 0 0 0 0 0 0 0 0 0 0 0 17246.54 0 0 0 1101246224 1215105291 47 Local Education Agencies STOCKTON CUSD 206 610851033 51 Jo Daviess 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 1292 0 0 0 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 1292 0 0 0 0 658.18 0 0 0 0 0 0 0 0 0 0 0 0 0 32749.23 0 33407.41 0 0 0 1101246229 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9210.21 0 0 0 0 0 0 0 0 0 0 0 0 0 9210.21 0 0 0 1101246235 1952410334 10 Physicians HALL DEBORAH 606123845 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 338.59 0 0 0 0 0 0 338.59 0 0 0 1101246246 30 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ARLINGTON HEIGHTS RENAL CENTER 600053905 200 Cook DIALYSIS Outpatient dialysis centers. 0 0 General Hospital - Adult and Child 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 0 0 0 0 0 0 0 0 186 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1747 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23149.98 0 0 0 0 0 23149.98 0 0 0 1101248511 2100238929 72 Taxicabs and Livery Companies G W P TRANSPORT 606172332 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2762 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2762 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25495.78 0 0 0 0 0 0 25495.78 0 0 0 1101248513 92 Waiver service provider--Disability (DHS/DRS) 803 Arizona 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9061.26 0 0 0 0 0 0 0 0 0 0 0 0 0 9061.26 0 0 0 1101248527 1043394729 10 Physicians UNAL ELIZABETH 627949640 91 Sangamon 0 0 Obstetric-Gynecology 0 0 0 0 5 0 0 0 0 0 0 383 0 288 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 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Cook 0 0 Geriatrics 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 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 93.71 0 0 0 0 0 0 93.71 0 0 0 1101248561 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9181.1 0 0 0 0 0 0 0 0 0 0 0 0 0 9181.1 0 0 0 1101248569 10 Physicians 852 Wisconsin 0 0 Pathology 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3.5 0 0 0 0 0 0 0 0 3.5 0 0 0 1101248588 1427013820 16 Nurse Practitioners TOPEL CYNTHIA 600684827 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 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 1109.23 0 0 0 0 0 0 1109.23 0 0 0 1101248591 1245229368 10 Physicians KETCHAM JEFFREY 616159506 80 Peoria 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 212 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 212 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28993.33 0 0 0 0 0 0 28993.33 0 0 0 1101248608 1174766653 33 Nursing Facilities PLEASANT VIEW REHAB AND HCC 612703004 106 Whiteside 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2553 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 222824.13 0 0 0 0 0 0 0 222824.13 0 0 0 1101248617 91 Waiver service provider--Adults (DHS/DDD) 88 Richland 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 0 251 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 251 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14209.25 0 0 0 0 0 0 0 0 0 0 0 0 0 14209.25 0 0 0 1101248620 1124183249 16 Nurse Practitioners SCHMIDT JUDITH 535482940 852 Wisconsin 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 0 0 0 0 0 0 0 0 23 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 0 0 0 0 0 0 0 0 79.01 0 0 0 0 0 0 79.01 0 0 0 1101248635 1669669321 33 Nursing Facilities ROSEWOOD CARE CENTER INVERNESS 600671216 200 Cook 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 0 514 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13525 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1235959.52 0 0 0 0 0 0 0 1235959.52 0 0 0 1101248644 1891711024 10 Physicians BOYER MARTIN I 191787642 107 Will 0 0 Surgery Hand 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 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2739.07 0 0 0 0 0 0 2739.07 0 0 0 1101248654 55 Early Intervention Services 107 Will 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 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 0 600.52 0 0 0 0 0 0 600.52 0 0 0 1101248660 1982615118 10 Physicians GARRETT JEREMY 631102515 826 Missouri 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21714.65 0 0 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0 0 0 0 0 0 1139.55 0 0 0 0 0 0 1139.55 0 0 0 1101248692 92 Waiver service provider--Disability (DHS/DRS) 24 Coles 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 28130.37 0 0 0 0 0 0 0 0 0 0 0 0 0 28130.37 0 0 0 1101248700 1861439663 10 Physicians KESWANI ABDULHAMID 606081732 200 Cook 0 1 Family Practice 0 39 0 0 9 0 0 0 0 0 0 21 0 208 0 0 0 0 0 0 111 0 0 20 0 0 0 0 0 0 23 0 424 0 0 0 0 0 0 111 0 0 20 0 0 0 0 0 0 23 0 424 0 0 0 0 0 0 276 0 0 161.6 0 0 0 0 0 0 84.86 0 9327.48 0 0 0 0 0 0 9849.94 0 0 0 1101248734 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7441.5 0 0 0 0 0 0 0 0 0 0 0 0 0 7441.5 0 0 0 1101248748 1093759490 10 Physicians LEE JENNY 606118709 200 Cook 0 1 Internal Medicine 0 8 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 2256.5 0 0 0 0 0 0 2282.5 0 0 0 1101248753 1528230455 29 ICF/MR HALLAM TERRACE 611015861 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 427 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8854 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 736606.59 0 0 0 0 0 0 0 0 0 0 736606.59 0 0 0 1101248756 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 14429.99 0 0 0 0 0 0 0 0 0 0 0 0 0 14429.99 0 0 0 1101248759 1265423917 30 General Hospitals KINGMAN REGIONAL MEDICAL CTR 864013619 803 Arizona NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 6 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 1557.42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1557.42 0 0 0 1101248763 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 2421.04 0 0 0 0 0 0 0 0 0 0 0 0 0 2421.04 0 0 0 1101248775 1194841668 62 Opticians / Optical Companies FOR SITE INC 606222218 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 251 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 259 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 259 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7387.52 0 0 0 0 7387.52 0 0 0 1101248789 1417160185 10 Physicians COULSON KATHRYN 631102515 65 Madison 0 0 Rheumatology 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 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 0 429.19 0 0 0 0 0 0 429.19 0 0 0 1101248791 1518105212 16 Nurse Practitioners NGUYEN TAMMY 600626822 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 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 0 218.63 0 0 0 0 0 0 218.63 0 0 0 1101248792 24 Speech Therapists 48 Jasper 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 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2713.96 2713.96 0 0 0 1101248796 30 General Hospitals 816 Iowa NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 444.05 0 0 0 0 0 0 0 0 0 0 0 0 0 0 444.05 0 0 0 1101248807 1932134269 10 Physicians GILBERT EMILY 601533328 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 187 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 544 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 544 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13060.51 0 0 0 0 0 0 13060.51 0 0 0 1101248811 1780885681 47 Local Education Agencies SANDRIDGE SCH DIST 172 604119755 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 977 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 977 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21793.37 0 21793.37 0 0 0 1101248818 1154535615 10 Physicians MCGINTY JASMIN 631102515 826 Missouri 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 252 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 252 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17038.13 0 0 0 0 0 0 17038.13 0 0 0 1101248821 1588769392 10 Physicians FREY JAMES 535451122 852 Wisconsin 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 45 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 1357.26 0 0 0 0 0 0 1357.26 0 0 0 1101248828 1396834271 10 Physicians RUSSELL BRIAN 627023719 91 Sangamon 0 0 Neurology Surgery 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 0 188 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 188 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25280.71 0 0 0 0 0 0 25280.71 0 0 0 1101248833 92 Waiver service provider--Disability (DHS/DRS) 106 Whiteside 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15214.11 0 0 0 0 0 0 0 0 0 0 0 0 0 15214.11 0 0 0 1101248842 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 350 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 350 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19886.16 0 0 0 0 0 0 0 0 0 0 0 0 0 19886.16 0 0 0 1101248846 1467422451 10 Physicians ZAK RICHARD 601533304 107 Will 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 3 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108.82 0 8085.16 0 0 0 0 0 0 8193.98 0 0 0 1101248851 1710936935 10 Physicians HANSBERRY MARIA 603041022 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 571.84 0 0 0 0 0 0 571.84 0 0 0 1101248852 1043264872 10 Physicians KUMAR PRAVEEN 606143363 200 Cook 0 0 Neonatology 0 0 0 0 0 0 0 0 0 0 0 0 0 213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 978 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 978 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 329626.04 0 0 0 0 0 0 329626.04 0 0 0 1101248867 1013913557 10 Physicians BEWLEY KATHLEEN 604611182 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 187.19 0 0 0 0 0 0 187.19 0 0 0 1101248869 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8449.46 0 0 0 0 0 0 0 0 0 0 0 0 0 8449.46 0 0 0 1101248876 1528215043 64 Imaging Services MEDICAL OUTSOURCING SERVICES L 605649360 107 Will 0 0 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 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 912.52 0 0 0 0 0 0 912.52 0 0 0 1101248877 30 General Hospitals 810 Florida NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 46.33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46.33 0 0 0 1101248884 1447380985 10 Physicians RUSSO RONALD 618012530 19 Champaign 0 0 Facial Plastic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 15 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 4214 0 0 0 0 0 0 4214 0 0 0 1101248886 1598897878 10 Physicians WELCH KEVIN 601533328 200 Cook 0 0 Otolaryngology 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 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10053.24 0 0 0 0 0 0 10053.24 0 0 0 1101248890 1851424006 12 Optometrists MURRAY LINDA 600677435 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 424 0 272 0 0 0 0 0 0 0 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SEALS METRO CHIC CFC 12 606042239 200 Cook 0 0 0 1541 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9710 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9710 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1128178.19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1128178.19 0 0 0 1101248943 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 28117.9 0 0 0 0 0 0 0 0 0 0 0 0 0 28117.9 0 0 0 1101248944 91 Waiver service provider--Adults (DHS/DDD) 57 Lake 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 0 217 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 217 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8244.5 0 0 0 0 0 0 0 0 0 0 0 0 0 8244.5 0 0 0 1101248947 1740404896 29 ICF/MR NORTH KICKAPOO 626561364 62 Logan 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 0 358 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8848 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 695775.81 0 0 0 0 0 0 0 0 0 0 695775.81 0 0 0 1101248955 1124094545 16 Nurse Practitioners JORDAN LU ANN 610851001 51 Jo Daviess 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 274 0 0 0 0 0 0 0 0 0 238 0 0 0 0 0 0 0 0 656 0 0 0 0 0 0 0 0 0 238 0 0 0 0 0 0 0 0 656 0 0 0 0 0 0 0 0 0 8707.98 0 0 0 0 0 0 0 0 22122.69 0 0 0 0 0 0 30830.67 0 0 0 1101248976 1215921622 33 Nursing Facilities MOMENCE MEADOWS NURSING AND RE 609541814 54 Kankakee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 668 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14830 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1762681.9 0 0 0 0 0 0 0 1762681.9 0 0 0 1101249001 1306805148 10 Physicians TILTON THOMAS 601783113 27 Dekalb 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 8 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 217.87 0 11693.19 0 0 0 0 0 0 11911.06 0 0 0 1101249003 25 Audiologists 72 McLean 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 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 1043.27 1043.27 0 0 0 1101249009 1336354562 10 Physicians SERRANO ANDRES 606081732 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 295 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1360 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1360 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33013.35 0 0 0 0 0 0 33013.35 0 0 0 1101249014 1740296227 10 Physicians OZGA TIMOTHY 601533328 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 623 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 862 0 311 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 862 0 311 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15290.05 0 5995.93 0 0 0 0 0 0 21285.98 0 0 0 1101249026 1851380927 11 Dentists MAREK RICHARD R 606465419 200 Cook 0 0 General Dentistry 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5665.99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5665.99 0 0 0 1101249028 10 Physicians 200 Cook 0 0 Ophthalmology 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36.97 0 0 0 0 0 0 36.97 0 0 0 1101249033 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 292 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 292 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8883 0 0 0 0 0 0 0 0 0 0 0 0 0 8883 0 0 0 1101249035 1376592832 10 Physicians WELLS ROBERT G. 530179709 852 Wisconsin 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 460 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 570 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 570 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10127.4 0 89.14 0 0 0 0 0 0 10216.54 0 0 0 1101249039 1417211756 10 Physicians MCDONALD NIKOL 620026723 65 Madison 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 0 46 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 17977.22 0 0 0 0 0 0 17977.22 0 0 0 1101249041 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11500.5 0 0 0 0 0 0 0 0 0 0 0 0 0 11500.5 0 0 0 1101249042 1205101003 16 Nurse Practitioners HADZIC SENKA 606313222 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1850.25 0 0 0 0 0 0 1850.25 0 0 0 1101249050 1366546210 60 Pharmacies CVS PHARMACY 3901 602013712 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 273 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1210 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30697 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57085.11 0 0 0 57085.11 0 0 0 1101249052 1003899808 10 Physicians FLAIS MICHAEL J 604513696 107 Will 0 0 Allergy-Immunization 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3531.98 0 0 0 0 0 0 3531.98 0 0 0 1101249056 94 Waiver service provider--Children's support (DHS/DDD) 94 Shelby 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 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7128 0 0 0 0 0 0 0 0 0 0 0 0 0 7128 0 0 0 1101249061 92 Waiver service provider--Disability (DHS/DRS) 47 Jackson 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 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 5628.31 0 0 0 0 0 0 0 0 0 0 0 0 0 5628.31 0 0 0 1101249077 1609063106 10 Physicians EZE PHYLLIS 627032403 91 Sangamon 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 14 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 205 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 205 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71.93 0 2560.81 0 0 0 0 0 0 2632.74 0 0 0 1101249094 1801862206 10 Physicians CAHILL SEAN 605639791 200 Cook 0 1 Internal Medicine 0 27 0 0 19 0 0 0 0 0 0 1 0 36 0 0 0 0 0 0 149 0 0 59 0 0 0 0 0 0 1 0 56 0 0 0 0 0 0 149 0 0 59 0 0 0 0 0 0 1 0 56 0 0 0 0 0 0 325 0 0 2457.97 0 0 0 0 0 0 15.7 0 2165.25 0 0 0 0 0 0 4963.92 0 0 0 1101249102 1386751790 10 Physicians REINGOLD STEWART 601533328 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 308 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 315 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 315 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8346.23 0 0 0 0 0 0 8346.23 0 0 0 1101249103 10 Physicians 53 Kane 0 0 Obstetric-Gynecology 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116.69 0 0 0 0 0 0 116.69 0 0 0 1101249115 1205940160 10 Physicians BERG LAWRENCE 601235888 53 Kane 0 0 Otorhinolaryngology 0 0 0 0 2 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 30.4 0 0 0 0 0 0 0 0 1029.91 0 0 0 0 0 0 1060.31 0 0 0 1101249137 1033157425 10 Physicians PAI EUGENE 600763898 200 Cook 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 218 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 257 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 257 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52494.27 0 0 0 0 0 0 0 0 52494.27 0 0 0 1101249152 10 Physicians 826 Missouri 0 0 Psychiatry 0 0 0 0 0 0 0 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 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 0 487.1 0 0 0 0 0 0 487.1 0 0 0 1101249183 1144429770 60 Pharmacies SAMS WEST INC 10 8298 604361249 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 208 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5789 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16008.56 0 0 0 16008.56 0 0 0 1101249190 1184930984 60 Pharmacies OSCO DRUG 3632 606133710 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 233 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5316 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10355.55 0 0 0 10355.55 0 0 0 1101249197 1700869385 10 Physicians FREIDHEIM JERE 606162315 200 Cook 0 1 Pediatrics 0 134 0 0 30 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 815 0 0 68 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 815 0 0 68 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 1630 0 0 3049.32 0 0 0 0 0 0 0 0 1692.5 0 0 0 0 0 0 6371.82 0 0 0 1101249217 1508867318 10 Physicians ROTHMAN RICHARD 631441317 826 Missouri 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 4 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 372 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 372 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 185.11 0 11433.05 0 0 0 0 0 0 11618.16 0 0 0 1101249219 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 15173.83 0 0 0 0 0 0 0 0 0 0 0 0 0 15173.83 0 0 0 1101249220 1215146808 24 Speech Therapists RAINGE HESTER SHERRY 604732815 200 Cook 0 0 0 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 0 0 0 0 0 0 0 0 167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14432.22 14432.22 0 0 0 1101249226 47 Local Education Agencies 45 Henry 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 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 30.79 0 30.79 0 0 0 1101249229 1447241336 10 Physicians JAY PATRICK 631101002 826 Missouri 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 212 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 212 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5106.81 0 0 0 0 0 0 5106.81 0 0 0 1101249230 1477529675 10 Physicians MERRY MICHAEL 610326600 97 Stephenson 0 1 Internal Medicine 0 1405 0 0 246 0 0 0 0 0 0 47 0 729 0 0 0 0 0 0 13646 0 0 1084 0 0 0 0 0 0 68 0 1924 0 0 0 0 0 0 13646 0 0 1084 0 0 0 0 0 0 68 0 1924 0 0 0 0 0 0 32130 0 0 36195.87 0 0 0 0 0 0 799 0 64530.28 0 0 0 0 0 0 133655.15 0 0 0 1101249236 1932340247 10 Physicians FERGUSON ERIKA 606081797 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 26 0 869 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 1022 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 1022 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 838.72 0 36765.95 0 0 0 0 0 0 37604.67 0 0 0 1101249239 1871616722 10 Physicians BANNIGAN CHRISTOPHER 606223086 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 515 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 548 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 548 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21830.68 0 0 0 0 0 0 21830.68 0 0 0 1101249275 22 Physical Therapists 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7082.99 7082.99 0 0 0 1101249277 1588695795 63 Other Providers of Medical Equipment/Supplies (Non-registered) LEGACY OXYGEN 420014442 818 Kentucky 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 0 399 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 399 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16536 0 0 0 0 0 0 16536 0 0 0 1101249281 1861628703 16 Nurse Practitioners CHIVARI SHARRON 605644715 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 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 0 257.43 0 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0 0 0 30 0 0 0 0 3 0 0 0 2 0 0 0 0 0 0 0 0 0 35 0 0 0 0 3 0 0 0 3 0 0 0 0 0 0 0 0 0 35 0 0 0 0 44 0 0 0 3 0 0 0 0 0 0 0 0 0 5143.44 0 0 0 0 28371.71 0 0 0 6076.14 0 0 0 0 0 39591.29 0 0 0 1101249326 1346568748 10 Physicians ACURIO ADRIANA 606081732 200 Cook 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 209 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 209 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3983.1 0 0 0 0 0 0 0 0 3983.1 0 0 0 1101249343 1316255383 24 Speech Therapists SIMON CHRISTINE 604291244 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 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 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9596.06 9596.06 0 0 0 1101249353 1770640724 10 Physicians KONSTANTINOVIC PREDRAG 600442203 57 Lake 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 2 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13045.56 0 0 0 0 0 0 13045.56 0 0 0 1101249356 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0 0 0 375 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25668.89 25668.89 0 0 0 1101249970 1437176799 60 Pharmacies WAL MART 10 0253 620523617 50 Jersey 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1262 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12340 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 326624 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 495049.27 0 0 0 495049.27 0 0 0 1101249977 1376654103 10 Physicians GOMEZ JAMES 601601605 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 75 0 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 181 0 320 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 181 0 320 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4942.88 0 99243.3 0 0 0 0 0 0 104186.18 0 0 0 1101249989 1871582163 40 Federally Qualified Health Centers CHC OF SOUTHEASTERN IOWA 526551667 816 Iowa 0 0 0 0 12 0 0 0 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 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1509.9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1509.9 0 0 0 1101249995 1821014044 10 Physicians DAWSON JEFFREY 631101077 826 Missouri 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 229 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 229 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31006.48 0 0 0 0 0 0 31006.48 0 0 0 1101250016 1356327910 10 Physicians YAPP ROCKFORD 605151548 30 DuPage 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4548.7 0 0 0 0 0 0 4548.7 0 0 0 1101250024 1629186739 70 Ambulance Service Providers OGLESBY VOL AMBULANCE SERVICE 613481469 58 La Salle 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 433 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 433 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35446.44 0 0 0 0 0 0 35446.44 0 0 0 1101250029 1104193499 40 Federally Qualified Health Centers GREATER ELGIN FAMILY CARE CTR 999999999 53 Kane 0 0 0 0 6 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 994.06 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 994.06 0 0 0 1101250032 1053450601 75 Department of Alcohol and Substance Abuse Provider CENTRAL EAST ALCOHOL AND DRUG 619201902 24 Coles 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2416 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2416 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 129468.15 0 0 129468.15 0 0 0 1101250052 11 Dentists 200 Cook 0 0 General Dentistry 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 57.4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57.4 0 0 0 1101250072 10 Physicians 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 81.1 0 0 0 0 0 0 81.1 0 0 0 1101250073 10 Physicians 852 Wisconsin 0 0 Emergency Medicine 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 113.25 0 0 0 0 0 0 113.25 0 0 0 1101250094 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7517.85 0 0 0 0 0 0 0 0 0 0 0 0 0 7517.85 0 0 0 1101250109 1659454742 16 Nurse Practitioners BRUMBAUGH GWENDOLYN G 606472319 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15015.11 0 0 0 0 0 0 15015.11 0 0 0 1101250134 23 Occupational Therapists 57 Lake 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 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 0 253.96 253.96 0 0 0 1101250140 92 Waiver service provider--Disability (DHS/DRS) 63 Macon 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 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 3010.78 0 0 0 0 0 0 0 0 0 0 0 0 0 3010.78 0 0 0 1101250145 1235279860 10 Physicians LEVITIN YELENA 600902979 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 8 0 405 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 1481 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 1481 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 155.01 0 34252.8 0 0 0 0 0 0 34407.81 0 0 0 1101250150 1275654964 55 Early Intervention Services MERON TOVA 606146005 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 375 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 375 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22779.68 0 0 0 0 0 0 22779.68 0 0 0 1101250174 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7920 0 0 0 0 0 0 0 0 0 0 0 0 0 7920 0 0 0 1101250186 1548275175 60 Pharmacies VAISHALI PHARMACY INC 606233306 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 995 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26600 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37080.88 0 0 0 37080.88 0 0 0 1101250213 1881794592 10 Physicians GORELIK JULIA 600351435 57 Lake 0 1 Family Practice 0 514 0 0 49 0 0 0 0 0 0 0 0 125 0 0 0 0 0 0 3472 0 0 50 0 0 0 0 0 0 0 0 378 0 0 0 0 0 0 3472 0 0 50 0 0 0 0 0 0 0 0 378 0 0 0 0 0 0 8264 0 0 4357.35 0 0 0 0 0 0 0 0 17454.89 0 0 0 0 0 0 30076.24 0 0 0 1101250233 1700827656 10 Physicians BOURI LOVEENA 605645040 107 Will 0 1 Internal Medicine 0 42 0 0 4 0 0 0 0 0 0 15 0 61 0 0 0 0 0 0 301 0 0 4 0 0 0 0 0 0 21 0 160 0 0 0 0 0 0 301 0 0 4 0 0 0 0 0 0 21 0 160 0 0 0 0 0 0 878 0 0 399.5 0 0 0 0 0 0 59.34 0 8343.39 0 0 0 0 0 0 9680.23 0 0 0 1101250238 2100240656 71 Medicar Provider COUNTRYVIEW CARE CTR MACOMB 614552867 70 McDonough 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1012 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1012 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10702.52 0 0 0 0 0 0 10702.52 0 0 0 1101250249 2100240667 91 Waiver service provider--Adults (DHS/DDD) "SEARCH, INC." 606144946 200 Cook 0 0 0 0 0 0 0 0 312 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 110829 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 110829 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9884934.7 0 0 0 0 0 0 0 0 0 0 0 0 0 9884934.7 0 0 0 1101250253 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 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 17025.71 0 0 0 0 0 0 0 0 0 0 0 0 0 17025.71 0 0 0 1101250254 10 Physicians 826 Missouri 0 0 Oncology 0 0 0 0 0 0 0 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 14 0 0 0 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 0 368.35 0 0 0 0 0 0 368.35 0 0 0 1101250280 1356341994 10 Physicians GORDON PAUL J 605141302 30 DuPage 0 0 Cardiovascular Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 238 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 238 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21056.08 0 0 0 0 0 0 21056.08 0 0 0 1101250290 1700839354 10 Physicians LAM LINDA 60190 53 Kane 0 0 Pulmonary Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 479 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 479 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7597.93 0 0 0 0 0 0 7597.93 0 0 0 1101250293 1851375562 70 Ambulance Service Providers MERCY REGIONAL EMS 420019117 818 Kentucky 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27887.85 0 0 0 0 0 0 27887.85 0 0 0 1101250294 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 228 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 228 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23337.6 0 0 0 0 0 0 0 0 0 0 0 0 0 23337.6 0 0 0 1101250297 1124303383 16 Nurse Practitioners BROWNLEE AISHA 60611 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 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5893.8 0 0 0 0 0 0 5893.8 0 0 0 1101250300 1245281831 10 Physicians EL KHATIB RUNDA 620255587 65 Madison 0 1 Family Practice 0 17 0 0 7 0 0 0 0 0 0 2 0 78 0 0 0 0 0 0 144 0 0 7 0 0 0 0 0 0 2 0 272 0 0 0 0 0 0 144 0 0 7 0 0 0 0 0 0 2 0 272 0 0 0 0 0 0 379 0 0 493.03 0 0 0 0 0 0 4.75 0 2894.29 0 0 0 0 0 0 3771.07 0 0 0 1101250302 1356543748 55 Early Intervention Services GILL TAYLOR VALERIE 604432284 200 Cook 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 0 430 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 430 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24470.65 0 0 0 0 0 0 24470.65 0 0 0 1101250311 1902973969 70 Ambulance Service Providers CITY OF CHARLESTON 619202030 24 Coles 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 580 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2225 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2225 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122906.76 0 0 0 0 0 0 122906.76 0 0 0 1101250319 1033106729 10 Physicians SHARIS CHRISTINE 612656892 89 Rock Island 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1186.53 0 0 0 0 0 0 1186.53 0 0 0 1101250320 1215943535 10 Physicians BRUMITT TOM 637034928 826 Missouri 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 79 0 157 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87 0 256 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87 0 256 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 897.59 0 15207.74 0 0 0 0 0 0 16105.33 0 0 0 1101250329 1285723957 10 Physicians HENNEBERRY KYLE 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 775.35 0 62.36 0 0 0 0 0 0 837.71 0 0 0 1101250342 1659572014 10 Physicians THOMAS TARITA 601533328 200 Cook 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 256 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 256 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5248.31 0 0 0 0 0 0 5248.31 0 0 0 1101250356 1508082215 10 Physicians SKARO ANTON 606118709 200 Cook 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8290.57 0 0 0 0 0 0 8290.57 0 0 0 1101250359 91 Waiver service provider--Adults (DHS/DDD) 79 Ogle 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 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11429.54 0 0 0 0 0 0 0 0 0 0 0 0 0 11429.54 0 0 0 1101250361 1821290057 63 Other Providers of Medical Equipment/Supplies (Non-registered) SIU PHYSICIANS AND SURGEONS 627949639 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1210.52 0 6957.43 0 0 0 0 8167.95 0 0 0 1101250367 11 Dentists 200 Cook 0 0 General Dentistry 0 0 0 4 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 0 357.47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 357.47 0 0 0 1101250368 1447364526 10 Physicians AHMAD NASIR J 601771534 53 Kane 0 0 Internal Medicine 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 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2399.38 0 0 0 0 0 0 2399.38 0 0 0 1101250370 1255330650 10 Physicians HERZOG JACQUES 630173662 826 Missouri 0 0 Otology 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 66 0 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 6353.03 0 0 0 0 0 0 6353.03 0 0 0 1101250378 10 Physicians 852 Wisconsin 0 0 Radiology Diagnosis 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 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 30 0 0 0 0 0 0 0 0 30 0 0 0 1101250395 1699872432 60 Pharmacies REX PHARMACEUTICALS INC 606211833 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 667 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83859 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87805.9 0 0 0 87805.9 0 0 0 1101250399 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10862.67 0 0 0 0 0 0 0 0 0 0 0 0 0 10862.67 0 0 0 1101250414 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 2012.12 0 0 0 0 0 0 0 0 0 0 0 0 0 2012.12 0 0 0 1101250416 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23794.35 0 0 0 0 0 0 0 0 0 0 0 0 0 23794.35 0 0 0 1101250422 16 Nurse Practitioners 826 Missouri 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101250431 91 Waiver service provider--Adults (DHS/DDD) 107 Will 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 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3017.3 0 0 0 0 0 0 0 0 0 0 0 0 0 3017.3 0 0 0 1101250432 1861602906 10 Physicians ARROYO PLASENCIA ANNA 631101010 826 Missouri 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1715.75 0 0 0 0 0 0 1715.75 0 0 0 1101250436 11 Dentists 80 Peoria 0 0 General Dentistry 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 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 1101250451 1689941924 33 Nursing Facilities SYMPHONY OF DECATUR 625263249 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1344 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35520 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3824157.74 0 0 0 0 0 0 0 3824157.74 0 0 0 1101250453 1447212113 10 Physicians BLAKEMAN BRADFORD 463212901 815 Indiana 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13512.15 0 0 0 0 0 0 13512.15 0 0 0 1101250459 1174887350 16 Nurse Practitioners SOUTHARD KARA 606118709 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 708.25 0 0 0 0 0 0 708.25 0 0 0 1101250468 23 Occupational Therapists 200 Cook 0 0 0 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 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3378.01 3378.01 0 0 0 1101250495 1871779744 10 Physicians SHEN EMILY 600146284 71 McHenry 0 1 Family Practice 0 58 0 0 29 0 0 0 0 0 0 50 0 98 0 0 0 0 0 0 214 0 0 52 0 0 0 0 0 0 135 0 263 0 0 0 0 0 0 214 0 0 52 0 0 0 0 0 0 135 0 263 0 0 0 0 0 0 519 0 0 1813.72 0 0 0 0 0 0 1740.76 0 6688.18 0 0 0 0 0 0 10761.66 0 0 0 1101250500 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29143.4 0 0 0 0 0 0 0 0 0 0 0 0 0 29143.4 0 0 0 1101250516 92 Waiver service provider--Disability (DHS/DRS) 53 Kane 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 27983.43 0 0 0 0 0 0 0 0 0 0 0 0 0 27983.43 0 0 0 1101250523 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8926.44 0 0 0 0 0 0 0 0 0 0 0 0 0 8926.44 0 0 0 1101250538 1366476772 10 Physicians KURTZ STEPHEN 616145065 80 Peoria 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 2 0 354 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 495 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 495 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10.59 0 13398.66 0 0 0 0 0 0 13409.25 0 0 0 1101250547 24 Speech Therapists 200 Cook 0 0 0 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 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2389.8 2389.8 0 0 0 1101250553 92 Waiver service provider--Disability (DHS/DRS) 30 DuPage 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 19833.31 0 0 0 0 0 0 0 0 0 0 0 0 0 19833.31 0 0 0 1101250557 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 23640.11 0 0 0 0 0 0 0 0 0 0 0 0 0 23640.11 0 0 0 1101250584 1750327003 36 Community mental health provider BEN GORDON COMM MENTAL HEALTH 601159637 27 Dekalb 0 0 Childrens mental health 0 1154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1389 0 0 11856 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12007 0 0 11856 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12007 0 0 258252.92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 785999.9 0 0 1044252.82 0 0 0 1101250596 1225143456 10 Physicians NASIR NABEELA 601533328 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6834.12 0 0 0 0 0 0 6834.12 0 0 0 1101250599 1609093517 24 Speech Therapists LIPPINCOTT AMY 629664856 47 Jackson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 339 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 339 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26924.81 26924.81 0 0 0 1101250608 10 Physicians 200 Cook 0 1 Family Practice 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 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 0 117.59 0 0 0 0 0 0 117.59 0 0 0 1101250610 1629003470 30 General Hospitals IROQUOIS MEMORIAL HOSPITAL 609701644 46 Iroquois DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 0 0 0 0 13 0 0 0 0 0 0 1250 0 0 522 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 6786 0 0 2425 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 6786 0 0 2425 0 0 0 0 0 0 0 0 173.1 0 0 0 0 0 0 65609.09 0 0 107545.1 0 0 0 0 0 173327.29 0 0 0 1101250616 1164439980 10 Physicians WHITFORD MICHAEL 615480950 110 Woodford 0 1 Family Practice 0 169 0 0 16 0 0 0 0 0 0 32 0 122 0 0 0 0 0 0 1476 0 0 26 0 0 0 0 0 0 43 0 285 0 0 0 0 0 0 1476 0 0 26 0 0 0 0 0 0 43 0 285 0 0 0 0 0 0 3979 0 0 1345.16 0 0 0 0 0 0 255.17 0 8152.2 0 0 0 0 0 0 13731.53 0 0 0 1101250618 1225084031 10 Physicians HARTZ WILSON 606112862 200 Cook 0 0 Surgery General 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 19 0 0 0 0 0 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 0 343.75 0 0 0 0 0 0 343.75 0 0 0 1101250636 1205963766 34 State-operated facility (DHS) UNIT 3164 HOME 4 KILEY 600856263 57 Lake 0 0 0 0 0 0 0 0 0 0 0 7 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 0 630 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 474088.9 0 0 0 0 0 0 0 0 0 0 474088.9 0 0 0 1101250641 91 Waiver service provider--Adults (DHS/DDD) 65 Madison 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 0 159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15748.37 0 0 0 0 0 0 0 0 0 0 0 0 0 15748.37 0 0 0 1101250642 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 889.1 0 0 0 0 0 0 0 0 0 0 0 0 0 889.1 0 0 0 1101250653 1770810194 16 Nurse Practitioners GREGORY AMY 999999999 98 Tazewell 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2209.92 0 0 0 0 0 0 2209.92 0 0 0 1101250669 16 Nurse Practitioners 826 Missouri 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42.5 0 0 0 0 0 0 42.5 0 0 0 1101250672 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 1595.94 0 0 0 0 0 0 0 0 0 0 0 0 0 1595.94 0 0 0 1101250681 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 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 17786.86 0 0 0 0 0 0 0 0 0 0 0 0 0 17786.86 0 0 0 1101250691 1295809259 10 Physicians HERST BARRY 606576163 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 242 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 242 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3623.36 0 0 0 0 0 0 3623.36 0 0 0 1101250692 1982969770 11 Dentists HENRY AMANDA 606222790 200 Cook 0 0 General Dentistry 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 286 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 286 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6253.92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6253.92 0 0 0 1101250693 1245311778 10 Physicians CHAVALI MALINI 616144686 80 Peoria 0 1 Internal Medicine 0 40 0 0 0 0 0 0 0 0 0 5 0 90 0 0 0 0 0 0 362 0 0 0 0 0 0 0 0 0 9 0 280 0 0 0 0 0 0 362 0 0 0 0 0 0 0 0 0 9 0 280 0 0 0 0 0 0 1097 0 0 0 0 0 0 0 0 0 64.33 0 7297.44 0 0 0 0 0 0 8458.77 0 0 0 1101250699 1841457850 10 Physicians KOVAC ADAM 601181454 53 Kane 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 228 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 244 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 244 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47954.72 0 0 0 0 0 0 47954.72 0 0 0 1101250704 1528075769 10 Physicians SINGH BALJIT 616025027 80 Peoria 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 236 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 936 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 936 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74366.31 0 0 0 0 0 0 74366.31 0 0 0 1101250713 1831214295 10 Physicians PATEL ANKUR 605212962 30 DuPage 0 1 Family Practice 0 1478 0 0 299 0 0 0 0 0 0 0 0 633 0 0 0 0 0 0 11308 0 0 951 0 0 0 0 0 0 0 0 1431 0 0 0 0 0 0 11308 0 0 951 0 0 0 0 0 0 0 0 1431 0 0 0 0 0 0 29268 0 0 35578.51 0 0 0 0 0 0 0 0 59949.15 0 0 0 0 0 0 124795.66 0 0 0 1101250714 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 2249.75 0 0 0 0 0 0 0 0 0 0 0 0 0 2249.75 0 0 0 1101250724 98 Waiver service provider--TBI (DHS/DRS) 77 Morgan 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 16326.79 0 0 0 0 0 0 0 0 0 0 0 0 0 16326.79 0 0 0 1101250738 1194807966 16 Nurse Practitioners DAVIES JEANINE 604772859 62 Logan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 561 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 561 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1532.13 0 0 0 0 0 0 1532.13 0 0 0 1101250739 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 335 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 335 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13810.5 0 0 0 0 0 0 0 0 0 0 0 0 0 13810.5 0 0 0 1101250753 92 Waiver service provider--Disability (DHS/DRS) 43 Hardin 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 14743.91 0 0 0 0 0 0 0 0 0 0 0 0 0 14743.91 0 0 0 1101250755 1073754149 60 Pharmacies OM RED GANESH LLC 606222923 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 472 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2484 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64003 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103030.01 0 0 0 103030.01 0 0 0 1101250758 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 6233.21 0 0 0 0 0 0 0 0 0 0 0 0 0 6233.21 0 0 0 1101250767 1992856819 30 General Hospitals VISTA MEDICAL CENTER WEST 600854980 57 Lake DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 0 0 38 0 0 2851 0 0 0 0 279 0 0 0 17 0 0 0 0 0 0 52 0 0 4182 0 0 0 0 312 0 0 0 19 0 0 0 0 0 0 370 0 0 4182 0 0 0 0 2042 0 0 0 26 0 0 0 0 0 0 41665.43 0 0 604082.88 0 0 0 0 744285.06 0 0 0 376.98 0 0 0 0 0 1390410.35 0 0 0 1101250771 1508979345 10 Physicians LENOX JACK 611073879 109 Winnebago 0 0 Obstetric-Gynecology 0 0 0 0 1 0 0 0 0 0 0 2 0 23 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 2 0 52 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 2 0 52 0 0 0 0 0 0 0 0 0 84.62 0 0 0 0 0 0 71.9 0 1246.69 0 0 0 0 0 0 1403.21 0 0 0 1101250779 91 Waiver service provider--Adults (DHS/DDD) 107 Will 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 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7892.5 0 0 0 0 0 0 0 0 0 0 0 0 0 7892.5 0 0 0 1101250780 1497984157 11 Dentists VERMA SACHIN 605053435 200 Cook 0 0 General Dentistry 0 0 0 400 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1595 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1595 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45174.62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45174.62 0 0 0 1101250793 2100241211 91 Waiver service provider--Adults (DHS/DDD) TRADE INDUSTRIES 628590070 41 Hamilton 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12327 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12327 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1172283.39 0 0 0 0 0 0 0 0 0 0 0 0 0 1172283.39 0 0 0 1101250807 1205096963 10 Physicians GANESAN RANI 606123833 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15859.08 0 0 0 0 0 0 15859.08 0 0 0 1101250817 1609140433 91 Waiver service provider--Adults (DHS/DDD) WINTERS ANNABELLE 606552018 200 Cook 0 0 0 0 0 0 0 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2002 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2002 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58758.88 0 0 0 0 0 0 0 0 0 0 0 0 0 58758.88 0 0 0 1101250842 1801098363 47 Local Education Agencies BMP TRI CO SPEC EDUC COOP 613689470 15 Bureau 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 405 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 3738 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 3738 0 0 0 0 144.78 0 0 0 0 0 0 0 0 0 0 0 0 0 30873 0 31017.78 0 0 0 1101250857 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15972 0 0 0 0 0 0 0 0 0 0 0 0 0 15972 0 0 0 1101250859 1508869876 11 Dentists LIM AMALOU 602012716 200 Cook 0 0 General Dentistry 0 0 0 337 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1617 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1617 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50667.7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50667.7 0 0 0 1101250861 10 Physicians 200 Cook 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 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 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 52.8 0 0 0 0 0 0 52.8 0 0 0 1101250863 1538241229 16 Nurse Practitioners PRANGER ANDREA 604877026 107 Will 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 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 222.8 0 0 0 0 0 0 222.8 0 0 0 1101250864 1407842594 10 Physicians BEERMANN MARTIN 606222743 200 Cook 0 0 Internal Medicine 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 0 484.67 0 0 0 0 0 0 484.67 0 0 0 1101250871 1528275740 70 Ambulance Service Providers PECATONICA FIRE PROT DIST 610639361 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 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 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1490.42 0 0 0 0 0 0 1490.42 0 0 0 1101250872 2100241290 90 Waiver service provider--Elderly (DOA) CARE FOR SOUL INC 999999999 200 Cook 0 0 0 0 0 0 0 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11380 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11380 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 586266.84 0 0 0 0 0 0 0 0 0 0 0 0 0 586266.84 0 0 0 1101250873 2100241291 90 Waiver service provider--Elderly (DOA) HEART TO HEARTS INC 604624782 200 Cook 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 0 344 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 344 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21938.89 0 0 0 0 0 0 0 0 0 0 0 0 0 21938.89 0 0 0 1101250876 1396712741 10 Physicians MURPHY PATRICIA 605151560 30 DuPage 0 1 Pediatrics 0 16 0 0 8 0 0 0 0 0 0 1 0 27 0 0 0 0 0 0 117 0 0 15 0 0 0 0 0 0 1 0 36 0 0 0 0 0 0 117 0 0 15 0 0 0 0 0 0 1 0 36 0 0 0 0 0 0 234 0 0 479.45 0 0 0 0 0 0 15.7 0 1084.05 0 0 0 0 0 0 1813.2 0 0 0 1101250891 10 Physicians 107 Will 0 0 Internal Medicine 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 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 53.87 0 0 0 0 0 0 53.87 0 0 0 1101250906 1902857808 10 Physicians CASEY TERRENCE 999999999 87 Randolph 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 328 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 328 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11027.04 0 0 0 0 0 0 11027.04 0 0 0 1101250908 1710019948 10 Physicians EASTON MICHAEL 606123706 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 927 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 927 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19523.6 0 0 0 0 0 0 19523.6 0 0 0 1101250913 1891708608 10 Physicians PETRAK RICHARD 604023429 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 312 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1501 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1501 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17597.42 0 0 0 0 0 0 17597.42 0 0 0 1101250922 92 Waiver service provider--Disability (DHS/DRS) 60 Lee 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 5689.74 0 0 0 0 0 0 0 0 0 0 0 0 0 5689.74 0 0 0 1101250923 1003884610 10 Physicians SLONEK RONALD 601082201 30 DuPage 0 0 Internal Medicine 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 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 296.76 0 0 0 0 0 0 296.76 0 0 0 1101250935 1588842942 36 Community mental health provider BOBBY E WRIGHT CC MHC 606243255 200 Cook 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 457 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 457 0 0 1341.34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19124.75 0 0 20466.09 0 0 0 1101250936 1881643401 30 General Hospitals LAWRENCE COUNTY MEMORIAL HOSP 624391852 59 Lawrence DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 1 0 General Hospital - Adult and Child 0 0 0 0 2 0 0 0 0 0 0 1586 0 0 452 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 8712 0 0 1544 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 8712 0 0 1544 0 0 0 0 0 0 0 0 18.79 0 0 0 0 0 0 69756.1 0 0 168922.87 0 0 0 0 0 238697.76 0 0 0 1101250937 1659390888 10 Physicians GINZBURG ALAN 617616500 72 McLean 0 0 Pulmonary Diseases 0 0 0 0 0 0 0 0 0 0 0 3 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18.42 0 2220.61 0 0 0 0 0 0 2239.03 0 0 0 1101250938 1578591384 10 Physicians KLEIN JAMES A 618012396 19 Champaign 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 549 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 672 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 672 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23036.3 0 0 0 0 0 0 23036.3 0 0 0 1101250940 1407003700 36 Community mental health provider THRESHOLDS 606491717 200 Cook 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 887 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 887 0 0 116.55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87284.27 0 0 87400.82 0 0 0 1101250943 94 Waiver service provider--Children's 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0 0 0 0 0 1509026.65 0 0 0 1101250969 24 Speech Therapists 200 Cook 0 0 0 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 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 1233.52 1233.52 0 0 0 1101250972 1023169349 10 Physicians WANG STEPHANIE 606123806 200 Cook 0 1 Internal Medicine 0 55 0 0 0 0 0 0 0 0 0 6 0 149 0 0 0 0 0 0 132 0 0 0 0 0 0 0 0 0 8 0 269 0 0 0 0 0 0 132 0 0 0 0 0 0 0 0 0 8 0 269 0 0 0 0 0 0 396 0 0 0 0 0 0 0 0 0 30.79 0 4306.47 0 0 0 0 0 0 4733.26 0 0 0 1101250996 1245373703 10 Physicians CHAN EDIE 606123723 200 Cook 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9480.02 0 0 0 0 0 0 9480.02 0 0 0 1101250998 1043213713 13 Podiatrists PERNS VINCENT 606344532 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 251 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 251 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 19184 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19184 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 573293.77 0 0 0 0 0 0 573293.77 0 0 0 1101251039 1588838676 10 Physicians SWICKHAMER CONNIE 606313707 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 2 0 310 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 330 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 330 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71.9 0 11668.29 0 0 0 0 0 0 11740.19 0 0 0 1101251054 10 Physicians 816 Iowa 0 0 Psychiatry 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102.46 0 0 0 0 0 0 102.46 0 0 0 1101251056 92 Waiver service provider--Disability (DHS/DRS) 79 Ogle 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 14 0 0 0 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 10886.04 0 0 0 0 0 0 0 0 0 0 0 0 0 10886.04 0 0 0 1101251059 1740287689 63 Other Providers of Medical Equipment/Supplies (Non-registered) GLEN HLTH AND HOME MANAGEMENT 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 0 189 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 189 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3668.32 0 0 0 0 0 0 3668.32 0 0 0 1101251062 1104040328 62 Opticians / Optical Companies SUPERIOR EYE CARE 606575314 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4069.43 0 0 0 0 4069.43 0 0 0 1101251071 1881655397 10 Physicians PEREZ TAMAYO RUHERI ANTHONY 605152075 200 Cook 0 0 Cardiovascular Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25902.22 0 0 0 0 0 0 25902.22 0 0 0 1101251087 1700974334 25 Audiologists SIEGMUND SARA 617613195 72 McLean 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 208 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 208 0 0 0 0 0 0 0 0 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provider--Adults (DHS/DDD) 64 Macoupin 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 0 201 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 201 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23206.4 0 0 0 0 0 0 0 0 0 0 0 0 0 23206.4 0 0 0 1101251125 1295858736 91 Waiver service provider--Adults (DHS/DDD) MOBILITY WORKS 605859588 107 Will 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 169040.36 0 0 0 0 0 0 0 0 0 0 0 0 0 169040.36 0 0 0 1101251158 92 Waiver service provider--Disability (DHS/DRS) 57 Lake 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 14357.36 0 0 0 0 0 0 0 0 0 0 0 0 0 14357.36 0 0 0 1101251173 1922358373 40 Federally Qualified Health Centers ROSECRANCE WARE CENTER 999999999 109 Winnebago 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4485.77 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13629 0 0 0 0 0 0 0 0 0 0 0 0 0 13629 0 0 0 1101251225 1912173766 10 Physicians ARE CHAITANYA 522421009 816 Iowa 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 286 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 286 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3914.44 0 0 0 0 0 0 3914.44 0 0 0 1101251233 1659427797 10 Physicians FAMILY PLANNING INC 623013054 10 Adams 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 253 0 559 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 403 0 2969 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 403 0 2969 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1283.15 0 113802.71 0 0 0 0 0 0 115085.86 0 0 0 1101251239 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 19 0 0 0 0 0 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 5081.69 0 0 0 0 0 0 0 0 0 0 0 0 0 5081.69 0 0 0 1101251244 1801047030 64 Imaging Services NORTHSHORE IMAGING SERVICES 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Federally Qualified Health Centers ERIE DENTAL HEALTH CENTER 606254227 200 Cook 0 0 0 0 762 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3255 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3255 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99510.36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99510.36 0 0 0 1101251289 91 Waiver service provider--Adults (DHS/DDD) 10 Adams 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 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4376.8 0 0 0 0 0 0 0 0 0 0 0 0 0 4376.8 0 0 0 1101251290 1558551119 10 Physicians ANDERSON JENNIFER 605276686 13 Boone 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9114.38 0 0 0 0 0 0 9114.38 0 0 0 1101251295 92 Waiver service provider--Disability (DHS/DRS) 54 Kankakee 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 13110.19 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8531.32 0 0 0 0 0 0 0 0 0 0 0 0 0 8531.32 0 0 0 1101251497 1700136124 40 Federally Qualified Health Centers MERCY FAMILY HEALTH CENTER 606082014 200 Cook 0 1 0 2106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13257 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13257 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38856 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38856 0 0 0 1101251514 1467578138 63 Other Providers of Medical Equipment/Supplies (Non-registered) MERCY MCHENRY MEDICAL CENTER 600503179 71 McHenry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6.49 0 325.89 0 0 0 0 332.38 0 0 0 1101251526 1629161781 30 General Hospitals CHILDRENS HEALTHCARE ST PAUL 551022346 824 Minnesota NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 Children's Hospital 0 0 0 0 0 6 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 706.69 0 0 0 0 2355.38 0 0 0 0 0 0 0 0 0 3062.07 0 0 0 1101251544 1083637029 10 Physicians RAMESH PRIYADARSINI 601697208 200 Cook 0 1 Pediatrics 0 19 0 0 146 0 0 0 0 0 0 104 0 146 0 0 0 0 0 0 79 0 0 489 0 0 0 0 0 0 191 0 221 0 0 0 0 0 0 79 0 0 489 0 0 0 0 0 0 191 0 221 0 0 0 0 0 0 158 0 0 14174.98 0 0 0 0 0 0 737.6 0 7067.81 0 0 0 0 0 0 22138.39 0 0 0 1101251545 91 Waiver service provider--Adults (DHS/DDD) 107 Will 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 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 7285.07 0 0 0 0 0 0 0 0 0 0 0 0 0 7285.07 0 0 0 1101251555 1912923137 10 Physicians PETERSON LINDA 631082212 826 Missouri 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 798.82 0 0 0 0 0 0 798.82 0 0 0 1101251556 98 Waiver service provider--TBI (DHS/DRS) 80 Peoria 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 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 3533.33 0 0 0 0 0 0 0 0 0 0 0 0 0 3533.33 0 0 0 1101251576 1932245198 10 Physicians STANLEY AVA 606431791 200 Cook 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4469.08 0 0 0 0 0 0 4469.08 0 0 0 1101251579 1376536615 10 Physicians RAZDAN AVTAR K 609142325 54 Kankakee 0 1 Pediatrics 0 49 0 0 53 0 0 0 0 0 0 52 0 94 0 0 0 0 0 0 327 0 0 105 0 0 0 0 0 0 128 0 397 0 0 0 0 0 0 327 0 0 105 0 0 0 0 0 0 128 0 397 0 0 0 0 0 0 654 0 0 6337.38 0 0 0 0 0 0 841.06 0 16211.74 0 0 0 0 0 0 24044.18 0 0 0 1101251581 1972579142 10 Physicians HURST ROBERT 606740018 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 566.49 0 0 0 0 0 0 566.49 0 0 0 1101251583 1497898191 55 Early Intervention Services REYES GLADY 601302019 200 Cook 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 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 1975.22 0 0 0 0 0 0 1975.22 0 0 0 1101251598 22 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 374.42 374.42 0 0 0 1101251601 98 Waiver service provider--TBI (DHS/DRS) 54 Kankakee 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5900.93 0 0 0 0 0 0 0 0 0 0 0 0 0 5900.93 0 0 0 1101251612 1689651580 10 Physicians LEEHEY DAVID 601533304 200 Cook 0 0 Nephrology 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 223 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 223 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2854.34 0 0 0 0 0 0 2854.34 0 0 0 1101251631 1144208091 10 Physicians LAMER 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0 1101251659 1023075173 10 Physicians SAXON DAVID 999999999 818 Kentucky 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1300.18 0 0 0 0 0 0 1300.18 0 0 0 1101251672 1912925652 16 Nurse Practitioners GOSSETT MICHAEL 631101010 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4954.57 0 0 0 0 0 0 4954.57 0 0 0 1101251673 92 Waiver service provider--Disability (DHS/DRS) 106 Whiteside 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 110.98 0 0 0 0 0 0 0 0 0 0 0 0 0 110.98 0 0 0 1101251680 92 Waiver service provider--Disability (DHS/DRS) 63 Macon 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 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 3114.89 0 0 0 0 0 0 0 0 0 0 0 0 0 3114.89 0 0 0 1101251685 1073558136 10 Physicians MIKHAEL MARCO 606910263 30 DuPage 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 240 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 256 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 256 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42338.91 0 0 0 0 0 0 42338.91 0 0 0 1101251690 1992889125 48 Rural Health Clinics GREENVILLE OBSTETRICS AND GYNE 622461161 12 Bond 0 0 0 0 723 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5831 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5831 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 244282.78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 244282.78 0 0 0 1101251722 1316965320 10 Physicians ABBOUD CAMILLE 631101010 826 Missouri 0 0 Oncology 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11288.6 0 0 0 0 0 0 11288.6 0 0 0 1101251729 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 13143.37 0 0 0 0 0 0 0 0 0 0 0 0 0 13143.37 0 0 0 1101251730 1780832519 11 Dentists VROMAN MAURA 612657745 89 Rock Island 0 0 General Dentistry 0 0 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37403.5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37403.5 0 0 0 1101251736 1881708444 10 Physicians CHRISTOPOULOS NIKOS 600052462 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1049.21 0 0 0 0 0 0 1049.21 0 0 0 1101251740 1861532608 10 Physicians BROWN TERRY 629663333 47 Jackson 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 1276 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2437 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2437 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82098.38 0 0 0 0 0 0 82098.38 0 0 0 1101251741 1003116617 11 Dentists BENJAMIN DALE 606391108 200 Cook 0 0 Orthodontist 0 0 0 1737 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3917 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3917 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1010061 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1010061 0 0 0 1101251745 1467578054 22 Physical Therapists ADANIN YELENA 600251774 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3893.06 3893.06 0 0 0 1101251762 1467523217 10 Physicians GREENBERG BRENT 605276686 30 DuPage 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 1149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1732 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1732 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10289.49 0 0 0 0 0 0 0 0 10289.49 0 0 0 1101251764 1194768432 10 Physicians MOOSA HANS 622265372 96 St Clair 0 0 Vascular Surgery 0 0 0 0 0 0 0 0 0 0 0 18 0 361 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 1074 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 1074 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 251.92 0 12790.08 0 0 0 0 0 0 13042 0 0 0 1101251774 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 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 19813.81 0 0 0 0 0 0 0 0 0 0 0 0 0 19813.81 0 0 0 1101251784 1750486965 10 Physicians YASTROW EDWARD 600250128 200 Cook 0 0 Admitting Privileges 0 0 0 0 0 0 0 0 0 0 0 2 0 148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13554.59 0 0 0 0 0 0 13554.59 0 0 0 1101251791 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5136.13 0 0 0 0 0 0 0 0 0 0 0 0 0 5136.13 0 0 0 1101251792 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5812.75 0 0 0 0 0 0 0 0 0 0 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0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2811.92 0 0 0 0 0 0 0 0 0 0 0 0 0 2811.92 0 0 0 1101251829 30 General Hospitals 805 California NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 3 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 148.88 0 0 0 0 3868.87 0 0 0 0 0 0 0 0 0 4017.75 0 0 0 1101251831 93 Waiver service provider--HIV/AIDS (DHS/DRS) 80 Peoria 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 4133.31 0 0 0 0 0 0 0 0 0 0 0 0 0 4133.31 0 0 0 1101251832 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 293 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 293 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12650 0 0 0 0 0 0 0 0 0 0 0 0 0 12650 0 0 0 1101251850 1659313823 10 Physicians WHITE PETER 627949639 91 Sangamon 0 0 Pulmonary Diseases 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0 0 1101251940 1285967398 60 Pharmacies WALGREENS 11711 631043323 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2980 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7461.92 0 0 0 7461.92 0 0 0 1101251946 1629020102 10 Physicians BRENNER CHRISTOPHER 605252607 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 748.13 0 0 0 0 0 0 748.13 0 0 0 1101251962 1760588214 47 Local Education Agencies CASEY WESTFIELD CUSD C4 624200100 21 Clark 0 0 0 0 0 0 272 0 0 0 0 0 0 0 0 0 0 0 0 0 108 0 0 0 0 548 0 0 0 0 0 0 0 0 0 0 0 0 0 3503 0 0 0 0 548 0 0 0 0 0 0 0 0 0 0 0 0 0 3503 0 0 0 0 3564.13 0 0 0 0 0 0 0 0 0 0 0 0 0 42950.39 0 46514.52 0 0 0 1101251963 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 11873.99 0 0 0 0 0 0 0 0 0 0 0 0 0 11873.99 0 0 0 1101251967 91 Waiver service provider--Adults (DHS/DDD) 96 St Clair 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 0 195 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 195 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24112 0 0 0 0 0 0 0 0 0 0 0 0 0 24112 0 0 0 1101251968 1245437797 28 Waiver service provider--Supportive living facility (HFS) HICKORY ESTATES OF PANA 625571205 20 Christian 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 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2625 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121193.12 0 0 0 0 0 0 0 0 0 0 0 0 0 121193.12 0 0 0 1101251969 2100242387 71 Medicar Provider ELDERLY ERRANDS INC 606474618 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 227 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10613 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10613 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72269.96 0 0 0 0 0 0 72269.96 0 0 0 1101251976 1750314845 10 Physicians BATTON ANGELA 627810001 91 Sangamon 0 0 Emergency 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6468.15 0 0 0 0 0 0 0 0 0 0 0 0 0 6468.15 0 0 0 1101252066 92 Waiver service provider--Disability (DHS/DRS) 107 Will 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 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 24081.88 0 0 0 0 0 0 0 0 0 0 0 0 0 24081.88 0 0 0 1101252071 1477510212 10 Physicians HOEHN MARY 381630001 844 Tennessee 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 380 0 0 0 0 0 0 380 0 0 0 1101252091 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22642.84 0 0 0 0 0 0 0 0 0 0 0 0 0 22642.84 0 0 0 1101252118 10 Physicians 816 Iowa 0 0 Pathology 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 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 197.78 0 0 0 0 0 0 0 0 197.78 0 0 0 1101252120 1578561577 52 Certified local public health department DEWITT PIATT BI CO HLTH DEPT 617272914 28 De Witt 0 0 0 0 114 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 147 0 262 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 147 0 262 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1785.62 0 2124.11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3909.73 0 0 0 1101252134 1225008113 36 Community mental health provider MENTAL HLTH CENTERS CENTRAL IL 627035761 91 Sangamon 0 0 Childrens mental health 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 387 0 0 564 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2166 0 0 564 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2166 0 0 12793.92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 224283.23 0 0 237077.15 0 0 0 1101252140 2100242558 10 Physicians LAD THOMAS 606471761 200 Cook 0 0 Oncology 0 0 0 0 0 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 327.61 0 0 0 0 0 0 327.61 0 0 0 1101252147 1871665380 30 General Hospitals ST JOSEPH HOSPITAL WEST 633671395 826 Missouri NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 38 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 5532.84 0 0 0 0 6448.12 0 0 0 0 0 0 0 0 0 11980.96 0 0 0 1101252155 1982618930 10 Physicians DAWALIBI ANTOINE 616152400 80 Peoria 0 1 Family Practice 0 20 0 0 2 0 0 0 0 0 0 30 0 62 0 0 0 0 0 0 162 0 0 2 0 0 0 0 0 0 54 0 195 0 0 0 0 0 0 162 0 0 2 0 0 0 0 0 0 54 0 195 0 0 0 0 0 0 491 0 0 161.46 0 0 0 0 0 0 293.33 0 6156.66 0 0 0 0 0 0 7102.45 0 0 0 1101252157 1891749784 10 Physicians NASH ROBERT 624502553 88 Richland 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 2940 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24226 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24226 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94151.89 0 0 0 0 0 0 0 0 94151.89 0 0 0 1101252174 1629002662 36 Community mental health provider TURNING POINT BEHAVIORAL HLTH 600772545 200 Cook 0 0 0 287 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 599 0 0 4285 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12120 0 0 4285 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12120 0 0 67959.45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 690012.72 0 0 757972.17 0 0 0 1101252178 1528003092 10 Physicians WENDECKER ANN 478042706 815 Indiana 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 7 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131.22 0 806.71 0 0 0 0 0 0 937.93 0 0 0 1101252179 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 227 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 227 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16783.54 0 0 0 0 0 0 0 0 0 0 0 0 0 16783.54 0 0 0 1101252182 1205025681 48 Rural Health Clinics FAMILY RURAL HEALTH OF LAHARPE 614509461 42 Hancock 0 1 0 460 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1311 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1311 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3359 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 11458.7 0 0 0 0 0 0 0 0 0 0 0 0 0 11458.7 0 0 0 1101252221 1528142445 10 Physicians SIMSIR SINAN A 616360002 80 Peoria 0 0 Cardiovascular Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 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 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18645.73 0 0 0 0 0 0 18645.73 0 0 0 1101252226 1578637401 22 Physical Therapists WOLFF SCOTT 601722037 30 DuPage 0 0 0 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 0 138 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 138 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 758.38 758.38 0 0 0 1101252229 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 175 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 175 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11264 0 0 0 0 0 0 0 0 0 0 0 0 0 11264 0 0 0 1101252233 1154342764 10 Physicians KRAUS MARK 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 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 24.22 0 0 0 0 0 0 24.22 0 0 0 1101252242 1023051141 16 Nurse Practitioners GATEWOOD ROSEANNA 477152753 815 Indiana 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 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 0 201.1 0 0 0 0 0 0 201.1 0 0 0 1101252243 1376840041 10 Physicians SAMALA ANUVESHA 600992608 57 Lake 0 1 Family Practice 0 443 0 0 91 0 0 0 0 0 0 15 0 306 0 0 0 0 0 0 3564 0 0 191 0 0 0 0 0 0 16 0 401 0 0 0 0 0 0 3564 0 0 191 0 0 0 0 0 0 16 0 401 0 0 0 0 0 0 9026 0 0 7548.88 0 0 0 0 0 0 52.16 0 19519.98 0 0 0 0 0 0 36147.02 0 0 0 1101252259 1235189499 48 Rural Health Clinics LITCHFIELD FAMILY PRACTICE CEN 620561700 76 Montgomery 0 1 0 6106 5712 0 1496 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 54718 46676 0 4033 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 54718 46676 0 4033 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 138512 2031923.24 0 0 0 0 0 0 0 0 0 0 14750 0 0 0 0 0 0 2185185.24 0 0 0 1101252268 2100242686 90 Waiver service provider--Elderly (DOA) RELIABLE HOME CARE PROVIDERS 600693015 57 Lake 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 688 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 688 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44283.59 0 0 0 0 0 0 0 0 0 0 0 0 0 44283.59 0 0 0 1101252274 92 Waiver service provider--Disability (DHS/DRS) 13 Boone 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 17931.55 0 0 0 0 0 0 0 0 0 0 0 0 0 17931.55 0 0 0 1101252306 10 Physicians 816 Iowa 0 0 Ophthalmology 0 0 0 0 0 0 0 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4969.49 0 0 0 0 0 0 4969.49 0 0 0 1101252325 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1030.82 0 0 0 0 0 0 0 0 0 0 0 0 0 1030.82 0 0 0 1101252330 92 Waiver service provider--Disability (DHS/DRS) 55 Kendall 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 9943.44 0 0 0 0 0 0 0 0 0 0 0 0 0 9943.44 0 0 0 1101252342 1831271709 10 Physicians OBREGON FELIX 606234036 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 797 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 797 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7081.24 0 0 0 0 0 0 7081.24 0 0 0 1101252344 1275540015 10 Physicians RAHMAN AZIZ 628013060 66 Marion 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 1073 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47405.47 0 0 0 0 0 0 47405.47 0 0 0 1101252350 91 Waiver service provider--Adults (DHS/DDD) 57 Lake 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 0 307 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 307 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23052.83 0 0 0 0 0 0 0 0 0 0 0 0 0 23052.83 0 0 0 1101252353 1336205186 23 Occupational Therapists HARMASCH LAURA 601756526 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6572.27 6572.27 0 0 0 1101252367 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 3216.44 0 0 0 0 0 0 0 0 0 0 0 0 0 3216.44 0 0 0 1101252370 10 Physicians 200 Cook 0 0 Psychiatry 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 76 0 0 0 1101252383 14 Chiropractors 89 Rock Island 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 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20.78 0 0 0 0 0 0 20.78 0 0 0 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0 0 0 0 0 0 0 0 0 13 0 343 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65.35 0 4035.49 0 0 0 0 0 0 4100.84 0 0 0 1101252453 1033148291 10 Physicians KWAK SANDY 605064356 53 Kane 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 1032 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1428 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1428 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31428.5 0 1999.32 0 0 0 0 0 0 33427.82 0 0 0 1101252460 1104812528 10 Physicians BROBBEY WAHAB 606344469 200 Cook 0 0 Infectious Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 427 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1250 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1250 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14760.48 0 0 0 0 0 0 14760.48 0 0 0 1101252464 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10630.77 0 0 0 0 0 0 0 0 0 0 0 0 0 10630.77 0 0 0 1101252471 1730324450 10 Physicians ESCOTO MICHAEL 999999999 30 DuPage 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 727 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 762 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 762 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28362.74 0 0 0 0 0 0 28362.74 0 0 0 1101252475 1902880362 10 Physicians SHANDS COURTNEY 631418657 826 Missouri 0 0 Urological Surgery 0 0 0 0 0 0 0 0 0 0 0 19 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 489.52 0 10580.31 0 0 0 0 0 0 11069.83 0 0 0 1101252482 1477610665 10 Physicians GOODMAN DAVID 600390619 71 McHenry 0 0 Otorhinolaryngology 0 0 0 0 0 0 0 0 0 0 0 3 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84.9 0 7464.21 0 0 0 0 0 0 7549.11 0 0 0 1101252490 92 Waiver service provider--Disability (DHS/DRS) 30 DuPage 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 28803.73 0 0 0 0 0 0 0 0 0 0 0 0 0 28803.73 0 0 0 1101252504 1609820448 10 Physicians PATEL K P 601181416 53 Kane 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9535.85 0 0 0 0 0 0 9535.85 0 0 0 1101252508 1518128255 10 Physicians STOLL TYRRELL VIRGINIA 60077 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 838 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 932 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 932 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31430.31 0 0 0 0 0 0 31430.31 0 0 0 1101252513 1376745877 47 Local Education Agencies LEE CO SPECIAL ED ASSOC 610219149 60 Lee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3972 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3972 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70048.74 0 70048.74 0 0 0 1101252517 1104975770 10 Physicians ABRAHAM DARYN 601882756 30 DuPage 0 0 Allergy-Immunization 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 538 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 538 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9142.67 0 0 0 0 0 0 9142.67 0 0 0 1101252518 1922130202 10 Physicians LA FORGIA CARLO 601262816 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 214 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 214 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2796.12 0 0 0 0 0 0 2796.12 0 0 0 1101252527 1053390302 10 Physicians TEMPLE ELIZABETH 612656158 89 Rock Island 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 1 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3.52 0 1311.94 0 0 0 0 0 0 1315.46 0 0 0 1101252537 1740509496 60 Pharmacies TARGET STORE T 2373 606405660 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 639 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83786 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 140542.75 0 0 0 140542.75 0 0 0 1101252547 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 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 22920.2 0 0 0 0 0 0 0 0 0 0 0 0 0 22920.2 0 0 0 1101252558 1518964469 63 Other Providers of Medical Equipment/Supplies (Non-registered) BEST AID MEDICAL SUPPLIES 600906202 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 600 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8683 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8683 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 675332.47 0 1385.83 0 0 0 0 676718.3 0 0 0 1101252565 94 Waiver service provider--Children's support (DHS/DDD) 107 Will 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 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3459.5 0 0 0 0 0 0 0 0 0 0 0 0 0 3459.5 0 0 0 1101252572 93 Waiver service provider--HIV/AIDS (DHS/DRS) 80 Peoria 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 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 11672.81 0 0 0 0 0 0 0 0 0 0 0 0 0 11672.81 0 0 0 1101252580 91 Waiver service provider--Adults (DHS/DDD) 53 Kane 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 0 188 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 188 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21256.12 0 0 0 0 0 0 0 0 0 0 0 0 0 21256.12 0 0 0 1101252588 1831343896 55 Early Intervention Services BENNETT DAYNA 531435284 852 Wisconsin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 632 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 632 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35492.26 0 0 0 0 0 0 35492.26 0 0 0 1101252591 1356412894 46 Ambulatory Surgical Treatment Centers ROCKFORD ORTHOPEDIC SURGERY CT 611075090 109 Winnebago ASTC Ambulatory Surgical Treatment Center. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 199 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 199 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47690.34 0 0 0 0 0 47690.34 0 0 0 1101252610 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 287 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 287 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22590.76 0 0 0 0 0 0 0 0 0 0 0 0 0 22590.76 0 0 0 1101252613 1528136561 10 Physicians KRIEGER RICHARD 601876078 30 DuPage 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 0 5 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 504 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 504 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28.53 0 15392.09 0 0 0 0 0 0 15420.62 0 0 0 1101252627 1346448388 10 Physicians KEUNG BONNIE 616370001 80 Peoria 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 1 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32.67 0 5318.42 0 0 0 0 0 0 5351.09 0 0 0 1101252635 1144215120 10 Physicians SICOTTE SUSAN 604023420 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 236 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 236 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3597.33 0 0 0 0 0 0 3597.33 0 0 0 1101252647 1396739462 10 Physicians AUSTMAN KATHERINE M 617410058 61 Livingston 0 0 Family Practice 0 0 0 0 4 0 0 0 0 0 0 8 0 43 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 12 0 94 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 12 0 94 0 0 0 0 0 0 0 0 0 417.12 0 0 0 0 0 0 48.75 0 22129.33 0 0 0 0 0 0 22595.2 0 0 0 1101252649 30 General Hospitals 823 Michigan NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 540.26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 540.26 0 0 0 1101252656 1699767855 10 Physicians SPILL GAYLE 606112654 200 Cook 0 0 Physical Medicine/Rehabilitation 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 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2024.1 0 0 0 0 0 0 2024.1 0 0 0 1101252667 1558502476 10 Physicians PURINSON ANNA 600771057 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 1 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 224 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 224 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 8596.81 0 0 0 0 0 0 8600.81 0 0 0 1101252669 1497774459 10 Physicians LUM BENNETT 608052746 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 314 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 405 0 236 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 405 0 236 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5835.65 0 3450.8 0 0 0 0 0 0 9286.45 0 0 0 1101252671 1689878480 10 Physicians CHEN ALAN 604358347 107 Will 0 0 Surgery Hand 0 0 0 0 0 0 0 0 0 0 0 10 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 169.7 0 7343.82 0 0 0 0 0 0 7513.52 0 0 0 1101252675 1164586707 10 Physicians RABAA EHAB 381123814 844 Tennessee 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 223 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 505 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 505 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6422.17 0 0 0 0 0 0 0 0 6422.17 0 0 0 1101252684 91 Waiver service provider--Adults (DHS/DDD) 10 Adams 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 0 230 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12956.1 0 0 0 0 0 0 0 0 0 0 0 0 0 12956.1 0 0 0 1101252695 1003922709 10 Physicians REGER PAUL 622581424 96 St Clair 0 1 Family Practice 0 11 0 0 5 0 0 0 0 0 0 5 0 41 0 0 0 0 0 0 94 0 0 10 0 0 0 0 0 0 6 0 87 0 0 0 0 0 0 94 0 0 10 0 0 0 0 0 0 6 0 87 0 0 0 0 0 0 215 0 0 770.16 0 0 0 0 0 0 54.14 0 2445.02 0 0 0 0 0 0 3484.32 0 0 0 1101252722 1427012004 10 Physicians VELEZ JO ESTRELLITA 604062426 200 Cook 0 0 Pulmonary Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 277 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 774 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 774 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15873.25 0 0 0 0 0 0 15873.25 0 0 0 1101252723 30 General Hospitals 839 Pennsylvania ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 252.06 0 0 0 0 0 252.06 0 0 0 1101252726 92 Waiver service provider--Disability (DHS/DRS) 98 Tazewell 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 1688.78 0 0 0 0 0 0 0 0 0 0 0 0 0 1688.78 0 0 0 1101252733 1457336851 10 Physicians LIEFER ALLAN 622331415 87 Randolph 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4206.47 0 0 0 0 0 0 4206.47 0 0 0 1101252735 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 3256.1 0 0 0 0 0 0 0 0 0 0 0 0 0 3256.1 0 0 0 1101252743 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 8268.23 0 0 0 0 0 0 0 0 0 0 0 0 0 8268.23 0 0 0 1101252747 1811908353 10 Physicians DIMAIO ANN 631102515 200 Cook 0 0 Pediatrics 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 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2213.32 0 0 0 0 0 0 2213.32 0 0 0 1101252748 1922166917 10 Physicians MARINELLI ANTHONY M 603022510 200 Cook 0 0 Pulmonary Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 205 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 640 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 640 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11080.92 0 0 0 0 0 0 11080.92 0 0 0 1101252756 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 26438.82 0 0 0 0 0 0 0 0 0 0 0 0 0 26438.82 0 0 0 1101252762 1154437671 16 Nurse Practitioners ASHBY MARSHALL 619389253 24 Coles 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51.76 0 0 0 0 0 0 51.76 0 0 0 1101252770 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 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 46570.22 0 0 0 0 0 0 0 0 0 0 0 0 0 46570.22 0 0 0 1101252774 1003007170 10 Physicians DANCIU SORIN 606573014 200 Cook 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 3 0 672 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 1360 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 1360 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80.18 0 14453.46 0 0 0 0 0 0 14533.64 0 0 0 1101252775 2100243193 91 Waiver service provider--Adults (DHS/DDD) EASTER SEAL SOC-METRO CHGO 606081237 200 Cook 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7756 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7756 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 390745.4 0 0 0 0 0 0 0 0 0 0 0 0 0 390745.4 0 0 0 1101252778 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1990.45 0 0 0 0 0 0 0 0 0 0 0 0 0 1990.45 0 0 0 1101252779 1891767224 10 Physicians AFZAL MOHAMMED 611084865 109 Winnebago 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 346 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 840 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 840 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17563.7 0 0 0 0 0 0 17563.7 0 0 0 1101252789 1144472523 13 Podiatrists BOCHAT SUMMER 602012468 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4449.58 0 0 0 0 0 0 4449.58 0 0 0 1101252803 92 Waiver service provider--Disability (DHS/DRS) 90 Saline 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14602.54 0 0 0 0 0 0 0 0 0 0 0 0 0 14602.54 0 0 0 1101252817 1437399961 16 Nurse Practitioners CAVATO 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 376 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 376 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7971.05 0 0 0 0 0 0 7971.05 0 0 0 1101253584 92 Waiver service provider--Disability (DHS/DRS) 91 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 19 0 0 0 0 0 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 9596.03 0 0 0 0 0 0 0 0 0 0 0 0 0 9596.03 0 0 0 1101253586 91 Waiver service provider--Adults (DHS/DDD) 72 McLean 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 0 346 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 346 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24420 0 0 0 0 0 0 0 0 0 0 0 0 0 24420 0 0 0 1101253588 1558477349 10 Physicians MITRY RAGAI 619389253 24 Coles 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 315 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1955 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1955 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74733.08 0 0 0 0 0 0 74733.08 0 0 0 1101253590 47 Local Education Agencies 35 Ford 0 0 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0 0 0 0 0 0 4 0 3200.01 0 0 0 0 0 0 3798.16 0 0 0 1101253611 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 29 0 0 0 0 0 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 11483.3 0 0 0 0 0 0 0 0 0 0 0 0 0 11483.3 0 0 0 1101253622 1174516520 10 Physicians PIEL IRA J 600312639 57 Lake 0 0 Oncology 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 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 364.75 0 0 0 0 0 0 364.75 0 0 0 1101253634 1215940424 10 Physicians MARVIN ROBERT 606127232 57 Lake 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 368 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 368 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24050.73 0 0 0 0 0 0 24050.73 0 0 0 1101253642 1205838216 16 Nurse Practitioners DIONISOPOULOS JAMES 601154939 27 Dekalb 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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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 18219.26 0 0 0 0 0 0 0 0 0 0 0 0 0 18219.26 0 0 0 1101254008 1073528204 60 Pharmacies BOND DRUG COMPANY OF IL 05602 626502811 77 Morgan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 5423 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 44023 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 1050348 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36.01 0 0 1943799.09 0 0 0 1943835.1 0 0 0 1101254034 1518025220 10 Physicians PEARLMAN STEVEN 606313745 200 Cook 0 1 Family Practice 0 16 0 0 4 0 0 0 0 0 0 1 0 9 0 0 0 0 0 0 129 0 0 8 0 0 0 0 0 0 3 0 17 0 0 0 0 0 0 129 0 0 8 0 0 0 0 0 0 3 0 17 0 0 0 0 0 0 282 0 0 221.23 0 0 0 0 0 0 44.48 0 462.32 0 0 0 0 0 0 1010.03 0 0 0 1101254035 1285737866 10 Physicians KUMAR SHASHI 606591219 200 Cook 0 1 Pediatrics 0 336 0 0 295 0 0 0 0 0 0 76 0 271 0 0 0 0 0 0 2883 0 0 1578 0 0 0 0 0 0 102 0 702 0 0 0 0 0 0 2883 0 0 1578 0 0 0 0 0 0 102 0 702 0 0 0 0 0 0 5766 0 0 43397.19 0 0 0 0 0 0 921.72 0 23138.73 0 0 0 0 0 0 73223.64 0 0 0 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98 Waiver service provider--TBI (DHS/DRS) 107 Will 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 12816.81 0 0 0 0 0 0 0 0 0 0 0 0 0 12816.81 0 0 0 1101254219 1891809620 10 Physicians BERKES JAMIE 601533328 200 Cook 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 233 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 0 0 0 0 0 673 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21291.38 0 0 0 0 0 0 21291.38 0 0 0 1101254220 16 Nurse Practitioners 96 St Clair 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 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69.55 0 0 0 0 0 0 69.55 0 0 0 1101254229 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11419.52 0 0 0 0 0 0 0 0 0 0 0 0 0 11419.52 0 0 0 1101254238 1881704062 10 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WAL MART STORES INC 10 5399 610219611 60 Lee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1408 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10679 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 278285 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 417073.54 0 0 0 417073.54 0 0 0 1101254382 1619916822 31 Psychiatric Hospitals BHC STREAMWOOD HOSPITAL INC 601073201 200 Cook PSYCH Psychiatric hospitals paid a Per Diem rate. 0 0 Hospital childrens mental health 0 0 858 0 0 0 0 0 0 0 1146 0 0 0 0 0 0 0 0 0 0 7635 0 0 0 0 0 0 0 1466 0 0 0 0 0 0 0 0 0 0 9627 0 0 0 0 0 0 0 17979 0 0 0 0 0 0 0 0 0 0 702595.05 0 0 0 0 0 0 0 14404514.3 0 0 0 0 0 0 0 0 0 15107109.35 0 0 0 1101254385 1154584076 11 Dentists DUGGIRALA SWETHA 604361243 107 Will 0 0 General Dentistry 0 0 0 716 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4042 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4042 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118521.3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118521.3 0 0 0 1101254390 1255346573 60 Pharmacies WALGREEN CO 6297 606384318 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230.98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230.98 0 0 0 1101254505 1447269568 10 Physicians SHARMA RAJA 600147978 71 McHenry 0 0 Cardiology 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 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1610.25 0 0 0 0 0 0 1610.25 0 0 0 1101254531 1730180878 10 Physicians MAYNARD JOHN 611075089 109 Winnebago 0 0 Nephrology 0 0 0 0 0 0 0 0 0 0 0 72 0 259 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132 0 809 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132 0 809 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 193.84 0 16000.73 0 0 0 0 0 0 16194.57 0 0 0 1101254538 16 Nurse Practitioners 200 Cook 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 0 154.66 0 0 0 0 0 0 154.66 0 0 0 1101254555 1669596755 44 Healthy Kids (EPSDT) screening clinics VNA HEALTH CARE 605063814 53 Kane 0 0 0 0 0 0 787 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 949 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 949 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12834.64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12834.64 0 0 0 1101254623 1629085212 10 Physicians NUGENT CLAUDIA 618203909 19 Champaign 0 0 Admitting Privileges 0 0 0 0 0 0 0 0 0 0 0 15 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 415.52 0 9339.58 0 0 0 0 0 0 9755.1 0 0 0 1101254625 22 Physical Therapists 30 DuPage 0 0 0 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 23 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 0 0 0 0 0 0 0 0 171.9 171.9 0 0 0 1101254631 16 Nurse Practitioners 826 Missouri 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16.4 0 0 0 0 0 0 16.4 0 0 0 1101254644 1457365991 22 Physical Therapists GILLUND LLOYD 528069312 816 Iowa 0 0 0 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 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0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7951 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7951 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67735.95 0 0 0 0 0 0 67735.95 0 0 0 1101254839 1588829329 10 Physicians PATEL SHRUTI 601533328 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 432 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 432 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8572.46 0 0 0 0 0 0 8572.46 0 0 0 1101254843 10 Physicians 816 Iowa 0 0 Pediatric Hematology Oncology 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 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101254852 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 14315.69 0 0 0 0 0 0 0 0 0 0 0 0 0 14315.69 0 0 0 1101254862 1710078415 10 Physicians LEE YOUNG S 606284200 200 Cook 0 0 Radiology 0 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Cook 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 9162.18 0 0 0 0 0 0 0 0 0 0 0 0 0 9162.18 0 0 0 1101254934 1235245481 10 Physicians MCLEOD METTISA 622942153 65 Madison 0 1 Family Practice 0 5 0 0 6 0 0 0 0 0 0 5 0 36 0 0 0 0 0 0 15 0 0 6 0 0 0 0 0 0 10 0 50 0 0 0 0 0 0 15 0 0 6 0 0 0 0 0 0 10 0 50 0 0 0 0 0 0 36 0 0 438.33 0 0 0 0 0 0 18.3 0 717.85 0 0 0 0 0 0 1210.48 0 0 0 1101254942 1972643633 10 Physicians ELBAUM SUSAN 600042315 200 Cook 0 0 Internal Medicine 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 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180.64 0 0 0 0 0 0 180.64 0 0 0 1101254956 14 Chiropractors 63 Macon 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 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 0 0 0 0 0 0 0 0 0 0 0 1101254962 1033110192 10 Physicians CONTERATO DEAN J 600258130 200 Cook 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 727.35 0 0 0 0 0 0 727.35 0 0 0 1101254966 1790836385 10 Physicians INOCENCIO EDDIE 606562304 200 Cook 0 0 Otorhinolaryngology 0 0 0 0 0 0 0 0 0 0 0 0 0 383 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1306 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1306 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1637.89 0 0 0 0 0 0 1637.89 0 0 0 1101254977 92 Waiver service provider--Disability (DHS/DRS) 63 Macon 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 24006.46 0 0 0 0 0 0 0 0 0 0 0 0 0 24006.46 0 0 0 1101254986 1902842628 10 Physicians FRITZ NANCY 605276686 30 DuPage 0 0 Pediatrics 0 0 0 0 102 0 0 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 153 0 0 0 0 0 0 0 0 193 0 0 0 0 0 0 0 0 0 153 0 0 0 0 0 0 0 0 193 0 0 0 0 0 0 0 0 0 8344.85 0 0 0 0 0 0 0 0 10056.13 0 0 0 0 0 0 18400.98 0 0 0 1101254993 1013209675 36 Community mental health provider ADAPT OF ILLINOIS INC 622266552 96 St Clair 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11516 0 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11516 0 0 4151.07 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 478096.24 0 0 482247.31 0 0 0 1101255006 1558587824 75 Department of Alcohol and Substance Abuse Provider REMEDIES RENEWING LIVES 611022218 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1894 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1894 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91237.06 0 0 91237.06 0 0 0 1101255019 1154395127 10 Physicians ROJAS ROBERT 601533304 200 Cook 0 1 Pediatrics 0 272 0 0 109 0 0 0 0 0 0 0 0 127 0 0 0 0 0 0 1986 0 0 157 0 0 0 0 0 0 0 0 216 0 0 0 0 0 0 1986 0 0 157 0 0 0 0 0 0 0 0 216 0 0 0 0 0 0 3972 0 0 12472.18 0 0 0 0 0 0 0 0 9458.73 0 0 0 0 0 0 25902.91 0 0 0 1101255026 1629085915 16 Nurse Practitioners NELSON KAREN 601533328 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 785.36 0 0 0 0 0 0 785.36 0 0 0 1101255029 1972699007 10 Physicians POLISKY ELLEN 606223043 200 Cook 0 0 Pathology 0 0 0 0 146 0 0 0 0 0 0 4034 0 5 0 0 0 0 0 0 0 0 0 146 0 0 0 0 0 0 18281 0 5 0 0 0 0 0 0 0 0 0 146 0 0 0 0 0 0 18281 0 5 0 0 0 0 0 0 0 0 0 841.2 0 0 0 0 0 0 81512.22 0 42.53 0 0 0 0 0 0 82395.95 0 0 0 1101255036 1295771186 10 Physicians SPEISMAN MELVIN 603022510 200 Cook 0 1 Internal Medicine 0 28 0 0 0 0 0 0 0 0 0 0 0 405 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 0 0 1656 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 0 0 1656 0 0 0 0 0 0 148 0 0 0 0 0 0 0 0 0 0 0 17905.23 0 0 0 0 0 0 18053.23 0 0 0 1101255055 1114075645 12 Optometrists EILENFELDT PAMELA 999999999 56 Knox 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 394 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 771 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 771 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21981.35 0 0 0 0 0 0 21981.35 0 0 0 1101255080 1851557433 10 Physicians DELEON MARIA 606162477 200 Cook 0 0 Pediatrics 0 0 0 0 137 0 0 0 0 0 0 2 0 75 0 0 0 0 0 0 0 0 0 359 0 0 0 0 0 0 2 0 82 0 0 0 0 0 0 0 0 0 359 0 0 0 0 0 0 2 0 82 0 0 0 0 0 0 0 0 0 13858.23 0 0 0 0 0 0 7.33 0 3499.7 0 0 0 0 0 0 17365.26 0 0 0 1101255084 92 Waiver service provider--Disability (DHS/DRS) 94 Shelby 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 16465.5 0 0 0 0 0 0 0 0 0 0 0 0 0 16465.5 0 0 0 1101255086 1669482873 10 Physicians KUHLMAN JOSEPH 623057005 10 Adams 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 361 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 416 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 416 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58737.3 0 0 0 0 0 0 58737.3 0 0 0 1101255096 16 Nurse Practitioners 57 Lake 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19.53 0 0 0 0 0 0 19.53 0 0 0 1101255110 1700852142 10 Physicians WARRIER KRISHNAN 628320192 81 Perry 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86.37 0 0 0 0 0 0 86.37 0 0 0 1101255115 1538169834 10 Physicians ZIFFRA KEVIN L 600681127 66 Marion 0 0 Otolaryngology 0 0 0 0 0 0 0 0 0 0 0 1 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4559.99 0 0 0 0 0 0 4559.99 0 0 0 1101255117 10 Physicians 200 Cook 0 0 Pulmonary Diseases 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 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 44.62 0 0 0 0 0 0 44.62 0 0 0 1101255122 1083662795 10 Physicians SZYFER MALGORZATA 606411331 200 Cook 0 1 Family Practice 0 355 0 0 40 0 0 0 0 0 0 23 0 188 0 0 0 0 0 0 638 0 0 109 0 0 0 0 0 0 23 0 445 0 0 0 0 0 0 638 0 0 109 0 0 0 0 0 0 23 0 445 0 0 0 0 0 0 1562 0 0 3836.76 0 0 0 0 0 0 201.06 0 11553.97 0 0 0 0 0 0 17153.79 0 0 0 1101255141 1235177080 22 Physical Therapists SZYMANSKI CANDICE 600315709 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 209 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 209 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1796.06 1796.06 0 0 0 1101255149 1023094786 10 Physicians MICHAEL JOHN 462786013 815 Indiana 0 0 Radiology Diagnosis 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 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 0 148.79 0 0 0 0 0 0 0 0 148.79 0 0 0 1101255169 48 Rural Health Clinics 818 Kentucky 0 0 0 0 5 0 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 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2651.31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2651.31 0 0 0 1101255170 1871586859 10 Physicians ALESSIA EVA 605437415 55 Kendall 0 1 Pediatrics 0 212 0 0 267 0 0 0 0 0 0 108 0 327 0 0 0 0 0 0 1461 0 0 764 0 0 0 0 0 0 143 0 510 0 0 0 0 0 0 1461 0 0 764 0 0 0 0 0 0 143 0 510 0 0 0 0 0 0 2922 0 0 25113.67 0 0 0 0 0 0 2053 0 21052.24 0 0 0 0 0 0 51140.91 0 0 0 1101255172 1912996604 11 Dentists ANDREW ALBERT 605438949 55 Kendall 0 0 General Dentistry 0 0 0 606 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4043 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4043 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151479.83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151479.83 0 0 0 1101255185 1972744431 63 Other Providers of Medical Equipment/Supplies (Non-registered) ALL AMERICAN MEDICAL SUPPLIES 342854636 810 Florida 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3846 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38869 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38869 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77870.2 0 9078.35 0 0 0 0 86948.55 0 0 0 1101255188 1205097607 10 Physicians WEISBERG MICHAEL 604095415 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 41 0 499 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 1364 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 1364 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 237.1 0 24969.23 0 0 0 0 0 0 25206.33 0 0 0 1101255214 16 Nurse Practitioners 826 Missouri 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 191.69 0 0 0 0 0 0 191.69 0 0 0 1101255220 98 Waiver service provider--TBI (DHS/DRS) 53 Kane 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 5524.71 0 0 0 0 0 0 0 0 0 0 0 0 0 5524.71 0 0 0 1101255229 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3727.5 0 0 0 0 0 0 0 0 0 0 0 0 0 3727.5 0 0 0 1101255232 1548424229 10 Physicians SUPHANGUL MONTHA 606313707 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 258 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 258 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4970.77 0 0 0 0 0 0 4970.77 0 0 0 1101255233 1861650442 10 Physicians CUNNINGHAM BRIAN 475911038 815 Indiana 0 0 Internal Medicine 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 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1568.47 0 0 0 0 0 0 1568.47 0 0 0 1101255243 1235440777 12 Optometrists MOORE CHELSEY 627047015 91 Sangamon 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 99 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3640.71 0 31.95 0 0 0 0 3672.66 0 0 0 1101255256 1568429009 10 Physicians LANKER WILLIAM 618562116 82 Piatt 0 1 Family Practice 0 141 0 0 1 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 1105 0 0 1 0 0 0 0 0 0 0 0 140 0 0 0 0 0 0 1105 0 0 1 0 0 0 0 0 0 0 0 140 0 0 0 0 0 0 2763 0 0 50 0 0 0 0 0 0 0 0 11735.07 0 0 0 0 0 0 14548.07 0 0 0 1101255261 92 Waiver service provider--Disability (DHS/DRS) 49 Jefferson 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 13348.94 0 0 0 0 0 0 0 0 0 0 0 0 0 13348.94 0 0 0 1101255266 1417997966 10 Physicians GADDIHERRERA MARIA 601181416 53 Kane 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 138 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 138 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14631.31 0 0 0 0 0 0 14631.31 0 0 0 1101255288 98 Waiver service provider--TBI (DHS/DRS) 91 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12495.55 0 0 0 0 0 0 0 0 0 0 0 0 0 12495.55 0 0 0 1101255298 92 Waiver service provider--Disability (DHS/DRS) 84 Pope 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 0 274.96 0 0 0 0 0 0 0 0 0 0 0 0 0 274.96 0 0 0 1101255306 1699732313 10 Physicians CARNS WENDI 641843225 80 Peoria 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 3 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 480.02 0 4556.98 0 0 0 0 0 0 5037 0 0 0 1101255310 55 Early Intervention Services 33 Effingham 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1108.94 0 0 0 0 0 0 1108.94 0 0 0 1101255331 1215920103 10 Physicians MCGUIRE PHILIP 463835860 815 Indiana 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 85 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 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 357.61 0 0 0 0 0 0 0 0 357.61 0 0 0 1101255344 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 351 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 351 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23526.16 0 0 0 0 0 0 0 0 0 0 0 0 0 23526.16 0 0 0 1101255350 1871552174 12 Optometrists FRANK JEFFREY 601783109 27 Dekalb 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 277 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 746 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 746 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18025.31 0 491.46 0 0 0 0 18516.77 0 0 0 1101255352 1740380591 11 Dentists BAHRANI HAYDER 600162414 200 Cook 0 0 General Dentistry 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 482.15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 482.15 0 0 0 1101255353 1578503678 10 Physicians FACCHINI FRANCIS 605252600 200 Cook 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 30 0 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 215.34 0 5522.85 0 0 0 0 0 0 5738.19 0 0 0 1101255361 1710041892 10 Physicians HANNA DIMA 600763000 200 Cook 0 1 Family Practice 0 759 0 0 314 0 0 0 0 0 0 71 0 1044 0 0 0 0 0 0 4929 0 0 699 0 0 0 0 0 0 92 0 3036 0 0 0 0 0 0 4929 0 0 699 0 0 0 0 0 0 92 0 3036 0 0 0 0 0 0 12383 0 0 29215.4 0 0 0 0 0 0 254.21 0 125252.67 0 0 0 0 0 0 167105.28 0 0 0 1101255363 1023102951 10 Physicians STEINER STEPHEN 606405759 200 Cook 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 331 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 535 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 535 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32143 0 0 0 0 0 0 32143 0 0 0 1101255364 1134225790 10 Physicians TAIMOORAZY BENJAMIN 600441421 57 Lake 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 965 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 965 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23121.84 0 0 0 0 0 0 23121.84 0 0 0 1101255379 1639383631 10 Physicians AHMED IRAM 605231221 30 DuPage 0 1 Internal Medicine 0 133 0 0 7 0 0 0 0 0 0 16 0 223 0 0 0 0 0 0 847 0 0 8 0 0 0 0 0 0 23 0 692 0 0 0 0 0 0 847 0 0 8 0 0 0 0 0 0 23 0 692 0 0 0 0 0 0 2537 0 0 713.66 0 0 0 0 0 0 76.03 0 14845.09 0 0 0 0 0 0 18171.78 0 0 0 1101255395 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 301 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 301 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11572 0 0 0 0 0 0 0 0 0 0 0 0 0 11572 0 0 0 1101255400 1063460897 75 Department of Alcohol and Substance Abuse Provider PERRY COUNTY COUNSELING CENTER 628322442 81 Perry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 304 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 304 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21121.6 0 0 21121.6 0 0 0 1101255424 1205921319 10 Physicians MYSLIWIEC ANITA 606304002 200 Cook 0 1 Internal Medicine 0 478 0 0 79 0 0 0 0 0 0 8 0 219 0 0 0 0 0 0 2927 0 0 126 0 0 0 0 0 0 8 0 639 0 0 0 0 0 0 2927 0 0 126 0 0 0 0 0 0 8 0 639 0 0 0 0 0 0 7556 0 0 6615.99 0 0 0 0 0 0 20.25 0 24546.08 0 0 0 0 0 0 38738.32 0 0 0 1101255430 1497736383 13 Podiatrists ZUCKER KEVIN 600896827 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 490 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1672 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1672 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2664.92 0 0 0 0 0 0 2664.92 0 0 0 1101255462 70 Ambulance Service Providers 54 Kankakee 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 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 0 333.14 0 0 0 0 0 0 333.14 0 0 0 1101255476 98 Waiver service provider--TBI (DHS/DRS) 54 Kankakee 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 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14556.53 0 0 0 0 0 0 0 0 0 0 0 0 0 14556.53 0 0 0 1101255488 98 Waiver service provider--TBI (DHS/DRS) 77 Morgan 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31339.68 0 0 0 0 0 0 0 0 0 0 0 0 0 31339.68 0 0 0 1101255493 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 41930.19 0 0 0 0 0 0 0 0 0 0 0 0 0 41930.19 0 0 0 1101255501 91 Waiver service provider--Adults (DHS/DDD) 67 Marshall 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 0 349 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 349 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10120 0 0 0 0 0 0 0 0 0 0 0 0 0 10120 0 0 0 1101255518 1518021245 10 Physicians SCHAINIS RODNEY 601601624 200 Cook 0 1 Internal Medicine 0 6 0 0 0 0 0 0 0 0 0 2 0 30 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 2 0 182 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 2 0 182 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 2.48 0 1132.26 0 0 0 0 0 0 1191.74 0 0 0 1101255522 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 20152.24 0 0 0 0 0 0 0 0 0 0 0 0 0 20152.24 0 0 0 1101255523 1679778716 10 Physicians RAMANA RAVI 604023429 200 Cook 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 278 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 536 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 536 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6271.93 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 1449 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13638.37 0 0 0 0 0 0 13638.37 0 0 0 1101255578 1952467847 73 Other Transportation Providers ( Non-Registered) AVISTON TERRACE 622163438 23 Clinton 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 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 430.56 0 0 0 0 0 0 430.56 0 0 0 1101255598 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 4711.8 0 0 0 0 0 0 0 0 0 0 0 0 0 4711.8 0 0 0 1101255606 16 Nurse Practitioners 826 Missouri 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 0 269.09 0 0 0 0 0 0 269.09 0 0 0 1101255618 1417956566 11 Dentists REEDY LYLE 610326778 97 Stephenson 0 0 General Dentistry 0 0 0 8 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 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OF WILL COUNTY,INC." 604362050 107 Will 0 0 0 0 0 0 0 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1570318.72 0 0 0 0 0 0 0 0 0 0 0 0 0 1570318.72 0 0 0 1101255628 1811998263 10 Physicians MCCOY RYAN 601955220 200 Cook 0 1 Pediatrics 0 80 0 0 73 0 0 0 0 0 0 23 0 98 0 0 0 0 0 0 701 0 0 186 0 0 0 0 0 0 33 0 133 0 0 0 0 0 0 701 0 0 186 0 0 0 0 0 0 33 0 133 0 0 0 0 0 0 1402 0 0 7120.15 0 0 0 0 0 0 409.4 0 5892.62 0 0 0 0 0 0 14824.17 0 0 0 1101255631 1124329206 16 Nurse Practitioners LIEBENDORFER JAYCIE 617610016 72 McLean 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 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 0 182.71 0 0 0 0 0 0 182.71 0 0 0 1101255647 1942381579 10 Physicians SYED JUNAID 999999999 826 Missouri 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 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 4877.1 0 0 0 0 0 0 0 0 0 0 0 0 0 4877.1 0 0 0 1101255719 1437411980 16 Nurse Practitioners MCAVITY PETER 999999999 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 168.59 0 0 0 0 0 0 168.59 0 0 0 1101255726 1104960400 10 Physicians CLIFFORD KELLY 606223086 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 547 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 591 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 591 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18355.73 0 0 0 0 0 0 18355.73 0 0 0 1101255744 1851390132 30 General Hospitals MEMORIAL HOSPITAL 622331116 87 Randolph ARS-PD Hospitals paid a Per Diem rate. 1 0 0 0 0 0 6 0 0 0 0 0 0 746 0 0 1117 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 2952 0 0 2457 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 2952 0 0 2457 0 0 0 0 0 0 0 0 39.9 0 0 0 0 0 0 16299.32 0 0 81105.77 0 0 0 0 0 97444.99 0 0 0 1101255746 1366459711 12 Optometrists GORDON JUSTIN R 607121317 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 417 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 808 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 808 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23124.33 0 0 0 0 0 0 23124.33 0 0 0 1101255748 1154697233 16 Nurse Practitioners MORRISON JAYNE 624481727 48 Jasper 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 677 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 727 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 727 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27684.81 0 0 0 0 0 0 27684.81 0 0 0 1101255750 93 Waiver service provider--HIV/AIDS (DHS/DRS) 80 Peoria 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 6802.92 0 0 0 0 0 0 0 0 0 0 0 0 0 6802.92 0 0 0 1101255752 1346359320 10 Physicians BANISAEED NASSIM 627810001 91 Sangamon 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 402 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 582 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 582 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8111.98 0 0 0 0 0 0 0 0 8111.98 0 0 0 1101255757 2100246175 71 Medicar Provider RICH TOWNSHIP TRANSPORTATION 604711247 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1923 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1923 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15980.21 0 0 0 0 0 0 15980.21 0 0 0 1101255759 1730132440 10 Physicians ARRUFFAT SANTIAGO 477140560 815 Indiana 0 0 Colon - Rectal Surgery 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 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 1361.69 0 0 0 0 0 0 1361.69 0 0 0 1101255760 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 27288.88 0 0 0 0 0 0 0 0 0 0 0 0 0 27288.88 0 0 0 1101255765 1174569438 30 General Hospitals HOPEDALE HOSPITAL 617470267 98 Tazewell DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 1 0 General Hospital - Adult and Child 0 0 0 0 0 160 0 0 0 0 11 0 0 0 100 0 0 0 0 0 0 0 0 0 218 0 0 0 0 11 0 0 0 239 0 0 0 0 0 0 0 0 0 218 0 0 0 0 54 0 0 0 239 0 0 0 0 0 0 0 0 0 20817.76 0 0 0 0 32694.61 0 0 0 23054.36 0 0 0 0 0 76566.73 0 0 0 1101255773 1396946125 10 Physicians BERCK LILLA 617013514 72 McLean 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 3 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28.68 0 137.48 0 0 0 0 0 0 166.16 0 0 0 1101255778 1790969897 22 Physical Therapists DUNN PATRICIA 627621000 91 Sangamon 0 0 0 0 0 0 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 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2916.83 2916.83 0 0 0 1101255788 1922012541 10 Physicians LANOFF MARTIN 600613111 57 Lake 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 0 1 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20.31 0 0 0 0 0 0 20.31 0 0 0 1101255790 10 Physicians 816 Iowa 0 0 Neurology 0 0 0 0 0 0 0 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 19 0 0 0 0 0 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 0 649.5 0 0 0 0 0 0 649.5 0 0 0 1101255802 1215924949 10 Physicians MACKIN WILLIAM 601344220 53 Kane 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3177.5 0 0 0 0 0 0 3177.5 0 0 0 1101255814 91 Waiver service provider--Adults (DHS/DDD) 30 DuPage 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 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3170 0 0 0 0 0 0 0 0 0 0 0 0 0 3170 0 0 0 1101255815 22 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3969.41 3969.41 0 0 0 1101255817 92 Waiver service provider--Disability (DHS/DRS) 826 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Physicians MODERT CHRISTOPHER 628644331 49 Jefferson 0 1 Family Practice 0 189 0 0 57 0 0 0 0 0 0 24 0 148 0 0 0 0 0 0 1859 0 0 68 0 0 0 0 0 0 32 0 311 0 0 0 0 0 0 1859 0 0 68 0 0 0 0 0 0 32 0 311 0 0 0 0 0 0 4278 0 0 5356.79 0 0 0 0 0 0 85.22 0 8119.03 0 0 0 0 0 0 17839.04 0 0 0 1101256600 1407832454 12 Optometrists WILSON RYAN 612017102 89 Rock Island 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5196.72 0 0 0 0 0 0 5196.72 0 0 0 1101256611 1134167133 10 Physicians SYMRENG TOMMY 477313276 10 Adams 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3219.28 0 0 0 0 0 0 3219.28 0 0 0 1101256617 92 Waiver service provider--Disability (DHS/DRS) 59 Lawrence 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 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Physicians CARROLL GREGORY 600442203 57 Lake 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 5 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7053.31 0 0 0 0 0 0 7053.31 0 0 0 1101256995 24 Speech Therapists 30 DuPage 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 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 961.6 961.6 0 0 0 1101256998 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3880.46 0 0 0 0 0 0 0 0 0 0 0 0 0 3880.46 0 0 0 1101257003 1124261342 10 Physicians NALBANTOGLU ILKE 631101010 826 Missouri 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1509.62 0 0 0 0 0 0 0 0 1509.62 0 0 0 1101257025 1740417526 55 Early Intervention Services MITSUKA WOODRUFF BRITTNEY 601409061 53 Kane 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 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7915.16 0 0 0 0 0 0 7915.16 0 0 0 1101257032 1902854623 74 Hospital-Based Transportation Providers CGH MEDICAL CENTER 610811278 106 Whiteside 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 612 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2082 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2082 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190989.1 0 0 0 0 0 0 190989.1 0 0 0 1101257074 1699715094 13 Podiatrists HORSLEY VICTOR 622264724 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 703 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 703 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3226 0 0 0 0 0 0 3226 0 0 0 1101257079 1457481590 10 Physicians PATRIANAKOS ATHENA 606222743 200 Cook 0 0 Pediatrics 0 0 0 0 10 0 0 0 0 0 0 0 0 258 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 894 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 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0 527.28 0 8403.52 0 0 0 0 0 0 8930.8 0 0 0 1101257332 92 Waiver service provider--Disability (DHS/DRS) 25 Crawford 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 19 0 0 0 0 0 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 0 240.29 0 0 0 0 0 0 0 0 0 0 0 0 0 240.29 0 0 0 1101257335 1477669455 10 Physicians COGHLAN JOAN 605151500 30 DuPage 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3476.81 0 0 0 0 0 0 3476.81 0 0 0 1101257348 1992026454 60 Pharmacies WALGREENS 13974 606112991 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 3505 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 17717 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 383951 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1071.9 0 0 4116944.93 0 0 0 4118016.83 0 0 0 1101257355 1124210109 10 Physicians KIM ANDREW 601691016 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 291 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2544.62 0 0 0 0 0 2544.62 0 0 0 1101257388 1497870117 10 Physicians SAROLI TANIA 606143363 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 14 0 429 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 1079 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 1079 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 808.8 0 28900.53 0 0 0 0 0 0 29709.33 0 0 0 1101257394 2100247812 71 Medicar Provider D AND I TRANSPORT INC 999999999 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32817.88 0 0 0 0 0 0 32817.88 0 0 0 1101257395 92 Waiver service provider--Disability (DHS/DRS) 55 Kendall 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 350.35 0 0 0 0 0 0 0 0 0 0 0 0 0 350.35 0 0 0 1101257397 1952329021 10 Physicians PALELLA FRANK 606114402 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1049.64 0 0 0 0 0 0 1049.64 0 0 0 1101257399 1477756732 10 Physicians KUNCHALA VINITHA 604413895 30 DuPage 0 1 Family Practice 0 438 0 0 33 0 0 0 0 0 0 2 0 118 0 0 0 0 0 0 2724 0 0 60 0 0 0 0 0 0 2 0 292 0 0 0 0 0 0 2724 0 0 60 0 0 0 0 0 0 2 0 292 0 0 0 0 0 0 7224 0 0 3379.67 0 0 0 0 0 0 8 0 15845.08 0 0 0 0 0 0 26456.75 0 0 0 1101257400 92 Waiver service provider--Disability (DHS/DRS) 77 Morgan 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111.96 0 0 0 0 0 0 0 0 0 0 0 0 0 111.96 0 0 0 1101257408 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 0 922.79 0 0 0 0 0 0 0 0 0 0 0 0 0 922.79 0 0 0 1101257410 1841464781 10 Physicians PATEL SONALI 604532600 200 Cook 0 1 Pediatrics 0 718 0 0 143 0 0 0 0 0 0 0 0 144 0 0 0 0 0 0 6635 0 0 389 0 0 0 0 0 0 0 0 208 0 0 0 0 0 0 6635 0 0 389 0 0 0 0 0 0 0 0 208 0 0 0 0 0 0 13272 0 0 11849.23 0 0 0 0 0 0 0 0 7716.08 0 0 0 0 0 0 32837.31 0 0 0 1101257411 1578642971 11 Dentists SHIKAMI STEVEN 604113523 200 Cook 0 0 General Dentistry 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1221.95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1221.95 0 0 0 1101257431 2100247849 71 Medicar Provider CHARLESTON REHAB AND HLTH CARE 619202382 24 Coles 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 956 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 956 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7280.07 0 0 0 0 0 0 7280.07 0 0 0 1101257432 30 General Hospitals 829 Nevada NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 573.07 0 0 0 0 0 0 0 0 0 0 0 0 0 0 573.07 0 0 0 1101257438 91 Waiver service provider--Adults (DHS/DDD) 73 Menard 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 19 0 0 0 0 0 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 2438.7 0 0 0 0 0 0 0 0 0 0 0 0 0 2438.7 0 0 0 1101257445 1386815504 10 Physicians SCHRIEDEL ADAM 605406555 30 DuPage 0 1 Internal Medicine 0 6 0 0 0 0 0 0 0 0 0 1 0 23 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 1 0 69 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 1 0 69 0 0 0 0 0 0 171 0 0 0 0 0 0 0 0 0 6.3 0 946.06 0 0 0 0 0 0 1123.36 0 0 0 1101257453 92 Waiver service provider--Disability (DHS/DRS) 47 Jackson 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3487.47 0 0 0 0 0 0 0 0 0 0 0 0 0 3487.47 0 0 0 1101257456 1457623753 33 Nursing Facilities MATTOON REHAB AND HCC 619386113 24 Coles 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 784 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17445 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1456440.27 0 0 0 0 0 0 0 1456440.27 0 0 0 1101257464 1407029598 10 Physicians KULKARNI KIRTI 605276686 200 Cook 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 101 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 110 0 269 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 110 0 269 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1257.32 0 2454.07 0 0 0 0 0 0 3711.39 0 0 0 1101257471 1245261684 10 Physicians KATZ ARIEL 606118709 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 869.92 0 0 0 0 0 0 869.92 0 0 0 1101257472 1669429890 63 Other Providers of Medical Equipment/Supplies (Non-registered) CHICAGO PAIN MEDICINE CENTER 606133011 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1.23 0 6037.04 0 0 0 0 6038.27 0 0 0 1101257489 1669723128 23 Occupational Therapists FASAN LAUREN 606551827 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3222.24 3222.24 0 0 0 1101257510 92 Waiver service provider--Disability (DHS/DRS) 10 Adams 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 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 1247.62 0 0 0 0 0 0 0 0 0 0 0 0 0 1247.62 0 0 0 1101257524 1811005630 10 Physicians NOVOTNY NANCY 600252425 200 Cook 0 1 Internal Medicine 0 18 0 0 0 0 0 0 0 0 0 3 0 46 0 0 0 0 0 0 124 0 0 0 0 0 0 0 0 0 3 0 71 0 0 0 0 0 0 124 0 0 0 0 0 0 0 0 0 3 0 71 0 0 0 0 0 0 372 0 0 0 0 0 0 0 0 0 15.43 0 2109.37 0 0 0 0 0 0 2496.8 0 0 0 1101257531 24 Speech Therapists 36 Franklin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6135.11 6135.11 0 0 0 1101257535 1982677597 10 Physicians PODE ROBERT 613642127 58 La Salle 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 37 0 653 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 1399 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 1399 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1043.91 0 105478.38 0 0 0 0 0 0 106522.29 0 0 0 1101257558 10 Physicians 852 Wisconsin 0 0 Physical Medicine/Rehabilitation 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66.05 0 0 0 0 0 0 66.05 0 0 0 1101257564 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 6164.74 0 0 0 0 0 0 0 0 0 0 0 0 0 6164.74 0 0 0 1101257585 10 Physicians 87 Randolph 0 0 Family Practice 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64.52 0 0 0 0 0 0 64.52 0 0 0 1101257586 91 Waiver service provider--Adults (DHS/DDD) 30 DuPage 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 0 285 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 285 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11616 0 0 0 0 0 0 0 0 0 0 0 0 0 11616 0 0 0 1101257595 1699778209 10 Physicians STROPE MARK 623411436 42 Hancock 0 0 Family Practice 0 0 0 0 3 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 3 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 64.41 0 0 0 0 0 0 64.41 0 0 0 1101257604 1407034218 23 Occupational Therapists KROLOW AMY 611144937 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 211 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 211 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3256.15 3256.15 0 0 0 1101257606 1659320109 10 Physicians RICHTER HARRY 606123863 200 Cook 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 15 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 2072.49 0 0 0 0 0 0 2072.49 0 0 0 1101257610 92 Waiver service provider--Disability (DHS/DRS) 63 Macon 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19697.39 0 0 0 0 0 0 0 0 0 0 0 0 0 19697.39 0 0 0 1101257611 1053554287 16 Nurse Practitioners CAMPBELL ELIZABETH 625264163 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1730.29 0 0 0 0 0 0 1730.29 0 0 0 1101257612 91 Waiver service provider--Adults (DHS/DDD) 96 St Clair 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 0 334 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 334 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22538.77 0 0 0 0 0 0 0 0 0 0 0 0 0 22538.77 0 0 0 1101257613 92 Waiver service provider--Disability (DHS/DRS) 91 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27699.87 0 0 0 0 0 0 0 0 0 0 0 0 0 27699.87 0 0 0 1101257619 92 Waiver service provider--Disability (DHS/DRS) 15 Bureau 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 22331.32 0 0 0 0 0 0 0 0 0 0 0 0 0 22331.32 0 0 0 1101257641 98 Waiver service provider--TBI (DHS/DRS) 80 Peoria 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 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 4086.39 0 0 0 0 0 0 0 0 0 0 0 0 0 4086.39 0 0 0 1101257644 1720236870 22 Physical Therapists KRAWZAK CAROLINE 605151394 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16107.79 16107.79 0 0 0 1101257646 1518989847 10 Physicians GANDHI AASHISH 609142325 54 Kankakee 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 0 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 516 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 516 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19127.67 0 0 0 0 0 0 19127.67 0 0 0 1101257653 2100248071 92 Waiver service provider--Disability (DHS/DRS) LIVING SPRING HOME HEALTH CARE 604302759 200 Cook 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 547 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 547 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1162700.49 0 0 0 0 0 0 0 0 0 0 0 0 0 1162700.49 0 0 0 1101257660 1740491331 10 Physicians RITTMANN ALLISON 601943548 200 Cook 0 1 Family Practice 0 9 0 0 6 0 0 0 0 0 0 6 0 39 0 0 0 0 0 0 35 0 0 11 0 0 0 0 0 0 7 0 122 0 0 0 0 0 0 35 0 0 11 0 0 0 0 0 0 7 0 122 0 0 0 0 0 0 77 0 0 256.12 0 0 0 0 0 0 64.26 0 1314.87 0 0 0 0 0 0 1712.25 0 0 0 1101257673 1346295631 29 ICF/MR WALTER LAWSON CHILDRENS HOME 611112757 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1879 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47752 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7634448.89 0 0 0 0 0 0 0 0 0 0 7634448.89 0 0 0 1101257677 1710147178 11 Dentists MURAD SANDY 606233701 200 Cook 0 0 General Dentistry 0 0 0 274 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34603.72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34603.72 0 0 0 1101257688 1447290465 10 Physicians WESTIN CRAIG 606017568 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 12 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115.99 0 2764.65 0 0 0 0 0 0 2880.64 0 0 0 1101257694 1740446269 28 Waiver service provider--Supportive living facility (HFS) WOODRIDGE SL RESIDENCE GENESEO 612547601 45 Henry 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 0 249 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6786 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 333245.67 0 0 0 0 0 0 0 0 0 0 0 0 0 333245.67 0 0 0 1101257712 1780799387 10 Physicians GIBSON SANDY 606123723 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 303.24 0 0 0 0 0 0 303.24 0 0 0 1101257715 1881707321 63 Other Providers of Medical Equipment/Supplies (Non-registered) AIR SYSTEMS OF ILLINOIS INC 604115506 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 630.94 0 0 0 0 0 0 630.94 0 0 0 1101257719 92 Waiver service provider--Disability (DHS/DRS) 30 DuPage 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26747.89 0 0 0 0 0 0 0 0 0 0 0 0 0 26747.89 0 0 0 1101257723 1447273859 10 Physicians SHAH SAMIR 608052107 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 566 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 566 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2198.71 0 0 0 0 0 0 2198.71 0 0 0 1101257727 92 Waiver service provider--Disability (DHS/DRS) 56 Knox 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2243.03 0 0 0 0 0 0 0 0 0 0 0 0 0 2243.03 0 0 0 1101257751 1396910261 10 Physicians WIGFIELD CHRISTOPHER 605277594 30 DuPage 0 0 Cardiovascular Surgery 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 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7171.54 0 0 0 0 0 0 7171.54 0 0 0 1101257753 1033249362 22 Physical Therapists WEAVER PRISCILLA 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9679.81 9679.81 0 0 0 1101257756 1982787289 16 Nurse Practitioners ERL JAMES 605061449 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 187 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 187 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4130.93 0 0 0 0 0 0 4130.93 0 0 0 1101257776 1235160326 63 Other Providers of Medical Equipment/Supplies (Non-registered) KRAMER ENTERPRISES 604355264 107 Will 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 0 454 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 454 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20018.19 0 0 0 0 0 0 20018.19 0 0 0 1101257781 1396877098 16 Nurse Practitioners WIEMER CHERYL 606313222 58 La Salle 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 15.83 0 0 0 0 0 0 0 0 1699.76 0 0 0 0 0 0 1715.59 0 0 0 1101257791 1831176692 10 Physicians COCHRAN MICHAEL 617013514 72 McLean 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 1 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75.64 0 0 0 0 0 0 75.64 0 0 0 1101257803 1437101094 10 Physicians GILL KULJEET 600073367 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4524.02 0 0 0 0 0 0 4524.02 0 0 0 1101257804 1013917327 10 Physicians LAYLAND MICHAEL 600681127 200 Cook 0 0 Otorhinolaryngology 0 0 0 0 0 0 0 0 0 0 0 2 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 250 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 250 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10706.21 0 0 0 0 0 0 10706.21 0 0 0 1101257819 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 25819.28 0 0 0 0 0 0 0 0 0 0 0 0 0 25819.28 0 0 0 1101257822 1518915842 10 Physicians KAWJI MAZEN 604322065 107 Will 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 255 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 688 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 688 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10862.97 0 0 0 0 0 0 10862.97 0 0 0 1101257841 1083789911 11 Dentists PARISH ROBERT 620470526 16 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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 4219.26 0 0 0 0 0 0 0 0 0 0 0 0 0 4219.26 0 0 0 1101258318 1700860707 10 Physicians SMITH ERICA 600614304 57 Lake 0 0 Obstetric-Gynecology 0 0 0 0 4 0 0 0 0 0 0 27 0 130 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 36 0 262 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 36 0 262 0 0 0 0 0 0 0 0 0 419.84 0 0 0 0 0 0 1558.02 0 23525.32 0 0 0 0 0 0 25503.18 0 0 0 1101258347 1609130632 11 Dentists MARTUSIEWICZ COURTNEY 606122228 200 Cook 0 0 General Dentistry 0 0 0 1004 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4851 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4851 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165810.66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165810.66 0 0 0 1101258350 92 Waiver service provider--Disability (DHS/DRS) 88 Richland 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 862.91 0 0 0 0 0 0 0 0 0 0 0 0 0 862.91 0 0 0 1101258382 1750375622 12 Optometrists MA SUN AE 606163878 200 Cook 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 271 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 306 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 306 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10952.11 0 0 0 0 0 0 10952.11 0 0 0 1101258400 1871603746 47 Local Education Agencies COLUMBIA COMM UNIT SCH DIST 4 622361130 75 Monroe 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 1139 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 1139 0 0 0 0 288.3 0 0 0 0 0 0 0 0 0 0 0 0 0 14329.16 0 14617.46 0 0 0 1101258409 91 Waiver service provider--Adults (DHS/DDD) 61 Livingston 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 0 361 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 361 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16368 0 0 0 0 0 0 0 0 0 0 0 0 0 16368 0 0 0 1101258467 1710988126 10 Physicians STAUDACHER MARK 605061449 53 Kane 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7847.37 0 0 0 0 0 0 7847.37 0 0 0 1101258475 30 General Hospitals 815 Indiana NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 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 0 645.89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 645.89 0 0 0 1101258480 98 Waiver service provider--TBI (DHS/DRS) 80 Peoria 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10727 0 0 0 0 0 0 0 0 0 0 0 0 0 10727 0 0 0 1101258518 92 Waiver service provider--Disability (DHS/DRS) 79 Ogle 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 33.31 0 0 0 0 0 0 0 0 0 0 0 0 0 33.31 0 0 0 1101258527 1013113265 13 Podiatrists PACACCIO JENNIFER 601783183 27 Dekalb 0 0 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 0 236 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 236 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4240.75 0 0 0 0 0 0 4240.75 0 0 0 1101258546 1780697953 16 Nurse Practitioners KANCEWICK DANIEL 624012006 33 Effingham 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 0 0 0 0 0 0 0 0 23 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 0 0 0 0 0 0 0 0 1125.84 0 0 0 0 0 0 1125.84 0 0 0 1101258566 1699889071 10 Physicians GUNNERSON HELENA 601181454 53 Kane 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20088.45 0 0 0 0 0 0 20088.45 0 0 0 1101258578 1588640783 12 Optometrists DARLINGTON GLENN 612017102 89 Rock Island 0 0 Therapeutic Pharmaceutical Agents 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 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1389.48 0 0 0 0 0 0 1389.48 0 0 0 1101258586 98 Waiver service provider--TBI (DHS/DRS) 19 Champaign 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 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 1945.23 0 0 0 0 0 0 0 0 0 0 0 0 0 1945.23 0 0 0 1101258591 91 Waiver service provider--Adults (DHS/DDD) 53 Kane 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 0 237 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 237 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13843.5 0 0 0 0 0 0 0 0 0 0 0 0 0 13843.5 0 0 0 1101258593 1285602516 10 Physicians MILOS GLENN J 535475081 30 DuPage 0 0 Emergency Medicine 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 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 0 513.72 0 0 0 0 0 0 513.72 0 0 0 1101258602 1619083730 33 Nursing Facilities ILLINI HERITAGE REHAB AND HC 618266179 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 584 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12077 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 868383.84 0 0 0 0 0 0 0 868383.84 0 0 0 1101258616 1154397354 10 Physicians MARTINEZ LUCIO 610324864 97 Stephenson 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1828.08 0 0 0 0 0 0 1828.08 0 0 0 1101258617 1245451996 11 Dentists JAVIER MARIA 606183301 200 Cook 0 0 General Dentistry 0 0 0 255 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1863 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1863 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60335.73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60335.73 0 0 0 1101258623 1265409353 10 Physicians PRIPSTEIN JEREMY 610324864 97 Stephenson 0 1 Internal Medicine 0 288 0 0 43 0 0 0 0 0 0 31 0 256 0 0 0 0 0 0 696 0 0 95 0 0 0 0 0 0 44 0 428 0 0 0 0 0 0 696 0 0 95 0 0 0 0 0 0 44 0 428 0 0 0 0 0 0 1644 0 0 3962.88 0 0 0 0 0 0 172.99 0 15512.68 0 0 0 0 0 0 21292.55 0 0 0 1101258627 1629040191 10 Physicians ENGEBRECHT BRIAN 602656145 89 Rock Island 0 0 Urology 0 0 0 0 0 0 0 0 0 0 0 22 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 240 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 240 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130.75 0 4900.1 0 0 0 0 0 0 5030.85 0 0 0 1101258666 98 Waiver service provider--TBI (DHS/DRS) 47 Jackson 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 8558.18 0 0 0 0 0 0 0 0 0 0 0 0 0 8558.18 0 0 0 1101258668 10 Physicians 815 Indiana 0 0 Anesthesiology 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 1125.29 0 0 0 0 0 0 1125.29 0 0 0 1101258692 1487788683 24 Speech Therapists LUNDY JULIE 604535235 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2492 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2492 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 186265.19 186265.19 0 0 0 1101258714 1245423284 10 Physicians LIU LIN 602011718 200 Cook 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 307 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 523 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 523 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4508.04 0 0 0 0 0 0 0 0 4508.04 0 0 0 1101258735 92 Waiver service provider--Disability (DHS/DRS) 96 St Clair 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 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3828.89 0 0 0 0 0 0 0 0 0 0 0 0 0 3828.89 0 0 0 1101258739 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 31020.36 0 0 0 0 0 0 0 0 0 0 0 0 0 31020.36 0 0 0 1101258740 1912114703 55 Early Intervention Services STEWART BONNIE 604776317 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 302 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 302 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27232.41 0 0 0 0 0 0 27232.41 0 0 0 1101258743 1699759282 10 Physicians PIELET ALLEN 604771758 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1502.04 0 0 0 0 0 0 1502.04 0 0 0 1101258768 1992052195 10 Physicians LUMBA ANGELA K 631101002 826 Missouri 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4417.73 0 0 0 0 0 0 4417.73 0 0 0 1101258769 1730257668 22 Physical Therapists MCMAHON LAURA 600761242 200 Cook 0 0 0 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 0 367 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 367 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27602.94 27602.94 0 0 0 1101258804 1154329753 30 General Hospitals ABRAHAM LINCOLN CHILDRENS HOSP 626565066 62 Logan CHILDRENS Hospital designated as childrens hospitals and paid a Per Diem rate. 1 0 General Hospital - Children Section 0 0 0 0 0 442 0 0 0 0 6 0 0 0 46 0 0 0 0 0 0 0 0 0 628 0 0 0 0 6 0 0 0 60 0 0 0 0 0 0 0 0 0 628 0 0 0 0 9 0 0 0 60 0 0 0 0 0 0 0 0 0 89471.07 0 0 0 0 15071.44 0 0 0 30867.51 0 0 0 0 0 135410.02 0 0 0 1101258840 1922120062 10 Physicians BEDINGFIELD BRUCE 601692044 200 Cook 0 1 Pediatrics 0 9 0 0 14 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 53 0 0 17 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 53 0 0 17 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 106 0 0 1181.6 0 0 0 0 0 0 0 0 1849.63 0 0 0 0 0 0 3137.23 0 0 0 1101258852 92 Waiver service provider--Disability (DHS/DRS) 19 Champaign 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 0 550.82 0 0 0 0 0 0 0 0 0 0 0 0 0 550.82 0 0 0 1101258857 1255331773 10 Physicians BAER JOHN 615680187 98 Tazewell 0 1 Family Practice 0 14 0 0 1 0 0 0 0 0 0 2 0 43 0 0 0 0 0 0 90 0 0 1 0 0 0 0 0 0 4 0 76 0 0 0 0 0 0 90 0 0 1 0 0 0 0 0 0 4 0 76 0 0 0 0 0 0 223 0 0 96.6 0 0 0 0 0 0 9.88 0 1766.6 0 0 0 0 0 0 2096.08 0 0 0 1101258864 24 Speech Therapists 24 Coles 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 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 0 232.21 232.21 0 0 0 1101258868 1386690139 10 Physicians SINGH INDER 606591706 200 Cook 0 0 Family Practice 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 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 251.81 0 0 0 0 0 0 251.81 0 0 0 1101258873 1750597811 10 Physicians ANSARI YASMEEN 601012889 30 DuPage 0 0 Family Practice 0 51 0 0 20 0 0 0 0 0 0 7 0 74 0 0 0 0 0 0 156 0 0 63 0 0 0 0 0 0 7 0 152 0 0 0 0 0 0 156 0 0 63 0 0 0 0 0 0 7 0 152 0 0 0 0 0 0 366 0 0 2173.28 0 0 0 0 0 0 45.95 0 5194.96 0 0 0 0 0 0 7780.19 0 0 0 1101258878 1922143015 47 Local Education Agencies MIDLOTHIAN SCHOOL DISTRICT 143 604453436 200 Cook 0 0 0 0 0 0 824 0 0 0 0 0 0 0 0 0 0 0 0 0 227 0 0 0 0 1483 0 0 0 0 0 0 0 0 0 0 0 0 0 6111 0 0 0 0 1483 0 0 0 0 0 0 0 0 0 0 0 0 0 6111 0 0 0 0 8740.77 0 0 0 0 0 0 0 0 0 0 0 0 0 110759.78 0 119500.55 0 0 0 1101258898 1235321423 28 Waiver service provider--Supportive living facility (HFS) FRIEDMAN PLACE 606252214 200 Cook 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 678 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17008 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1171008 0 0 0 0 0 0 0 0 0 0 0 0 0 1171008 0 0 0 1101258907 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6321.81 0 0 0 0 0 0 0 0 0 0 0 0 0 6321.81 0 0 0 1101258909 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 14 0 0 0 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 17243.4 0 0 0 0 0 0 0 0 0 0 0 0 0 17243.4 0 0 0 1101258912 1447485545 63 Other Providers of Medical Equipment/Supplies (Non-registered) SCHECK AND SIRESS PROSTHETICS 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 224 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 224 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8646.8 0 55083.77 0 0 0 0 63730.57 0 0 0 1101258930 1366478125 10 Physicians SARROCA MANUEL 606144620 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 395 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 413 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 413 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14246.57 0 0 0 0 0 0 14246.57 0 0 0 1101258937 1184852998 11 Dentists WORTH CHRIS 606233740 200 Cook 0 0 General Dentistry 0 0 0 476 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3444 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3444 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105039.95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105039.95 0 0 0 1101258941 1104916485 10 Physicians HICKERSON ROBERT G 614481339 56 Knox 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 332 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 332 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 736.31 0 0 0 0 0 0 736.31 0 0 0 1101258946 1497080865 16 Nurse Practitioners NADOLSKI STEVEN 600442203 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1580.75 0 0 0 0 0 0 1580.75 0 0 0 1101258979 1952464844 46 Ambulatory Surgical Treatment Centers EDWARDSVILLE AMBULATORY S CTR 620343502 65 Madison ASTC Ambulatory Surgical Treatment Center. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18562.57 0 0 0 0 0 18562.57 0 0 0 1101258993 91 Waiver service provider--Adults (DHS/DDD) 57 Lake 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 0 138 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 138 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23782 0 0 0 0 0 0 0 0 0 0 0 0 0 23782 0 0 0 1101258994 1104012129 28 Waiver service provider--Supportive living facility (HFS) GLENWOOD STAUNTON 620882334 64 Macoupin 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 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59880.68 0 0 0 0 0 0 0 0 0 0 0 0 0 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278039.43 0 0 0 999086.4 0 0 0 0 0 2729788.98 0 0 0 1101259586 1629056890 30 General Hospitals WAUKESHA MEMORIAL HOSPITAL 531885031 852 Wisconsin NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 316 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 316 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1998.37 0 0 0 0 0 0 0 0 1998.37 0 0 0 1101259598 1154619062 55 Early Intervention Services SUTTON MARY 606146383 200 Cook 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 0 373 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 373 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20109.39 0 0 0 0 0 0 20109.39 0 0 0 1101259599 1114050812 70 Ambulance Service Providers UTICA FIRE PROTECTION DIST 613789729 60 Lee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3302.17 0 0 0 0 0 0 3302.17 0 0 0 1101259613 1659380343 10 Physicians STONE JAMES 602011780 200 Cook 0 0 Neurology Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82399.58 0 0 0 0 0 0 82399.58 0 0 0 1101259617 1316037906 10 Physicians DULL RANDAL 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64 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 23829.21 0 0 0 0 0 0 23829.21 0 0 0 1101259623 22 Physical Therapists 57 Lake 0 0 0 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 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 89.16 89.16 0 0 0 1101259624 1952358939 10 Physicians DASTICE MICHAEL 604535205 200 Cook 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 194 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 491 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 491 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12547.44 0 0 0 0 0 0 12547.44 0 0 0 1101259625 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12675.93 0 0 0 0 0 0 0 0 0 0 0 0 0 12675.93 0 0 0 1101259626 92 Waiver service provider--Disability (DHS/DRS) 97 Stephenson 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 15083.7 0 0 0 0 0 0 0 0 0 0 0 0 0 15083.7 0 0 0 1101259627 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 316 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 316 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9274.65 0 0 0 0 0 0 0 0 0 0 0 0 0 9274.65 0 0 0 1101259631 1982622437 10 Physicians DICKE JEFF 631101010 826 Missouri 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 129 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 310 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 310 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6542.14 0 2975.65 0 0 0 0 0 0 9517.79 0 0 0 1101259636 1205807658 10 Physicians BAUMWELL STERLING 604023429 200 Cook 0 0 Obstetric-Gynecology 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 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13379.27 0 0 0 0 0 0 13379.27 0 0 0 1101259637 1912096231 10 Physicians THOMAS ANISH 999999999 103 Washington 0 0 Cardiovascular Diseases 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 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 1311.49 0 0 0 0 0 0 1311.49 0 0 0 1101259644 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 47 0 0 0 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 2618 0 0 0 0 0 0 0 0 0 0 0 0 0 2618 0 0 0 1101259653 1356368617 60 Pharmacies WALMART PHARMACY 10-0786 601152067 27 Dekalb 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1495 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 361978 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 520415.55 0 0 0 520415.55 0 0 0 1101259656 1831119767 36 Community mental health provider FAMILY SERVICE MHC OF CICERO 606502817 200 Cook 0 0 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 602 0 0 425 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3453 0 0 425 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3453 0 0 15757.76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230097.47 0 0 245855.23 0 0 0 1101259667 1811081094 16 Nurse Practitioners BRITTON DENISE 600257635 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70.55 0 0 0 0 0 0 70.55 0 0 0 1101259688 47 Local Education Agencies 103 Washington 0 0 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 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 113.62 0 113.62 0 0 0 1101259708 1609859289 10 Physicians FUREY PETER 606118709 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 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JONATHAN 601901222 30 DuPage 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 112 0 553 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 672 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 672 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1357.7 0 16377 0 0 0 0 0 0 17734.7 0 0 0 1101259729 1659382679 10 Physicians FARAHVAR ARASH 618012530 19 Champaign 0 0 Neurology Surgery 0 0 0 0 0 0 0 0 0 0 0 13 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 343 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 343 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 321.4 0 77326.72 0 0 0 0 0 0 77648.12 0 0 0 1101259734 1083831895 11 Dentists KHAN MOHD 606492902 200 Cook 0 0 General Dentistry 0 0 0 315 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1449 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1449 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57568.39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57568.39 0 0 0 1101259736 1194989178 10 Physicians BECKERLY RENA 606118709 200 Cook 0 0 Anesthesiology 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 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41554.17 0 0 0 0 0 0 41554.17 0 0 0 1101259767 1902822158 10 Physicians TANIS DONALD 606123863 200 Cook 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 2 0 178 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 436 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 436 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14.02 0 6631.17 0 0 0 0 0 0 6645.19 0 0 0 1101259768 1205843398 10 Physicians TYO CARISSA 605321348 30 DuPage 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 2 0 704 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 995 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 995 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116.59 0 82350.83 0 0 0 0 0 0 82467.42 0 0 0 1101259771 1922112408 10 Physicians HENSEL PRISCILLA 606743452 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54304.39 0 0 0 0 0 0 54304.39 0 0 0 1101259775 1255574281 10 Physicians COSTIGAN DANIEL 601181454 53 Kane 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 2 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6772.67 0 0 0 0 0 0 6772.67 0 0 0 1101259777 1376535120 10 Physicians ALI NABIL 600508409 71 McHenry 0 0 Pathology 0 0 0 0 6 0 0 0 0 0 0 1870 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 14556 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 14556 0 0 0 0 0 0 0 0 0 0 0 35.58 0 0 0 0 0 0 54771.24 0 0 0 0 0 0 0 0 54806.82 0 0 0 1101259778 93 Waiver service provider--HIV/AIDS (DHS/DRS) 65 Madison 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 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 5656.07 0 0 0 0 0 0 0 0 0 0 0 0 0 5656.07 0 0 0 1101259782 92 Waiver service provider--Disability (DHS/DRS) 37 Fulton 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 6466.25 0 0 0 0 0 0 0 0 0 0 0 0 0 6466.25 0 0 0 1101259785 16 Nurse Practitioners 826 Missouri 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107.45 0 0 0 0 0 0 107.45 0 0 0 1101259795 92 Waiver service provider--Disability (DHS/DRS) 54 Kankakee 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 81.03 0 0 0 0 0 0 0 0 0 0 0 0 0 81.03 0 0 0 1101259802 94 Waiver service provider--Children's support (DHS/DDD) 30 DuPage 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 277.86 0 0 0 0 0 0 0 0 0 0 0 0 0 277.86 0 0 0 1101259806 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 20736.05 0 0 0 0 0 0 0 0 0 0 0 0 0 20736.05 0 0 0 1101259824 1881612471 10 Physicians GRANBERRY KATHERINE 606431791 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 793 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 857 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 857 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27418.17 0 0 0 0 0 0 27418.17 0 0 0 1101259827 1568623197 10 Physicians INGENERI AMY 606232460 200 Cook 0 0 Pediatrics 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 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4139.3 0 0 0 0 0 0 4139.3 0 0 0 1101259834 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 15004.1 0 0 0 0 0 0 0 0 0 0 0 0 0 15004.1 0 0 0 1101259850 1487628228 10 Physicians TURK CHARLES O 604632391 200 Cook 0 0 Urological Surgery 0 0 0 0 0 0 0 0 0 0 0 3 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16.47 0 1780.5 0 0 0 0 0 0 1796.97 0 0 0 1101259853 91 Waiver service provider--Adults (DHS/DDD) 72 McLean 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 82 0 0 0 0 0 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 6579.5 0 0 0 0 0 0 0 0 0 0 0 0 0 6579.5 0 0 0 1101259859 1114170073 10 Physicians USMANI REHMAN 616360001 80 Peoria 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 330 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 330 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4707.54 0 0 0 0 0 0 4707.54 0 0 0 1101259864 1710077219 30 General Hospitals RCG MERRIONETTE PARK 608036302 200 Cook DIALYSIS Outpatient dialysis centers. 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 253 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3343 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75170.42 0 0 0 0 0 75170.42 0 0 0 1101259865 1720024219 10 Physicians MITAL DEEPAK 601533328 200 Cook 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1068.81 0 0 0 0 0 0 1068.81 0 0 0 1101259877 1306962121 16 Nurse Practitioners KRAESSIG DANIELLE 604021108 200 Cook 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 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 6737.46 0 0 0 0 0 0 6737.46 0 0 0 1101259879 1992766190 10 Physicians BOWMAN MARSH JAN 705083870 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 163 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 485 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 485 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6472.78 0 0 0 0 0 0 6472.78 0 0 0 1101259880 1891986873 47 Local Education Agencies MATTESON ELEM SCHOOL DIST 162 604711470 200 Cook 0 0 0 0 0 0 506 0 0 0 0 0 0 0 0 0 0 0 0 0 329 0 0 0 0 1037 0 0 0 0 0 0 0 0 0 0 0 0 0 10573 0 0 0 0 1037 0 0 0 0 0 0 0 0 0 0 0 0 0 10573 0 0 0 0 6182.02 0 0 0 0 0 0 0 0 0 0 0 0 0 200001.85 0 206183.87 0 0 0 1101259886 1396958864 11 Dentists CHAMPION HARRIS TINA 604711461 200 Cook 0 0 General Dentistry 0 0 0 305 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1638 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1638 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42487.7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42487.7 0 0 0 1101259889 1821021007 10 Physicians CZAJKOWSKI GEORGE 606313222 200 Cook 0 1 Internal Medicine 0 21 0 0 0 0 0 0 0 0 0 18 0 114 0 0 0 0 0 0 159 0 0 0 0 0 0 0 0 0 22 0 274 0 0 0 0 0 0 159 0 0 0 0 0 0 0 0 0 22 0 274 0 0 0 0 0 0 464 0 0 0 0 0 0 0 0 0 95.91 0 6822.63 0 0 0 0 0 0 7382.54 0 0 0 1101259901 1770611642 34 State-operated facility (DHS) UNIT 3566 HOME 46 KILEY 600856263 57 Lake 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 540 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 406254.05 0 0 0 0 0 0 0 0 0 0 406254.05 0 0 0 1101259912 1821016395 10 Physicians CSERNANSKY JOHN 606118709 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 943.68 0 0 0 0 0 0 943.68 0 0 0 1101259927 92 Waiver service provider--Disability (DHS/DRS) 107 Will 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 15191.66 0 0 0 0 0 0 0 0 0 0 0 0 0 15191.66 0 0 0 1101259928 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 6284.37 0 0 0 0 0 0 0 0 0 0 0 0 0 6284.37 0 0 0 1101259942 1770629073 70 Ambulance Service Providers MINIER RESCUE SQUAD 617590680 98 Tazewell 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 736.7 0 0 0 0 0 0 736.7 0 0 0 1101259943 1972524403 10 Physicians KOCHENDORFER KARL 999999999 200 Cook 0 0 0 97 0 0 17 0 0 0 0 0 0 2 0 104 0 0 0 0 0 0 614 0 0 24 0 0 0 0 0 0 4 0 197 0 0 0 0 0 0 614 0 0 24 0 0 0 0 0 0 4 0 197 0 0 0 0 0 0 1656 0 0 1913.52 0 0 0 0 0 0 18.51 0 24304.89 0 0 0 0 0 0 27892.92 0 0 0 1101259961 1427109248 10 Physicians STROPE SETH 631101010 826 Missouri 0 0 Urological Surgery 0 0 0 0 0 0 0 0 0 0 0 16 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2.6 0 1343.52 0 0 0 0 0 0 1346.12 0 0 0 1101259969 1598701088 10 Physicians HARB TAREK 611042235 109 Winnebago 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 54 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135 0 344 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135 0 344 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5823.26 0 35657.99 0 0 0 0 0 0 41481.25 0 0 0 1101259979 1518953520 10 Physicians JAKUPCAK JANET 613411484 58 La Salle 0 1 Family Practice 0 35 0 0 5 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 175 0 0 5 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 175 0 0 5 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 470 0 0 387.29 0 0 0 0 0 0 0 0 743.11 0 0 0 0 0 0 1600.4 0 0 0 1101259989 1235420019 75 Department of Alcohol and Substance Abuse Provider GATEWAY FOUNDATION CARBONDALE 629013812 47 Jackson 0 0 0 0 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 2632 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2632 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 381575.32 0 0 381575.32 0 0 0 1101260024 1962515783 63 Other Providers of Medical Equipment/Supplies (Non-registered) COMPREHENSIVE DECUBITUS THERAP 722234696 804 Arkansas 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10662 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10662 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 330294.99 0 0 0 0 0 0 330294.99 0 0 0 1101260040 1144314477 10 Physicians JAVIDAN NEJAD CYLEN 631101016 826 Missouri 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 322 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 557 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 557 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7421.23 0 0 0 0 0 0 0 0 7421.23 0 0 0 1101260045 1225203110 16 Nurse Practitioners SPENCER ERIKA 631102500 826 Missouri 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 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 414.12 0 0 0 0 0 0 414.12 0 0 0 1101260046 10 Physicians 826 Missouri 0 0 Anesthesiology 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 14 0 0 0 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 1136.85 0 0 0 0 0 0 1136.85 0 0 0 1101260055 1487719860 40 Federally Qualified Health Centers SIHF BETHALTO HEALTH CTR 620242294 65 Madison 0 1 0 534 2223 0 594 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4038 13139 0 1941 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4038 13139 0 1941 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9736 581964.56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 591700.56 0 0 0 1101260064 1750329074 10 Physicians BAUER MARSH ELIZABETH 616360001 80 Peoria 0 0 Pathology 0 0 0 0 10 0 0 0 0 0 0 1159 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 6640 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 6640 0 0 0 0 0 0 0 0 0 0 0 59.3 0 0 0 0 0 0 26393.58 0 0 0 0 0 0 0 0 26452.88 0 0 0 1101260069 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 13169.25 0 0 0 0 0 0 0 0 0 0 0 0 0 13169.25 0 0 0 1101260072 91 Waiver service provider--Adults (DHS/DDD) 53 Kane 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 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11142 0 0 0 0 0 0 0 0 0 0 0 0 0 11142 0 0 0 1101260078 91 Waiver service provider--Adults (DHS/DDD) 91 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 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18356.24 0 0 0 0 0 0 0 0 0 0 0 0 0 18356.24 0 0 0 1101260088 1164527347 10 Physicians KOH EUN-KYU 602011718 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 175 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 175 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17303.14 0 0 0 0 0 0 17303.14 0 0 0 1101260097 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 11141.94 0 0 0 0 0 0 0 0 0 0 0 0 0 11141.94 0 0 0 1101260129 1043448491 13 Podiatrists BARSKY YELANA 606473611 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 515 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10904.48 0 0 0 0 0 0 10904.48 0 0 0 1101260130 1033365275 36 Community mental health provider HEARTLAND HUMAN SERVICES 624011635 33 Effingham 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 1192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3086 0 0 1192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3086 0 0 313 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 134679.47 0 0 134992.47 0 0 0 1101260138 1679552350 10 Physicians COOKE LINDA 634016877 826 Missouri 0 0 Dermatology 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 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1315.27 0 0 0 0 0 0 1315.27 0 0 0 1101260146 1861458952 10 Physicians WAGONER RICHARD 626440530 68 Mason 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2905.82 0 0 0 0 0 0 2905.82 0 0 0 1101260148 1487687299 10 Physicians EVERAKES SARAH 606124861 200 Cook 0 0 Rheumatology 0 0 0 0 0 0 0 0 0 0 0 0 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 338 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 338 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4711.14 0 0 0 0 0 0 4711.14 0 0 0 1101260151 92 Waiver service provider--Disability (DHS/DRS) 106 Whiteside 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 163.04 0 0 0 0 0 0 0 0 0 0 0 0 0 163.04 0 0 0 1101260157 1407984297 70 Ambulance Service Providers JOHNSON COUNTY AMBULANCE 629951778 52 Johnson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 452 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 452 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18791.32 0 0 0 0 0 0 18791.32 0 0 0 1101260170 1053617589 16 Nurse Practitioners SPRUELL AMIE 628642857 49 Jefferson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 195 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40375.9 0 0 0 0 0 0 40375.9 0 0 0 1101260172 1407038367 10 Physicians MICHEL MARJORIE 606173909 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72965.17 0 0 0 0 0 0 72965.17 0 0 0 1101260179 1164519054 10 Physicians ROJAS MANUEL O 606324642 200 Cook 0 1 Pediatrics 0 854 0 0 262 0 0 0 0 0 0 270 0 419 0 0 0 0 0 0 7643 0 0 684 0 0 0 0 0 0 307 0 513 0 0 0 0 0 0 7643 0 0 684 0 0 0 0 0 0 307 0 513 0 0 0 0 0 0 15286 0 0 23212.14 0 0 0 0 0 0 3633.31 0 20741.94 0 0 0 0 0 0 62873.39 0 0 0 1101260183 1053366740 63 Other Providers of Medical Equipment/Supplies (Non-registered) BYRAM HEALTHCARE CENTERS INC 605155415 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2632 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27554 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27554 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1830006.89 0 0 0 0 0 0 1830006.89 0 0 0 1101260190 91 Waiver service provider--Adults (DHS/DDD) 89 Rock Island 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 0 331 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 331 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20821.24 0 0 0 0 0 0 0 0 0 0 0 0 0 20821.24 0 0 0 1101260191 1780809152 10 Physicians SAJJAD MOHAMMED 600315257 57 Lake 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 223 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1577 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1577 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27934.13 0 0 0 0 0 0 27934.13 0 0 0 1101260193 1063438380 10 Physicians CONNOLLY ANNE 631101010 826 Missouri 0 0 Child Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2514.19 0 0 0 0 0 0 2514.19 0 0 0 1101260217 1649249673 10 Physicians SHARMA DINESH 618323752 100 Vermilion 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 497 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 547 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 547 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18001.67 0 0 0 0 0 0 18001.67 0 0 0 1101260228 1376743088 10 Physicians CARPENTER DANIELLE 631101010 826 Missouri 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2054.09 0 0 0 0 0 0 0 0 2054.09 0 0 0 1101260231 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3670.27 0 0 0 0 0 0 0 0 0 0 0 0 0 3670.27 0 0 0 1101260233 1447274279 10 Physicians ABRAHMIAN FRIDA 606123723 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 716.44 0 0 0 0 0 0 716.44 0 0 0 1101260244 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 3663.34 0 0 0 0 0 0 0 0 0 0 0 0 0 3663.34 0 0 0 1101260255 1902831696 10 Physicians CHIANG PAUL 601873112 30 DuPage 0 1 Internal Medicine 0 7 0 0 0 0 0 0 0 0 0 1 0 47 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 1 0 138 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 1 0 138 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 10 0 1825.68 0 0 0 0 0 0 1907.68 0 0 0 1101260262 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 23509.79 0 0 0 0 0 0 0 0 0 0 0 0 0 23509.79 0 0 0 1101260275 1679651053 60 Pharmacies WALGREENS 07267 606212012 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 2904 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 10594 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 246090 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24.64 0 0 468844.65 0 0 0 468869.29 0 0 0 1101260281 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13427.59 0 0 0 0 0 0 0 0 0 0 0 0 0 13427.59 0 0 0 1101260285 1093872822 10 Physicians NIKOLOV MIHAIL 600442203 57 Lake 0 0 General Practice 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 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7862.62 0 0 0 0 0 0 7862.62 0 0 0 1101260299 1225013238 10 Physicians LAMBA ANIL 604521403 200 Cook 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9965.48 0 0 0 0 0 0 9965.48 0 0 0 1101260303 1558379024 10 Physicians AMBROSE STEVEN 608052853 200 Cook 0 0 Obstetrics 0 0 0 0 0 0 0 0 0 0 0 181 0 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 734 0 260 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 734 0 260 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25522.26 0 10478.7 0 0 0 0 0 0 36000.96 0 0 0 1101260306 1205828084 10 Physicians JUNKER JESSIE 625264371 63 Macon 0 1 Family Practice 0 47 0 0 31 0 0 0 0 0 0 32 0 179 0 0 0 0 0 0 333 0 0 83 0 0 0 0 0 0 39 0 280 0 0 0 0 0 0 333 0 0 83 0 0 0 0 0 0 39 0 280 0 0 0 0 0 0 980 0 0 2916.38 0 0 0 0 0 0 361.04 0 22263 0 0 0 0 0 0 26520.42 0 0 0 1101260317 1881689602 10 Physicians ZENG ZHUOWEN 463212807 815 Indiana 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 27 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 0 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 500.68 0 0 0 0 0 0 0 0 500.68 0 0 0 1101260326 92 Waiver service provider--Disability (DHS/DRS) 96 St Clair 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 17194.01 0 0 0 0 0 0 0 0 0 0 0 0 0 17194.01 0 0 0 1101260337 1447217625 10 Physicians VILLASUSO RAUL 601533328 30 DuPage 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 223 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 223 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1723.92 0 0 0 0 0 0 1723.92 0 0 0 1101260339 10 Physicians 815 Indiana 0 0 Radiology Diagnosis 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 30 0 0 0 0 0 0 0 0 30 0 0 0 1101260341 1346393428 10 Physicians CURTIN JOHN 604624401 200 Cook 0 0 Family Practice 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 14 0 0 0 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 0 130.96 0 0 0 0 0 0 130.96 0 0 0 1101260358 10 Physicians 826 Missouri 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 2 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12.02 0 148.66 0 0 0 0 0 0 160.68 0 0 0 1101260360 98 Waiver service provider--TBI (DHS/DRS) 97 Stephenson 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 3683.61 0 0 0 0 0 0 0 0 0 0 0 0 0 3683.61 0 0 0 1101260379 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 18366.79 0 0 0 0 0 0 0 0 0 0 0 0 0 18366.79 0 0 0 1101260387 1053342758 16 Nurse Practitioners GRAF AMY 606405704 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5495.6 0 0 0 0 0 0 5495.6 0 0 0 1101260389 1346498292 10 Physicians SHAH ARPIT 604677331 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 401 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2353 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2353 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13883.3 0 0 0 0 0 0 13883.3 0 0 0 1101260394 1285630780 10 Physicians PETCHENIK LON 600052382 200 Cook 0 0 Otorhinolaryngology 0 0 0 0 0 0 0 0 0 0 0 0 0 40 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 0 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2393.27 0 0 0 0 0 0 2393.27 0 0 0 1101260398 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24357.29 0 0 0 0 0 0 0 0 0 0 0 0 0 24357.29 0 0 0 1101260430 1659334134 10 Physicians GRIFFITHS ALLISON 604532600 200 Cook 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 864 0 153 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1127 0 184 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1127 0 184 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14986.86 0 1905.84 0 0 0 0 0 0 16892.7 0 0 0 1101260433 1720275084 28 Waiver service provider--Supportive living facility (HFS) VICTORY CENTRE OF SIERRA RIDGE 999999999 200 Cook 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 493 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 861293.56 0 0 0 0 0 0 0 0 0 0 0 0 0 861293.56 0 0 0 1101260436 1477629541 10 Physicians DONALDSON CAROLYN 602011718 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 690 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 872 0 187 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 872 0 187 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21258.12 0 2780.55 0 0 0 0 0 0 24038.67 0 0 0 1101260437 1508944018 10 Physicians YEN EUGENE 602011779 200 Cook 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13626.36 0 0 0 0 0 0 13626.36 0 0 0 1101260441 1528014065 10 Physicians RECHITSKY IGOR 600628108 200 Cook 0 0 Neurology 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 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 0 230.13 0 0 0 0 0 0 230.13 0 0 0 1101260449 1922141647 46 Ambulatory Surgical Treatment Centers RIVER NORTH SAME DAY SURGERY 606112770 200 Cook ASTC Ambulatory Surgical Treatment Center. 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 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 8612.09 0 0 0 0 0 8612.09 0 0 0 1101260455 91 Waiver service provider--Adults (DHS/DDD) 108 Williamson 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 0 109 0 0 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 14664.33 0 0 0 0 0 0 0 0 0 0 0 0 0 14664.33 0 0 0 1101260457 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 553.76 0 0 0 0 0 0 0 0 0 0 0 0 0 553.76 0 0 0 1101260463 92 Waiver service provider--Disability (DHS/DRS) 77 Morgan 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 844 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32389.32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32389.32 0 0 0 1101261526 91 Waiver service provider--Adults (DHS/DDD) 96 St Clair 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 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1951.86 0 0 0 0 0 0 0 0 0 0 0 0 0 1951.86 0 0 0 1101261534 1477551489 30 General Hospitals ELKHART GENERAL HOSPITAL 465142499 815 Indiana NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 23 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 6111.13 0 0 0 0 9672.17 0 0 0 0 0 0 0 0 0 15783.3 0 0 0 1101261541 1821375379 24 Speech Therapists GRIFFITH TAMORROW 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 656 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 656 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 611.57 0 0 0 1101261624 1659387538 10 Physicians RAY ADRIENNE 606113162 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 676.28 0 0 0 0 0 0 676.28 0 0 0 1101261628 1205941127 10 Physicians CHIN SEONG H 600252442 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 194 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 847 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 847 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7388.35 0 0 0 0 0 0 7388.35 0 0 0 1101261630 1063446193 10 Physicians BERLIN RICHARD 618012530 19 Champaign 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4881.75 0 0 0 0 0 0 4881.75 0 0 0 1101261632 1841385242 23 Occupational Therapists PAWLOWSKI RACHEL 611032159 109 Winnebago 0 0 0 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 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General Hospitals ST ANTHONYS MEMORIAL HOSPITAL 624012006 33 Effingham DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 0 0 0 0 8 0 0 0 0 0 0 2442 0 0 1910 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 11610 0 0 5372 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 11610 0 0 5372 0 0 0 0 0 0 0 0 35.08 0 0 0 0 0 0 58735.73 0 0 236544.38 0 0 0 0 0 295315.19 0 0 0 1101261716 1518193192 10 Physicians TAI JAHANGIR 610324864 97 Stephenson 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 550 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 593 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 593 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17458.71 0 0 0 0 0 0 17458.71 0 0 0 1101261724 1205953916 34 State-operated facility (DHS) UNIT 4490 BLDG 411 SHAPIRO 609015018 54 Kankakee 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1731 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1135222.62 0 0 0 0 0 0 0 0 0 0 1135222.62 0 0 0 1101261731 1982768461 10 Physicians PICCIONE WILLIAM 606123835 200 Cook 0 0 Thoracic Surgery 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 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 128.57 0 0 0 0 0 0 128.57 0 0 0 1101261745 1982809356 10 Physicians ABRAHAM JOSEPH 606162477 200 Cook 0 0 Cardiology 0 61 0 0 0 0 0 0 0 0 0 0 0 138 0 0 0 0 0 0 380 0 0 0 0 0 0 0 0 0 0 0 318 0 0 0 0 0 0 380 0 0 0 0 0 0 0 0 0 0 0 318 0 0 0 0 0 0 1122 0 0 0 0 0 0 0 0 0 0 0 2843.54 0 0 0 0 0 0 3965.54 0 0 0 1101261758 1346213170 10 Physicians AIYER MEENAKSHY 616370001 80 Peoria 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6499.88 0 0 0 0 0 0 6499.88 0 0 0 1101261760 1104943737 34 State-operated facility (DHS) UNIT 3291 BLDG 202B SHAPIRO 609015018 54 Kankakee 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 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1816 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1186544.56 0 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0 0 0 0 0 0 0 1992 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3078 0 304 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3078 0 304 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50296.83 0 8738.76 0 0 0 0 0 0 59035.59 0 0 0 1101261814 92 Waiver service provider--Disability (DHS/DRS) 57 Lake 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28.41 0 0 0 0 0 0 0 0 0 0 0 0 0 28.41 0 0 0 1101261829 1164578357 23 Occupational Therapists BANE SUSAN 618779601 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11418.18 11418.18 0 0 0 1101261832 1386845246 16 Nurse Practitioners SILVELA BACALING BRIDGID 606035606 200 Cook 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 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 522.21 0 0 0 0 0 0 522.21 0 0 0 1101261834 1689612459 10 Physicians LICHT SHERRY 606123723 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 456.21 0 0 0 0 0 0 456.21 0 0 0 1101261836 10 Physicians 30 DuPage 0 0 Psychiatry 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 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 88.1 0 0 0 0 0 0 88.1 0 0 0 1101261840 1508874181 10 Physicians KAUFMAN DALE 606118709 200 Cook 0 0 Delivery Privileges 0 0 0 0 0 0 0 0 0 0 0 0 0 288 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 311 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 311 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9209.6 0 0 0 0 0 0 9209.6 0 0 0 1101261845 10 Physicians 844 Tennessee 0 0 Radiology 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 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 0 180.92 0 0 0 0 0 0 0 0 180.92 0 0 0 1101261846 1225149990 10 Physicians ALLCOCK DARREN 999999999 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 262.63 0 2312.37 0 0 0 0 0 0 2575 0 0 0 1101261852 1538345632 47 Local Education Agencies SKOKIE SCHOOL DISTRICT 73 5 600763402 200 Cook 0 0 0 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 2174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40841.93 0 40841.93 0 0 0 1101261856 1063792141 47 Local Education Agencies ODIN PUBLIC SCHOOL DIST 722 628701112 66 Marion 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 414 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 414 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7269.57 0 7269.57 0 0 0 1101261862 1164458337 91 Waiver service provider--Adults (DHS/DDD) PAPPAS DEBORAH 601544358 200 Cook 0 0 0 0 0 0 0 0 8 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 27328.86 0 0 0 0 0 0 0 0 0 0 0 0 0 27328.86 0 0 0 1101261867 1427024835 63 Other Providers of Medical Equipment/Supplies (Non-registered) WHEELCHAIR SALES SERVICE INC 604513282 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2852 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2852 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 554446.48 0 0 0 0 0 0 554446.48 0 0 0 1101261877 1619902236 10 Physicians LUBBEN GEORGIA 606493913 200 Cook 0 1 Family Practice 0 71 0 0 6 0 0 0 0 0 0 10 0 100 0 0 0 0 0 0 209 0 0 16 0 0 0 0 0 0 11 0 259 0 0 0 0 0 0 209 0 0 16 0 0 0 0 0 0 11 0 259 0 0 0 0 0 0 544 0 0 214.01 0 0 0 0 0 0 21.25 0 4268.53 0 0 0 0 0 0 5047.79 0 0 0 1101261878 92 Waiver service provider--Disability (DHS/DRS) 107 Will 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 19 0 0 0 0 0 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 18845 0 0 0 0 0 0 0 0 0 0 0 0 0 18845 0 0 0 1101261883 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 22701.9 0 0 0 0 0 0 0 0 0 0 0 0 0 22701.9 0 0 0 1101261886 1831213669 73 Other Transportation Providers ( Non-Registered) COLES COUNTY MENTAL HLTH ASSN 619384016 24 Coles 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5745 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5745 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13847.95 0 0 0 0 0 0 13847.95 0 0 0 1101261887 1770565905 10 Physicians SRIVASTAV MADHAV 611082272 109 Winnebago 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 337 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 337 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5513.51 0 0 0 0 0 0 5513.51 0 0 0 1101261891 1326061284 60 Pharmacies TOLEDO PHARMACY 62468 26 Cumberland 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 755 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7913 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 197634 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 397770.07 0 0 0 397770.07 0 0 0 1101261901 92 Waiver service provider--Disability (DHS/DRS) 22 Clay 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 13627.16 0 0 0 0 0 0 0 0 0 0 0 0 0 13627.16 0 0 0 1101261908 1679746317 63 Other Providers of Medical Equipment/Supplies (Non-registered) AMBASSADOR NURSING REHAB CTR 606255146 200 Cook 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 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 1431.18 0 0 0 0 0 0 1431.18 0 0 0 1101261913 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 18694.63 0 0 0 0 0 0 0 0 0 0 0 0 0 18694.63 0 0 0 1101261924 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 3140.51 0 0 0 0 0 0 0 0 0 0 0 0 0 3140.51 0 0 0 1101261936 10 Physicians 815 Indiana 0 0 Anesthesiology 0 0 0 0 0 0 0 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 905.65 0 0 0 0 0 0 905.65 0 0 0 1101261943 1659350411 16 Nurse Practitioners TEMME ANGELA 631101010 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 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 2117.92 0 0 0 0 0 0 2117.92 0 0 0 1101261964 1194742585 60 Pharmacies WAL MART STORES INC 10 0559 527615811 816 Iowa 0 0 0 0 0 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 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1760 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1119.7 0 0 0 1119.7 0 0 0 1101261984 1477729796 10 Physicians KRZYZANIAK SARA 616370001 80 Peoria 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 223 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 223 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6807.44 0 0 0 0 0 0 6807.44 0 0 0 1101262000 1801863683 16 Nurse Practitioners GARNER KENNETH 627810001 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1071.15 0 0 0 0 0 0 1071.15 0 0 0 1101262003 1760670897 28 Waiver service provider--Supportive living facility (HFS) FOXES GROVE SUPPORTIVE LIVING 620951600 65 Madison 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 496 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13864 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 654035.71 0 0 0 0 0 0 0 0 0 0 0 0 0 654035.71 0 0 0 1101262005 1043415771 10 Physicians TOLENTINO CEZAR 601603930 200 Cook 0 1 Family Practice 0 332 0 0 73 0 0 0 0 0 0 0 0 163 0 0 0 0 0 0 2015 0 0 174 0 0 0 0 0 0 0 0 289 0 0 0 0 0 0 2015 0 0 174 0 0 0 0 0 0 0 0 289 0 0 0 0 0 0 4745 0 0 6222.89 0 0 0 0 0 0 0 0 12036.93 0 0 0 0 0 0 23004.82 0 0 0 1101262011 1386805307 10 Physicians COOK VIVIAN 476308909 815 Indiana 0 0 Oncology 0 0 0 0 0 0 0 0 0 0 0 3 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16.1 0 598.35 0 0 0 0 0 0 614.45 0 0 0 1101262018 98 Waiver service provider--TBI (DHS/DRS) 91 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 1844.34 0 0 0 0 0 0 0 0 0 0 0 0 0 1844.34 0 0 0 1101262026 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18513 0 0 0 0 0 0 0 0 0 0 0 0 0 18513 0 0 0 1101262031 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 44158.97 0 0 0 0 0 0 0 0 0 0 0 0 0 44158.97 0 0 0 1101262034 1679672869 10 Physicians TIPIRNENI NAVEEN 600442203 57 Lake 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 73 0 0 0 1101262040 1306883756 10 Physicians KRISSBERG ALLEN 600451673 57 Lake 0 1 Pediatrics 0 18 0 0 54 0 0 0 0 0 0 46 0 82 0 0 0 0 0 0 75 0 0 169 0 0 0 0 0 0 96 0 112 0 0 0 0 0 0 75 0 0 169 0 0 0 0 0 0 96 0 112 0 0 0 0 0 0 150 0 0 4271.61 0 0 0 0 0 0 806.92 0 4862.07 0 0 0 0 0 0 10090.6 0 0 0 1101262046 1104851997 10 Physicians JONES JEFFREY 604264267 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 143 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 168 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 168 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3645.35 0 31.61 0 0 0 0 0 0 3676.96 0 0 0 1101262047 1316058043 10 Physicians GASKILL JOHN 946081844 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 446 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 511 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 511 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13987.09 0 0 0 0 0 0 13987.09 0 0 0 1101262052 1871739185 28 Waiver service provider--Supportive living facility (HFS) WOODRIDGE OF PONTIAC 617649403 61 Livingston 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 406 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8797 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 469915.24 0 0 0 0 0 0 0 0 0 0 0 0 0 469915.24 0 0 0 1101262054 91 Waiver service provider--Adults (DHS/DDD) 98 Tazewell 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 0 178 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 178 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14595.9 0 0 0 0 0 0 0 0 0 0 0 0 0 14595.9 0 0 0 1101262063 10 Physicians 836 Ohio 0 0 Pediatrics 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 94.78 0 0 0 0 0 0 94.78 0 0 0 1101262089 92 Waiver service provider--Disability (DHS/DRS) 54 Kankakee 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3956.58 0 0 0 0 0 0 0 0 0 0 0 0 0 3956.58 0 0 0 1101262095 1629085501 60 Pharmacies WALGREEN CO 4350 532154349 852 Wisconsin 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 0 146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2819 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5186.44 0 0 0 5186.44 0 0 0 1101262100 16 Nurse Practitioners 826 Missouri 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 23 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 0 0 0 0 0 0 0 0 764.85 0 0 0 0 0 0 764.85 0 0 0 1101262104 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17456.98 0 0 0 0 0 0 0 0 0 0 0 0 0 17456.98 0 0 0 1101262117 1972669265 10 Physicians HICKEY RYAN MATTHEW 606118709 200 Cook 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 58 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 96 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 96 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 668.23 0 9224.11 0 0 0 0 0 0 9892.34 0 0 0 1101262150 1003999293 16 Nurse Practitioners VILLWOCK MICHAEL 605445413 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 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 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1855.39 0 0 0 0 0 0 1855.39 0 0 0 1101262151 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14400.37 0 0 0 0 0 0 0 0 0 0 0 0 0 14400.37 0 0 0 1101262157 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 15381.35 0 0 0 0 0 0 0 0 0 0 0 0 0 15381.35 0 0 0 1101262176 98 Waiver service provider--TBI (DHS/DRS) 30 DuPage 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4114.05 0 0 0 0 0 0 0 0 0 0 0 0 0 4114.05 0 0 0 1101262177 1164440897 10 Physicians AFT REBECCA 631101010 826 Missouri 0 0 Surgery General 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 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11855.75 0 0 0 0 0 0 11855.75 0 0 0 1101262183 10 Physicians 57 Lake 0 0 Obstetric-Gynecology 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 77.5 0 0 0 0 0 0 77.5 0 0 0 1101262190 1760481220 10 Physicians FISHER MICHAEL 607143244 200 Cook 0 1 Family Practice 0 24 0 0 4 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 175 0 0 5 0 0 0 0 0 0 0 0 92 0 0 0 0 0 0 175 0 0 5 0 0 0 0 0 0 0 0 92 0 0 0 0 0 0 464 0 0 309.26 0 0 0 0 0 0 0 0 2403.77 0 0 0 0 0 0 3177.03 0 0 0 1101262202 92 Waiver service provider--Disability (DHS/DRS) 63 Macon 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 22641.29 0 0 0 0 0 0 0 0 0 0 0 0 0 22641.29 0 0 0 1101262203 1174764724 10 Physicians PARK GYE 606127323 200 Cook 0 0 Pulmonary Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8412.92 0 0 0 0 0 0 8412.92 0 0 0 1101262206 1821257148 10 Physicians CHEN LAN 602011718 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 201 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 345 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 345 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22913.85 0 0 0 0 0 0 22913.85 0 0 0 1101262216 1083827810 10 Physicians BROWNE DESLYN 606081732 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 1 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94.18 0 15439.25 0 0 0 0 0 0 15533.43 0 0 0 1101262220 93 Waiver service provider--HIV/AIDS (DHS/DRS) 109 Winnebago 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 24382.73 0 0 0 0 0 0 0 0 0 0 0 0 0 24382.73 0 0 0 1101262226 1417104159 22 Physical Therapists GLENN LINDA 600987401 71 McHenry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 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 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 870.96 870.96 0 0 0 1101262230 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 350 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 350 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22184.9 0 0 0 0 0 0 0 0 0 0 0 0 0 22184.9 0 0 0 1101262231 1780851956 10 Physicians KARSAN ANAND 625213883 63 Macon 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 303 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 326 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 326 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11638.53 0 0 0 0 0 0 11638.53 0 0 0 1101262237 1457319808 10 Physicians ALSAMMAN M OMAR 606304002 200 Cook 0 1 Internal Medicine 0 904 0 0 143 0 0 0 0 0 0 8 0 543 0 0 0 0 0 0 6403 0 0 244 0 0 0 0 0 0 9 0 1783 0 0 0 0 0 0 6403 0 0 244 0 0 0 0 0 0 9 0 1783 0 0 0 0 0 0 16827 0 0 12414.59 0 0 0 0 0 0 27.11 0 73488.73 0 0 0 0 0 0 102757.43 0 0 0 1101262265 1972792281 75 Department of Alcohol and Substance Abuse Provider HABILITATIVE SYSTEMS INC 606363117 200 Cook 0 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 0 563 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 563 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39360.06 0 0 39360.06 0 0 0 1101262271 1902985211 10 Physicians HESS MELVIN 609013854 54 Kankakee 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1683.27 0 0 0 0 0 0 1683.27 0 0 0 1101262272 1033135686 10 Physicians LJUBANOVIC MARIJANA 606123833 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 113 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1700858917 10 Physicians KIM KUMIE 606910263 30 DuPage 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 153 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35605.89 0 0 0 0 0 0 35605.89 0 0 0 1101262300 1588914675 24 Speech Therapists DONAHUE LAUREN 606553711 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3391.64 3391.64 0 0 0 1101262301 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6663.06 0 0 0 0 0 0 0 0 0 0 0 0 0 6663.06 0 0 0 1101262302 92 Waiver service provider--Disability (DHS/DRS) 63 Macon 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 17684.74 0 0 0 0 0 0 0 0 0 0 0 0 0 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Waiver service provider--Disability (DHS/DRS) 200 Cook 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 14163.7 0 0 0 0 0 0 0 0 0 0 0 0 0 14163.7 0 0 0 1101262598 1205128253 47 Local Education Agencies APTAKISIC TRIPP CCSD NO 102 600897040 57 Lake 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 2726 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 2726 0 0 0 0 242.83 0 0 0 0 0 0 0 0 0 0 0 0 0 56964.04 0 57206.87 0 0 0 1101262602 1952521791 10 Physicians WOERNER PHILIP 623531561 14 Brown 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 536 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1540 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1540 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37646.97 0 0 0 0 0 0 37646.97 0 0 0 1101262604 92 Waiver service provider--Disability (DHS/DRS) 106 Whiteside 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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1101262771 1982994489 16 Nurse Practitioners WHEDON ANDREA 606123828 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 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 0 104.76 0 0 0 0 0 0 104.76 0 0 0 1101262774 1891902359 10 Physicians PARESI ROBERT 531472655 852 Wisconsin 0 0 Plastic Surgery 0 0 0 0 0 0 0 0 0 0 0 1 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2.98 0 1180.2 0 0 0 0 0 0 1183.18 0 0 0 1101262778 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46336.87 0 0 0 0 0 0 0 0 0 0 0 0 0 46336.87 0 0 0 1101262787 1821215856 10 Physicians VIJAYKUMAR AARTHI 601771534 53 Kane 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 376 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 376 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2340.56 0 0 0 0 0 0 2340.56 0 0 0 1101262793 92 Waiver service provider--Disability (DHS/DRS) 64 Macoupin 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 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 4595.23 0 0 0 0 0 0 0 0 0 0 0 0 0 4595.23 0 0 0 1101262795 1144367715 23 Occupational Therapists ROBINSON STANLEY 604282733 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1235 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1235 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85716.44 85716.44 0 0 0 1101262797 10 Physicians 826 Missouri 0 0 Cardiology 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38.6 0 0 0 0 0 0 38.6 0 0 0 1101262803 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 17864.61 0 0 0 0 0 0 0 0 0 0 0 0 0 17864.61 0 0 0 1101262806 1740267954 10 Physicians DESAI SUNIL 600052349 10 Adams 0 0 Pulmonary Diseases 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 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 58.36 0 0 0 0 0 0 58.36 0 0 0 1101262809 1043472798 11 Dentists LEE THOMAS 606302511 200 Cook 0 0 General Dentistry 0 0 0 128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 459 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 459 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15128.77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15128.77 0 0 0 1101262817 1033104807 10 Physicians FREELAND JOHN P 600853676 57 Lake 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 185 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 222 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 222 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2631.15 0 0 0 0 0 0 2631.15 0 0 0 1101262822 1821160516 10 Physicians NIXON ROBERT 600123711 71 McHenry 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 13 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 295.05 0 6541.32 0 0 0 0 0 0 6836.37 0 0 0 1101262828 1730388703 60 Pharmacies B AND K DRUG INC 606513823 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 851 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 5738 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 130625 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1491.85 0 0 213163.39 0 0 0 214655.24 0 0 0 1101262831 1114935681 30 General Hospitals GIBSON COMMUNITY HOSPITAL ASSO 609361477 35 Ford DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 1 0 General Hospital - Adult and Child 0 0 0 0 0 907 0 0 0 0 179 1 0 5 636 0 0 0 0 0 0 0 0 0 1346 0 0 0 0 188 1 0 5 1358 0 0 0 0 0 0 0 0 0 1346 0 0 0 0 428 1 0 5 1367 0 0 0 0 0 0 0 0 0 585350.88 0 0 0 0 215817.17 280.46 0 27636.5 898274.29 0 0 0 0 0 1727359.3 0 0 0 1101262852 1255584397 10 Physicians GINNE PURSHOTHAM 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 333 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 389 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 389 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16017.95 0 0 0 0 0 0 16017.95 0 0 0 1101262853 1295969111 10 Physicians WILLE MARK 606123723 200 Cook 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 8 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43.05 0 3232.14 0 0 0 0 0 0 3275.19 0 0 0 1101262858 1013917434 10 Physicians OHL BRENT 600442203 57 Lake 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6343.57 0 0 0 0 0 0 6343.57 0 0 0 1101262864 2100253282 90 Waiver service provider--Elderly (DOA) VZ AND Y HOMECARE LP 600041965 200 Cook 0 0 0 0 0 0 0 0 138 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19718 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19718 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1309297.93 0 0 0 0 0 0 0 0 0 0 0 0 0 1309297.93 0 0 0 1101262866 91 Waiver service provider--Adults (DHS/DDD) 57 Lake 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 0 256 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 256 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7307.01 0 0 0 0 0 0 0 0 0 0 0 0 0 7307.01 0 0 0 1101262868 1265431712 10 Physicians FLORES STADLER ELBIO 604263558 200 Cook 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 308 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 556 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 556 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3911.28 0 0 0 0 0 0 0 0 3911.28 0 0 0 1101262881 1295952596 10 Physicians SINGH VEERPAL 601239405 53 Kane 0 0 Oncology 0 0 0 0 0 0 0 0 0 0 0 0 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 730 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 730 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7138.85 0 0 0 0 0 0 7138.85 0 0 0 1101262889 1295773414 10 Physicians LEVIN THOMAS 604536460 200 Cook 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 2 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 302 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 302 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17.01 0 6440.11 0 0 0 0 0 0 6457.12 0 0 0 1101262905 1538204201 10 Physicians RUSSO CHERISE 606114546 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3194.93 0 0 0 0 0 0 3194.93 0 0 0 1101262926 70 Ambulance Service Providers 37 Fulton 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 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 0 230.15 0 0 0 0 0 0 230.15 0 0 0 1101262931 1689778177 47 Local Education Agencies NEW BERLIN COMM SCH DIST 16 626700230 91 Sangamon 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 1443 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 1443 0 0 0 0 126.06 0 0 0 0 0 0 0 0 0 0 0 0 0 26917.93 0 27043.99 0 0 0 1101262967 1760590889 10 Physicians WATSON ARTELIA 606021895 200 Cook 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 0 5 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 328 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 328 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77.53 0 5076.69 0 0 0 0 0 0 5154.22 0 0 0 1101262977 1558476739 13 Podiatrists BUCKROP BRADLEY 612017078 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3306.19 0 0 0 0 0 0 3306.19 0 0 0 1101262991 1639146368 10 Physicians COUCH DEBORAH 601533304 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 476 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 476 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14371.37 0 0 0 0 0 0 14371.37 0 0 0 1101262994 92 Waiver service provider--Disability (DHS/DRS) 91 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 3731.09 0 0 0 0 0 0 0 0 0 0 0 0 0 3731.09 0 0 0 1101263007 92 Waiver service provider--Disability (DHS/DRS) 57 Lake 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12938.13 0 0 0 0 0 0 0 0 0 0 0 0 0 12938.13 0 0 0 1101263016 1053307660 10 Physicians GUERRERO RAUL 300092064 58 La Salle 0 1 Internal Medicine 0 169 0 0 0 0 0 0 0 0 0 2 0 287 0 0 0 0 0 0 1473 0 0 0 0 0 0 0 0 0 2 0 825 0 0 0 0 0 0 1473 0 0 0 0 0 0 0 0 0 2 0 825 0 0 0 0 0 0 4504 0 0 0 0 0 0 0 0 0 4.73 0 26879.48 0 0 0 0 0 0 31388.21 0 0 0 1101263022 1346281110 10 Physicians AKHIGBE CLARA 606212029 200 Cook 0 1 Pediatrics 0 888 0 0 273 0 0 0 0 0 0 1 0 106 0 0 0 0 0 0 6373 0 0 804 0 0 0 0 0 0 1 0 150 0 0 0 0 0 0 6373 0 0 804 0 0 0 0 0 0 1 0 150 0 0 0 0 0 0 13504 0 0 27021.41 0 0 0 0 0 0 4 0 6613.84 0 0 0 0 0 0 47143.25 0 0 0 1101263025 1194703702 33 Nursing Facilities MASON POINT 619519467 78 Moultrie 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 760 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18484 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1400810.3 0 0 0 0 0 0 0 1400810.3 0 0 0 1101263030 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 20000 0 0 0 0 0 0 0 0 0 0 0 0 0 20000 0 0 0 1101263041 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10294.51 0 0 0 0 0 0 0 0 0 0 0 0 0 10294.51 0 0 0 1101263051 1437469343 10 Physicians BEJGUM PAVAN 629602467 69 Massac 0 1 Internal Medicine 0 79 0 0 0 0 0 0 0 0 0 1 0 721 0 0 0 0 0 0 598 0 0 0 0 0 0 0 0 0 1 0 2154 0 0 0 0 0 0 598 0 0 0 0 0 0 0 0 0 1 0 2154 0 0 0 0 0 0 1806 0 0 0 0 0 0 0 0 0 2.17 0 48237.64 0 0 0 0 0 0 50045.81 0 0 0 1101263057 92 Waiver service provider--Disability (DHS/DRS) 44 Henderson 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 649.91 0 0 0 0 0 0 0 0 0 0 0 0 0 649.91 0 0 0 1101263067 93 Waiver service provider--HIV/AIDS (DHS/DRS) 100 Vermilion 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13627.73 0 0 0 0 0 0 0 0 0 0 0 0 0 13627.73 0 0 0 1101263070 1366428328 10 Physicians MAKKI MOJGAN 606407860 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 199 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 714 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 714 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33725.01 0 0 0 0 0 0 33725.01 0 0 0 1101263091 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 25768.06 0 0 0 0 0 0 0 0 0 0 0 0 0 25768.06 0 0 0 1101263093 1295967552 63 Other Providers of Medical Equipment/Supplies (Non-registered) CLINICAL HEARING SERVICES 605403995 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 521 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1527 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1527 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 495105.8 0 0 0 0 0 0 495105.8 0 0 0 1101263106 1144347774 34 State-operated facility (DHS) UNIT 4290 BLDG 201A SHAPIRO 609015018 54 Kankakee 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 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1710 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1126902.42 0 0 0 0 0 0 0 0 0 0 1126902.42 0 0 0 1101263116 1558375030 10 Physicians AUSTIN TONJA 604291902 200 Cook 0 1 Family Practice 0 117 0 0 28 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 880 0 0 66 0 0 0 0 0 0 0 0 139 0 0 0 0 0 0 880 0 0 66 0 0 0 0 0 0 0 0 139 0 0 0 0 0 0 2119 0 0 2550.1 0 0 0 0 0 0 0 0 5137.03 0 0 0 0 0 0 9806.13 0 0 0 1101263118 1083888762 11 Dentists NGUYEN DAVID 601891404 30 DuPage 0 0 General Dentistry 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 500 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 500 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16364.24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16364.24 0 0 0 1101263128 1104877414 10 Physicians MOORE PHILIP 605061459 53 Kane 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 608 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 608 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5707.54 0 0 0 0 0 0 5707.54 0 0 0 1101263139 91 Waiver service provider--Adults (DHS/DDD) 91 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 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3036 0 0 0 0 0 0 0 0 0 0 0 0 0 3036 0 0 0 1101263141 1235164328 10 Physicians JACKER MICHAEL 600614103 57 Lake 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 9 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77.6 0 1881.02 0 0 0 0 0 0 1958.62 0 0 0 1101263164 1912932690 10 Physicians KIMURA ROBERT 606751611 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 720 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 720 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91880.4 0 0 0 0 0 0 91880.4 0 0 0 1101263165 1134372071 63 Other Providers of Medical Equipment/Supplies (Non-registered) MCLEAN COUNTY NURSING HOME 617611501 72 McLean 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 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 7887.74 0 0 0 0 0 0 7887.74 0 0 0 1101263167 1063709491 12 Optometrists SURBER LEXI 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 677 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1334 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1334 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30954.04 0 0 0 0 0 0 30954.04 0 0 0 1101263175 1265490239 10 Physicians WILSON JAMES 605651469 30 DuPage 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 7 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 0 169.99 0 0 0 0 0 0 169.99 0 0 0 1101263178 1477658177 55 Early Intervention Services PERPOLI JOANNE 606412925 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 418 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 418 0 0 0 0 0 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0 0 4531.71 0 0 0 0 0 0 4531.71 0 0 0 1101263473 1245266337 40 Federally Qualified Health Centers CHICAGO FAM HLTH CTR SO CHI 606174225 200 Cook 0 1 0 3376 7376 0 2370 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11403 32486 0 9354 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11403 32486 0 9354 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27748 1929780.9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1957528.9 0 0 0 1101263475 98 Waiver service provider--TBI (DHS/DRS) 53 Kane 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 37619.99 0 0 0 0 0 0 0 0 0 0 0 0 0 37619.99 0 0 0 1101263477 1801880117 10 Physicians DOBKIN DAVID 600044830 200 Cook 0 1 Pediatrics 0 21 0 0 35 0 0 0 0 0 0 15 0 21 0 0 0 0 0 0 95 0 0 81 0 0 0 0 0 0 28 0 30 0 0 0 0 0 0 95 0 0 81 0 0 0 0 0 0 28 0 30 0 0 0 0 0 0 190 0 0 2258.94 0 0 0 0 0 0 103.2 0 1296.25 0 0 0 0 0 0 3848.39 0 0 0 1101263483 10 Physicians 815 Indiana 0 0 Thoracic Surgery 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 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 942 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 942 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1442.34 0 0 0 0 0 0 1442.34 0 0 0 1101263555 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 279 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 279 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10917.5 0 0 0 0 0 0 0 0 0 0 0 0 0 10917.5 0 0 0 1101263568 1043528904 36 Community mental health provider PIONEER CENTER FOR HUMAN SRVCS 600983437 71 McHenry 0 0 0 343 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 339 0 0 1310 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4187 0 0 1310 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4187 0 0 41254.14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 367725.12 0 0 408979.26 0 0 0 1101263571 1376543249 10 Physicians CORNFIELD JOEL 605218609 30 DuPage 0 0 Admitting Privileges 0 0 0 0 0 0 0 0 0 0 0 1 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43.36 0 725.17 0 0 0 0 0 0 768.53 0 0 0 1101263574 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Waiver service provider--Adults (DHS/DDD) BEVERLY FARM FOUNDATION 620352163 65 Madison 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 807 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 807 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47884.43 0 0 0 0 0 0 0 0 0 0 0 0 0 47884.43 0 0 0 1101263975 1033135272 16 Nurse Practitioners HOORMANN SYLVIA 631366119 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4640.53 0 0 0 0 0 0 4640.53 0 0 0 1101263999 92 Waiver service provider--Disability (DHS/DRS) 36 Franklin 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 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 1461.45 0 0 0 0 0 0 0 0 0 0 0 0 0 1461.45 0 0 0 1101264004 1811025240 36 Community mental health provider MOULTRIE COUNTY COUNSELING CTR 619511907 78 Moultrie 0 0 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 275 0 0 727 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3673 0 0 727 0 0 0 0 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Will 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 6802.95 0 0 0 0 0 0 0 0 0 0 0 0 0 6802.95 0 0 0 1101264293 1710950464 10 Physicians KURTZER TRACI 602011718 200 Cook 0 0 Obstetric-Gynecology 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 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 0 780.59 0 0 0 0 0 0 780.59 0 0 0 1101264294 1588985261 10 Physicians JETTON JENNIFER 522421007 816 Iowa 0 0 Nephrology 0 0 0 0 0 0 0 0 0 0 0 0 0 8 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 727.29 0 0 0 0 0 0 727.29 0 0 0 1101264295 1639256118 14 Chiropractors MANGAN HARLENE 612653637 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1028.61 0 0 0 0 0 0 1028.61 0 0 0 1101264296 92 Waiver service provider--Disability (DHS/DRS) 103 Washington 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 34863.95 0 0 0 0 0 0 0 0 0 0 0 0 0 34863.95 0 0 0 1101264303 1598835308 30 General Hospitals DEPAUL HEALTH CENTER 630442512 826 Missouri ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 0 0 0 0 0 158 0 0 0 0 109 0 0 0 90 0 0 0 0 0 0 0 0 0 207 0 0 0 0 119 0 0 0 188 0 0 0 0 0 0 0 0 0 207 0 0 0 0 587 0 0 0 190 0 0 0 0 0 0 0 0 0 36608.56 0 0 0 0 259085.05 0 0 0 58673.81 0 0 0 0 0 354367.42 0 0 0 1101264316 10 Physicians 836 Ohio 0 0 Anesthesiology 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 168.85 0 0 0 0 0 0 168.85 0 0 0 1101264333 1780622266 10 Physicians STOBNICKI ALEKSANDRA 606313745 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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Cook 0 0 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 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 609.66 0 0 0 0 0 0 609.66 0 0 0 1101264363 1730444597 16 Nurse Practitioners HERRICKS KATHRYN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 235 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 235 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1353.79 0 0 0 0 0 0 1353.79 0 0 0 1101264371 1386622819 10 Physicians POWELL JONATHAN 600042315 200 Cook 0 1 Pediatrics 0 9 0 0 5 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 48 0 0 8 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 48 0 0 8 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 96 0 0 581.21 0 0 0 0 0 0 0 0 186.24 0 0 0 0 0 0 863.45 0 0 0 1101264384 1659598225 10 Physicians SOOD ANSHU 622265360 96 St Clair 0 0 Internal Medicine 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 0 339 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 339 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2041.52 0 0 0 0 0 0 2041.52 0 0 0 1101264385 1316992969 10 Physicians HULSEY DAVID 610324864 97 Stephenson 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 1438 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1705 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1705 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58156.78 0 0 0 0 0 0 58156.78 0 0 0 1101264396 1033179940 10 Physicians ELLYIN FREDRICK 606253656 200 Cook 0 0 Endocrinology 0 0 0 0 0 0 0 0 0 0 0 0 0 216 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15801.74 0 0 0 0 0 0 15801.74 0 0 0 1101264402 1467436972 10 Physicians MCDONNELL MICHAEL 606294417 200 Cook 0 1 Internal Medicine 0 194 0 0 0 0 0 0 0 0 0 0 0 153 0 0 0 0 0 0 1029 0 0 0 0 0 0 0 0 0 0 0 322 0 0 0 0 0 0 1029 0 0 0 0 0 0 0 0 0 0 0 322 0 0 0 0 0 0 3051 0 0 0 0 0 0 0 0 0 0 0 5422.3 0 0 0 0 0 0 8473.3 0 0 0 1101264406 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 50616.73 0 0 0 0 0 0 0 0 0 0 0 0 0 50616.73 0 0 0 1101264407 1124085899 63 Other Providers of Medical Equipment/Supplies (Non-registered) MEDTEC MEDICAL INC 600894523 57 Lake 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 0 213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2907.27 0 0 0 0 0 0 2907.27 0 0 0 1101264409 1316174154 16 Nurse Practitioners KUJAWA SUZANNE 606143363 200 Cook 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 19 0 0 0 0 0 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 0 384.21 0 0 0 0 0 0 384.21 0 0 0 1101264412 92 Waiver service provider--Disability (DHS/DRS) 97 Stephenson 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 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25274.49 0 0 0 0 0 0 0 0 0 0 0 0 0 25274.49 0 0 0 1101264415 1750310579 60 Pharmacies HY VEE PHARMACY 1534 623052822 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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CHANG JASON 606123723 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 447 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 447 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13414.98 0 0 0 0 0 0 13414.98 0 0 0 1101264440 1750537452 10 Physicians GARBIS NICKOLAS 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 201 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 460 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 460 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38828.82 0 0 0 0 0 0 38828.82 0 0 0 1101264441 1124292727 10 Physicians BOLDEN NATHAN 601901237 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2874 0 0 0 0 0 0 2874 0 0 0 1101264453 1386717502 60 Pharmacies BROWNS DRUG 624012344 33 Effingham 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 229 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 2487 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 60871 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 480.18 0 0 127866.58 0 0 0 128346.76 0 0 0 1101264454 1922209980 47 Local Education Agencies CALUMET PUBLIC SCHOOLS D 132 608276025 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1674 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1674 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29438.41 0 29438.41 0 0 0 1101264478 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 8279.95 0 0 0 0 0 0 0 0 0 0 0 0 0 8279.95 0 0 0 1101264500 1639395114 10 Physicians GUPTA AMIT 627023749 91 Sangamon 0 0 General Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 702 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 702 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70476.54 0 0 0 0 0 0 70476.54 0 0 0 1101264502 2100254920 71 Medicar Provider HOPE MEDIVAN INC 604552143 200 Cook 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 8684 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 704 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17482 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17482 0 0 0 1101264538 1982699633 10 Physicians WOHLTMANN CHRISTOPHER 627949639 91 Sangamon 0 0 Traumatic Surgery 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 0 274 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 274 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55377.32 0 0 0 0 0 0 55377.32 0 0 0 1101264542 1659583938 10 Physicians PERUMAL SATHISH 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 263 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 274 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 274 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15.7 0 10206.01 0 0 0 0 0 0 10221.71 0 0 0 1101264563 1407079635 29 ICF/MR MILESTONE ELMWOOD HEIGHTS 611031573 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2088 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50676 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6276145.83 0 0 0 0 0 0 0 0 0 0 6276145.83 0 0 0 1101264565 1063408631 10 Physicians KALIVODA POPELA VICTORIA 614621007 102 Warren 0 0 General Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 241 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 241 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8710.87 0 0 0 0 0 0 8710.87 0 0 0 1101264571 92 Waiver service provider--Disability (DHS/DRS) 42 Hancock 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 17165.51 0 0 0 0 0 0 0 0 0 0 0 0 0 17165.51 0 0 0 1101264573 1851596886 22 Physical Therapists KLINGER SUSANNE 603041206 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 168 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 168 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11619.11 11619.11 0 0 0 1101264578 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 4470.39 0 0 0 0 0 0 0 0 0 0 0 0 0 4470.39 0 0 0 1101264579 1477535201 10 Physicians LULLA SUNIL 605152266 30 DuPage 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 234 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 234 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2141.58 0 0 0 0 0 0 2141.58 0 0 0 1101264594 1295771624 10 Physicians KIM STEVEN 600041565 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 696 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 696 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1932.26 0 0 0 0 0 0 1932.26 0 0 0 1101264619 30 General Hospitals 842 South Carolina NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 308.88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 308.88 0 0 0 1101264623 1083683783 10 Physicians GUINN BRETT 478044021 815 Indiana 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11602.46 0 0 0 0 0 0 0 0 0 0 0 0 0 11602.46 0 0 0 1101266395 1730397878 10 Physicians COHEN LENNY 603042817 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 371 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 371 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2717.72 0 0 0 0 0 0 2717.72 0 0 0 1101266402 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 2465.52 0 0 0 0 0 0 0 0 0 0 0 0 0 2465.52 0 0 0 1101266412 1194856021 10 Physicians KOPP DANIEL 633012844 826 Missouri 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 483.27 0 0 0 0 0 0 483.27 0 0 0 1101266416 1598797094 30 General Hospitals ST LOUIS UNIVERSITY HOSPITAL 631102500 826 Missouri DRG Hospitals reimbursed under our 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Surgery 0 0 0 0 0 0 0 0 0 0 0 45 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 170 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 170 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3739.67 0 6994.14 0 0 0 0 0 0 10733.81 0 0 0 1101266885 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 2265.43 0 0 0 0 0 0 0 0 0 0 0 0 0 2265.43 0 0 0 1101266888 1083662050 10 Physicians DIIORIO DANIEL 626811465 92 Schuyler 0 0 Family Practice 0 0 0 0 6 0 0 0 0 0 0 13 0 168 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 41 0 236 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 41 0 236 0 0 0 0 0 0 0 0 0 24.6 0 0 0 0 0 0 247.75 0 6004.34 0 0 0 0 0 0 6276.69 0 0 0 1101266890 1164635165 10 Physicians ANWAR MOHAMMAD 606575640 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 215 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 215 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21763.53 0 0 0 0 0 0 21763.53 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 16 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 284.38 0 9059.66 0 0 0 0 0 0 9344.04 0 0 0 1101266971 1891709440 10 Physicians KIM ELLEN 606142896 200 Cook 0 0 Pediatrics 0 0 0 0 3 0 0 0 0 0 0 9 0 97 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 18 0 137 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 18 0 137 0 0 0 0 0 0 0 0 0 25.6 0 0 0 0 0 0 95.98 0 8354.4 0 0 0 0 0 0 8475.98 0 0 0 1101266973 1639298722 23 Occupational Therapists PORCH LORI 615179529 110 Woodford 0 0 0 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 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 5547.32 5547.32 0 0 0 1101266979 1124171491 52 Certified local public health department SCOTT COUNTY HEALTH DEPARTMENT 626940115 93 Scott 0 0 0 0 266 0 247 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 549 0 1846 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 549 0 1846 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6299.86 0 23200.73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29500.59 0 0 0 1101266982 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 10641.17 0 0 0 0 0 0 0 0 0 0 0 0 0 10641.17 0 0 0 1101266985 1598845554 10 Physicians UPADHYAYA VARSHA 604532654 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 6 0 0 0 0 0 0 121 0 168 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 388 0 631 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 388 0 631 0 0 0 0 0 0 0 0 0 147.44 0 0 0 0 0 0 6484.58 0 40684.35 0 0 0 0 0 0 47316.37 0 0 0 1101266990 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 20480.83 0 0 0 0 0 0 0 0 0 0 0 0 0 20480.83 0 0 0 1101267004 92 Waiver service provider--Disability (DHS/DRS) 37 Fulton 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 10937.26 0 0 0 0 0 0 0 0 0 0 0 0 0 10937.26 0 0 0 1101267035 1265609903 10 Physicians HANAK MICHAEL 606123849 200 Cook 0 0 Family Practice 0 0 0 0 4 0 0 0 0 0 0 5 0 117 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 5 0 181 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 5 0 181 0 0 0 0 0 0 0 0 0 479.9 0 0 0 0 0 0 44.15 0 4573.82 0 0 0 0 0 0 5097.87 0 0 0 1101267044 1003971144 10 Physicians SCHWANER ROBERT 605232230 30 DuPage 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 27 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 417.81 0 2348.59 0 0 0 0 0 0 2766.4 0 0 0 1101267046 1124038955 13 Podiatrists ROECKELL MORENO SUZANNE 604292052 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 972 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3824 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3824 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13025.69 0 0 0 0 0 0 13025.69 0 0 0 1101267053 10 Physicians 200 Cook 0 0 Clinical Pathology 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39.5 0 0 0 0 0 0 0 0 39.5 0 0 0 1101267086 1124156716 24 Speech Therapists DETMER MARIBETH 622301074 23 Clinton 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14920.64 14920.64 0 0 0 1101267089 91 Waiver service provider--Adults (DHS/DDD) 57 Lake 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 0 224 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 224 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18476.7 0 0 0 0 0 0 0 0 0 0 0 0 0 18476.7 0 0 0 1101267091 1669745436 62 Opticians / Optical Companies CHICAGO MY OPTICAL 607143207 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 342 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 534 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 534 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9098.68 0 0 0 0 9098.68 0 0 0 1101267096 1750450326 10 Physicians RENNER GERALYNN 600681143 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2500.46 0 0 0 0 0 0 2500.46 0 0 0 1101267100 1740474063 16 Nurse Practitioners HOLLEMAN JUDITH 605276686 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1536.04 0 0 0 0 0 0 1536.04 0 0 0 1101267102 91 Waiver service provider--Adults (DHS/DDD) 30 DuPage 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 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5868.19 0 0 0 0 0 0 0 0 0 0 0 0 0 5868.19 0 0 0 1101267103 1114944402 60 Pharmacies SAM'S CLUB PHARMACY 10-8128 616154405 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 304 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9222 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14915.58 0 0 0 14915.58 0 0 0 1101267109 92 Waiver service provider--Disability (DHS/DRS) 108 Williamson 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 19 0 0 0 0 0 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 23299.69 0 0 0 0 0 0 0 0 0 0 0 0 0 23299.69 0 0 0 1101267118 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 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 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8233.92 0 0 0 0 0 0 0 0 0 0 0 0 0 8233.92 0 0 0 1101267126 1679590111 10 Physicians SANCHEZ LUIS 631101010 826 Missouri 0 0 Vascular Surgery 0 0 0 0 0 0 0 0 0 0 0 10 0 308 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 510 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 510 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 162.85 0 15516.75 0 0 0 0 0 0 15679.6 0 0 0 1101267147 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 9768.43 0 0 0 0 0 0 0 0 0 0 0 0 0 9768.43 0 0 0 1101267158 1306897269 10 Physicians PALMISANO CYNTHIA 600073224 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 786.86 0 0 0 0 0 0 786.86 0 0 0 1101267159 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 34381.71 0 0 0 0 0 0 0 0 0 0 0 0 0 34381.71 0 0 0 1101267168 1134161664 60 Pharmacies SAPSTEIN DRUGS 606195312 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1434 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6787 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 143685 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160560.23 0 0 0 160560.23 0 0 0 1101267183 16 Nurse Practitioners 826 Missouri 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101267206 10 Physicians 852 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GERMAN MARK 610212010 60 Lee 0 0 General Dentistry 0 0 0 254 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 944 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 944 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28699.19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28699.19 0 0 0 1101268230 24 Speech Therapists 96 St Clair 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 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 7.51 7.51 0 0 0 1101268231 1972732808 11 Dentists MORGAN SARA 607071601 200 Cook 0 0 General Dentistry 0 0 0 256 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 671 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 671 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 175545.1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 175545.1 0 0 0 1101268248 1952572661 10 Physicians GONG CHUNLING 618562116 82 Piatt 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 330 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 330 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5996.42 0 0 0 0 0 0 5996.42 0 0 0 1101268256 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0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10532.61 0 0 0 0 0 0 0 0 0 0 0 0 0 10532.61 0 0 0 1101268393 10 Physicians 816 Iowa 0 0 Gastroenterology 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122.55 0 0 0 0 0 0 122.55 0 0 0 1101268416 1154325892 33 Nursing Facilities HILLCREST RETIREMENT VILG LTD 600733803 57 Lake 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 0 590 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14375 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1362591.82 0 0 0 0 0 0 0 1362591.82 0 0 0 1101268418 1124156773 11 Dentists ISHAYA EDISON A 606222204 200 Cook 0 0 General Dentistry 0 0 0 406 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 1430 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 1430 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 44472.14 0 0 0 0 0 0 0 0 0 0 0 26344.5 0 0 0 0 70816.64 0 0 0 1101268440 91 Waiver service provider--Adults (DHS/DDD) 89 Rock Island 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 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Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 285.93 0 0 0 0 0 0 285.93 0 0 0 1101268512 1144371519 12 Optometrists ROJAS CATHERINE 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 271 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 547 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 547 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16044.54 0 0 0 0 0 0 16044.54 0 0 0 1101268517 91 Waiver service provider--Adults (DHS/DDD) 105 White 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 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13464 0 0 0 0 0 0 0 0 0 0 0 0 0 13464 0 0 0 1101268518 1043219579 10 Physicians CURRIE ROBERT 370689022 56 Knox 0 1 Family Practice 0 11 0 0 3 0 0 0 0 0 0 5 0 348 0 0 0 0 0 0 125 0 0 3 0 0 0 0 0 0 5 0 2244 0 0 0 0 0 0 125 0 0 3 0 0 0 0 0 0 5 0 2244 0 0 0 0 0 0 339 0 0 97.42 0 0 0 0 0 0 7.8 0 10606.73 0 0 0 0 0 0 11050.95 0 0 0 1101268524 1164428165 10 Physicians BALLARD CHRISTOPHER 628371219 104 Wayne 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 138 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 138 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2614.71 0 0 0 0 0 0 2614.71 0 0 0 1101268525 22 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 168.87 168.87 0 0 0 1101268559 1821296237 10 Physicians KELTON DAVID 611082425 109 Winnebago 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 1097 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1353 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1353 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43601.29 0 0 0 0 0 0 43601.29 0 0 0 1101268570 1437116324 10 Physicians RICHIER JOHN 616142845 80 Peoria 0 0 Urology 0 0 0 0 0 0 0 0 0 0 0 38 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70 0 183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70 0 183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 532.73 0 7808.32 0 0 0 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0 0 0 0 0 0 0 0 0 2388 0 357 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49771.37 0 5890.91 0 0 0 0 0 0 55662.28 0 0 0 1101268585 1770589244 12 Optometrists PELFREY JONES SANDRA 626569790 62 Logan 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 538 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1071 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1071 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28016.77 0 0 0 0 0 0 28016.77 0 0 0 1101268596 1104887801 52 Certified local public health department CASS COUNTY PUBLIC HEALTH DEPT 626911545 18 Cass 0 0 0 0 555 0 562 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 1049 0 2020 0 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 1049 0 2020 0 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 12271.82 0 14266.05 0 0 8064 0 0 0 0 0 0 0 0 0 0 0 0 34601.87 0 0 0 1101268607 1366516213 22 Physical Therapists ALIKHAN MASHKOOR 601301404 27 Dekalb 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11870.94 11870.94 0 0 0 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0 0 169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16644.21 0 0 0 0 0 0 16644.21 0 0 0 1101268689 1790707701 70 Ambulance Service Providers EMERGENCY 116 AMB SERV INC 615487113 110 Woodford 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5893.65 0 0 0 0 0 0 5893.65 0 0 0 1101268692 1588801732 16 Nurse Practitioners ZIMMER DIANE 60453 107 Will 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 173 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 243 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 243 0 0 0 0 0 0 0 0 0 116.67 0 0 0 0 0 0 0 0 5739.23 0 0 0 0 0 0 5855.9 0 0 0 1101268693 1952510729 10 Physicians MACWAR RACHID R 615258709 80 Peoria 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 12 0 937 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 1503 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 1503 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 537.67 0 22544.76 0 0 0 0 0 0 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Waiver service provider--Disability (DHS/DRS) 200 Cook 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 14808.44 0 0 0 0 0 0 0 0 0 0 0 0 0 14808.44 0 0 0 1101269969 1942242375 10 Physicians WANG JEAN 631101010 826 Missouri 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4195.2 0 0 0 0 0 0 4195.2 0 0 0 1101269980 1528006103 30 General Hospitals BRYAN MEDICAL CENTER 685061299 828 Nebraska NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 11 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 1019.95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1019.95 0 0 0 1101269992 1942401294 16 Nurse Practitioners BALISI MARLENE 600314223 57 Lake 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 1 0 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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 14955.64 0 0 0 0 0 0 0 0 0 0 0 0 0 14955.64 0 0 0 1101270028 1235211301 30 General Hospitals DR JOHN WARNER HOSPITAL 617272140 28 De Witt DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 1 0 Government Owned 0 0 0 0 0 726 0 0 0 0 21 0 0 0 189 0 0 0 0 0 0 0 0 0 1207 0 0 0 0 24 0 0 0 372 0 0 0 0 0 0 0 0 0 1207 0 0 0 0 78 0 0 0 503 0 0 0 0 0 0 0 0 0 327912.12 0 0 0 0 23633.67 0 0 0 128479.35 0 0 0 0 0 480025.14 0 0 0 1101270040 1740306885 63 Other Providers of Medical Equipment/Supplies (Non-registered) QUAD COUNTY HOME MED SUPPLIES 625571721 20 Christian 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 249 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 249 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4611.19 0 565.84 0 0 0 0 5177.03 0 0 0 1101270044 29 ICF/MR 60 Lee 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2422 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319408.49 0 0 0 0 0 0 0 0 0 0 319408.49 0 0 0 1101270051 1013121243 10 Physicians EATON STEPHEN 999999999 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5778.48 0 0 0 0 0 0 5778.48 0 0 0 1101270052 1912974940 10 Physicians PULLURU SOUJANYA 605644231 107 Will 0 1 Family Practice 0 6 0 0 1 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 21 0 0 1 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 21 0 0 1 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 52 0 0 84.62 0 0 0 0 0 0 0 0 114.2 0 0 0 0 0 0 250.82 0 0 0 1101270058 1568656031 55 Early Intervention Services BUTLER MADELEINE 603021728 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 210 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 210 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22387.95 0 0 0 0 0 0 22387.95 0 0 0 1101270059 92 Waiver service provider--Disability (DHS/DRS) 72 McLean 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 979.33 0 0 0 0 0 0 0 0 0 0 0 0 0 979.33 0 0 0 1101270072 1972508885 10 Physicians FINLEY ROBERT COE 605213247 30 DuPage 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 255 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 393 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 393 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2917.38 0 0 0 0 0 0 2917.38 0 0 0 1101270090 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 30996.81 0 0 0 0 0 0 0 0 0 0 0 0 0 30996.81 0 0 0 1101270096 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 2963.75 0 0 0 0 0 0 0 0 0 0 0 0 0 2963.75 0 0 0 1101270108 92 Waiver service provider--Disability (DHS/DRS) 96 St Clair 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 13042.92 0 0 0 0 0 0 0 0 0 0 0 0 0 13042.92 0 0 0 1101270113 1649248824 10 Physicians MIENTUS THOMAS 600451696 57 Lake 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 473.75 0 0 0 0 0 0 0 0 473.75 0 0 0 1101270120 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 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 15872.57 0 0 0 0 0 0 0 0 0 0 0 0 0 15872.57 0 0 0 1101270124 1285692889 10 Physicians ALBORES RUDOLPH 605591745 30 DuPage 0 1 Internal Medicine 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 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63.74 0 0 0 0 0 0 63.74 0 0 0 1101270128 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 15601.47 0 0 0 0 0 0 0 0 0 0 0 0 0 15601.47 0 0 0 1101270155 1770658429 16 Nurse Practitioners EARLES JULIE 618012529 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 392.48 0 0 0 0 0 0 392.48 0 0 0 1101270157 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 291 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 291 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22296.17 0 0 0 0 0 0 0 0 0 0 0 0 0 22296.17 0 0 0 1101270159 1639147002 10 Physicians MANCINI ANTHONY 606112991 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10095.72 0 0 0 0 0 0 10095.72 0 0 0 1101270178 1730383662 10 Physicians JOHNSON MARK A 618012500 19 Champaign 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 357 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 357 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22083.6 0 0 0 0 0 0 22083.6 0 0 0 1101270191 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8602.73 0 0 0 0 0 0 0 0 0 0 0 0 0 8602.73 0 0 0 1101270203 1083924740 12 Optometrists BRASEL MICAH 624712339 34 Fayette 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 1543 0 859 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3205 0 904 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3205 0 904 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61751.69 0 25623.39 0 0 0 0 87375.08 0 0 0 1101270205 1295730117 10 Physicians RADWAN KARAM 605276686 30 DuPage 0 0 Psychiatry 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 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 623.15 0 0 0 0 0 0 623.15 0 0 0 1101270214 1841529625 10 Physicians JAIN SHIVI 606123723 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7750.32 0 0 0 0 0 0 7750.32 0 0 0 1101270217 1336119593 10 Physicians SCHEINOST MICHAEL 477470001 815 Indiana 0 0 Internal Medicine 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 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1991.25 0 0 0 0 0 0 1991.25 0 0 0 1101270239 92 Waiver service provider--Disability (DHS/DRS) 37 Fulton 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 33320.79 0 0 0 0 0 0 0 0 0 0 0 0 0 33320.79 0 0 0 1101270249 10 Physicians 815 Indiana 0 0 Anesthesiology 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 153.5 0 0 0 0 0 0 153.5 0 0 0 1101270250 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 9380.48 0 0 0 0 0 0 0 0 0 0 0 0 0 9380.48 0 0 0 1101270255 1467472159 10 Physicians SMITH BRIDGETTE 605231956 30 DuPage 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 383 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 398 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 398 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12908.78 0 0 0 0 0 0 12908.78 0 0 0 1101270257 1639338296 24 Speech Therapists OSWALD ALLISON 601393674 30 DuPage 0 0 0 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 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10253.07 10253.07 0 0 0 1101270263 1780659912 10 Physicians FOODY ROBERT 605061451 53 Kane 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 10 0 214 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 485 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 485 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9157.59 0 0 0 0 0 0 9157.59 0 0 0 1101270265 1407079494 63 Other Providers of Medical Equipment/Supplies (Non-registered) LINCARE INC 629663950 47 Jackson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 709 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8085 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8085 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 418667.47 0 0 0 0 0 0 418667.47 0 0 0 1101270268 1033151923 10 Physicians SHIRAZI SYED 608052701 200 Cook 0 0 Oncology 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2648.79 0 0 0 0 0 0 2648.79 0 0 0 1101270273 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5860.19 0 0 0 0 0 0 0 0 0 0 0 0 0 5860.19 0 0 0 1101270276 1992737969 10 Physicians LYON ALICE 606114402 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 28 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 485 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 485 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1426.56 0 39636.09 0 0 0 0 0 0 41062.65 0 0 0 1101270280 1932207487 10 Physicians REICH ALAN 606313722 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1999.3 0 0 0 0 0 0 1999.3 0 0 0 1101270281 1851361935 10 Physicians ANDONIADIS MATTHEW 604631256 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1908.52 0 0 0 0 0 0 1908.52 0 0 0 1101270282 1770684359 47 Local Education Agencies SULLIVAN COMM UNIT DIST 300 619511540 78 Moultrie 0 0 0 0 0 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 287 0 0 0 0 293 0 0 0 0 0 0 0 0 0 0 0 0 0 5683 0 0 0 0 293 0 0 0 0 0 0 0 0 0 0 0 0 0 5683 0 0 0 0 1769.11 0 0 0 0 0 0 0 0 0 0 0 0 0 101153.62 0 102922.73 0 0 0 1101270293 1831364132 36 Community mental health provider LORETTO HOSPITAL 606445032 200 Cook 0 0 0 141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 283 0 0 344 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 437 0 0 344 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 437 0 0 9287.92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51018.39 0 0 60306.31 0 0 0 1101270295 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 42982.83 0 0 0 0 0 0 0 0 0 0 0 0 0 42982.83 0 0 0 1101270310 1801870977 10 Physicians LOPEZ RICHARD 608052795 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 253 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 277 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 277 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6129.04 0 0 0 0 0 0 6129.04 0 0 0 1101270321 92 Waiver service provider--Disability (DHS/DRS) 63 Macon 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 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 3271.08 0 0 0 0 0 0 0 0 0 0 0 0 0 3271.08 0 0 0 1101270326 1669466066 10 Physicians ONEILL BRIAN A 622265372 200 Cook 0 0 General Practice 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 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 201.2 0 0 0 0 0 0 201.2 0 0 0 1101270330 1427190222 60 Pharmacies BRADFORD PHARMACY 614215022 95 Stark 0 0 0 0 0 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 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3508 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5604.04 0 0 0 5604.04 0 0 0 1101270349 1497837009 60 Pharmacies IVAN T MATTHEI PHARMACY 606021708 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 945 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1599.56 0 0 0 1599.56 0 0 0 1101270351 10 Physicians 844 Tennessee 0 0 Anesthesiology 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 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 99.15 0 0 0 0 0 0 99.15 0 0 0 1101270352 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 1119.56 0 0 0 0 0 0 0 0 0 0 0 0 0 1119.56 0 0 0 1101270354 92 Waiver service provider--Disability (DHS/DRS) 85 Pulaski 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 7180.59 0 0 0 0 0 0 0 0 0 0 0 0 0 7180.59 0 0 0 1101270361 92 Waiver service provider--Disability (DHS/DRS) 71 McHenry 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 34545.22 0 0 0 0 0 0 0 0 0 0 0 0 0 34545.22 0 0 0 1101270368 1760673248 60 Pharmacies WALGREENS 7811 999999999 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2227 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18886.97 0 0 0 18886.97 0 0 0 1101270375 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 18352.7 0 0 0 0 0 0 0 0 0 0 0 0 0 18352.7 0 0 0 1101270397 1588637839 10 Physicians MITTAPALLI ARUNA 617014364 72 McLean 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 1290 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1441 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1441 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47225.28 0 0 0 0 0 0 47225.28 0 0 0 1101270401 1851354690 10 Physicians RASHID FAISAL 628013056 66 Marion 0 0 Nephrology 0 0 0 0 0 0 0 0 0 0 0 0 0 536 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2187 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2187 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23992.35 0 0 0 0 0 0 23992.35 0 0 0 1101270406 1932210978 10 Physicians BARCLAY JOANNA 601222300 53 Kane 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 1 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 397 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 397 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6372.57 0 0 0 0 0 0 6372.57 0 0 0 1101270414 1043217110 10 Physicians RAO VEERA A 480991239 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 886.45 0 0 0 0 0 0 886.45 0 0 0 1101270416 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3927 0 0 0 0 0 0 0 0 0 0 0 0 0 3927 0 0 0 1101270419 92 Waiver service provider--Disability (DHS/DRS) 57 Lake 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 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 11331.34 0 0 0 0 0 0 0 0 0 0 0 0 0 11331.34 0 0 0 1101270429 10 Physicians 852 Wisconsin 0 0 Pediatric Cardiology 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 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 58.36 0 0 0 0 0 0 58.36 0 0 0 1101270430 1225067903 63 Other Providers of Medical Equipment/Supplies (Non-registered) TRINITY HEALTH ENTERPRISES 612653753 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 344 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1913 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1913 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69544.49 0 26.12 0 0 0 0 69570.61 0 0 0 1101270435 1225259773 16 Nurse Practitioners KAMMANN MARY 606081797 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3404.54 0 0 0 0 0 0 3404.54 0 0 0 1101270436 1154547875 16 Nurse Practitioners BRANDL KIMBERLY 606253666 200 Cook 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 269 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 269 0 0 0 0 0 0 0 0 0 86.28 0 0 0 0 0 0 0 0 20808.29 0 0 0 0 0 0 20894.57 0 0 0 1101270443 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 37378.05 0 0 0 0 0 0 0 0 0 0 0 0 0 37378.05 0 0 0 1101270446 1154526770 10 Physicians PATEL DAKSESH 604405125 30 DuPage 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 320 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 320 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9107.76 0 0 0 0 0 0 9107.76 0 0 0 1101270448 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 1287.5 0 0 0 0 0 0 0 0 0 0 0 0 0 1287.5 0 0 0 1101270449 1841218435 10 Physicians PETERSON LOANN 606118702 200 Cook 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1452.6 0 0 0 0 0 0 0 0 1452.6 0 0 0 1101270455 1356575690 10 Physicians CHWAJOL MARK 606124300 200 Cook 0 0 Neurology Surgery 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 0 113 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 11906.68 0 0 0 0 0 0 11906.68 0 0 0 1101270456 2100260874 94 Waiver service provider--Children's support (DHS/DDD) EASTER SEALS JOLIET REGION 604355271 107 Will 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 2493 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2493 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132685.27 0 0 0 0 0 0 0 0 0 0 0 0 0 132685.27 0 0 0 1101270458 1356438436 10 Physicians RAPPAPORT JESSICA 999999999 57 Lake 0 0 0 0 0 0 3 0 0 0 0 0 0 4 0 7 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 4 0 8 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 4 0 8 0 0 0 0 0 0 0 0 0 181.51 0 0 0 0 0 0 22.51 0 215.7 0 0 0 0 0 0 419.72 0 0 0 1101270465 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 19 0 0 0 0 0 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 17130.78 0 0 0 0 0 0 0 0 0 0 0 0 0 17130.78 0 0 0 1101270478 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 19 0 0 0 0 0 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 22377.62 0 0 0 0 0 0 0 0 0 0 0 0 0 22377.62 0 0 0 1101270482 10 Physicians 826 Missouri 0 0 Radiology Diagnosis 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 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 651.6 0 0 0 0 0 0 0 0 651.6 0 0 0 1101270492 92 Waiver service provider--Disability (DHS/DRS) 98 Tazewell 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 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 9551.39 0 0 0 0 0 0 0 0 0 0 0 0 0 9551.39 0 0 0 1101270514 1720264898 10 Physicians CARSON KENNETH 637014556 826 Missouri 0 0 Oncology 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28908.27 0 0 0 0 0 0 28908.27 0 0 0 1101270520 10 Physicians 816 Iowa 0 0 Gastroenterology 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 149.95 0 0 0 0 0 0 149.95 0 0 0 1101270527 92 Waiver service provider--Disability (DHS/DRS) 63 Macon 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 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 6120.09 0 0 0 0 0 0 0 0 0 0 0 0 0 6120.09 0 0 0 1101270533 1730126004 10 Physicians DESAI ANJALI 606118709 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1280.29 0 0 0 0 0 0 1280.29 0 0 0 1101270553 1558338160 10 Physicians SCHMIDT KENNETH D 600161209 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 276 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 472 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 472 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5120.39 0 2048.81 0 0 0 0 0 0 7169.2 0 0 0 1101270571 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 21211.87 0 0 0 0 0 0 0 0 0 0 0 0 0 21211.87 0 0 0 1101270574 1912029521 38 Specialized Mental Health Rehabilitation Facilities (SMHRF) BAYSIDE TERRACE 600857710 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 457 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8707 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 667922.63 0 0 0 0 0 0 0 667922.63 0 0 0 1101270583 24 Speech 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 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 1995.4 1995.4 0 0 0 1101270589 1386994416 16 Nurse Practitioners HOLLOWAY LORI 618344509 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1649.81 0 0 0 0 0 0 1649.81 0 0 0 1101270594 1316279961 16 Nurse Practitioners FREEMAN WENDY 420037914 818 Kentucky 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 879.86 0 0 0 0 0 0 879.86 0 0 0 1101270598 1194779595 10 Physicians ORLIN KRAFF CARYN 606021703 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3461.72 0 0 0 0 0 0 3461.72 0 0 0 1101270600 1013023894 47 Local Education Agencies EDGAR COUNTY C U DIST 6 619249601 31 Edgar 0 0 0 0 0 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 789 0 0 0 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 789 0 0 0 0 908.72 0 0 0 0 0 0 0 0 0 0 0 0 0 6652.96 0 7561.68 0 0 0 1101270603 1831389204 60 Pharmacies OSCO DRUG 3776 604519507 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 347 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19201.44 0 0 0 19201.44 0 0 0 1101270612 1922210178 10 Physicians SIDDIQUI ALI 615543822 98 Tazewell 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 645 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 703 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 703 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20128.36 0 0 0 0 0 0 20128.36 0 0 0 1101270622 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 201 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 201 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16013.25 0 0 0 0 0 0 0 0 0 0 0 0 0 16013.25 0 0 0 1101270668 24 Speech Therapists 200 Cook 0 0 0 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 23 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 0 0 0 0 0 0 0 0 1814 1814 0 0 0 1101270670 1366402992 10 Physicians MEYERSON SHARI 606118709 57 Lake 0 0 Thoracic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2812.65 0 0 0 0 0 0 2812.65 0 0 0 1101270672 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15507.83 0 0 0 0 0 0 0 0 0 0 0 0 0 15507.83 0 0 0 1101270688 1699765842 10 Physicians BAIER THOMAS 600313326 57 Lake 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 56 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 270 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 270 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1183.02 0 11785.87 0 0 0 0 0 0 12968.89 0 0 0 1101270693 91 Waiver service provider--Adults (DHS/DDD) 60 Lee 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 0 244 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 244 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11358.6 0 0 0 0 0 0 0 0 0 0 0 0 0 11358.6 0 0 0 1101270700 1548200934 91 Waiver service provider--Adults (DHS/DDD) "OPPORTUNITY HOUSE, INC." 601781214 27 Dekalb 0 0 0 0 0 0 0 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3515245.64 0 0 0 0 0 0 0 0 0 0 0 0 0 3515245.64 0 0 0 1101270705 91 Waiver service provider--Adults (DHS/DDD) 104 Wayne 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 0 259 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 259 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13464 0 0 0 0 0 0 0 0 0 0 0 0 0 13464 0 0 0 1101270718 1134316631 40 Federally Qualified Health Centers ERIE TEEN HEALTH CENTER 606405258 200 Cook 0 1 School-based 0 442 97 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 918 290 0 228 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 918 290 0 228 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2045 17652.52 0 8346.36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28043.88 0 0 0 1101270720 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14520 0 0 0 1101270753 91 Waiver service provider--Adults (DHS/DDD) 57 Lake 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 0 317 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 317 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22260.66 0 0 0 0 0 0 0 0 0 0 0 0 0 22260.66 0 0 0 1101270777 1487878229 55 Early Intervention Services YAMBERT LESLIE 629580010 47 Jackson 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 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7140.61 0 0 0 0 0 0 7140.61 0 0 0 1101270784 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 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 15491.1 0 0 0 0 0 0 0 0 0 0 0 0 0 15491.1 0 0 0 1101270801 1629217161 40 Federally Qualified Health Centers LINCOLN SQUARE 606252944 200 Cook 0 1 0 1203 1073 0 336 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8592 5513 0 1446 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8592 5513 0 1446 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21772 362375.69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 384147.69 0 0 0 1101270812 1255463451 10 Physicians OBEL JENNIFER 602011718 200 Cook 0 0 Hematology 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1483.59 0 0 0 0 0 0 1483.59 0 0 0 1101270816 1528203882 52 Certified local public health department MONTGOMERY CO HLTH DEPT 620490185 76 Montgomery 0 0 0 0 1185 0 1273 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 1784 0 4180 0 0 0 0 0 0 0 0 994 0 0 0 0 0 0 0 1784 0 4180 0 0 0 0 0 0 0 0 994 0 0 0 0 0 0 0 18976.32 0 32328.58 0 0 0 0 0 0 0 0 6719.44 0 0 0 0 0 0 58024.34 0 0 0 1101270822 1457631442 16 Nurse Practitioners HIGGINS ELIZABETH 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 468 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1432 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1432 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54608.7 0 0 0 0 0 0 54608.7 0 0 0 1101270824 92 Waiver service provider--Disability (DHS/DRS) 30 DuPage 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 5836.06 0 0 0 0 0 0 0 0 0 0 0 0 0 5836.06 0 0 0 1101270842 1942423256 22 Physical Therapists TU HOA 605276686 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 364 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 364 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49795.8 49795.8 0 0 0 1101270844 92 Waiver service provider--Disability (DHS/DRS) 56 Knox 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5732.42 0 0 0 0 0 0 0 0 0 0 0 0 0 5732.42 0 0 0 1101270845 1942203500 10 Physicians MCDONALD RAYMOND J 606560555 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 834 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 834 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1383.07 0 0 0 0 0 0 1383.07 0 0 0 1101270856 1699944561 33 Nursing Facilities FOUR SEASONS LIVING CENTER 612703042 106 Whiteside 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 692 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59269.39 0 0 0 0 0 0 0 59269.39 0 0 0 1101270857 92 Waiver service provider--Disability (DHS/DRS) 101 Wabash 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 25737.11 0 0 0 0 0 0 0 0 0 0 0 0 0 25737.11 0 0 0 1101270860 92 Waiver service provider--Disability (DHS/DRS) 24 Coles 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 597.43 0 0 0 0 0 0 0 0 0 0 0 0 0 597.43 0 0 0 1101270861 1194730333 60 Pharmacies WALGREEN CO 09481 630433909 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2648 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4374.87 0 0 0 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0 0 0 81333.64 0 0 0 0 0 0 81333.64 0 0 0 1101272423 1912134347 33 Nursing Facilities SOUTHPOINT NURSING REHAB CTR 606431522 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 199 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1517 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33322 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4302630.18 0 0 0 0 0 0 0 4302630.18 0 0 0 1101272431 1720331473 16 Nurse Practitioners LAAS TAMMY 999999999 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 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 0 140.88 0 0 0 0 0 0 140.88 0 0 0 1101272451 1326116104 10 Physicians SENNO RICARDO 604592190 200 Cook 0 0 Physical Medicine/Rehabilitation 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 152.4 0 0 0 0 0 0 152.4 0 0 0 1101272453 92 Waiver service provider--Disability (DHS/DRS) 52 Johnson 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 13431.07 0 0 0 0 0 0 0 0 0 0 0 0 0 13431.07 0 0 0 1101272456 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12043.11 0 0 0 0 0 0 0 0 0 0 0 0 0 12043.11 0 0 0 1101272461 1033315098 22 Physical Therapists RAY JESSICA 617641067 61 Livingston 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 457 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 457 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14196.14 14196.14 0 0 0 1101272469 92 Waiver service provider--Disability (DHS/DRS) 10 Adams 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 18991.54 0 0 0 0 0 0 0 0 0 0 0 0 0 18991.54 0 0 0 1101272479 1144535022 97 Waiver service provider--Children's residential (DHS/DDD) PINGO JOSEPH 61111 109 Winnebago 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 244 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 244 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20932.99 0 0 0 0 0 0 0 0 0 0 0 0 0 20932.99 0 0 0 1101272481 1003801093 33 Nursing Facilities BIRCHWOOD PLAZA INC 606261807 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1879 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47750 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4249989.26 0 0 0 0 0 0 0 4249989.26 0 0 0 1101272483 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5120.5 0 0 0 0 0 0 0 0 0 0 0 0 0 5120.5 0 0 0 1101272484 1891727236 10 Physicians ABDUR- RAHMAN IDRIES 275606600 80 Peoria 0 0 Obstetric-Gynecology 0 0 0 0 3 0 0 0 0 0 0 0 0 358 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 806 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 806 0 0 0 0 0 0 0 0 0 42.94 0 0 0 0 0 0 0 0 138479.26 0 0 0 0 0 0 138522.2 0 0 0 1101272486 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 36794.69 0 0 0 0 0 0 0 0 0 0 0 0 0 36794.69 0 0 0 1101272488 1063549616 34 State-operated facility (DHS) UNIT 3161 HOME 1 KILEY 600856263 57 Lake 0 0 0 0 0 0 0 0 0 0 0 7 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 0 630 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 478791.9 0 0 0 0 0 0 0 0 0 0 478791.9 0 0 0 1101272496 1104824374 10 Physicians GROSDIDIER MAUREEN E 600682302 30 DuPage 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 210.8 0 0 0 0 0 0 210.8 0 0 0 1101272502 1821105057 10 Physicians DREXLER MARK 600261610 200 Cook 0 1 Family Practice 0 373 0 0 205 0 0 0 0 0 0 59 0 486 0 0 0 0 0 0 2338 0 0 398 0 0 0 0 0 0 70 0 675 0 0 0 0 0 0 2338 0 0 398 0 0 0 0 0 0 70 0 675 0 0 0 0 0 0 5797 0 0 13070.99 0 0 0 0 0 0 408.36 0 34625.42 0 0 0 0 0 0 53901.77 0 0 0 1101272508 1649246224 50 Home Health Agencies - In Home PRIVATE HOME CARE UNLIMITED 606564738 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 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5328 0 0 0 0 0 0 5328 0 0 0 1101272517 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 18987.03 0 0 0 0 0 0 0 0 0 0 0 0 0 18987.03 0 0 0 1101272522 94 Waiver service provider--Children's support (DHS/DDD) 64 Macoupin 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 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5753 0 0 0 0 0 0 0 0 0 0 0 0 0 5753 0 0 0 1101272532 1558300038 10 Physicians TANNEY ROBERT 600896740 57 Lake 0 1 General Practice 0 100 0 0 19 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 634 0 0 21 0 0 0 0 0 0 0 0 187 0 0 0 0 0 0 634 0 0 21 0 0 0 0 0 0 0 0 187 0 0 0 0 0 0 1623 0 0 1659.5 0 0 0 0 0 0 0 0 6399.83 0 0 0 0 0 0 9682.33 0 0 0 1101272539 1184754798 22 Physical Therapists MOHAMED MOATZZ 606174225 200 Cook 0 0 0 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 0 201 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 201 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1301.08 1301.08 0 0 0 1101272543 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 19317.31 0 0 0 0 0 0 0 0 0 0 0 0 0 19317.31 0 0 0 1101272548 1962442509 10 Physicians GILL SANTOSH 605047205 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 7 0 606 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 1328 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 1328 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64.22 0 17046.49 0 0 0 0 0 0 17110.71 0 0 0 1101272556 70 Ambulance Service Providers 58 La Salle 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 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 0 0 0 0 0 0 0 0 0 0 0 1101272567 10 Physicians 852 Wisconsin 0 0 Pediatrics 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 589.52 0 0 0 0 0 0 589.52 0 0 0 1101272614 1679539993 12 Optometrists THOMAS MICHAEL W 601522239 58 La Salle 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 224 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 224 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4635.13 0 79.25 0 0 0 0 4714.38 0 0 0 1101272615 1568470888 10 Physicians KUMAR RAMANA 629591668 108 Williamson 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1137.45 0 0 0 0 0 0 1137.45 0 0 0 1101272616 1326366790 48 Rural Health Clinics MMG AT CHILLICOTHE 615232229 80 Peoria 0 0 0 0 353 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1634 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1634 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62210.1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62210.1 0 0 0 1101272624 1972543551 29 ICF/MR MINIAT HOUSE 606601017 200 Cook 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 0 344 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6968 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 845068.69 0 0 0 0 0 0 0 0 0 0 845068.69 0 0 0 1101272640 1629036157 10 Physicians WINTERFIELD LAURA 601533328 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 0 0 361 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 651 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 651 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18045.94 0 0 0 0 0 0 18045.94 0 0 0 1101272645 1518968379 63 Other Providers of Medical Equipment/Supplies (Non-registered) BEYOND MEDICAL USA 999999999 810 Florida 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 377 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2529 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2529 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10447.05 0 10370.93 0 0 0 0 20817.98 0 0 0 1101272647 1437100856 11 Dentists MILORO MICHAEL 605276686 30 DuPage 0 0 Oral Surgery 0 0 0 1457 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5764 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5764 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 462901.48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 462901.48 0 0 0 1101272648 1124003967 10 Physicians LOBO PHILIP A 600051069 200 Cook 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 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 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1670.28 0 0 0 0 0 0 1670.28 0 0 0 1101272674 92 Waiver service provider--Disability (DHS/DRS) 86 Putnam 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 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21682.09 0 0 0 0 0 0 0 0 0 0 0 0 0 21682.09 0 0 0 1101272678 16 Nurse Practitioners 852 Wisconsin 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 44 0 0 0 1101272713 1649321001 12 Optometrists PASMAN ALLA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2990.94 0 0 0 0 0 0 2990.94 0 0 0 1101272722 1831139286 10 Physicians SHU HUI 631101016 826 Missouri 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 6 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 0 156.19 0 0 0 0 0 0 0 0 156.19 0 0 0 1101272730 1962701805 91 Waiver service provider--Adults (DHS/DDD) CRUZ SARAI 999999999 200 Cook 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93335.28 0 0 0 0 0 0 0 0 0 0 0 0 0 93335.28 0 0 0 1101272753 10 Physicians 852 Wisconsin 0 0 Surgery General 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75.4 0 0 0 0 0 0 75.4 0 0 0 1101272759 92 Waiver service provider--Disability (DHS/DRS) 89 Rock Island 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 1735.73 0 0 0 0 0 0 0 0 0 0 0 0 0 1735.73 0 0 0 1101272769 1316968779 10 Physicians NAGALDINNE GOVINDARAJULU 631280000 826 Missouri 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 8 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 760.65 0 0 0 0 0 0 760.65 0 0 0 1101272773 92 Waiver service provider--Disability (DHS/DRS) 60 Lee 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 29608.46 0 0 0 0 0 0 0 0 0 0 0 0 0 29608.46 0 0 0 1101272782 98 Waiver service provider--TBI (DHS/DRS) 107 Will 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16528.09 0 0 0 0 0 0 0 0 0 0 0 0 0 16528.09 0 0 0 1101272785 1922081249 10 Physicians MARSHALL JACOB 622344368 65 Madison 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 442 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 484 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 484 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13285.2 0 0 0 0 0 0 13285.2 0 0 0 1101272803 55 Early Intervention Services 100 Vermilion 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 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 0 689.25 0 0 0 0 0 0 689.25 0 0 0 1101272805 1003800707 64 Imaging Services LIFE SUPPORT SYSTEMS INC 999999999 810 Florida 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 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1772.98 0 0 0 0 0 0 1772.98 0 0 0 1101272807 92 Waiver service provider--Disability (DHS/DRS) 55 Kendall 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 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 11689.33 0 0 0 0 0 0 0 0 0 0 0 0 0 11689.33 0 0 0 1101272818 1457301087 10 Physicians HARRIS ZENA 606112991 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 406 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 406 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50952.39 0 0 0 0 0 0 50952.39 0 0 0 1101272819 1861488801 10 Physicians HANSEN MARK 627046487 91 Sangamon 0 1 Internal Medicine 0 143 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 1126 0 0 0 0 0 0 0 0 0 0 0 140 0 0 0 0 0 0 1126 0 0 0 0 0 0 0 0 0 0 0 140 0 0 0 0 0 0 3362 0 0 0 0 0 0 0 0 0 0 0 2950.97 0 0 0 0 0 0 6312.97 0 0 0 1101272821 1780820985 16 Nurse Practitioners KINAHAN PATRICIA 606413255 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1580.07 0 0 0 0 0 0 1580.07 0 0 0 1101272832 1326398801 11 Dentists TEKLE LEAH 620331473 64 Macoupin 0 0 General Dentistry 0 0 0 404 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9751 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9751 0 0 0 1101272844 1013035674 34 State-operated facility (DHS) UNIT 4892 BLDG 813A SHAPIRO 609015018 54 Kankakee 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 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1620 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1084064.4 0 0 0 0 0 0 0 0 0 0 1084064.4 0 0 0 1101272845 1447260344 10 Physicians TSANG CELINA 627046483 91 Sangamon 0 1 Internal Medicine 0 2 0 0 0 0 0 0 0 0 0 16 0 32 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 110 0 76 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 110 0 76 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 524.21 0 1852.88 0 0 0 0 0 0 2419.09 0 0 0 1101272867 1760593594 10 Physicians AMIN PINAKIN 608031608 200 Cook 0 1 Internal Medicine 0 33 0 0 0 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 0 0 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Service Providers BURLINGTON FIRE DEPT AMBULANCE 526015515 816 Iowa 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2487.45 0 0 0 0 0 0 2487.45 0 0 0 1101274988 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5828.46 0 0 0 0 0 0 0 0 0 0 0 0 0 5828.46 0 0 0 1101275006 1013925593 63 Other Providers of Medical Equipment/Supplies (Non-registered) OSF HOME MEDICAL EQUIPMENT 611082490 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 315 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1832 0 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1832 0 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49393.81 0 3280.29 0 0 0 0 52674.1 0 0 0 1101275010 10 Physicians 844 Tennessee 0 0 Pediatrics 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56.7 0 0 0 0 0 0 56.7 0 0 0 1101275024 92 Waiver service provider--Disability (DHS/DRS) 68 Mason 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 15196.91 0 0 0 0 0 0 0 0 0 0 0 0 0 15196.91 0 0 0 1101275032 1154329753 30 General Hospitals ABRAHAM LINCOLN MEMORIAL HOSP 626565066 62 Logan ARS-PD Hospitals paid a Per Diem rate. 1 0 0 0 0 0 6 0 0 0 0 0 0 289 0 0 132 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 1308 0 0 520 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 1308 0 0 520 0 0 0 0 0 0 0 0 34.62 0 0 0 0 0 0 5815.05 0 0 57025.41 0 0 0 0 0 62875.08 0 0 0 1101275046 92 Waiver service provider--Disability (DHS/DRS) 34 Fayette 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17184.42 0 0 0 0 0 0 0 0 0 0 0 0 0 17184.42 0 0 0 1101275108 1265692081 11 Dentists TAN JENNIFER 606392351 200 Cook 0 0 General Dentistry 0 0 0 261 0 0 0 0 0 0 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0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4811.5 0 0 0 0 0 0 0 0 0 0 0 0 0 4811.5 0 0 0 1101275394 1629076021 13 Podiatrists WEIK DAVID 631193937 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 478 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1302 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1302 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1289.31 0 0 0 0 0 0 1289.31 0 0 0 1101275401 1083681654 10 Physicians SCHILLING DAVID 601545716 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4304.22 0 0 0 0 0 0 4304.22 0 0 0 1101275405 1508090234 10 Physicians DESAI CHAITANYA 999999999 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 620 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 620 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27.36 0 7068.67 0 0 0 0 0 0 7096.03 0 0 0 1101275407 1386608859 30 General Hospitals SCOTTSDALE HEALTHCARE SHEA 852606709 803 Arizona ARS-LS Long-term stay 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0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5844.89 0 0 0 0 0 0 5844.89 0 0 0 1101275487 1538129069 10 Physicians KEITH JOHN 611031673 109 Winnebago 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14434.74 0 0 0 0 0 0 14434.74 0 0 0 1101275488 1407830698 10 Physicians MANDA RAMANUJA 531435031 852 Wisconsin 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 389.94 0 0 0 0 0 0 389.94 0 0 0 1101275490 92 Waiver service provider--Disability (DHS/DRS) 69 Massac 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 23204.84 0 0 0 0 0 0 0 0 0 0 0 0 0 23204.84 0 0 0 1101275523 24 Speech Therapists 107 Will 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1596.32 1596.32 0 0 0 1101275529 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12850.2 0 0 0 0 0 0 0 0 0 0 0 0 0 12850.2 0 0 0 1101275539 1679513642 10 Physicians DINH DZUNG 616052531 80 Peoria 0 0 Neurology Surgery 0 0 0 0 0 0 0 0 0 0 0 9 0 226 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 414 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 414 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101.8 0 82987.11 0 0 0 0 0 0 83088.91 0 0 0 1101275541 47 Local Education Agencies 103 Washington 0 0 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 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 0 144.99 0 144.99 0 0 0 1101275549 91 Waiver service provider--Adults (DHS/DDD) 104 Wayne 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 0 347 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 347 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11904.05 0 0 0 0 0 0 0 0 0 0 0 0 0 11904.05 0 0 0 1101275552 1013018449 10 Physicians SADEGI BARRY 605151548 30 DuPage 0 1 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 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 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12783.55 0 0 0 0 0 0 12783.55 0 0 0 1101275554 1306004601 10 Physicians SHAHPAR SAMMAN 999999999 200 Cook 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 0 387 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 387 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4874.82 0 0 0 0 0 0 4874.82 0 0 0 1101275562 1376799577 10 Physicians LABOWITZ DAVID A. 602011718 200 Cook 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 284 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 284 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 246 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 246 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15288.91 0 0 0 0 0 0 15288.91 0 0 0 1101275593 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29292.17 0 0 0 0 0 0 0 0 0 0 0 0 0 29292.17 0 0 0 1101275595 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 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 2746.42 0 0 0 0 0 0 0 0 0 0 0 0 0 2746.42 0 0 0 1101275597 10 Physicians 200 Cook 0 0 Internal Medicine 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 14 0 0 0 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 7.36 0 0 0 0 0 0 7.36 0 0 0 1101275598 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22453.2 0 0 0 0 0 0 0 0 0 0 0 0 0 22453.2 0 0 0 1101275602 1033215728 16 Nurse Practitioners SONDEEN OPILA LESLIE 606143363 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12878.18 0 0 0 0 0 0 12878.18 0 0 0 1101275607 1316900087 10 Physicians COTTS WILLIAM 604532658 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 466 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 466 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8338.66 0 0 0 0 0 0 8338.66 0 0 0 1101275622 1811008444 10 Physicians BABER WILLIAM 631463119 826 Missouri 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 8 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 0 306.94 0 0 0 0 0 0 0 0 306.94 0 0 0 1101275635 1871547638 10 Physicians MALIK FARAH 605604567 55 Kendall 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 2 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54.79 0 1152.07 0 0 0 0 0 0 1206.86 0 0 0 1101275648 1548228745 10 Physicians KNIGHT STANLEY D 379233632 30 DuPage 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12441.2 0 0 0 0 0 0 12441.2 0 0 0 1101275654 92 Waiver service provider--Disability (DHS/DRS) 36 Franklin 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 13746.48 0 0 0 0 0 0 0 0 0 0 0 0 0 13746.48 0 0 0 1101275659 1740273986 10 Physicians THAKRAR JAYESH 463212901 815 Indiana 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 132 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5083.79 0 10.77 0 0 0 0 0 0 5094.56 0 0 0 1101275660 1184602096 10 Physicians VAKASSI M M 622265359 96 St Clair 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 551 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1234 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1234 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6741.22 0 0 0 0 0 0 6741.22 0 0 0 1101275668 10 Physicians 852 Wisconsin 0 0 Pediatrics 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24.9 0 0 0 0 0 0 24.9 0 0 0 1101275671 30 General Hospitals 811 Georgia NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 0 283.1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 283.1 0 0 0 1101275676 1881872588 10 Physicians TAHA RAMI 600485321 57 Lake 0 0 Infectious Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 207 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 845 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 845 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8782.05 0 0 0 0 0 0 8782.05 0 0 0 1101275688 1245362920 22 Physical Therapists KRUCKEBERG RICHARD 619389252 24 Coles 0 0 0 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 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1594.23 1594.23 0 0 0 1101275703 1285788208 10 Physicians WOODS DORIAN S. 606118709 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 298 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 327 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 327 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9901.81 0 0 0 0 0 0 9901.81 0 0 0 1101275708 1457485641 23 Occupational Therapists SWEENEY SARAH 600913406 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9469.08 9469.08 0 0 0 1101275721 1811007735 10 Physicians PATEL RAMESH 604111748 200 Cook 0 0 Otorhinolaryngology 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 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MEDICAL CENTER 614621007 102 Warren DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 1 0 General Hospital - Adult and Child 0 0 0 0 0 1843 0 0 0 0 56 0 0 0 761 0 0 0 0 0 0 0 0 0 3369 0 0 0 0 62 0 0 0 1292 0 0 0 0 0 0 0 0 0 3375 0 0 0 0 158 0 0 0 1292 0 0 0 0 0 0 0 0 0 1967436.12 0 0 0 0 79583.22 0 0 0 1265864.65 0 0 0 0 0 3312883.99 0 0 0 1101275753 1750303277 10 Physicians WOLODKO MARGARET 600162335 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 17 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 247 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 247 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5034.15 0 31039.93 0 0 0 0 0 0 36074.08 0 0 0 1101275760 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 12008.28 0 0 0 0 0 0 0 0 0 0 0 0 0 12008.28 0 0 0 1101275766 1720227069 70 Ambulance Service Providers POLO FIRE PROTECTION AMB SERV 610641716 79 Ogle 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7695.02 0 0 0 0 0 0 7695.02 0 0 0 1101275768 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 45416.07 0 0 0 0 0 0 0 0 0 0 0 0 0 45416.07 0 0 0 1101275771 1942214168 10 Physicians RAZZAQ ABDUL 620404701 65 Madison 0 1 Internal Medicine 0 2 0 0 0 0 0 0 0 0 0 0 0 362 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 755 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 755 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 3746.84 0 0 0 0 0 0 3788.84 0 0 0 1101275786 1386605962 33 Nursing Facilities GLENWOOD HEALTHCARE AND REHAB 604251834 200 Cook 0 0 0 1 0 0 0 0 0 0 0 0 0 0 161 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1166 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 28078 0 0 0 0 0 0 0 1789.36 0 0 0 0 0 0 0 0 0 0 3503126 0 0 0 0 0 0 0 3504915.36 0 0 0 1101275803 1467552133 10 Physicians OMARRO STEVEN 627011041 91 Sangamon 0 0 Infectious Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 244 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1185 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1185 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13516.47 0 0 0 0 0 0 13516.47 0 0 0 1101275805 14 Chiropractors 79 Ogle 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 23 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 0 0 0 0 0 0 0 0 228.58 0 0 0 0 0 0 228.58 0 0 0 1101275809 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 2535.2 0 0 0 0 0 0 0 0 0 0 0 0 0 2535.2 0 0 0 1101275816 1629375886 16 Nurse Practitioners BERNINGER JULIE 631101010 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 193.8 0 0 0 0 0 0 193.8 0 0 0 1101275818 92 Waiver service provider--Disability (DHS/DRS) 30 DuPage 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10787.93 0 0 0 0 0 0 0 0 0 0 0 0 0 10787.93 0 0 0 1101275820 22 Physical Therapists 30 DuPage 0 0 0 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 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 0 339.42 339.42 0 0 0 1101275824 92 Waiver service provider--Disability (DHS/DRS) 15 Bureau 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 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9136.32 0 0 0 0 0 0 0 0 0 0 0 0 0 9136.32 0 0 0 1101275828 10 Physicians 852 Wisconsin 0 0 Internal Medicine 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 254 0 0 0 0 0 0 254 0 0 0 1101275838 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 18185.72 0 0 0 0 0 0 0 0 0 0 0 0 0 18185.72 0 0 0 1101275839 1376705236 10 Physicians MURPHY JOSHUA 631101002 826 Missouri 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9921.85 0 0 0 0 0 0 9921.85 0 0 0 1101275852 1154336865 70 Ambulance Service Providers LAGRANGE FIRE DEPT 605252469 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 175 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 175 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7057.41 0 0 0 0 0 0 7057.41 0 0 0 1101275861 1467586669 36 Community mental health provider FSMHC OAK PARK RIVER FOREST 603022809 200 Cook 0 0 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 368 0 0 740 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3982 0 0 740 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3982 0 0 24999.94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 229898.72 0 0 254898.66 0 0 0 1101275886 1073555488 10 Physicians KUGANESWARAN ELIATHAMBY 616021074 80 Peoria 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10615.87 0 0 0 0 0 0 10615.87 0 0 0 1101275888 16 Nurse Practitioners 200 Cook 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 170.05 0 0 0 0 0 0 170.05 0 0 0 1101275904 1841280831 10 Physicians MILLER RONALD D 622261919 27 Dekalb 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 7 0 243 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 453 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 453 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 126.4 0 17864.71 0 0 0 0 0 0 17991.11 0 0 0 1101275917 48 Rural Health Clinics 826 Missouri 0 1 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 86.61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86.61 0 0 0 1101275925 1386713964 61 Independent Laboratories LABORATORY CORPORATION AMERICA 622201952 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 919.69 0 0 0 0 0 0 0 0 919.69 0 0 0 1101275931 92 Waiver service provider--Disability (DHS/DRS) 107 Will 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 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 2549.93 0 0 0 0 0 0 0 0 0 0 0 0 0 2549.93 0 0 0 1101275934 92 Waiver service provider--Disability (DHS/DRS) 106 Whiteside 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 0 440.97 0 0 0 0 0 0 0 0 0 0 0 0 0 440.97 0 0 0 1101275937 1902864499 10 Physicians LEVITAN ARIELLE 600353109 57 Lake 0 1 Internal Medicine 0 26 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 188 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 188 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 554 0 0 0 0 0 0 0 0 0 0 0 1482.3 0 0 0 0 0 0 2036.3 0 0 0 1101275942 1841459138 10 Physicians ANSCHEL ALAN 606112654 200 Cook 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 364 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 364 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2002.9 0 0 0 0 0 0 2002.9 0 0 0 1101275953 1104864347 60 Pharmacies OSCO DRUG 3316 601953729 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 397 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 9766 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319.98 0 0 16281.01 0 0 0 16600.99 0 0 0 1101275955 91 Waiver service provider--Adults (DHS/DDD) 106 Whiteside 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 947.87 0 0 0 0 0 0 0 0 0 0 0 0 0 947.87 0 0 0 1101275958 1407854771 30 General Hospitals TOLEDO HOSPITAL 436063895 836 Ohio NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 7 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 1433.06 0 0 0 0 7108.51 0 0 0 0 0 0 0 0 0 8541.57 0 0 0 1101275960 92 Waiver service provider--Disability (DHS/DRS) 47 Jackson 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 30288.87 0 0 0 0 0 0 0 0 0 0 0 0 0 30288.87 0 0 0 1101275964 1235194028 10 Physicians DEUTSCH HAREL 606123846 200 Cook 0 0 Neurology Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10306.4 0 0 0 0 0 0 10306.4 0 0 0 1101275968 1225094097 10 Physicians WEGNER DONNA 603022361 200 Cook 0 1 Pediatrics 0 17 0 0 7 0 0 0 0 0 0 6 0 15 0 0 0 0 0 0 78 0 0 23 0 0 0 0 0 0 6 0 21 0 0 0 0 0 0 78 0 0 23 0 0 0 0 0 0 6 0 21 0 0 0 0 0 0 156 0 0 740.1 0 0 0 0 0 0 69.12 0 986.79 0 0 0 0 0 0 1952.01 0 0 0 1101275977 1093763799 16 Nurse Practitioners MANUEL RUBIO MARIA 606112991 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 298 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 298 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16125.94 0 0 0 0 0 0 16125.94 0 0 0 1101275978 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2133.45 0 0 0 0 0 0 0 0 0 0 0 0 0 2133.45 0 0 0 1101275982 91 Waiver service provider--Adults (DHS/DDD) 65 Madison 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 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12958 0 0 0 0 0 0 0 0 0 0 0 0 0 12958 0 0 0 1101275986 1821289315 10 Physicians BHATTACHARYYA PRIYA 608052701 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 2 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2.58 0 431.46 0 0 0 0 0 0 434.04 0 0 0 1101275990 91 Waiver service provider--Adults (DHS/DDD) 57 Lake 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 0 320 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 320 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20942.51 0 0 0 0 0 0 0 0 0 0 0 0 0 20942.51 0 0 0 1101275992 10 Physicians 107 Will 0 0 Anesthesiology 0 0 0 0 0 0 0 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 769.85 0 0 0 0 0 0 769.85 0 0 0 1101275993 1144228487 30 General Hospitals ST FRANCIS HOSPITAL INC 741361902 837 Oklahoma NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 9 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 1449.01 0 0 0 0 14232.66 0 0 0 0 0 0 0 0 0 15681.67 0 0 0 1101276005 1851371561 61 Independent Laboratories UNIVERSITY HYGIENIC LABORATORY 522414721 816 Iowa 0 0 0 0 0 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 461 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 461 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6187.97 0 0 0 0 0 0 0 0 6187.97 0 0 0 1101276015 1215960026 10 Physicians DUDLEY LEE 617613558 72 McLean 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3389.52 0 0 0 0 0 0 3389.52 0 0 0 1101276026 1033224969 10 Physicians RAO PYDISETTY 600683277 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6960.24 0 0 0 0 0 0 6960.24 0 0 0 1101276028 1851377048 10 Physicians ROBINSON CARMELITA 606197061 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 838.81 0 0 0 0 0 0 838.81 0 0 0 1101276037 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 8352.13 0 0 0 0 0 0 0 0 0 0 0 0 0 8352.13 0 0 0 1101276039 1255659751 10 Physicians OPARANOZIE OBIOMA 606493603 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 14 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100.16 0 29072 0 0 0 0 0 0 29172.16 0 0 0 1101276046 1578540985 10 Physicians THORSEN CHARLES 602013664 200 Cook 0 1 Internal Medicine 0 78 0 0 0 0 0 0 0 0 0 0 0 61 0 0 0 0 0 0 500 0 0 0 0 0 0 0 0 0 0 0 140 0 0 0 0 0 0 500 0 0 0 0 0 0 0 0 0 0 0 140 0 0 0 0 0 0 1474 0 0 0 0 0 0 0 0 0 0 0 3820.83 0 0 0 0 0 0 5294.83 0 0 0 1101276052 1326123613 70 Ambulance Service Providers OFALLON AMBULANCE SERVICE 622694110 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 537 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 537 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11473.13 0 0 0 0 0 0 11473.13 0 0 0 1101276057 1932147154 10 Physicians KRAUSS DANIEL 605212902 30 DuPage 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 3 0 229 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 337 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 337 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19.1 0 3809.01 0 0 0 0 0 0 3828.11 0 0 0 1101276059 1629395868 16 Nurse Practitioners MATHEW ANNAMMA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101.62 0 0 0 0 0 0 101.62 0 0 0 1101276069 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6824.4 0 0 0 0 0 0 0 0 0 0 0 0 0 6824.4 0 0 0 1101276070 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 27377.16 0 0 0 0 0 0 0 0 0 0 0 0 0 27377.16 0 0 0 1101276081 1841296340 63 Other Providers of Medical Equipment/Supplies (Non-registered) RIVERSIDE PROSTHETICS INC 477154020 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 142.15 0 2457.85 0 0 0 0 2600 0 0 0 1101276094 1083902308 11 Dentists MOON TAEHYUNG 611151621 109 Winnebago 0 0 General Dentistry 0 0 0 398 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2415 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2415 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58081.61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58081.61 0 0 0 1101276099 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 20324.62 0 0 0 0 0 0 0 0 0 0 0 0 0 20324.62 0 0 0 1101276103 1801871876 10 Physicians SKULSKI MICHAEL 473033428 815 Indiana 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 7 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 0 228.04 0 0 0 0 0 0 0 0 228.04 0 0 0 1101276105 94 Waiver service provider--Children's support (DHS/DDD) 79 Ogle 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 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5964.75 0 0 0 0 0 0 0 0 0 0 0 0 0 5964.75 0 0 0 1101276118 1134148182 10 Physicians BLAIR KENNETH 603022510 200 Cook 0 1 Family Practice 0 153 0 0 19 0 0 0 0 0 0 20 0 101 0 0 0 0 0 0 502 0 0 52 0 0 0 0 0 0 27 0 182 0 0 0 0 0 0 502 0 0 52 0 0 0 0 0 0 27 0 182 0 0 0 0 0 0 1230 0 0 1798.59 0 0 0 0 0 0 85.69 0 4812.58 0 0 0 0 0 0 7926.86 0 0 0 1101276120 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45273.79 0 0 0 0 0 0 0 0 0 0 0 0 0 45273.79 0 0 0 1101276724 1003982257 11 Dentists GAO WEI 611082514 109 Winnebago 0 0 General Dentistry 0 0 0 598 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 3567 0 0 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 3567 0 0 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 89897.64 0 0 0 0 0 0 0 0 0 0 0 26199.09 0 0 0 0 116096.73 0 0 0 1101276725 10 Physicians 816 Iowa 0 0 Neurology 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 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 0 370.35 0 0 0 0 0 0 370.35 0 0 0 1101276727 1235163734 10 Physicians ZIFFRA MICHAEL 606118709 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1097.88 0 0 0 0 0 0 1097.88 0 0 0 1101276733 1619115508 24 Speech Therapists CLAIR BREANNE 336075999 91 Sangamon 0 0 0 0 0 0 0 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0 0 0 607.52 0 0 0 1101276757 1891776860 16 Nurse Practitioners ADAMS WILLIAM 623012834 10 Adams 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 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1079.6 0 0 0 0 0 0 1079.6 0 0 0 1101276767 2100267185 90 Waiver service provider--Elderly (DOA) CLASSIC CARE HEALTH SERVICES I 604292409 200 Cook 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2085 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2085 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111271.28 0 0 0 0 0 0 0 0 0 0 0 0 0 111271.28 0 0 0 1101276794 94 Waiver service provider--Children's support (DHS/DDD) 30 DuPage 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 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7412.35 0 0 0 0 0 0 0 0 0 0 0 0 0 7412.35 0 0 0 1101276796 1699807685 10 Physicians JAVED MUHAMMAD 616370001 80 Peoria 0 0 Neonatal-Perinatal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 258 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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232.21 0 0 0 0 0 0 215.85 0 58181.59 0 0 0 0 0 0 58629.65 0 0 0 1101276861 92 Waiver service provider--Disability (DHS/DRS) 12 Bond 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 11898.57 0 0 0 0 0 0 0 0 0 0 0 0 0 11898.57 0 0 0 1101276872 1023137015 24 Speech Therapists BERRY STACY 615359525 98 Tazewell 0 0 0 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 0 388 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 388 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16964.32 16964.32 0 0 0 1101276876 1770686305 10 Physicians TOMUR RASHMI 605647002 107 Will 0 0 Obstetric-Gynecology 0 0 0 0 8 0 0 0 0 0 0 104 0 359 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 142 0 1319 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 142 0 1319 0 0 0 0 0 0 0 0 0 153.37 0 0 0 0 0 0 4883.08 0 165245.01 0 0 0 0 0 0 170281.46 0 0 0 1101276886 92 Waiver service provider--Disability (DHS/DRS) 53 Kane 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 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Cook 0 1 Pediatrics 0 625 0 0 214 0 0 0 0 0 0 0 0 285 0 0 0 0 0 0 1949 0 0 580 0 0 0 0 0 0 0 0 465 0 0 0 0 0 0 1949 0 0 580 0 0 0 0 0 0 0 0 465 0 0 0 0 0 0 3901 0 0 18705.29 0 0 0 0 0 0 0 0 14648.45 0 0 0 0 0 0 37254.74 0 0 0 1101276937 94 Waiver service provider--Children's support (DHS/DDD) 852 Wisconsin 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 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12295.8 0 0 0 0 0 0 0 0 0 0 0 0 0 12295.8 0 0 0 1101276939 1326162769 47 Local Education Agencies GRAYSLAKE CC DISTRICT 46 600301327 57 Lake 0 0 0 0 0 0 171 0 0 0 0 0 0 0 0 0 0 0 0 0 235 0 0 0 0 301 0 0 0 0 0 0 0 0 0 0 0 0 0 11265 0 0 0 0 301 0 0 0 0 0 0 0 0 0 0 0 0 0 11265 0 0 0 0 1623.7 0 0 0 0 0 0 0 0 0 0 0 0 0 218250.16 0 219873.86 0 0 0 1101276943 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 15494.34 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 810 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 497129.21 0 0 0 0 0 0 0 0 0 0 497129.21 0 0 0 1101277013 1861582165 10 Physicians SMITH TERRY 616144675 80 Peoria 0 1 Internal Medicine 0 83 0 0 37 0 0 0 0 0 0 5 0 88 0 0 0 0 0 0 674 0 0 128 0 0 0 0 0 0 5 0 195 0 0 0 0 0 0 674 0 0 128 0 0 0 0 0 0 5 0 195 0 0 0 0 0 0 1573 0 0 3655.41 0 0 0 0 0 0 39.76 0 6244.57 0 0 0 0 0 0 11512.74 0 0 0 1101277017 1659306181 10 Physicians BERIKAI PADMALATHA 605044385 30 DuPage 0 0 Endocrinology 0 0 0 0 0 0 0 0 0 0 0 6 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 378 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 378 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 330.5 0 8716.69 0 0 0 0 0 0 9047.19 0 0 0 1101277024 1639242506 46 Ambulatory Surgical Treatment Centers RENAL INTERVENTION CENTER LLC 615502495 98 Tazewell NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 580.48 580.48 0 0 0 1101278110 10 Physicians 816 Iowa 0 0 Obstetric-Gynecology 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7.9 0 0 0 0 0 0 7.9 0 0 0 1101278116 1821254731 10 Physicians SHIRAZI HAIDER 604877510 200 Cook 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 175 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 175 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5276.31 0 0 0 0 0 0 5276.31 0 0 0 1101278127 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11464.84 0 0 0 0 0 0 0 0 0 0 0 0 0 11464.84 0 0 0 1101278136 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 21001.67 0 0 0 0 0 0 0 0 0 0 0 0 0 21001.67 0 0 0 1101278140 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11121 0 0 0 0 0 0 0 0 0 0 0 0 0 11121 0 0 0 1101278151 1902970866 63 Other Providers of Medical Equipment/Supplies (Non-registered) HANGER PROSTHETICS ORTHOTICS 628643647 49 Jefferson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 272 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 272 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1251.87 0 66977.15 0 0 0 0 68229.02 0 0 0 1101278157 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 4291.13 0 0 0 0 0 0 0 0 0 0 0 0 0 4291.13 0 0 0 1101278162 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 19 0 0 0 0 0 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 9197.48 0 0 0 0 0 0 0 0 0 0 0 0 0 9197.48 0 0 0 1101278188 10 Physicians 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101278191 92 Waiver service provider--Disability (DHS/DRS) 104 Wayne 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11072.57 0 0 0 0 0 0 0 0 0 0 0 0 0 11072.57 0 0 0 1101278201 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 7345.15 0 0 0 0 0 0 0 0 0 0 0 0 0 7345.15 0 0 0 1101278202 1386634525 10 Physicians FRITZ MARK 604356604 107 Will 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 11 0 242 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 664 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 664 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 282.12 0 18656.25 0 0 0 0 0 0 18938.37 0 0 0 1101278205 1891735890 10 Physicians HALLMAN GREGG 637034927 826 Missouri 0 0 Urology 0 0 0 0 0 0 0 0 0 0 0 17 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 225 0 4385.17 0 0 0 0 0 0 4610.17 0 0 0 1101278215 1073543112 10 Physicians BENZIGER KEITH 605064356 53 Kane 0 0 Pediatrics 0 0 0 0 5 0 0 0 0 0 0 15 0 50 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 36 0 76 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 36 0 76 0 0 0 0 0 0 0 0 0 269.16 0 0 0 0 0 0 224.94 0 1402.45 0 0 0 0 0 0 1896.55 0 0 0 1101278225 1548413917 24 Speech Therapists SLEMER DEBORAH 620628500 65 Madison 0 0 0 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 0 368 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 368 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26286.3 26286.3 0 0 0 1101278228 1427146430 55 Early Intervention Services LARABIDA CHILDRENS HOSP CFC 10 606372623 200 Cook 0 0 0 1417 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9246 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9246 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1029145.62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1029145.62 0 0 0 1101278245 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 13621.78 0 0 0 0 0 0 0 0 0 0 0 0 0 13621.78 0 0 0 1101278255 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3924.77 0 0 0 0 0 0 0 0 0 0 0 0 0 3924.77 0 0 0 1101278262 91 Waiver service provider--Adults (DHS/DDD) 96 St Clair 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 0 230 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23281.5 0 0 0 0 0 0 0 0 0 0 0 0 0 23281.5 0 0 0 1101278279 1669434247 10 Physicians APPLEWHITE THOMAS 631417129 826 Missouri 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 24 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 605.68 0 78.28 0 0 0 0 0 0 683.96 0 0 0 1101278285 1881652089 10 Physicians HAZARD KEVIN 627032403 91 Sangamon 0 0 Endocrinology 0 0 0 0 0 0 0 0 0 0 0 0 0 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 302 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 302 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14139.44 0 0 0 0 0 0 14139.44 0 0 0 1101278287 1417947490 30 General Hospitals VALLEY HOSPITAL MEDICAL CENTER 891064119 829 Nevada NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 7 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 1467.47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1467.47 0 0 0 1101278312 16 Nurse Practitioners 65 Madison 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16.29 0 0 0 0 0 0 16.29 0 0 0 1101278318 92 Waiver service provider--Disability (DHS/DRS) 63 Macon 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 4017.67 0 0 0 0 0 0 0 0 0 0 0 0 0 4017.67 0 0 0 1101278319 1932208063 10 Physicians KASSAR AMER 601159602 27 Dekalb 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 5 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22.26 0 479.09 0 0 0 0 0 0 501.35 0 0 0 1101278323 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 250 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 250 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20737.93 0 0 0 0 0 0 0 0 0 0 0 0 0 20737.93 0 0 0 1101278345 92 Waiver service provider--Disability (DHS/DRS) 30 DuPage 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 21502.32 0 0 0 0 0 0 0 0 0 0 0 0 0 21502.32 0 0 0 1101278351 94 Waiver service provider--Children's support (DHS/DDD) 58 La Salle 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 0 163 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 163 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16038 0 0 0 0 0 0 0 0 0 0 0 0 0 16038 0 0 0 1101278361 1720235765 24 Speech Therapists FOX NICOLE 999999999 107 Will 0 0 0 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 0 218 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 218 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14937.21 14937.21 0 0 0 1101278365 1801849161 10 Physicians PELLEGRINI LISA 606781034 200 Cook 0 0 Psychiatry 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 61 0 0 0 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 0 842.87 0 0 0 0 0 0 842.87 0 0 0 1101278368 30 General Hospitals 829 Nevada NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 457.85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 457.85 0 0 0 1101278379 1154530384 10 Physicians PATEL SAPAN 601873112 30 DuPage 0 1 Internal Medicine 0 1 0 0 0 0 0 0 0 0 0 1 0 21 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 1 0 41 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 1 0 41 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 2.6 0 280.96 0 0 0 0 0 0 289.56 0 0 0 1101278384 1477799062 55 Early Intervention Services FOSTER TAMARA 619519353 78 Moultrie 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 438 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 438 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11720.39 0 0 0 0 0 0 11720.39 0 0 0 1101278394 1063425965 10 Physicians ABBASY SHAMEEM 601429558 71 McHenry 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 48 0 194 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 596 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 596 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 173.76 0 25195.96 0 0 0 0 0 0 25369.72 0 0 0 1101278400 92 Waiver service provider--Disability (DHS/DRS) 54 Kankakee 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 13342.34 0 0 0 0 0 0 0 0 0 0 0 0 0 13342.34 0 0 0 1101278403 92 Waiver service provider--Disability (DHS/DRS) 21 Clark 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 28789.5 0 0 0 0 0 0 0 0 0 0 0 0 0 28789.5 0 0 0 1101278457 1144274606 10 Physicians DURUDOGAN I HARUN 604532862 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 49 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 473 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 473 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1138.14 0 12521.57 0 0 0 0 0 0 13659.71 0 0 0 1101278458 1861453540 10 Physicians CASALINO DAVID 606118702 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 393 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 475 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 475 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12715.1 0 404.43 0 0 0 0 0 0 13119.53 0 0 0 1101278463 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 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 2037.45 0 0 0 0 0 0 0 0 0 0 0 0 0 2037.45 0 0 0 1101278464 30 General Hospitals 852 Wisconsin NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 71.12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71.12 0 0 0 1101278475 1801861380 10 Physicians BISHOP D 629011409 47 Jackson 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 279 0 499 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 642 0 1812 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 642 0 1812 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30278.32 0 195463.79 0 0 0 0 0 0 225742.11 0 0 0 1101278489 1487715264 10 Physicians SIDDIQUI TAHSEEN 604677611 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 322 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 972 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 972 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15189.91 0 0 0 0 0 0 15189.91 0 0 0 1101278497 1679579239 16 Nurse Practitioners FRANK KAREN 631101010 826 Missouri 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 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 0 641.03 0 0 0 0 0 0 641.03 0 0 0 1101278508 10 Physicians 815 Indiana 0 0 Neurology 0 0 0 0 0 0 0 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 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 0 604.89 0 0 0 0 0 0 604.89 0 0 0 1101278516 1659358539 10 Physicians DILLING DANIEL 601533328 200 Cook 0 0 Pulmonary Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 261 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 261 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3008.92 0 0 0 0 0 0 3008.92 0 0 0 1101278522 1952329096 10 Physicians CURRY DAVID 606313707 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 401 0 145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 524 0 285 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 524 0 285 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5306.87 0 4305.47 0 0 0 0 0 0 9612.34 0 0 0 1101278532 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 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 10963.87 0 0 0 0 0 0 0 0 0 0 0 0 0 10963.87 0 0 0 1101278534 1902032410 11 Dentists SINJOANU BOGDAN 604531295 200 Cook 0 0 General Dentistry 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2231.79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2231.79 0 0 0 1101278548 2100268966 93 Waiver service provider--HIV/AIDS (DHS/DRS) M D HEALTH CARE INC 606593320 200 Cook 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 189 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 189 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 194094.55 0 0 0 0 0 0 0 0 0 0 0 0 0 194094.55 0 0 0 1101278560 10 Physicians 826 Missouri 0 0 Urology 0 0 0 0 0 0 0 0 0 0 0 1 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58.81 0 0 0 0 0 0 58.81 0 0 0 1101278564 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 17992.99 0 0 0 0 0 0 0 0 0 0 0 0 0 17992.99 0 0 0 1101278569 10 Physicians 826 Missouri 0 0 Rheumatology 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28.83 0 0 0 0 0 0 28.83 0 0 0 1101278577 1376543041 10 Physicians WARREN MITCHELL 600154328 57 Lake 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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129 0 0 22 0 0 0 0 0 0 48 0 54 0 0 0 0 0 0 258 0 0 1888.98 0 0 0 0 0 0 215.49 0 2576.61 0 0 0 0 0 0 4939.08 0 0 0 1101278746 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 334 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 334 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22383.62 0 0 0 0 0 0 0 0 0 0 0 0 0 22383.62 0 0 0 1101278758 1336170240 10 Physicians WATSON CYNTHIA 606123723 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1.33 0 0 0 0 0 0 1.33 0 0 0 1101278761 1730127275 10 Physicians SHADID ANTHONY 462063272 80 Peoria 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 1114 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1530 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1530 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24250.28 0 1732.54 0 0 0 0 0 0 25982.82 0 0 0 1101278781 1386638906 16 Nurse Practitioners LUNDEBERG JOHN 629037605 47 Jackson 0 0 0 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Physicians MACSAI KAPLAN MARIAN 602011718 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 3 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49.8 0 8575.65 0 0 0 0 0 0 8625.45 0 0 0 1101278830 1073528220 60 Pharmacies BOND DRUG COMPANY OF ILL 13861 601898171 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 296 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1271 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29431 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63064.75 0 0 0 63064.75 0 0 0 1101278833 1174522866 10 Physicians KAMEL PERRY 606116662 200 Cook 0 0 Gastroenterology 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 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 0 101.62 0 0 0 0 0 0 101.62 0 0 0 1101278866 98 Waiver service provider--TBI (DHS/DRS) 13 Boone 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 16800.67 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 1828 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64104.29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64104.29 0 0 0 1101278977 1629317003 55 Early Intervention Services WILLIAMS TARA 604774143 200 Cook 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 0 109 0 0 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 6064.76 0 0 0 0 0 0 6064.76 0 0 0 1101278983 1386838340 10 Physicians ZACHARIAH PHENU 637034927 826 Missouri 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 2 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 4642.61 0 0 0 0 0 0 4710.61 0 0 0 1101278992 1013081140 60 Pharmacies PEARMAN PHARMACY INC 619441735 31 Edgar 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 343 0 0 1241 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2024 0 0 16159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2024 0 0 381855 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86911.2 0 0 739247.66 0 0 0 826158.86 0 0 0 1101279006 1477571198 10 Physicians BRANHAM 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0 0 0 69974.31 0 0 0 1101279029 1295751220 40 Federally Qualified Health Centers YOUNG WOMENS LEADERSHIP CHRTR 606162901 200 Cook 0 1 School-based 0 292 235 0 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1557 1663 0 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1557 1663 0 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3257 103591.4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106848.4 0 0 0 1101279033 94 Waiver service provider--Children's support (DHS/DDD) 71 McHenry 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 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5004.97 0 0 0 0 0 0 0 0 0 0 0 0 0 5004.97 0 0 0 1101279034 1144330325 10 Physicians CARRION FRANCISCO 600681110 200 Cook 0 0 Pediatric Endocrinology 0 0 0 0 0 0 0 0 0 0 0 0 0 356 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 791 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 791 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40658.99 0 0 0 0 0 0 40658.99 0 0 0 1101279038 94 Waiver service provider--Children's support (DHS/DDD) 48 Jasper 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 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8959.5 0 0 0 0 0 0 0 0 0 0 0 0 0 8959.5 0 0 0 1101279051 1538410766 23 Occupational Therapists GARY SHAUN 606092230 200 Cook 0 0 0 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 0 604 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 604 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43771.8 43771.8 0 0 0 1101279077 1649476706 10 Physicians VAZQUEZ LETICIA 601391405 30 DuPage 0 0 Anesthesiology 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 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6166.8 0 0 0 0 0 0 6166.8 0 0 0 1101279090 16 Nurse Practitioners 62 Logan 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74.95 0 0 0 0 0 0 74.95 0 0 0 1101279114 1033147673 10 Physicians GOLDBERGER JEFFREY 606114402 200 Cook 0 0 Cardiovascular Diseases 0 0 0 0 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SARA 381052794 844 Tennessee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1274.05 0 0 0 0 0 0 1274.05 0 0 0 1101279187 1104891001 10 Physicians NAZIR JAVED 605256137 200 Cook 0 1 Internal Medicine 0 13 0 0 0 0 0 0 0 0 0 0 0 263 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 1230 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 1230 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 13597.74 0 0 0 0 0 0 13666.74 0 0 0 1101279198 1386641272 63 Other Providers of Medical Equipment/Supplies (Non-registered) CARDINAL HILL HEALTHCARE 622462607 12 Bond 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 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8301.08 0 0 0 0 0 0 8301.08 0 0 0 1101279207 1902872153 10 Physicians JOHNSON MARILANNE 601374402 30 DuPage 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 2 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8.32 0 1988.91 0 0 0 0 0 0 1997.23 0 0 0 1101279212 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21346.01 0 0 0 0 0 0 0 0 0 0 0 0 0 21346.01 0 0 0 1101279214 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20677.16 0 0 0 0 0 0 0 0 0 0 0 0 0 20677.16 0 0 0 1101279217 1003014457 10 Physicians KHAJA ASLAM 606127330 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 331 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 331 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9961.19 0 0 0 0 0 0 9961.19 0 0 0 1101279219 10 Physicians 852 Wisconsin 0 0 Ophthalmology 0 0 0 0 0 0 0 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 175.33 0 0 0 0 0 0 175.33 0 0 0 1101279233 1992898332 60 Pharmacies PRESCRIPTIONS PLUS 622941349 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 530 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16858.34 0 0 0 16858.34 0 0 0 1101279236 1962436782 10 Physicians HARRISON AMY 604023471 200 Cook 0 1 Family Practice 0 1146 0 0 134 0 0 0 0 0 0 49 0 340 0 0 0 0 0 0 5039 0 0 352 0 0 0 0 0 0 55 0 626 0 0 0 0 0 0 5039 0 0 352 0 0 0 0 0 0 55 0 626 0 0 0 0 0 0 11716 0 0 10676.43 0 0 0 0 0 0 132.52 0 41287.52 0 0 0 0 0 0 63812.47 0 0 0 1101279247 92 Waiver service provider--Disability (DHS/DRS) 836 Ohio 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 0 106.35 0 0 0 0 0 0 0 0 0 0 0 0 0 106.35 0 0 0 1101279250 1649436569 10 Physicians BRITT AMANDA N. 602011718 200 Cook 0 1 Pediatrics 0 0 0 0 41 0 0 0 0 0 0 10 0 40 0 0 0 0 0 0 0 0 0 129 0 0 0 0 0 0 12 0 53 0 0 0 0 0 0 0 0 0 129 0 0 0 0 0 0 12 0 53 0 0 0 0 0 0 0 0 0 4957.4 0 0 0 0 0 0 134.74 0 2260.92 0 0 0 0 0 0 7353.06 0 0 0 1101279254 1720055809 63 Other Providers of Medical Equipment/Supplies (Non-registered) MEDINA NURSING CENTER INC 610249590 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6840.12 0 0 0 0 0 0 6840.12 0 0 0 1101279262 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5622.72 0 0 0 0 0 0 0 0 0 0 0 0 0 5622.72 0 0 0 1101279269 92 Waiver service provider--Disability (DHS/DRS) 10 Adams 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 2098.75 0 0 0 0 0 0 0 0 0 0 0 0 0 2098.75 0 0 0 1101279296 1699828061 10 Physicians WILLIAMSON WAYNE C 602013664 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 291 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 291 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2000.72 0 0 0 0 0 0 2000.72 0 0 0 1101279298 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17913.28 0 0 0 0 0 0 0 0 0 0 0 0 0 17913.28 0 0 0 1101279299 1699790287 10 Physicians ORTEZA DEOFIL 613560372 15 Bureau 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 232 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 882 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 882 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32781.76 0 0 0 0 0 0 32781.76 0 0 0 1101279305 1508803339 10 Physicians VASIREDDY PRASAD 627044183 91 Sangamon 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 175 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4202.82 0 177.99 0 0 0 0 0 0 4380.81 0 0 0 1101279317 1811943632 10 Physicians BOSKOV TANJA 601262816 30 DuPage 0 1 General Practice 0 24 0 0 9 0 0 0 0 0 0 4 0 95 0 0 0 0 0 0 58 0 0 13 0 0 0 0 0 0 4 0 211 0 0 0 0 0 0 58 0 0 13 0 0 0 0 0 0 4 0 211 0 0 0 0 0 0 152 0 0 827.51 0 0 0 0 0 0 24.68 0 4955.91 0 0 0 0 0 0 5960.1 0 0 0 1101279334 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 14223.47 0 0 0 0 0 0 0 0 0 0 0 0 0 14223.47 0 0 0 1101279336 92 Waiver service provider--Disability (DHS/DRS) 107 Will 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 17261.7 0 0 0 0 0 0 0 0 0 0 0 0 0 17261.7 0 0 0 1101279344 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 14148.29 0 0 0 0 0 0 0 0 0 0 0 0 0 14148.29 0 0 0 1101279345 1801932991 70 Ambulance Service Providers KEWANEE AMBULANCE SERVICE 614438319 45 Henry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 232 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1030 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1030 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21075.14 0 0 0 0 0 0 21075.14 0 0 0 1101279349 92 Waiver service provider--Disability (DHS/DRS) 50 Jersey 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 10921.59 0 0 0 0 0 0 0 0 0 0 0 0 0 10921.59 0 0 0 1101279352 1639116528 10 Physicians ECKERSLEY JULIA 606391450 200 Cook 0 0 Family Practice 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 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 874.9 0 0 0 0 0 0 874.9 0 0 0 1101279373 91 Waiver service provider--Adults (DHS/DDD) 89 Rock Island 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 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1854.75 0 0 0 0 0 0 0 0 0 0 0 0 0 1854.75 0 0 0 1101279374 1255328878 10 Physicians KLEIN LEONARD 607145825 200 Cook 0 0 Hematology 0 0 0 0 0 0 0 0 0 0 0 1 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 224 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 224 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5603.14 0 0 0 0 0 0 5603.14 0 0 0 1101279381 1184909335 10 Physicians ARORA SARIKA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37831.09 0 0 0 0 0 0 37831.09 0 0 0 1101279390 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 15156.22 0 0 0 0 0 0 0 0 0 0 0 0 0 15156.22 0 0 0 1101279391 1023230968 10 Physicians BILYEU JOE 627810001 91 Sangamon 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 19 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82.79 0 1.54 0 0 0 0 0 0 84.33 0 0 0 1101279394 1447247424 10 Physicians TOMASIK FRANCIS G 604047608 107 Will 0 0 Obstetric-Gynecology 0 0 0 0 17 0 0 0 0 0 0 74 0 135 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 193 0 595 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 193 0 595 0 0 0 0 0 0 0 0 0 1593.1 0 0 0 0 0 0 10071.17 0 40500.68 0 0 0 0 0 0 52164.95 0 0 0 1101279397 1861596850 23 Occupational Therapists THOMAS JAMI 629595256 108 Williamson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 170 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 170 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2185.31 2185.31 0 0 0 1101279402 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 1089.2 0 0 0 0 0 0 0 0 0 0 0 0 0 1089.2 0 0 0 1101279410 1902900319 10 Physicians ALZEIN MOHAMMAD 606385409 200 Cook 0 0 Internal Medicine 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 0 687 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 687 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3215.54 0 0 0 0 0 0 3215.54 0 0 0 1101279418 1861418188 10 Physicians HSIEH CHYI 631101010 826 Missouri 0 0 Rheumatology 0 0 0 0 0 0 0 0 0 0 0 1 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 713.46 0 0 0 0 0 0 717.46 0 0 0 1101279423 47 Local Education Agencies 61 Livingston 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 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116.95 0 116.95 0 0 0 1101279425 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 193 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 193 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24205.43 0 0 0 0 0 0 0 0 0 0 0 0 0 24205.43 0 0 0 1101279426 92 Waiver service provider--Disability (DHS/DRS) 57 Lake 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 10168.96 0 0 0 0 0 0 0 0 0 0 0 0 0 10168.96 0 0 0 1101279439 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 442.17 0 0 0 0 0 0 0 0 0 0 0 0 0 442.17 0 0 0 1101279441 1891939161 10 Physicians REDDY HARSHITA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4392.18 0 0 0 0 0 0 4392.18 0 0 0 1101279445 1629089966 30 General Hospitals METROPLEX HOSPITAL 765424110 845 Texas NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1053.02 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1053.02 0 0 0 1101279451 1184757353 40 Federally Qualified Health Centers THE CLINIC IN ALTGELD INC 606286908 200 Cook 0 1 0 1587 1834 0 700 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3633 6954 0 2050 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3633 6954 0 2050 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8505 401443.23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 409948.23 0 0 0 1101279458 1275638215 10 Physicians SIERANTOWICZ MARGARET 600109531 57 Lake 0 1 Pediatrics 0 88 0 0 77 0 0 0 0 0 0 29 0 111 0 0 0 0 0 0 386 0 0 207 0 0 0 0 0 0 32 0 213 0 0 0 0 0 0 386 0 0 207 0 0 0 0 0 0 32 0 213 0 0 0 0 0 0 772 0 0 8141.61 0 0 0 0 0 0 273.17 0 10875.84 0 0 0 0 0 0 20062.62 0 0 0 1101279462 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 3890.6 0 0 0 0 0 0 0 0 0 0 0 0 0 3890.6 0 0 0 1101279464 1750682985 10 Physicians IRSHAD SABA 601603930 200 Cook 0 0 Family Practice 0 630 0 0 194 0 0 0 0 0 0 14 0 336 0 0 0 0 0 0 1808 0 0 598 0 0 0 0 0 0 14 0 673 0 0 0 0 0 0 1808 0 0 598 0 0 0 0 0 0 14 0 673 0 0 0 0 0 0 4086 0 0 19723.89 0 0 0 0 0 0 52 0 20512.77 0 0 0 0 0 0 44374.66 0 0 0 1101279469 92 Waiver service provider--Disability (DHS/DRS) 30 DuPage 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 40913.9 0 0 0 0 0 0 0 0 0 0 0 0 0 40913.9 0 0 0 1101279481 1790737757 10 Physicians KELIKIAN ARMEN 606114451 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5337.9 0 0 0 0 0 0 5337.9 0 0 0 1101279482 1730107202 10 Physicians SIEGEL BARRY 631600352 15 Bureau 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1880.88 0 0 0 0 0 0 1880.88 0 0 0 1101279496 1710963350 10 Physicians ZIMMERMANN ANNE J 605400907 30 DuPage 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 15 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21.5 0 216.27 0 0 0 0 0 0 237.77 0 0 0 1101279500 1760699623 10 Physicians HANSEN LUKE 606118709 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2329.95 0 0 0 0 0 0 2329.95 0 0 0 1101279531 1154336337 60 Pharmacies BOND DRUG COMPANY OF IL 05104 604523223 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 902 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90042 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 189609.82 0 0 0 189609.82 0 0 0 1101279576 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 33615.68 0 0 0 0 0 0 0 0 0 0 0 0 0 33615.68 0 0 0 1101279577 1518913524 10 Physicians SAKYIAMA EZEKIEL 606081732 30 DuPage 0 1 Internal Medicine 0 15 0 0 0 0 0 0 0 0 0 0 0 261 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 877 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 877 0 0 0 0 0 0 201 0 0 0 0 0 0 0 0 0 0 0 15545.19 0 0 0 0 0 0 15746.19 0 0 0 1101279578 1346409703 10 Physicians LINK MICHAEL 626501136 77 Morgan 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 246 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 278 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 278 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42906.61 0 0 0 0 0 0 42906.61 0 0 0 1101279586 1437133295 10 Physicians AZAR NATHALIE 606127242 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 1 0 331 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 650 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 650 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79.55 0 67182.37 0 0 0 0 0 0 67261.92 0 0 0 1101279587 1265512164 10 Physicians LEVIS 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0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3767.26 0 0 0 0 0 0 0 0 0 0 0 0 0 3767.26 0 0 0 1101280737 1023081502 10 Physicians HOLT W 623014096 10 Adams 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 14 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 242 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 242 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 209.11 0 4684.37 0 0 0 0 0 0 4893.48 0 0 0 1101280738 91 Waiver service provider--Adults (DHS/DDD) 109 Winnebago 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 0 181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23801.25 0 0 0 0 0 0 0 0 0 0 0 0 0 23801.25 0 0 0 1101280740 1114928629 16 Nurse Practitioners BREFELD LINDSAY 631041003 826 Missouri 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 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1338.46 0 0 0 0 0 0 1338.46 0 0 0 1101280744 92 Waiver service provider--Disability (DHS/DRS) 107 Will 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 0 282 0 0 0 0 0 0 0 0 0 0 0 0 0 282 0 0 0 1101280750 1760545271 10 Physicians STERN SCOTT 605276686 30 DuPage 0 1 Internal Medicine 0 1 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 147 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 147 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 1379.37 0 0 0 0 0 0 1382.37 0 0 0 1101280751 1992763791 10 Physicians LARKNER LAURA 600147530 71 McHenry 0 1 Pediatrics 0 17 0 0 29 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 102 0 0 59 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 102 0 0 59 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 204 0 0 2725.21 0 0 0 0 0 0 0 0 2340.03 0 0 0 0 0 0 5269.24 0 0 0 1101280771 1548201411 60 Pharmacies CVS PHARMACY 08536 611031612 841 Rhode Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 283 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1722 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42708 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68568.06 0 0 0 68568.06 0 0 0 1101280780 92 Waiver service provider--Disability (DHS/DRS) 105 White 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 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 0 992.63 0 0 0 0 0 0 0 0 0 0 0 0 0 992.63 0 0 0 1101280785 1952463705 52 Certified local public health department CARROLL COUNTY HEALTH DEPT 610531243 17 Carroll 0 0 0 0 170 0 273 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 252 0 465 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 252 0 465 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3004.15 0 5271.63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8275.78 0 0 0 1101280794 1831276872 10 Physicians DITTO ANNE 606114402 200 Cook 0 0 Internal Medicine 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 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1720.53 0 0 0 0 0 0 1720.53 0 0 0 1101280797 1962609859 55 Early Intervention Services HALLMAN SANDRA 606164887 200 Cook 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 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 2915.34 0 0 0 0 0 0 2915.34 0 0 0 1101280807 1285706754 10 Physicians ALKHUDARI AZZAM 606123723 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4120.05 0 0 0 0 0 0 4120.05 0 0 0 1101280818 1669488029 36 Community mental health provider THRESHOLDS 606263718 200 Cook 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 680 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5563 0 0 680 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5563 0 0 16563.55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 269252.88 0 0 285816.43 0 0 0 1101280829 1932320819 10 Physicians HOLT TRAVIS 617042101 72 McLean 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6572.63 0 0 0 0 0 0 6572.63 0 0 0 1101280837 91 Waiver service provider--Adults (DHS/DDD) 30 DuPage 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 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 352 0 0 0 0 0 0 0 0 0 0 0 0 0 352 0 0 0 1101280839 92 Waiver service provider--Disability (DHS/DRS) 68 Mason 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 19 0 0 0 0 0 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 4665.49 0 0 0 0 0 0 0 0 0 0 0 0 0 4665.49 0 0 0 1101280853 94 Waiver service provider--Children's support (DHS/DDD) 54 Kankakee 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 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15695.05 0 0 0 0 0 0 0 0 0 0 0 0 0 15695.05 0 0 0 1101280860 1548382690 36 Community mental health provider ASIAN HUMAN SERVICES 606405266 200 Cook 0 0 0 290 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 304 0 0 2515 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6795 0 0 2515 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6795 0 0 181632.4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 417254.65 0 0 598887.05 0 0 0 1101280862 1811044803 24 Speech Therapists BONNEY LARAMORE VANESSA 606523834 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10695.56 10695.56 0 0 0 1101280873 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 9532.14 0 0 0 0 0 0 0 0 0 0 0 0 0 9532.14 0 0 0 1101280876 1528065646 10 Physicians GUPTA ASHUTOSH 606493913 200 Cook 0 0 Nephrology 0 0 0 0 0 0 0 0 0 0 0 0 0 225 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1015 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1015 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19504.09 0 0 0 0 0 0 19504.09 0 0 0 1101280877 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 6567.26 0 0 0 0 0 0 0 0 0 0 0 0 0 6567.26 0 0 0 1101280882 1750310264 13 Podiatrists POWERS 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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 18254.56 0 0 0 0 0 0 0 0 0 0 0 0 0 18254.56 0 0 0 1101280954 24 Speech Therapists 90 Saline 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 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 0 816.3 816.3 0 0 0 1101280969 1598918385 28 Waiver service provider--Supportive living facility (HFS) COURTYARD ESTATES OF SULLIVAN 619517001 78 Moultrie 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 209 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5537 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319061.53 0 0 0 0 0 0 0 0 0 0 0 0 0 319061.53 0 0 0 1101280982 1093707457 10 Physicians SAFVI AMJAD 604671412 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 243 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 336 0 259 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 336 0 259 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3348.69 0 9680.13 0 0 0 0 0 0 13028.82 0 0 0 1101281011 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 17031.63 0 0 0 0 0 0 0 0 0 0 0 0 0 17031.63 0 0 0 1101281013 1821289943 10 Physicians WERTHEIM JASON 606113092 200 Cook 0 0 Surgery General 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 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 587.01 0 0 0 0 0 0 587.01 0 0 0 1101281018 1841449451 10 Physicians GUTTI PADMAJA 605064356 53 Kane 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 282 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 282 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3824.82 0 0 0 0 0 0 3824.82 0 0 0 1101281028 1033327143 10 Physicians SATTAR SOHA 601811419 30 DuPage 0 1 Family Practice 0 40 0 0 19 0 0 0 0 0 0 17 0 89 0 0 0 0 0 0 82 0 0 48 0 0 0 0 0 0 31 0 245 0 0 0 0 0 0 82 0 0 48 0 0 0 0 0 0 31 0 245 0 0 0 0 0 0 203 0 0 1448.88 0 0 0 0 0 0 168.52 0 6463.04 0 0 0 0 0 0 8283.44 0 0 0 1101281033 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 18885 0 0 0 0 0 0 0 0 0 0 0 0 0 18885 0 0 0 1101281040 1912120767 22 Physical Therapists MEHL LESA 606074912 200 Cook 0 0 0 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 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 7771.68 7771.68 0 0 0 1101281049 1760474993 36 Community mental health provider GREATER LAWN MENTAL HEALTH CTR 606324242 200 Cook 0 0 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 0 0 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 552 0 0 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 552 0 0 9531.42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39963.04 0 0 49494.46 0 0 0 1101281062 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 901.53 0 0 0 0 0 0 0 0 0 0 0 0 0 901.53 0 0 0 1101281065 1245250885 10 Physicians SERGEL MICHELLE 601604039 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 339 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 347 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 347 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12285.53 0 0 0 0 0 0 12285.53 0 0 0 1101281078 1669609988 10 Physicians CHUNG PEI 620026751 65 Madison 0 0 Surgery General 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 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11420.5 0 0 0 0 0 0 11420.5 0 0 0 1101281083 1255439436 10 Physicians KUGLER MORRIS A 622642818 96 St Clair 0 0 Surgery General 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 0 152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11070.23 0 0 0 0 0 0 11070.23 0 0 0 1101281090 1598787202 60 Pharmacies TARGET STORE T 1889 606052159 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 377 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1461 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42399 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 237861.02 0 0 0 237861.02 0 0 0 1101281116 92 Waiver service provider--Disability (DHS/DRS) 99 Union 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20769.79 0 0 0 0 0 0 0 0 0 0 0 0 0 20769.79 0 0 0 1101281129 1679589931 11 Dentists SHARMA DHIRAJ 606324949 200 Cook 0 0 General Dentistry 0 0 0 273 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1042 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1042 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26470.2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26470.2 0 0 0 1101281140 92 Waiver service provider--Disability (DHS/DRS) 98 Tazewell 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 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 10691.79 0 0 0 0 0 0 0 0 0 0 0 0 0 10691.79 0 0 0 1101281164 1063516797 10 Physicians DAVIS JAMES 629486334 108 Williamson 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 295 0 401 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 532 0 1269 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 532 0 1269 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15619.26 0 88043.77 0 0 0 0 0 0 103663.03 0 0 0 1101281171 1346201795 10 Physicians PFAU PATRICK 535625531 852 Wisconsin 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2691.56 0 0 0 0 0 0 2691.56 0 0 0 1101281172 92 Waiver service provider--Disability (DHS/DRS) 54 Kankakee 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 14 0 0 0 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 6929.78 0 0 0 0 0 0 0 0 0 0 0 0 0 6929.78 0 0 0 1101281176 92 Waiver service provider--Disability (DHS/DRS) 97 Stephenson 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 28105.29 0 0 0 0 0 0 0 0 0 0 0 0 0 28105.29 0 0 0 1101281177 1558392589 10 Physicians LEONARD SHERALD 606751611 200 Cook 0 1 Pediatrics 0 464 0 0 179 0 0 0 0 0 0 41 0 71 0 0 0 0 0 0 1108 0 0 510 0 0 0 0 0 0 44 0 82 0 0 0 0 0 0 1108 0 0 510 0 0 0 0 0 0 44 0 82 0 0 0 0 0 0 2228 0 0 16758.08 0 0 0 0 0 0 157.67 0 2270.01 0 0 0 0 0 0 21413.76 0 0 0 1101281183 1891028379 63 Other Providers of Medical Equipment/Supplies (Non-registered) UNION ASSOC PHYSICIANS CLINIC 478074214 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 249.46 0 3885.21 0 0 0 0 4134.67 0 0 0 1101281194 1851384200 10 Physicians CHANDEL CHHAYA 600601613 57 Lake 0 1 Pediatrics 0 222 0 0 148 0 0 0 0 0 0 60 0 134 0 0 0 0 0 0 1483 0 0 711 0 0 0 0 0 0 68 0 342 0 0 0 0 0 0 1483 0 0 711 0 0 0 0 0 0 68 0 342 0 0 0 0 0 0 2982 0 0 20213.69 0 0 0 0 0 0 350.98 0 11469.39 0 0 0 0 0 0 35016.06 0 0 0 1101281201 1205149010 16 Nurse Practitioners VARVEL ANNA M 627034514 91 Sangamon 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 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 331.69 0 0 0 0 0 0 331.69 0 0 0 1101281204 1982787693 36 Community mental health provider ECKER CENTER FOR MENTAL HEALTH 601234981 53 Kane 0 0 0 716 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 877 0 0 7069 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12040 0 0 7069 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12040 0 0 232721.68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 506945.83 0 0 739667.51 0 0 0 1101281207 1225062037 60 Pharmacies KROGER PHARMACY L 714 629026417 47 Jackson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 778 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6811 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 179784 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 331695.71 0 0 0 331695.71 0 0 0 1101281220 1275868648 16 Nurse Practitioners FURMANEK JENNIFER 602011718 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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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 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 132 0 0 0 1101281575 1750535795 10 Physicians BRANTLEY JONATHAN C 436047101 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2738.06 0 0 0 0 0 0 2738.06 0 0 0 1101281581 1447468715 10 Physicians GOSWAMI ROOPA M 528072710 816 Iowa 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 343 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 470 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 470 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6432.95 0 796.91 0 0 0 0 0 0 7229.86 0 0 0 1101281590 1275659021 47 Local Education Agencies ROSEMONT ELEM SCHOOL DIST 78 600184450 200 Cook 0 0 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 1266 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1266 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17693.76 0 17693.76 0 0 0 1101281592 30 General Hospitals 852 Wisconsin NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 78.87 0 0 0 0 0 78.87 0 0 0 1101281594 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 36096.01 0 0 0 0 0 0 0 0 0 0 0 0 0 36096.01 0 0 0 1101281597 93 Waiver service provider--HIV/AIDS (DHS/DRS) 91 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 14872.12 0 0 0 0 0 0 0 0 0 0 0 0 0 14872.12 0 0 0 1101281602 1942445663 16 Nurse Practitioners PAPINEAU EVA 606118709 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 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 0 256.22 0 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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 8.85 0 0 0 0 0 0 8.85 0 0 0 1101281712 1285835090 10 Physicians PARKS LAURA 631101010 826 Missouri 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 0 13 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 1267.55 0 0 0 0 0 0 1267.55 0 0 0 1101281713 1346215407 10 Physicians FITZGERALD MICHAEL 605401936 30 DuPage 0 1 Family Practice 0 8 0 0 2 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 46 0 0 2 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 46 0 0 2 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 124 0 0 169.24 0 0 0 0 0 0 0 0 1019.69 0 0 0 0 0 0 1312.93 0 0 0 1101281722 1770557431 32 Rehabilitation Hospitals THE REHAB INSTITUTE OF ST. LOU 631101111 826 Missouri REHAB Rehabilitation hospitals paid a Per Diem rate. 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 301 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 301 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22210.93 0 0 0 0 0 22210.93 0 0 0 1101281726 1013944263 16 Nurse Practitioners DEMICK SUSAN 605868262 107 Will 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 121 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 121 0 0 0 0 0 0 0 0 0 174.33 0 0 0 0 0 0 0 0 3040.15 0 0 0 0 0 0 3214.48 0 0 0 1101281735 1366710006 91 Waiver service provider--Adults (DHS/DDD) DUNNING JOHNNA 629183285 108 Williamson 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16973.35 0 0 0 0 0 0 0 0 0 0 0 0 0 16973.35 0 0 0 1101281758 1295773513 60 Pharmacies OSCO DRUG 3059 605403937 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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Therapists CASTRONOVO JOE 606465726 200 Cook 0 0 0 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 0 0 0 0 0 0 0 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2004.94 2004.94 0 0 0 1101284895 1821048760 10 Physicians MALKI AFREM 610811252 106 Whiteside 0 1 Family Practice 0 205 0 0 40 0 0 0 0 0 0 55 0 273 0 0 0 0 0 0 2092 0 0 80 0 0 0 0 0 0 70 0 990 0 0 0 0 0 0 2092 0 0 80 0 0 0 0 0 0 70 0 990 0 0 0 0 0 0 5269 0 0 4351.15 0 0 0 0 0 0 361.86 0 38990.99 0 0 0 0 0 0 48973 0 0 0 1101284900 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7735.58 0 0 0 0 0 0 0 0 0 0 0 0 0 7735.58 0 0 0 1101284913 1003942491 10 Physicians LOME STEVEN 613542757 58 La Salle 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 867 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1458 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1458 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3264 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 206154.83 0 0 0 0 0 0 0 0 0 0 0 0 0 206154.83 0 0 0 1101284940 1154601995 11 Dentists KOCHANSKI IWONA 601232800 53 Kane 0 0 General Dentistry 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1571.45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1571.45 0 0 0 1101284951 1194763318 10 Physicians AMIN HANJANI SEPIDEH 606127325 200 Cook 0 0 Neurology Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56184.94 0 0 0 0 0 0 56184.94 0 0 0 1101284953 1174675136 32 Rehabilitation Hospitals REHABILITATION INSTITUTE 606113015 200 Cook REHAB Rehabilitation hospitals paid a Per Diem rate. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1217 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14035 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14035 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 334 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 781 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 781 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78461.88 0 0 0 0 0 0 78461.88 0 0 0 1101285016 1558479113 10 Physicians SHEK YUHANG 605063814 53 Kane 0 0 Obstetric-Gynecology 0 7 0 0 0 0 0 0 0 0 0 92 0 151 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 137 0 603 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 137 0 603 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 397.08 0 55500.81 0 0 0 0 0 0 55969.89 0 0 0 1101285018 1508895954 16 Nurse Practitioners BEARE RONALD 624012006 33 Effingham 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 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 199.55 0 0 0 0 0 0 199.55 0 0 0 1101285033 30 General Hospitals 845 Texas NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 4 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 0 445.9 0 0 0 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0 0 0 0 0 0 0 0 0 381.15 0 0 0 0 0 0 381.15 0 0 0 1101285064 1609819820 10 Physicians BOUDEMAN JOHN 601901295 30 DuPage 0 0 Anesthesiology 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 23 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 0 0 0 0 0 0 0 0 2906.68 0 0 0 0 0 0 2906.68 0 0 0 1101285091 1487861688 10 Physicians SIMMONS JOEL 620026751 65 Madison 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 199 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 199 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3272.01 0 0 0 0 0 0 3272.01 0 0 0 1101285093 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 5033.68 0 0 0 0 0 0 0 0 0 0 0 0 0 5033.68 0 0 0 1101285094 1053443895 10 Physicians VERMA PRIYADARSHINI 605033669 55 Kendall 0 0 Infectious Diseases 0 0 0 0 0 0 0 0 0 0 0 2 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 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service provider--Adults (DHS/DDD) 200 Cook 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 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11884.95 0 0 0 0 0 0 0 0 0 0 0 0 0 11884.95 0 0 0 1101285121 1437159142 10 Physicians ALEXANDER PHILIP J 604532658 200 Cook 0 0 Cardiovascular Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15387.35 0 0 0 0 0 0 15387.35 0 0 0 1101285123 1033130752 50 Home Health Agencies - In Home PEKIN HOSPITAL HOME CARE 615546229 98 Tazewell 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 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 4907.34 0 0 0 0 0 0 4907.34 0 0 0 1101285126 2100275544 90 Waiver service provider--Elderly (DOA) MA DEAR HOME SERVICES INC 606154575 200 Cook 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 1169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70782.6 0 0 0 0 0 0 0 0 0 0 0 0 0 70782.6 0 0 0 1101285137 10 Physicians 815 Indiana 0 0 Pediatric Pulmonary 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 227.98 0 0 0 0 0 0 227.98 0 0 0 1101285139 55 Early Intervention Services 200 Cook 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 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4312.02 0 0 0 0 0 0 4312.02 0 0 0 1101285141 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 2598.36 0 0 0 0 0 0 0 0 0 0 0 0 0 2598.36 0 0 0 1101285150 1841489200 48 Rural Health Clinics MID ILLINOIS MED CARE ASSC LLC 624012005 33 Effingham 0 1 0 278 432 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2557 2200 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2557 2200 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6384 90745.53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97129.53 0 0 0 1101285152 10 Physicians 815 Indiana 0 0 Surgery General 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 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 0 425.9 0 0 0 0 0 0 425.9 0 0 0 1101285167 1538166210 10 Physicians SCHLIEBEN DAVID 605406558 30 DuPage 0 0 Nephrology 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 556 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 556 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6464.21 0 0 0 0 0 0 6464.21 0 0 0 1101285183 1033162839 10 Physicians CONNOLLY MARK 606576211 200 Cook 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5405.18 0 0 0 0 0 0 5405.18 0 0 0 1101285186 1982682944 10 Physicians GRUBER JAMES 628371203 104 Wayne 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 634 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 773 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 773 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19349.7 0 0 0 0 0 0 19349.7 0 0 0 1101285195 1649392952 91 Waiver service provider--Adults (DHS/DDD) FREEMAN JUSTIN 619510406 78 Moultrie 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 0 356 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 356 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6418.64 0 0 0 0 0 0 0 0 0 0 0 0 0 6418.64 0 0 0 1101285215 1821128703 24 Speech Therapists STUDT CHRISTINE 601240230 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 222 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 222 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14564.84 14564.84 0 0 0 1101285218 1801850276 60 Pharmacies AXLINE PHARMACY INC 614621741 102 Warren 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 930 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 10505 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 273828 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1242.26 0 0 591516.95 0 0 0 592759.21 0 0 0 1101285223 1598988297 22 Physical Therapists JACKSON ANN 604774789 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9222.52 9222.52 0 0 0 1101285226 1730142274 10 Physicians IGOU DONNA 631417129 826 Missouri 0 0 Radiology 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 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 225.28 0 0 0 0 0 0 0 0 225.28 0 0 0 1101285252 1518948181 10 Physicians MARTY GERARD 600044767 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 10 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 331.78 0 1678.58 0 0 0 0 0 0 2010.36 0 0 0 1101285253 1528080546 10 Physicians UNDERWOOD JOHN 611042315 109 Winnebago 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 199 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 209 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 209 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 569 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 648 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 648 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99222.33 0 0 0 0 0 99222.33 0 0 0 1101285317 1871549402 60 Pharmacies OSCO DRUG 3188 604302009 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 511 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 3080 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 72557 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 207.94 0 0 141881.81 0 0 0 142089.75 0 0 0 1101285319 1386707750 10 Physicians CHEEMA AMIR 624012187 33 Effingham 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 318 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 648 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 648 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14618.9 0 0 0 0 0 0 14618.9 0 0 0 1101285328 1912044223 52 Certified local public health department BUREAU COUNTY DEPT OF HEALTH 613562204 15 Bureau 0 0 0 0 614 0 437 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1059 0 996 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1059 0 996 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12787.67 0 8573.25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21360.92 0 0 0 1101285359 1093078388 10 Physicians BADDOUR BISHARA 611148011 109 Winnebago 0 0 Obstetric-Gynecology 0 0 0 0 1 0 0 0 0 0 0 122 0 260 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 174 0 599 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 174 0 599 0 0 0 0 0 0 0 0 0 14.6 0 0 0 0 0 0 7262.43 0 60769.39 0 0 0 0 0 0 68046.42 0 0 0 1101285368 1073659280 56 School Based / Linked Health Clinics EVANSTON TOWNSHIP HIGH SCHOOL 602013449 200 Cook 0 1 0 285 32 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1365 32 0 250 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1365 32 0 250 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3362 204.8 0 3095.8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6662.6 0 0 0 1101285382 47 Local Education Agencies 40 Grundy 0 0 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 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1339.44 0 1339.44 0 0 0 1101285398 92 Waiver service provider--Disability (DHS/DRS) 107 Will 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6662.79 0 0 0 0 0 0 0 0 0 0 0 0 0 6662.79 0 0 0 1101285399 1811128317 63 Other Providers of Medical Equipment/Supplies (Non-registered) POLARIS PHYSICAL THERAPY 605172850 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 207.6 0 847.65 0 0 0 0 1055.25 0 0 0 1101285401 1962420448 10 Physicians KOCH MATTHEW 622265366 96 St Clair 0 0 Nephrology 0 0 0 0 0 0 0 0 0 0 0 1 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1065 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1065 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13777.54 0 0 0 0 0 0 13777.54 0 0 0 1101285410 1932279031 10 Physicians GINSBURG BETH 601601634 200 Cook 0 0 Pulmonary Diseases 0 0 0 0 0 0 0 0 0 0 0 6 0 272 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 513 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 513 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18.42 0 10789.48 0 0 0 0 0 0 10807.9 0 0 0 1101285412 1447244496 10 Physicians WYERS MARY 606143363 200 Cook 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 1162 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1591 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1591 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34531.96 0 2789.47 0 0 0 0 0 0 37321.43 0 0 0 1101285419 1023270733 10 Physicians ROBERTS JOHN 606123723 200 Cook 0 0 Ophthalmology 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 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16142.05 0 0 0 0 0 0 16142.05 0 0 0 1101285420 1568663524 47 Local Education Agencies BURNHAM SCHOOL DISTRICT 154 5 606331671 200 Cook 0 0 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 0 616 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 616 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15269.96 0 15269.96 0 0 0 1101285443 1669408183 60 Pharmacies SCHNUCKS PHARMACY 144 622082121 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 897 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22327 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58177.25 0 0 0 58177.25 0 0 0 1101285444 1861557084 10 Physicians SWEITZER BOBBIE 606371839 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6031.18 0 0 0 0 0 0 6031.18 0 0 0 1101285447 1831430941 60 Pharmacies OKAWVILLE FAMILY PHARMACY 622711799 103 Washington 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 235 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2555 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64907 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84666.82 0 0 0 84666.82 0 0 0 1101285453 1699752204 10 Physicians CAMILLERI CATHERINE 605171222 30 DuPage 0 0 Psychiatry 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 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1758.52 0 0 0 0 0 0 1758.52 0 0 0 1101285462 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 12855.9 0 0 0 0 0 0 0 0 0 0 0 0 0 12855.9 0 0 0 1101285471 1003832312 10 Physicians RIVES WILLIAM L. 631600352 89 Rock Island 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 20 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 0 886.63 0 0 0 0 0 0 886.63 0 0 0 1101285485 1578594479 10 Physicians RODRIGUEZ FRANCISCO 600442203 57 Lake 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17709.6 0 0 0 0 0 0 17709.6 0 0 0 1101285486 1780668251 10 Physicians LANG JAMES 606472228 200 Cook 0 0 Family Practice 0 0 0 0 7 0 0 0 0 0 0 3 0 89 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 3 0 121 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 3 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11008.29 0 0 0 0 0 0 11008.29 0 0 0 1101285495 1144264086 10 Physicians RENE MARTIN 600774302 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 1 0 813 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 870 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 870 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35.95 0 33670.36 0 0 0 0 0 0 33706.31 0 0 0 1101285499 1306978903 55 Early Intervention Services BENNEY ELIZABETH 606134701 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 335 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 335 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18740.21 0 0 0 0 0 0 18740.21 0 0 0 1101285501 22 Physical Therapists 89 Rock Island 0 0 0 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 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 536.33 536.33 0 0 0 1101285505 91 Waiver service provider--Adults (DHS/DDD) 57 Lake 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 0 146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24336.78 0 0 0 0 0 0 0 0 0 0 0 0 0 24336.78 0 0 0 1101285509 1437239340 10 Physicians WARNER BRAD 631101010 826 Missouri 0 0 Pediatric Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15632.53 0 0 0 0 0 0 15632.53 0 0 0 1101285513 93 Waiver service provider--HIV/AIDS (DHS/DRS) 107 Will 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 8762.02 0 0 0 0 0 0 0 0 0 0 0 0 0 8762.02 0 0 0 1101285516 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 240 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 240 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24700.5 0 0 0 0 0 0 0 0 0 0 0 0 0 24700.5 0 0 0 1101285534 1407890650 10 Physicians SARAF SANTOSH 606127323 200 Cook 0 0 Hematology 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 320 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 320 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17307.96 0 0 0 0 0 0 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0 0 0 0 0 0 0 2 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1884.97 0 0 0 0 0 0 1884.97 0 0 0 1101285569 1770557670 63 Other Providers of Medical Equipment/Supplies (Non-registered) PHYSIO O&P 629027294 47 Jackson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118 0 548 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118 0 548 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7596.85 0 163231.89 0 0 0 0 170828.74 0 0 0 1101285589 91 Waiver service provider--Adults (DHS/DDD) 65 Madison 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 0 294 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 294 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9266.08 0 0 0 0 0 0 0 0 0 0 0 0 0 9266.08 0 0 0 1101285603 1548219454 24 Speech Therapists ANTONOPOULOS VASILIKITSA 606108694 200 Cook 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 1551 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1551 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111342.04 111342.04 0 0 0 1101285606 92 Waiver service provider--Disability (DHS/DRS) 66 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0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4101.51 0 0 0 0 0 0 0 0 0 0 0 0 0 4101.51 0 0 0 1101285997 1821290396 47 Local Education Agencies NORTH PEKIN MARQUETTE HTS 102 615541152 98 Tazewell 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1618 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1618 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20371.2 0 20371.2 0 0 0 1101286003 1174623854 10 Physicians PETERSON WILLIAM 627949248 91 Sangamon 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 352 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 352 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22141.24 0 0 0 0 0 0 22141.24 0 0 0 1101286015 1962664540 10 Physicians KAO CHENG KAI 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4727.9 0 0 0 0 0 0 4727.9 0 0 0 1101286029 1750374500 10 Physicians TRIVEDI DINKER 604532504 200 Cook 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 1 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 272 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 272 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3.82 0 3198.35 0 0 0 0 0 0 3202.17 0 0 0 1101286030 92 Waiver service provider--Disability (DHS/DRS) 54 Kankakee 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11827.06 0 0 0 0 0 0 0 0 0 0 0 0 0 11827.06 0 0 0 1101286031 55 Early Intervention Services 107 Will 0 0 0 0 0 0 0 0 0 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 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 1740.03 0 0 0 0 0 0 1740.03 0 0 0 1101286043 1235288416 10 Physicians LAZZARO GIANLUCA 608036307 200 Cook 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 257 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 257 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2153.48 0 0 0 0 0 0 2153.48 0 0 0 1101286051 1134344922 10 Physicians KAAR SCOTT 631102515 826 Missouri 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12565.69 0 0 0 0 0 0 12565.69 0 0 0 1101286053 1386841260 10 Physicians CHOI JANET 600352556 57 Lake 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 148 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 0 0 0 0 0 0 0 0 0 0 0 0 295 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12813.31 0 0 0 0 0 0 12813.31 0 0 0 1101286062 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1738.26 0 0 0 0 0 0 0 0 0 0 0 0 0 1738.26 0 0 0 1101286074 1245364405 24 Speech Therapists DESMOND TERRI 616033103 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4588.11 4588.11 0 0 0 1101286080 30 General Hospitals 803 Arizona ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 251.32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 251.32 0 0 0 1101286081 1083878862 16 Nurse Practitioners CURRY LESLIE 629351300 90 Saline 0 1 0 245 0 0 69 0 0 0 0 0 0 0 0 218 0 0 0 0 0 0 2116 0 0 183 0 0 0 0 0 0 0 0 862 0 0 0 0 0 0 2116 0 0 183 0 0 0 0 0 0 0 0 862 0 0 0 0 0 0 5214 0 0 6546.77 0 0 0 0 0 0 0 0 26672.51 0 0 0 0 0 0 38433.28 0 0 0 1101286098 1679739965 10 Physicians DEAN ANDREW 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 387.91 0 0 0 0 0 0 387.91 0 0 0 1101286103 1740211150 10 Physicians OSEI ALBERT 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1.33 0 0 0 0 0 0 1.33 0 0 0 1101286107 92 Waiver service provider--Disability (DHS/DRS) 18 Cass 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 14725.42 0 0 0 0 0 0 0 0 0 0 0 0 0 14725.42 0 0 0 1101286108 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 2963.9 0 0 0 0 0 0 0 0 0 0 0 0 0 2963.9 0 0 0 1101286120 1588834519 10 Physicians NONEVSKI ILCHE 611075075 109 Winnebago 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 6 0 176 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 252 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 252 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12.02 0 12718.61 0 0 0 0 0 0 12730.63 0 0 0 1101286122 1023043643 60 Pharmacies JW PHARMACY AND DME INC 605252600 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 364 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56.99 0 0 0 0 0 0 56.99 0 0 0 1101286143 1134166051 10 Physicians VAN STAVERN GREGORY 631600352 91 Sangamon 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 0 0 28 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 0 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1834.02 0 0 0 0 0 0 1834.02 0 0 0 1101286154 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 11290.05 0 0 0 0 0 0 0 0 0 0 0 0 0 11290.05 0 0 0 1101286158 1376555748 63 Other Providers of Medical Equipment/Supplies (Non-registered) VANDENBERG MED TECH EQUIPMENT 604772501 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 152 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 152 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13126.71 0 30.4 0 0 0 0 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0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22258.15 0 0 0 0 0 0 0 0 0 0 0 0 0 22258.15 0 0 0 1101286229 1447236229 10 Physicians DAM WILLIAM C 600419208 57 Lake 0 1 Internal Medicine 0 16 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 132 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 132 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 1786.9 0 0 0 0 0 0 1857.9 0 0 0 1101286231 98 Waiver service provider--TBI (DHS/DRS) 90 Saline 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 4069.49 0 0 0 0 0 0 0 0 0 0 0 0 0 4069.49 0 0 0 1101286244 1437263662 10 Physicians INGRASSIA THEODORE 611082443 109 Winnebago 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 170 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 527 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 527 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11153.71 0 0 0 0 0 0 11153.71 0 0 0 1101286248 1952310047 10 Physicians COLLIGAN JOSEPH 600442203 57 Lake 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 1 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5186.33 0 0 0 0 0 0 5186.33 0 0 0 1101286254 1174685622 10 Physicians BHORADE SANGEETA 606118709 200 Cook 0 0 Pulmonary Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1810.64 0 0 0 0 0 0 1810.64 0 0 0 1101286255 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 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 14 0 0 0 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 14612.15 0 0 0 0 0 0 0 0 0 0 0 0 0 14612.15 0 0 0 1101286266 91 Waiver service provider--Adults (DHS/DDD) 65 Madison 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 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16808 0 0 0 0 0 0 0 0 0 0 0 0 0 16808 0 0 0 1101286268 1215924410 10 Physicians BENYAMIN RAMSIN 600442203 57 Lake 0 0 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0 0 0 0 0 0 0 0 0 0 0 851815 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64232141.22 0 0 0 0 0 0 0 0 0 0 0 0 0 64232141.22 0 0 0 1101286423 1851349013 10 Physicians MURRELL RICHARD 477101668 815 Indiana 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 937.24 0 0 0 0 0 0 937.24 0 0 0 1101286439 1457346082 10 Physicians RUOCCO ERIC M 627034514 96 St Clair 0 0 Anesthesiology 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 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18627.67 0 0 0 0 0 0 18627.67 0 0 0 1101286441 1962604181 10 Physicians BRIGGS RODNEY 611033655 109 Winnebago 0 0 Maternal and Fetal Medicine 0 0 0 0 0 0 0 0 0 0 0 186 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 284 0 226 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 284 0 226 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8240.98 0 10806.98 0 0 0 0 0 0 19047.96 0 0 0 1101286451 1295793479 10 Physicians MORALES MAURICIO 604355765 107 Will 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8438.72 0 0 0 0 0 0 8438.72 0 0 0 1101286452 1073531760 10 Physicians WOELTJE KEITH 631101010 826 Missouri 0 0 Infectious Diseases 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 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 689.18 0 0 0 0 0 0 689.18 0 0 0 1101286453 1437138997 10 Physicians PARIKH PRANAV 634016749 826 Missouri 0 0 Pulmonary Diseases 0 0 0 0 0 0 0 0 0 0 0 1 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10.75 0 165.4 0 0 0 0 0 0 176.15 0 0 0 1101286460 30 General Hospitals 806 Colorado ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 446.25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 446.25 0 0 0 1101286470 1427079961 10 Physicians KELLY KAY 605615038 30 DuPage 0 1 Pediatrics 0 15 0 0 11 0 0 0 0 0 0 2 0 13 0 0 0 0 0 0 74 0 0 17 0 0 0 0 0 0 4 0 16 0 0 0 0 0 0 74 0 0 17 0 0 0 0 0 0 4 0 16 0 0 0 0 0 0 148 0 0 956.49 0 0 0 0 0 0 43 0 715.49 0 0 0 0 0 0 1862.98 0 0 0 1101286475 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16586.57 0 0 0 0 0 0 0 0 0 0 0 0 0 16586.57 0 0 0 1101286482 1851394829 52 Certified local public health department HENRY COUNTY HEALTH DEPT 614438319 45 Henry 0 0 0 0 382 0 208 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 719 0 407 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 719 0 407 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19001.15 0 3965.9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22967.05 0 0 0 1101286483 1346294246 10 Physicians PARK HONG 600681330 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 131 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 168 0 276 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 168 0 276 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1688.52 0 9005.58 0 0 0 0 0 0 10694.1 0 0 0 1101286488 1235180381 10 Physicians KALISKI JOSEPH 601262816 200 Cook 0 1 Internal Medicine 0 13 0 0 0 0 0 0 0 0 0 1 0 41 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 1 0 79 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 1 0 79 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 2.58 0 1428.57 0 0 0 0 0 0 1503.15 0 0 0 1101286522 1972555738 10 Physicians LESKIW ULANA 606127232 30 DuPage 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43836.2 0 0 0 0 0 0 43836.2 0 0 0 1101286557 1437369030 48 Rural Health Clinics ACORN MEDICAL ASSOCIATES 626269133 64 Macoupin 0 1 0 572 657 0 236 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5478 4332 0 355 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5478 4332 0 355 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12800 180232.73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 193032.73 0 0 0 1101286568 92 Waiver service provider--Disability (DHS/DRS) 70 McDonough 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84.25 0 0 0 0 0 0 0 0 0 0 0 0 0 84.25 0 0 0 1101286581 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 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 6974.73 0 0 0 0 0 0 0 0 0 0 0 0 0 6974.73 0 0 0 1101286598 1003929175 10 Physicians SCOTT TERRY TONI 604239046 107 Will 0 0 Obstetric-Gynecology 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 725.77 0 0 0 0 0 0 725.77 0 0 0 1101286602 1457339863 10 Physicians GENDLEMAN MARK 602012468 200 Cook 0 0 Dermatology 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 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 28.35 0 0 0 0 0 0 28.35 0 0 0 1101286603 91 Waiver service provider--Adults (DHS/DDD) 72 McLean 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 0 113 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 9164.54 0 0 0 0 0 0 0 0 0 0 0 0 0 9164.54 0 0 0 1101286610 1790924306 46 Ambulatory Surgical Treatment Centers CENTRAL IL ENDOSCOPY CTR LLC 616062037 80 Peoria DIALYSIS Outpatient dialysis centers. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 223 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 223 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29219.13 0 0 0 0 0 29219.13 0 0 0 1101286611 16 Nurse Practitioners 844 Tennessee 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29.65 0 0 0 0 0 0 29.65 0 0 0 1101286613 92 Waiver service provider--Disability (DHS/DRS) 96 St Clair 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 25427.15 0 0 0 0 0 0 0 0 0 0 0 0 0 25427.15 0 0 0 1101286622 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 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 23110.08 0 0 0 0 0 0 0 0 0 0 0 0 0 23110.08 0 0 0 1101286625 1730151499 10 Physicians LINDNER PAULA 62959 47 Jackson 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 1472 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1607 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1607 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62784.88 0 0 0 0 0 0 62784.88 0 0 0 1101286655 1508812173 10 Physicians SHIN LAUREN 60169 200 Cook 0 0 Child Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 721 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 721 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21909.01 0 0 0 0 0 0 21909.01 0 0 0 1101286667 33 Nursing Facilities 91 Sangamon 0 0 0 0 0 0 0 0 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 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 544 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53977.71 0 0 0 0 0 0 0 53977.71 0 0 0 1101286668 1265469860 10 Physicians BARTELSMEYER JAMES 631418221 826 Missouri 0 0 Maternal and Fetal Medicine 0 0 0 0 0 0 0 0 0 0 0 36 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1921.82 0 2255.19 0 0 0 0 0 0 4177.01 0 0 0 1101286681 91 Waiver service provider--Adults (DHS/DDD) 71 McHenry 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 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24535.33 0 0 0 0 0 0 0 0 0 0 0 0 0 24535.33 0 0 0 1101286689 1386717940 61 Independent Laboratories CUTANEOUS AND MAXILLOFACIAL 462601828 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 458.05 0 0 0 0 0 0 0 0 458.05 0 0 0 1101286696 1982746848 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77.11 0 0 0 0 0 0 77.11 0 0 0 1101286716 1821194424 11 Dentists ITZKOFF DAVID 606154530 200 Cook 0 0 General Dentistry 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1042.79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1042.79 0 0 0 1101286722 1932186277 10 Physicians HOWCROFT MICHAEL 612015394 89 Rock Island 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 3 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 284 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 284 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65.35 0 57860.79 0 0 0 0 0 0 57926.14 0 0 0 1101286725 90 Waiver service provider--Elderly (DOA) 53 Kane 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 0 380 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 380 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16503.86 0 0 0 0 0 0 0 0 0 0 0 0 0 16503.86 0 0 0 1101286730 92 Waiver service provider--Disability (DHS/DRS) 37 Fulton 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 15971.35 0 0 0 0 0 0 0 0 0 0 0 0 0 15971.35 0 0 0 1101286758 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 20210.33 0 0 0 0 0 0 0 0 0 0 0 0 0 20210.33 0 0 0 1101286773 91 Waiver service provider--Adults (DHS/DDD) 58 La Salle 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 0 361 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 361 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24393.46 0 0 0 0 0 0 0 0 0 0 0 0 0 24393.46 0 0 0 1101286801 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10342.53 0 0 0 0 0 0 0 0 0 0 0 0 0 10342.53 0 0 0 1101286807 10 Physicians 852 Wisconsin 0 0 Emergency Medicine 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 10.45 0 0 0 0 0 0 10.45 0 0 0 1101286814 1093740821 12 Optometrists WILSON JOSHUA 622262965 96 St Clair 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 28 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 0 854.41 0 0 0 0 0 0 854.41 0 0 0 1101286817 1679896138 10 Physicians AL MURADI HAZEM 604356654 107 Will 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 581 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 993 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 993 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13985.25 0 0 0 0 0 0 13985.25 0 0 0 1101286823 1295790525 10 Physicians AHMED AZAM 999999999 852 Wisconsin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 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 7550.05 0 0 0 0 0 0 7550.05 0 0 0 1101286825 1598772584 60 Pharmacies BOND DRUG COMPANY OF IL 02073 606096300 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2033 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6965 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 185341 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 354501.49 0 0 0 354501.49 0 0 0 1101286827 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 23511.3 0 0 0 0 0 0 0 0 0 0 0 0 0 23511.3 0 0 0 1101286828 1932262292 16 Nurse Practitioners ZIEGLER DAWN 605061325 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 959.77 0 0 0 0 0 0 959.77 0 0 0 1101286834 94 Waiver service provider--Children's support (DHS/DDD) 61 Livingston 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 0 240 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 240 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15734.4 0 0 0 0 0 0 0 0 0 0 0 0 0 15734.4 0 0 0 1101286839 1124262522 10 Physicians ONUJIOGU NONYEM 606127313 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26313.17 0 0 0 0 0 0 26313.17 0 0 0 1101286843 12 Optometrists 91 Sangamon 0 0 Therapeutic Pharmaceutical Agents 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 0 1101286846 1902981970 10 Physicians OCONNELL DENIS 601691063 200 Cook 0 0 Family Practice 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 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 880.78 0 0 0 0 0 0 880.78 0 0 0 1101286858 11 Dentists 200 Cook 0 0 General Dentistry 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 21.8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21.8 0 0 0 1101286868 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 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 7129.36 0 0 0 0 0 0 0 0 0 0 0 0 0 7129.36 0 0 0 1101286889 1972531861 10 Physicians EDWARDS JOHN 631102515 30 DuPage 0 0 Nephrology 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 686.2 0 0 0 0 0 0 686.2 0 0 0 1101286891 1679660740 70 Ambulance Service Providers STONE PARK FIRE DEPT 601651025 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7502.97 0 0 0 0 0 0 7502.97 0 0 0 1101286901 98 Waiver service provider--TBI (DHS/DRS) 76 Montgomery 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 19 0 0 0 0 0 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 8417.01 0 0 0 0 0 0 0 0 0 0 0 0 0 8417.01 0 0 0 1101286915 1194943894 16 Nurse Practitioners WILEY BENSON SHERRI 605063814 53 Kane 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 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9620.8 0 0 0 0 0 0 9620.8 0 0 0 1101286925 10 Physicians 100 Vermilion 0 0 Plastic Surgery 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1418.8 0 0 0 0 0 0 1418.8 0 0 0 1101286928 30 General Hospitals 803 Arizona NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 99.26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99.26 0 0 0 1101286934 1639166259 10 Physicians SEIGLE MICHAEL 601247837 53 Kane 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1966.41 0 0 0 0 0 0 1966.41 0 0 0 1101286951 1023082807 10 Physicians WELLS MICHAEL 610368118 51 Jo Daviess 0 1 Family Practice 0 1127 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 9476 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 9476 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 23219 0 0 0 0 0 0 0 0 0 0 0 33.06 0 0 0 0 0 0 23252.06 0 0 0 1101286958 92 Waiver service provider--Disability (DHS/DRS) 64 Macoupin 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 12803.66 0 0 0 0 0 0 0 0 0 0 0 0 0 12803.66 0 0 0 1101286964 1972651636 12 Optometrists KULBAK ADALINA 607073439 200 Cook 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 1023 0 1108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2161 0 1111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2161 0 1111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61032.43 0 31447.18 0 0 0 0 92479.61 0 0 0 1101286971 1154541274 34 State-operated facility (DHS) UNIT 0108 HOME 8 LUDEMAN 604661200 200 Cook 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 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 810 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 500654.23 0 0 0 0 0 0 0 0 0 0 500654.23 0 0 0 1101286973 10 Physicians 108 Williamson 0 0 Emergency Medicine 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 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 12.85 0 0 0 0 0 0 12.85 0 0 0 1101286982 1164521928 10 Physicians NESSELROAD JAMES 614889517 56 Knox 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 305 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 305 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6335.77 0 0 0 0 0 0 6335.77 0 0 0 1101287041 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 1730.56 0 0 0 0 0 0 0 0 0 0 0 0 0 1730.56 0 0 0 1101287042 1861485153 10 Physicians SPEARS REGINALD 600475083 57 Lake 0 1 Internal Medicine 0 9 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 78 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 78 0 0 0 0 0 0 118 0 0 0 0 0 0 0 0 0 0 0 1452.58 0 0 0 0 0 0 1570.58 0 0 0 1101287043 92 Waiver service provider--Disability (DHS/DRS) 66 Marion 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9955.96 0 0 0 0 0 0 0 0 0 0 0 0 0 9955.96 0 0 0 1101287057 1770737140 63 Other Providers of Medical Equipment/Supplies (Non-registered) GENESIS HOME MEDICAL EQUIPMENT 612655016 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6384.59 0 0 0 0 0 0 6384.59 0 0 0 1101287063 1770695793 10 Physicians CHANG STEPHEN 601901222 30 DuPage 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1273.95 0 0 0 0 0 0 1273.95 0 0 0 1101287064 1174625867 10 Physicians SAXENA SANJAY 617043750 72 McLean 0 1 Pediatrics 0 799 0 0 590 0 0 0 0 0 0 262 0 582 0 0 0 0 0 0 7809 0 0 2189 0 0 0 0 0 0 425 0 1456 0 0 0 0 0 0 7809 0 0 2189 0 0 0 0 0 0 425 0 1456 0 0 0 0 0 0 15620 0 0 67155.19 0 0 0 0 0 0 6405.45 0 65261.94 0 0 0 0 0 0 154442.58 0 0 0 1101287067 1376569335 33 Nursing Facilities CHRISTIAN NURSING HOME 626562216 62 Logan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 585 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15291 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1298852.45 0 0 0 0 0 0 0 1298852.45 0 0 0 1101287070 94 Waiver service provider--Children's support (DHS/DDD) 57 Lake 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 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5994.45 0 0 0 0 0 0 0 0 0 0 0 0 0 5994.45 0 0 0 1101287073 92 Waiver service provider--Disability (DHS/DRS) 58 La Salle 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 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11596.97 0 0 0 0 0 0 0 0 0 0 0 0 0 11596.97 0 0 0 1101287087 92 Waiver service provider--Disability (DHS/DRS) 97 Stephenson 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 8787.74 0 0 0 0 0 0 0 0 0 0 0 0 0 8787.74 0 0 0 1101287091 1972735785 10 Physicians HAJI ABDIRAHMAN HASSAN 612651231 89 Rock Island 0 0 Family Practice 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 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 348.02 0 0 0 0 0 0 348.02 0 0 0 1101287141 1982843561 10 Physicians VINCA AARTHI 600623636 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 2 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5.48 0 5536.99 0 0 0 0 0 0 5542.47 0 0 0 1101287142 92 Waiver service provider--Disability (DHS/DRS) 107 Will 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 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 6871.51 0 0 0 0 0 0 0 0 0 0 0 0 0 6871.51 0 0 0 1101287146 91 Waiver service provider--Adults (DHS/DDD) 108 Williamson 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 0 258 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 258 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20501.22 0 0 0 0 0 0 0 0 0 0 0 0 0 20501.22 0 0 0 1101287148 1548492200 10 Physicians ADARAMOLA AKINDELE 627949248 109 Winnebago 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 339 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 339 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4186.25 0 0 0 0 0 0 4186.25 0 0 0 1101287151 92 Waiver service provider--Disability (DHS/DRS) 30 DuPage 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25249.14 0 0 0 0 0 0 0 0 0 0 0 0 0 25249.14 0 0 0 1101287153 1134321680 47 Local Education Agencies PIKELAND C U SCH DIST 10 623631960 83 Pike 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3314 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3314 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37526.94 0 37526.94 0 0 0 1101287155 1548490311 10 Physicians ABBEG ANDREW 622265360 96 St Clair 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 573 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 649 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 649 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15471.39 0 0 0 0 0 0 15471.39 0 0 0 1101287160 94 Waiver service provider--Children's support (DHS/DDD) 106 Whiteside 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 0 187 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 187 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4480.3 0 0 0 0 0 0 0 0 0 0 0 0 0 4480.3 0 0 0 1101287161 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 10892.47 0 0 0 0 0 0 0 0 0 0 0 0 0 10892.47 0 0 0 1101287163 1720020308 10 Physicians SALIMATH JAYARAJ 616021074 80 Peoria 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 178 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 178 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17295.94 0 0 0 0 0 0 17295.94 0 0 0 1101287164 91 Waiver service provider--Adults (DHS/DDD) 57 Lake 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 0 176 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 176 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21274 0 0 0 0 0 0 0 0 0 0 0 0 0 21274 0 0 0 1101287171 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 1856.09 0 0 0 0 0 0 0 0 0 0 0 0 0 1856.09 0 0 0 1101287175 1629015904 63 Other Providers of Medical Equipment/Supplies (Non-registered) AD MEDICAL SUPPLY INC 606421285 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2688 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7624 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7624 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 347077.98 0 0 0 0 0 0 347077.98 0 0 0 1101287177 1447266903 60 Pharmacies WALGREENS #07545 601944051 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 285 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1090 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28153 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47990.98 0 0 0 47990.98 0 0 0 1101287195 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7137.97 0 0 0 0 0 0 0 0 0 0 0 0 0 7137.97 0 0 0 1101287197 1023190816 60 Pharmacies NEW ENGLAND PHARMACY 606382320 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 696 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20400 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21689.96 0 0 0 21689.96 0 0 0 1101287206 1194061465 16 Nurse Practitioners PATEL ARPITA 999999999 200 Cook 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 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 676.32 0 0 0 0 0 0 676.32 0 0 0 1101287207 10 Physicians 852 Wisconsin 0 0 Vascular Surgery 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3389.78 0 0 0 0 0 0 3389.78 0 0 0 1101287213 1851440200 60 Pharmacies CRUSADERS WEST END PHARMACY 611022112 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 655 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86280 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133191.97 0 0 0 133191.97 0 0 0 1101287215 1700850526 63 Other Providers of Medical Equipment/Supplies (Non-registered) CASEYVILLE NURSING AND REHABIL 622321306 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23001.22 0 0 0 0 0 0 23001.22 0 0 0 1101287221 1801901640 30 General Hospitals FRESENIUS MEDICAL CARE SALINE 629463352 90 Saline ARS-LS Long-term stay hospitals paid under an ARS 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 322 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4509 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102089.16 0 0 0 0 0 102089.16 0 0 0 1101287234 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 22558.99 0 0 0 0 0 0 0 0 0 0 0 0 0 22558.99 0 0 0 1101287242 1023011863 10 Physicians BUESCHER LUCINDA 627949639 91 Sangamon 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 0 8 0 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 314 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 314 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131.74 0 23067.41 0 0 0 0 0 0 23199.15 0 0 0 1101287243 92 Waiver service provider--Disability (DHS/DRS) 96 St Clair 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 14954.68 0 0 0 0 0 0 0 0 0 0 0 0 0 14954.68 0 0 0 1101287255 1790726495 10 Physicians BEKERMAN CARLOS 606162333 200 Cook 0 0 Radiology 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 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 425.25 0 0 0 0 0 0 425.25 0 0 0 1101287261 1699729186 10 Physicians SUSTENTO REODICA NEDJEMA 606118709 200 Cook 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 567 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 567 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1359.4 0 0 0 0 0 0 0 0 1359.4 0 0 0 1101287275 1174782916 10 Physicians HANSON MATTHEW 528032459 816 Iowa 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1255.53 0 0 0 0 0 0 1255.53 0 0 0 1101287280 1346545183 10 Physicians OWUSU OSEI 616370001 80 Peoria 0 0 Pediatrics 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 0 174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77115.31 0 0 0 0 0 0 77115.31 0 0 0 1101287283 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23478 0 0 0 0 0 0 0 0 0 0 0 0 0 23478 0 0 0 1101287285 92 Waiver service provider--Disability (DHS/DRS) 107 Will 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5368.71 0 0 0 0 0 0 0 0 0 0 0 0 0 5368.71 0 0 0 1101287286 1194838045 10 Physicians DIMITROPOULOS VASSILIOUS 606123844 200 Cook 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 0 2 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 179.76 0 0 0 0 0 0 179.76 0 0 0 1101287289 1952381766 10 Physicians MCKINNON SALLY 537151849 852 Wisconsin 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 266.95 0 0 0 0 0 0 0 0 266.95 0 0 0 1101287300 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 18846.86 0 0 0 0 0 0 0 0 0 0 0 0 0 18846.86 0 0 0 1101287301 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24700 0 0 0 0 0 0 0 0 0 0 0 0 0 24700 0 0 0 1101287309 1912984261 10 Physicians HOTALING ANDREW 601533304 200 Cook 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 279 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 608 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 608 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37257.81 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0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26801.15 0 0 0 0 0 0 26801.15 0 0 0 1101288895 1972607604 10 Physicians MORGAN RICHARD L 629486334 108 Williamson 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 317 0 360 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 617 0 1366 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 617 0 1366 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15535.75 0 112853.29 0 0 0 0 0 0 128389.04 0 0 0 1101288905 1750449880 10 Physicians DALAWARI SATINDER 604534793 200 Cook 0 1 Internal Medicine 0 1266 0 0 1 0 0 0 0 0 0 75 0 598 0 0 0 0 0 0 8275 0 0 1 0 0 0 0 0 0 156 0 1947 0 0 0 0 0 0 8275 0 0 1 0 0 0 0 0 0 156 0 1947 0 0 0 0 0 0 24530 0 0 104.96 0 0 0 0 0 0 577.59 0 55261.63 0 0 0 0 0 0 80474.18 0 0 0 1101288914 91 Waiver service provider--Adults (DHS/DDD) 96 St Clair 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1397.55 0 0 0 0 0 0 0 0 0 0 0 0 0 1397.55 0 0 0 1101288919 1124126909 10 Physicians KRECKMAN JOHN 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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 20960.68 0 0 0 0 0 0 0 0 0 0 0 0 0 20960.68 0 0 0 1101288993 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3940.71 0 0 0 0 0 0 0 0 0 0 0 0 0 3940.71 0 0 0 1101288995 1922015932 60 Pharmacies WALGREEN CO 05047 631365618 826 Missouri 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 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1736 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1210.64 0 0 0 1210.64 0 0 0 1101289003 1811927098 10 Physicians IONIDES STAVROS 605213829 30 DuPage 0 0 Admitting Privileges 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 0 333 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 333 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40426.28 0 0 0 0 0 0 40426.28 0 0 0 1101289018 1336235563 10 Physicians NAJMAN DAVID M 602011718 57 Lake 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 0 0 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Waiver service provider--Adults (DHS/DDD) 68 Mason 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 0 171 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 171 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20011.75 0 0 0 0 0 0 0 0 0 0 0 0 0 20011.75 0 0 0 1101289053 1649424672 11 Dentists ZHANG LIQING 604711462 200 Cook 0 0 General Dentistry 0 0 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 699 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 699 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20867.08 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20867.08 0 0 0 1101289058 1154607125 71 Medicar Provider TRANSPORTATION OPTIONS CORP 600771804 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1381 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94481 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94481 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 676437.95 0 0 0 0 0 0 676437.95 0 0 0 1101289064 1447394325 34 State-operated facility (DHS) UNIT 3165 ELM COTTAGE 628015805 66 Marion 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 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1260 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5847.6 0 0 0 0 0 0 0 0 0 0 0 0 0 5847.6 0 0 0 1101289213 2100279631 28 Waiver service provider--Supportive living facility (HFS) RIVER TO RIVER COMM OF ANNA 629063290 99 Union 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 361 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9993 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 480725.54 0 0 0 0 0 0 0 0 0 0 0 0 0 480725.54 0 0 0 1101289223 1619957297 40 Federally Qualified Health Centers REA CLINIC DUQUOIN FACILITY 628323866 81 Perry 0 1 0 2225 1582 0 397 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18708 10787 0 1275 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18708 10787 0 1275 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48500 496842.31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 545342.31 0 0 0 1101289230 1770695611 60 Pharmacies INFANT JESUS PHARMACY 606512904 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 428 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1886 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35004 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45938.51 0 0 0 45938.51 0 0 0 1101289232 1336204841 70 Ambulance Service Providers STICKNEY FIRE DEPARTMENT 604024048 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5356.52 0 0 0 0 0 0 5356.52 0 0 0 1101289233 1861423659 10 Physicians SCHUTZENHOFER JAMES 628013056 66 Marion 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 233 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 309 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 309 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2291.15 0 0 0 0 0 0 2291.15 0 0 0 1101289252 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 3148.75 0 0 0 0 0 0 0 0 0 0 0 0 0 3148.75 0 0 0 1101289254 1699732925 10 Physicians PARKEY JOE 762628832 845 Texas 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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Kankakee 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 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24804.56 0 0 0 0 0 0 0 0 0 0 0 0 0 24804.56 0 0 0 1101289506 2100279924 90 Waiver service provider--Elderly (DOA) LIFECARE IN HOME SERVICES INC 600622365 200 Cook 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2788 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2788 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 158624.92 0 0 0 0 0 0 0 0 0 0 0 0 0 158624.92 0 0 0 1101289508 1184681637 10 Physicians ALBAGHDADI SAADI 527325067 816 Iowa 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 17 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 389 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 389 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 356.43 0 6870.74 0 0 0 0 0 0 7227.17 0 0 0 1101289510 1447260112 10 Physicians HAMMOND CASSING 606114496 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 140 0 0 0 0 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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 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 134.25 0 0 0 0 0 0 134.25 0 0 0 1101291172 1538381355 10 Physicians NAIR PRASANNA 606253660 200 Cook 0 1 Internal Medicine 0 56 0 0 0 0 0 0 0 0 0 2 0 58 0 0 0 0 0 0 402 0 0 0 0 0 0 0 0 0 2 0 185 0 0 0 0 0 0 402 0 0 0 0 0 0 0 0 0 2 0 185 0 0 0 0 0 0 1206 0 0 0 0 0 0 0 0 0 8 0 5251.81 0 0 0 0 0 0 6465.81 0 0 0 1101291173 1821290958 16 Nurse Practitioners KIELER KATIE 535661569 852 Wisconsin 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 85.65 0 0 0 0 0 0 0 0 1549.34 0 0 0 0 0 0 1634.99 0 0 0 1101291187 1962474809 10 Physicians SLATER JONATHAN 609361477 35 Ford 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 272 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 311 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 311 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9909.36 0 0 0 0 0 0 9909.36 0 0 0 1101291189 1780663963 10 Physicians SIMPSON KAREEN 608052814 200 Cook 0 0 Nephrology 0 0 0 0 0 0 0 0 0 0 0 0 0 338 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1485 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1485 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16363.47 0 0 0 0 0 0 16363.47 0 0 0 1101291213 24 Speech Therapists 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 82 0 0 0 0 0 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 6095.04 6095.04 0 0 0 1101291250 1619015062 11 Dentists SO EUN 601941732 200 Cook 0 0 General Dentistry 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11854.78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11854.78 0 0 0 1101291265 1629060710 10 Physicians DELEW JONATHAN 601374464 30 DuPage 0 1 Internal Medicine 0 2 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 158.74 0 0 0 0 0 0 164.74 0 0 0 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291.85 0 0 0 0 0 0 291.85 0 0 0 1101291404 92 Waiver service provider--Disability (DHS/DRS) 106 Whiteside 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 12183.66 0 0 0 0 0 0 0 0 0 0 0 0 0 12183.66 0 0 0 1101291417 1891700027 60 Pharmacies BOND DRUG COMPANY OF IL 04067 600891701 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 1388 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 6694 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 157981 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6.12 0 0 320228.59 0 0 0 320234.71 0 0 0 1101291430 10 Physicians 852 Wisconsin 0 0 Nuclear Medicine 0 0 0 0 0 0 0 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 280.3 0 0 0 0 0 0 280.3 0 0 0 1101291434 1811926736 50 Home Health Agencies - In Home AWAKENED ALTERNATIVES INC 604222065 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 457 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 457 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1157383.45 0 0 0 0 0 0 1157383.45 0 0 0 1101291439 1720073414 33 Nursing Facilities MAPLE LAWN HEALTH CENTER 615301045 110 Woodford 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 386 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10761 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 873307.67 0 0 0 0 0 0 0 873307.67 0 0 0 1101291445 92 Waiver service provider--Disability (DHS/DRS) 24 Coles 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 1296.03 0 0 0 0 0 0 0 0 0 0 0 0 0 1296.03 0 0 0 1101291459 1568498079 70 Ambulance Service Providers CITY OF BLOOMINGTON FIRE DEPT 617013834 72 McLean 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 671 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2451 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2451 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84148.78 0 0 0 0 0 0 84148.78 0 0 0 1101291466 10 Physicians 200 Cook 0 0 Neonatal-Perinatal Medicine 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 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 1755.46 0 0 0 0 0 0 1755.46 0 0 0 1101291480 1346282449 10 Physicians JACKSON ROBYN 604631145 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 454.88 0 0 0 0 0 0 454.88 0 0 0 1101291487 1356360796 10 Physicians DOPPENBERG ANNE 600257657 200 Cook 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 145 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 183 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 183 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7696.88 0 129.31 0 0 0 0 0 0 7826.19 0 0 0 1101291493 1679695274 16 Nurse Practitioners BEAUDUY PAMELA 605276686 30 DuPage 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 385.65 0 0 0 0 0 0 0 0 6.4 0 0 0 0 0 0 392.05 0 0 0 1101291495 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 12700.28 0 0 0 0 0 0 0 0 0 0 0 0 0 12700.28 0 0 0 1101291497 1437355146 10 Physicians LEVY ROSS M. 602011718 200 Cook 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8271.94 0 0 0 0 0 0 8271.94 0 0 0 1101291501 1164415139 12 Optometrists KEHOE PETER 614014501 56 Knox 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 535.18 0 320.08 0 0 0 0 855.26 0 0 0 1101291513 10 Physicians 815 Indiana 0 0 Emergency Medicine 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101.29 0 0 0 0 0 0 101.29 0 0 0 1101291518 1720180508 16 Nurse Practitioners BEVERIDGE DAVID 628642857 49 Jefferson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10036.91 0 0 0 0 0 0 10036.91 0 0 0 1101291521 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6003.59 0 0 0 0 0 0 0 0 0 0 0 0 0 6003.59 0 0 0 1101291522 1407938186 10 Physicians LEAGUE ALAN 606777007 53 Kane 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 71 0 204 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 124 0 330 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 124 0 330 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1540.15 0 20986.05 0 0 0 0 0 0 22526.2 0 0 0 1101291530 1326161365 55 Early Intervention Services BULTHUIS JENNIFER 605864003 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 266 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 266 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17668.63 0 0 0 0 0 0 17668.63 0 0 0 1101291532 1790702611 10 Physicians TULAIMAT AIMAN 606123723 200 Cook 0 0 Internal Medicine 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 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 278.89 0 0 0 0 0 0 278.89 0 0 0 1101291533 1982613006 10 Physicians AMIRY ABAS A 600101805 57 Lake 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2839.97 0 0 0 0 0 0 2839.97 0 0 0 1101291534 10 Physicians 99 Union 0 0 Family Practice 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 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40.9 0 0 0 0 0 0 40.9 0 0 0 1101291550 10 Physicians 836 Ohio 0 0 Child Neurology 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 152.2 0 0 0 0 0 0 152.2 0 0 0 1101291557 1831180892 63 Other Providers of Medical Equipment/Supplies (Non-registered) HERITAGE MANOR CARLINVILLE LLC 626269600 64 Macoupin 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 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7782.52 0 0 0 0 0 0 7782.52 0 0 0 1101291561 1821193327 10 Physicians WAHL CORA 606123833 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 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 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2626.02 0 0 0 0 0 0 2626.02 0 0 0 1101291568 1831295815 10 Physicians GARCIA PHILIP 627949248 91 Sangamon 0 0 Otolaryngology 0 0 0 0 0 0 0 0 0 0 0 0 0 281 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 542 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 542 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24303.48 0 0 0 0 0 0 24303.48 0 0 0 1101291573 1942253091 70 Ambulance Service Providers MOUNT PROSPECT FIRE DEPT 600563232 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 241 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 664 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 664 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25826.84 0 0 0 0 0 0 25826.84 0 0 0 1101291600 1821261892 10 Physicians NASEER JIBRAN 617042101 72 McLean 0 1 Family Practice 0 32 0 0 30 0 0 0 0 0 0 81 0 316 0 0 0 0 0 0 208 0 0 62 0 0 0 0 0 0 91 0 451 0 0 0 0 0 0 208 0 0 62 0 0 0 0 0 0 91 0 451 0 0 0 0 0 0 561 0 0 2159.58 0 0 0 0 0 0 839.17 0 11576.79 0 0 0 0 0 0 15136.54 0 0 0 1101291601 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 8180.49 0 0 0 0 0 0 0 0 0 0 0 0 0 8180.49 0 0 0 1101291606 1386850071 10 Physicians PHILLIPS PAUL 627032403 91 Sangamon 0 1 Family Practice 0 14 0 0 2 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 81 0 0 2 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 81 0 0 2 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 234 0 0 169.24 0 0 0 0 0 0 0 0 2533.42 0 0 0 0 0 0 2936.66 0 0 0 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NEUMANN ASSN., INC." 606401125 200 Cook 0 0 0 0 0 0 0 0 193 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78881 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78881 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8683728.97 0 0 0 0 0 0 0 0 0 0 0 0 0 8683728.97 0 0 0 1101293058 91 Waiver service provider--Adults (DHS/DDD) 53 Kane 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 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19178.5 0 0 0 0 0 0 0 0 0 0 0 0 0 19178.5 0 0 0 1101293086 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 363 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 363 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6520.8 0 0 0 0 0 0 0 0 0 0 0 0 0 6520.8 0 0 0 1101293087 1669456018 10 Physicians MOURILLON NICOLE 605231956 30 DuPage 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 439 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 454 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 454 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13709.29 0 0 0 0 0 0 13709.29 0 0 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Winnebago 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 20192.1 0 0 0 0 0 0 0 0 0 0 0 0 0 20192.1 0 0 0 1101295059 10 Physicians 200 Cook 0 0 Emergency Medicine 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 113.25 0 0 0 0 0 0 113.25 0 0 0 1101295063 1639194053 10 Physicians KIEFFER PETER 630318014 826 Missouri 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 612 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 661 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 661 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23664.17 0 0 0 0 0 0 23664.17 0 0 0 1101295065 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9758.91 0 0 0 0 0 0 0 0 0 0 0 0 0 9758.91 0 0 0 1101295074 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 0 0 0 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SURGICAL CENTER LLC 601783172 27 Dekalb ASTC Ambulatory Surgical Treatment Center. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 253 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 305 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 305 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 144343.4 0 0 0 0 0 144343.4 0 0 0 1101295107 1699806968 10 Physicians JOAQUIN ALICIA 606162419 200 Cook 0 0 General Practice 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 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 615.16 0 0 0 0 0 0 615.16 0 0 0 1101295108 1699708636 10 Physicians LUCIETTO SIERADZKI THERESE 610080298 13 Boone 0 1 Family Practice 0 34 0 0 16 0 0 0 0 0 0 18 0 96 0 0 0 0 0 0 318 0 0 17 0 0 0 0 0 0 36 0 295 0 0 0 0 0 0 318 0 0 17 0 0 0 0 0 0 36 0 295 0 0 0 0 0 0 748 0 0 1226.7 0 0 0 0 0 0 52.84 0 11642.56 0 0 0 0 0 0 13670.1 0 0 0 1101295120 2100285538 91 Waiver service provider--Adults (DHS/DDD) ENVISION UNLIMITED 606033300 200 Cook 0 0 0 0 0 0 0 0 830 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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(DHS/DDD) 96 St Clair 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 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14916 0 0 0 0 0 0 0 0 0 0 0 0 0 14916 0 0 0 1101295187 1649267469 10 Physicians ZOTOS VERONICA 631282106 826 Missouri 0 0 Pathology 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 191.06 0 0 0 0 0 0 0 0 191.06 0 0 0 1101295193 1689693475 10 Physicians GALVAN JEFFREY 617613592 72 McLean 0 0 Obstetric-Gynecology 0 0 0 0 32 0 0 0 0 0 0 98 0 226 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 189 0 861 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 189 0 861 0 0 0 0 0 0 0 0 0 2587.64 0 0 0 0 0 0 8962.12 0 72085.14 0 0 0 0 0 0 83634.9 0 0 0 1101295195 1134305402 10 Physicians SALCEDO SUSANA 600532953 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 13 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 0 804.74 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0 0 0 0 0 0 0 0 28297.86 0 0 0 1101295241 1811937311 10 Physicians PAK JOHN 601873190 30 DuPage 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 255 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 255 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4796.12 0 0 0 0 0 0 4796.12 0 0 0 1101295244 10 Physicians 30 DuPage 0 0 Physical Medicine/Rehabilitation 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 715.88 0 0 0 0 0 0 715.88 0 0 0 1101295251 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 13587.47 0 0 0 0 0 0 0 0 0 0 0 0 0 13587.47 0 0 0 1101295258 1063518488 10 Physicians LALYRE YOLANDA 606472443 200 Cook 0 1 Gastroenterology 0 4 0 0 0 0 0 0 0 0 0 7 0 135 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 7 0 958 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 7 0 958 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 56.61 0 5159.65 0 0 0 0 0 0 5243.26 0 0 0 1101295263 1821053216 30 General Hospitals ROCHELLE COMMUNITY HOSP 610681764 79 Ogle DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 1 0 0 0 0 0 38 0 0 0 0 0 0 1163 0 0 330 0 0 0 0 0 0 0 0 70 0 0 0 0 0 0 5760 0 0 1622 0 0 0 0 0 0 0 0 70 0 0 0 0 0 0 5760 0 0 1622 0 0 0 0 0 0 0 0 355.47 0 0 0 0 0 0 29708.92 0 0 317565.43 0 0 0 0 0 347629.82 0 0 0 1101295265 10 Physicians 826 Missouri 0 0 Pediatrics 0 0 0 0 0 0 0 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 214.7 0 0 0 0 0 0 214.7 0 0 0 1101295275 1447284898 30 General Hospitals MERCY HOSPITAL LEBANON 655369210 826 Missouri NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 7 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 1741.25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1741.25 0 0 0 1101295293 1942256813 23 Occupational Therapists BRENNAN JULEE 600162359 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 668.63 668.63 0 0 0 1101295301 1063500304 16 Nurse Practitioners NOBIS POLLY 610811252 106 Whiteside 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 138 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 138 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 313.36 0 0 0 0 0 0 313.36 0 0 0 1101295312 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3223.63 0 0 0 0 0 0 0 0 0 0 0 0 0 3223.63 0 0 0 1101295316 1083870844 24 Speech Therapists LEVY GOLDA 606591604 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 355 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 355 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26231.16 26231.16 0 0 0 1101295321 1386758506 10 Physicians LAWLER ROBERT C 605153572 30 DuPage 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 8 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 551.12 0 9615.37 0 0 0 0 0 0 10166.49 0 0 0 1101295337 1427295807 16 Nurse Practitioners KORF SUSAN 610639361 109 Winnebago 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 409 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 450 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 450 0 0 0 0 0 0 0 0 0 335.72 0 0 0 0 0 0 0 0 16689.64 0 0 0 0 0 0 17025.36 0 0 0 1101295345 1003897786 10 Physicians SHAPIRO BRADLEY 601691021 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 242 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 242 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3141.84 0 0 0 0 0 0 3141.84 0 0 0 1101295357 1548225212 10 Physicians MATHEU JOSEPH 604675561 200 Cook 0 1 Family Practice 0 41 0 0 0 0 0 0 0 0 0 26 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0 18 0 0 0 0 0 0 22 0 0 2 0 0 0 0 0 0 6 0 27 0 0 0 0 0 0 22 0 0 2 0 0 0 0 0 0 6 0 27 0 0 0 0 0 0 44 0 0 12.8 0 0 0 0 0 0 49.35 0 552.14 0 0 0 0 0 0 658.29 0 0 0 1101296008 16 Nurse Practitioners 852 Wisconsin 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182.63 0 0 0 0 0 0 182.63 0 0 0 1101296021 10 Physicians 200 Cook 0 0 Neonatal-Perinatal Medicine 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 0 550.52 0 0 0 0 0 0 550.52 0 0 0 1101296046 22 Physical Therapists 27 Dekalb 0 0 0 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73.28 73.28 0 0 0 1101296047 1679573240 10 Physicians KUESIS DANIEL 600073306 200 Cook 0 0 Infectious Diseases 0 0 0 0 0 0 0 0 0 0 0 62 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 188 0 377 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 188 0 377 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 680.38 0 2777.56 0 0 0 0 0 0 3457.94 0 0 0 1101296050 1205862653 10 Physicians CHIN JANET 605321348 30 DuPage 0 0 Oncology 0 0 0 0 0 0 0 0 0 0 0 4 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 193.27 0 4065.65 0 0 0 0 0 0 4258.92 0 0 0 1101296058 10 Physicians 12 Bond 0 0 Emergency Medicine 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101296072 1225022759 10 Physicians MUNOZ LORENZO 606123841 200 Cook 0 0 Neurology Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 272 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 272 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61230.46 0 0 0 0 0 0 61230.46 0 0 0 1101296081 1114087731 10 Physicians MONKEMEYER JON 611072574 109 Winnebago 0 1 Internal Medicine 0 16 0 0 0 0 0 0 0 0 0 0 0 64 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 0 0 296 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 0 0 296 0 0 0 0 0 0 423 0 0 0 0 0 0 0 0 0 0 0 3413.95 0 0 0 0 0 0 3836.95 0 0 0 1101296084 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1364 0 0 0 0 0 0 0 0 0 0 0 0 0 1364 0 0 0 1101296103 1396791729 10 Physicians GUPTA ATUL 605276686 30 DuPage 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10536.98 0 0 0 0 0 0 10536.98 0 0 0 1101296106 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 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 38146.69 0 0 0 0 0 0 0 0 0 0 0 0 0 38146.69 0 0 0 1101296111 1497876825 94 Waiver service provider--Children's support (DHS/DDD) SOUTHWEST COMMUNITY SERVICES 604774789 200 Cook 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 0 335 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 335 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9081.07 0 0 0 0 0 0 0 0 0 0 0 0 0 9081.07 0 0 0 1101296115 98 Waiver service provider--TBI (DHS/DRS) 30 DuPage 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 2025.98 0 0 0 0 0 0 0 0 0 0 0 0 0 2025.98 0 0 0 1101296123 1568468015 10 Physicians CARD EDWIN 614553313 70 McDonough 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 9 0 257 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 486 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 486 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 394.41 0 18594.3 0 0 0 0 0 0 18988.71 0 0 0 1101296126 91 Waiver service provider--Adults (DHS/DDD) 109 Winnebago 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 0 213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17380 0 0 0 0 0 0 0 0 0 0 0 0 0 17380 0 0 0 1101296137 94 Waiver service provider--Children's support (DHS/DDD) 53 Kane 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 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7748.89 0 0 0 0 0 0 0 0 0 0 0 0 0 7748.89 0 0 0 1101296141 1205098753 10 Physicians PENNINGTON BRENT 622461154 12 Bond 0 0 Family Practice 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 0 269 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 269 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3181.69 0 0 0 0 0 0 3181.69 0 0 0 1101296151 1700804341 10 Physicians DARCY MICHAEL 631101076 826 Missouri 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 31 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 224.73 0 3876.9 0 0 0 0 0 0 4101.63 0 0 0 1101296153 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 223 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 223 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20849.4 0 0 0 0 0 0 0 0 0 0 0 0 0 20849.4 0 0 0 1101296158 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 28289.08 0 0 0 0 0 0 0 0 0 0 0 0 0 28289.08 0 0 0 1101296159 1730171067 10 Physicians MISRA SHARMITA 606143363 200 Cook 0 1 Neonatal-Perinatal Medicine 0 60 0 0 29 0 0 0 0 0 0 8 0 53 0 0 0 0 0 0 365 0 0 164 0 0 0 0 0 0 10 0 129 0 0 0 0 0 0 365 0 0 164 0 0 0 0 0 0 10 0 129 0 0 0 0 0 0 730 0 0 3557.05 0 0 0 0 0 0 40 0 7494.19 0 0 0 0 0 0 11821.24 0 0 0 1101296169 94 Waiver service provider--Children's support (DHS/DDD) 63 Macon 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 0 187 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 187 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12745.29 0 0 0 0 0 0 0 0 0 0 0 0 0 12745.29 0 0 0 1101296182 1861580128 10 Physicians PROVOW SUSAN 610811252 106 Whiteside 0 1 Family Practice 0 292 0 0 85 0 0 0 0 0 0 78 0 354 0 0 0 0 0 0 2753 0 0 200 0 0 0 0 0 0 96 0 1171 0 0 0 0 0 0 2753 0 0 200 0 0 0 0 0 0 96 0 1171 0 0 0 0 0 0 7060 0 0 10581.01 0 0 0 0 0 0 403.48 0 46048.84 0 0 0 0 0 0 64093.33 0 0 0 1101296230 93 Waiver service provider--HIV/AIDS (DHS/DRS) 30 DuPage 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6432.34 0 0 0 0 0 0 0 0 0 0 0 0 0 6432.34 0 0 0 1101296235 91 Waiver service provider--Adults (DHS/DDD) 91 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 0 991.99 0 0 0 0 0 0 0 0 0 0 0 0 0 991.99 0 0 0 1101296237 2100286655 90 Waiver service provider--Elderly (DOA) ASSYRIAN NATIONAL COUNCIL 606594113 200 Cook 0 0 0 0 0 0 0 0 711 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 112351 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 112351 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7722774.11 0 0 0 0 0 0 0 0 0 0 0 0 0 7722774.11 0 0 0 1101296239 1376549139 10 Physicians RAWDON DAVID 622265366 96 St Clair 0 0 Family Practice 0 0 0 0 3 0 0 0 0 0 0 4 0 138 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 5 0 424 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 5 0 424 0 0 0 0 0 0 0 0 0 167.86 0 0 0 0 0 0 50.61 0 4040.8 0 0 0 0 0 0 4259.27 0 0 0 1101296242 1356613590 16 Nurse Practitioners DOMESCIK RINK TAMRA 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 488.13 0 0 0 0 0 0 488.13 0 0 0 1101296246 1366778946 22 Physical Therapists OMYLA MARIOLA 606146005 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2459 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2459 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 181458.82 181458.82 0 0 0 1101296252 1144307596 60 Pharmacies SINAI TOUHY PHARMACY LLC 606452937 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1060 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7094 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 198972 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 338146.19 0 0 0 338146.19 0 0 0 1101296253 1467470906 48 Rural Health Clinics IMH KENTLAND CLINIC 479511379 815 Indiana 0 1 0 309 281 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2309 1656 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2309 1656 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5964 43258.88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49222.88 0 0 0 1101296256 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 26062.23 0 0 0 0 0 0 0 0 0 0 0 0 0 26062.23 0 0 0 1101296273 1184870131 10 Physicians RIKERT DEJAN 601873112 30 DuPage 0 1 Family Practice 0 1 0 0 1 0 0 0 0 0 0 1 0 18 0 0 0 0 0 0 9 0 0 3 0 0 0 0 0 0 13 0 34 0 0 0 0 0 0 9 0 0 3 0 0 0 0 0 0 13 0 34 0 0 0 0 0 0 18 0 0 90.67 0 0 0 0 0 0 48.4 0 500.33 0 0 0 0 0 0 657.4 0 0 0 1101296276 1922192210 10 Physicians COMBS GENE 600261373 200 Cook 0 0 Psychiatry 0 0 0 0 1 0 0 0 0 0 0 0 0 88 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 176 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 176 0 0 0 0 0 0 0 0 0 6.4 0 0 0 0 0 0 0 0 4929.49 0 0 0 0 0 0 4935.89 0 0 0 1101296281 1659492544 16 Nurse Practitioners BOWMAN TAMMY 631101002 826 Missouri 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 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 738.88 0 0 0 0 0 0 738.88 0 0 0 1101296288 1861507220 10 Physicians MYERS SUSAN 631102515 826 Missouri 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7150.28 0 0 0 0 0 0 7150.28 0 0 0 1101296305 14 Chiropractors 17 Carroll 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61.62 0 0 0 0 0 0 61.62 0 0 0 1101296310 60 Pharmacies 827 Montana 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 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1077.58 0 0 0 1077.58 0 0 0 1101296320 1578580007 10 Physicians HENDERSON KATHERINE E 631600352 826 Missouri 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101296321 1679529101 60 Pharmacies OSCO DRUG 3096 463211612 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 447 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12820 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39657.67 0 0 0 39657.67 0 0 0 1101296326 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 362 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 362 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23958 0 0 0 0 0 0 0 0 0 0 0 0 0 23958 0 0 0 1101296352 1568435568 10 Physicians MAVES TIMOTHY 528072125 816 Iowa 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 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1332.87 0 0 0 0 0 0 1332.87 0 0 0 1101296355 1518994508 10 Physicians KASZUBA SCOTT 601533328 200 Cook 0 0 Otorhinolaryngology 0 0 0 0 10 0 0 0 0 0 0 0 0 170 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 552 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 552 0 0 0 0 0 0 0 0 0 162.12 0 0 0 0 0 0 0 0 20222.75 0 0 0 0 0 0 20384.87 0 0 0 1101296370 1518970334 16 Nurse Practitioners NELSON CELESTE 527221626 816 Iowa 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 476 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 512 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 512 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17381.17 0 0 0 0 0 0 17381.17 0 0 0 1101296389 16 Nurse Practitioners 844 Tennessee 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 85.05 0 0 0 0 0 0 85.05 0 0 0 1101296393 1881743599 63 Other Providers of Medical Equipment/Supplies (Non-registered) APTI INCORPORATED 600905078 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1886 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1886 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102703.21 0 633.49 0 0 0 0 103336.7 0 0 0 1101296394 1790712701 48 Rural Health Clinics OSF MEDICAL GROUP CULLOM 609297133 61 Livingston 0 1 0 407 299 0 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3127 1239 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3127 1239 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7996 54796.39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62792.39 0 0 0 1101296397 1780782383 10 Physicians GERSTEIN MELVYN 606593729 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 0 0 434 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 950 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 950 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18694.41 0 0 0 0 0 0 18694.41 0 0 0 1101296401 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 5280.54 0 0 0 0 0 0 0 0 0 0 0 0 0 5280.54 0 0 0 1101296414 1275599219 10 Physicians MEADOWS MATTHEW 60625 200 Cook 0 0 Urology 0 0 0 0 0 0 0 0 0 0 0 81 0 193 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 0 588 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 0 588 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1350.1 0 15340.95 0 0 0 0 0 0 16691.05 0 0 0 1101296418 1528181575 11 Dentists SAMA SREELEKHA 605065134 53 Kane 0 0 General Dentistry 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 452 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 452 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11896.75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11896.75 0 0 0 1101296419 1265404750 10 Physicians MILLER JOSEPH 637035701 826 Missouri 0 0 Radiation Oncology 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 77 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 0 0 0 2271.15 0 0 0 0 0 0 2271.15 0 0 0 1101296421 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 264 0 0 0 0 0 0 0 0 0 0 0 0 0 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hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 604.99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 604.99 0 0 0 1101296946 10 Physicians 109 Winnebago 0 0 Thoracic Surgery 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1489.22 0 0 0 0 0 0 1489.22 0 0 0 1101296949 1962488973 16 Nurse Practitioners MOODY ANDREW 617616286 72 McLean 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6648.37 0 0 0 0 0 0 6648.37 0 0 0 1101296951 10 Physicians 91 Sangamon 0 0 Family Practice 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0.02 0 0 0 0 0 0 0 0 141.31 0 0 0 0 0 0 141.33 0 0 0 1101296952 93 Waiver service provider--HIV/AIDS (DHS/DRS) 100 Vermilion 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 8876.24 0 0 0 0 0 0 0 0 0 0 0 0 0 8876.24 0 0 0 1101296955 23 Occupational Therapists 96 St Clair 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 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 34.56 34.56 0 0 0 1101296964 1811961147 10 Physicians RINELLA ANTHONY 604917721 107 Will 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3456.26 0 0 0 0 0 0 3456.26 0 0 0 1101296970 1023165644 10 Physicians WITTMAN RANDY 600143621 71 McHenry 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 13 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 672.28 0 2738.6 0 0 0 0 0 0 3410.88 0 0 0 1101296991 1083757728 22 Physical Therapists MILLER LINDA S 625264163 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 532 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 532 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37236.41 37236.41 0 0 0 1101296993 55 Early Intervention Services 815 Indiana 0 0 0 0 0 0 0 0 0 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 66 0 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 4228.64 0 0 0 0 0 0 4228.64 0 0 0 1101296994 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19608.68 0 0 0 0 0 0 0 0 0 0 0 0 0 19608.68 0 0 0 1101297004 1205034998 10 Physicians DAVULURI SRIKANTH 600313338 57 Lake 0 0 Pulmonary Diseases 0 0 0 0 0 0 0 0 0 0 0 2 0 440 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 1195 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 1195 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23879.27 0 0 0 0 0 0 23879.27 0 0 0 1101297005 1518178730 10 Physicians KERSHAW MELISSA 620628560 65 Madison 0 0 Cardiology 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 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 863.31 0 0 0 0 0 0 863.31 0 0 0 1101297014 1376618082 29 ICF/MR GROUP HOME I 620352122 65 Madison 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 0 636 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9511 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 731745.99 0 0 0 0 0 0 0 0 0 0 731745.99 0 0 0 1101297030 1922203595 16 Nurse Practitioners MORALES MELISA 604363172 107 Will 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 185 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 763 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 763 0 0 0 0 0 0 0 0 0 155.37 0 0 0 0 0 0 0 0 14704.36 0 0 0 0 0 0 14859.73 0 0 0 1101297038 1760466411 10 Physicians YOO SIMON 606118709 200 Cook 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 330 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 330 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10819.17 0 0 0 0 0 0 10819.17 0 0 0 1101297053 1588701452 11 Dentists ADELEKE FUNMI 604061493 200 Cook 0 0 General Dentistry 0 0 0 377 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1749 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1749 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44505.26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44505.26 0 0 0 1101297063 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 25458.53 0 0 0 0 0 0 0 0 0 0 0 0 0 25458.53 0 0 0 1101297066 1871571208 10 Physicians ARORA SORAJ 463210281 815 Indiana 0 1 Internal Medicine 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 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 2995.46 0 0 0 0 0 0 2995.46 0 0 0 1101297084 30 General Hospitals 811 Georgia NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 293.83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 293.83 0 0 0 1101297088 1245290733 10 Physicians GILLIAM DAVID 474041616 815 Indiana 0 0 Psychiatry 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 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1125.04 0 0 0 0 0 0 1125.04 0 0 0 1101297091 1760788467 16 Nurse Practitioners CARTWRIGHT PHILLIP 420037914 818 Kentucky 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1142.74 0 0 0 0 0 0 1142.74 0 0 0 1101297109 1093720294 60 Pharmacies WALGREEN CO 069 611082471 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 635 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3039 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 129809.2 0 0 0 129809.2 0 0 0 1101297114 1740361195 16 Nurse Practitioners WARREN KIMBERLY 605406551 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 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 0 167.41 0 0 0 0 0 0 167.41 0 0 0 1101297125 91 Waiver service provider--Adults (DHS/DDD) 96 St Clair 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 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11228.25 0 0 0 0 0 0 0 0 0 0 0 0 0 11228.25 0 0 0 1101297127 1659559292 29 ICF/MR BJORKLUND HOUSE 604522911 200 Cook 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 0 374 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8986 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 888423.15 0 0 0 0 0 0 0 0 0 0 888423.15 0 0 0 1101297132 1437182128 10 Physicians QUATTROMANI ANTONELLA 631171844 826 Missouri 0 0 Cardiology 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 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 1934.4 0 0 0 0 0 0 1934.4 0 0 0 1101297147 1003915620 10 Physicians SALAZAR MARIO 606344704 200 Cook 0 1 Family Practice 0 610 0 0 7 0 0 0 0 0 0 3 0 151 0 0 0 0 0 0 3790 0 0 7 0 0 0 0 0 0 3 0 341 0 0 0 0 0 0 3790 0 0 7 0 0 0 0 0 0 3 0 341 0 0 0 0 0 0 10757 0 0 627.3 0 0 0 0 0 0 12 0 14287.93 0 0 0 0 0 0 25684.23 0 0 0 1101297149 1700027323 60 Pharmacies WALGREENS 12426 606545105 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 306 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1178 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29504 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68278.55 0 0 0 68278.55 0 0 0 1101297154 30 General Hospitals 816 Iowa NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 591.97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 591.97 0 0 0 1101297163 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20340.92 0 0 0 0 0 0 0 0 0 0 0 0 0 20340.92 0 0 0 1101297189 1740273697 63 Other Providers of Medical Equipment/Supplies (Non-registered) WORLD WIDE MEDICAL SRVC INC 336341241 810 Florida 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 302 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 185 0 824 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 185 0 824 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4724.87 0 70703.27 0 0 0 0 75428.14 0 0 0 1101297198 1295870137 71 Medicar Provider WARREN ACHIEVEMENT CENTER INC 614622688 102 Warren 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 1050 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1050 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8932.5 0 0 0 0 0 0 8932.5 0 0 0 1101297200 30 General Hospitals 801 Alabama NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 0 252.31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 252.31 0 0 0 1101297203 1023222627 55 Early Intervention Services MACON CNTY COMM MH BD CFC 19 625231061 63 Macon 0 0 0 687 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4268 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4268 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 512120.64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 512120.64 0 0 0 1101297210 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 16275.01 0 0 0 0 0 0 0 0 0 0 0 0 0 16275.01 0 0 0 1101297218 1639490568 36 Community mental health provider CHRISTIAN COUNTY MENTAL HEALTH 625681303 20 Christian 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 768 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1712 0 0 768 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1712 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135088.26 0 0 135088.26 0 0 0 1101297223 1780665513 10 Physicians PUTNAM NANCY 604631027 200 Cook 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 1125 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2004 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2004 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27170.82 0 737.55 0 0 0 0 0 0 27908.37 0 0 0 1101297231 1972766186 11 Dentists OBAISI REEM 604551905 200 Cook 0 0 General Dentistry 0 0 0 561 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2990 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2990 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76908.19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76908.19 0 0 0 1101297232 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5526.95 0 0 0 0 0 0 0 0 0 0 0 0 0 5526.95 0 0 0 1101297235 1629230834 10 Physicians LIBERMAN COLIN W 627810001 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 3 0 122 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 18947.19 0 0 0 0 0 0 18947.19 0 0 0 1101297243 1467420950 10 Physicians TUITE MICHAEL 535625531 852 Wisconsin 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 5 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62.3 0 38.11 0 0 0 0 0 0 100.41 0 0 0 1101297246 1609094788 29 ICF/MR PARK LAWN HOME 608032625 200 Cook 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 0 509 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8382 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 635610.84 0 0 0 0 0 0 0 0 0 0 635610.84 0 0 0 1101297263 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37564.88 0 0 0 0 0 0 0 0 0 0 0 0 0 37564.88 0 0 0 1101297289 1871607507 10 Physicians CHANG MARK K 463111995 815 Indiana 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 12 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98.87 0 2801.07 0 0 0 0 0 0 2899.94 0 0 0 1101297298 10 Physicians 200 Cook 0 1 Internal Medicine 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 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 42.51 0 0 0 0 0 0 42.51 0 0 0 1101297305 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 10302.24 0 0 0 0 0 0 0 0 0 0 0 0 0 10302.24 0 0 0 1101297312 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 2010.24 0 0 0 0 0 0 0 0 0 0 0 0 0 2010.24 0 0 0 1101297313 1033184445 10 Physicians MALUF HORACIO 631101010 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4261.37 0 0 0 0 0 0 0 0 4261.37 0 0 0 1101297314 10 Physicians 200 Cook 0 0 Internal Medicine 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 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101297324 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 15806.18 0 0 0 0 0 0 0 0 0 0 0 0 0 15806.18 0 0 0 1101297325 1386847747 10 Physicians THOMAS SCOTT 631101002 826 Missouri 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6192.81 0 0 0 0 0 0 6192.81 0 0 0 1101297352 1568485795 10 Physicians ALI ISHANI 616021005 80 Peoria 0 1 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 881.06 0 0 0 0 0 0 881.06 0 0 0 1101297364 1760630420 16 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Therapists SZEFER KRZYSZTOF 627116370 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1008 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1008 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80143.95 80143.95 0 0 0 1101297541 1396856019 10 Physicians MULLAN JOAN 606118709 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 7 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 0 265.92 0 0 0 0 0 0 265.92 0 0 0 1101297550 1043322886 10 Physicians ADAIR DANIEL 627023719 91 Sangamon 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 5 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18.49 0 6142.5 0 0 0 0 0 0 6160.99 0 0 0 1101297551 1952577967 10 Physicians HARKENRIDER MATTHEW 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 283 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 283 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 1209 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5.1 0 0 883.99 0 0 0 889.09 0 0 0 1101298355 16 Nurse Practitioners 852 Wisconsin 0 0 0 0 0 0 0 0 0 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 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 0 370.46 0 0 0 0 0 0 370.46 0 0 0 1101298370 1861468076 10 Physicians VYAS RAVISHANKER 601324865 30 DuPage 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 16 0 364 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 1131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 1131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1402.36 0 102754.51 0 0 0 0 0 0 104156.87 0 0 0 1101298398 1235458910 60 Pharmacies BASINGERS MADISON PHARMACY 604356572 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 333 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10563.76 0 0 0 10563.76 0 0 0 1101298423 30 General Hospitals 828 Nebraska NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 0 148.19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 148.19 0 0 0 1101298424 1619982832 60 Pharmacies WALGREEN CO 09508 616045640 80 Peoria 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 7756 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 174380 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 436688.61 0 0 0 436688.61 0 0 0 1101298427 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10359.3 0 0 0 0 0 0 0 0 0 0 0 0 0 10359.3 0 0 0 1101298428 92 Waiver service provider--Disability (DHS/DRS) 54 Kankakee 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 0 842.75 0 0 0 0 0 0 0 0 0 0 0 0 0 842.75 0 0 0 1101298432 94 Waiver service provider--Children's support (DHS/DDD) 96 St Clair 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 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5120.5 0 0 0 0 0 0 0 0 0 0 0 0 0 5120.5 0 0 0 1101298437 1528151867 10 Physicians KOPPARTHI ROM MOHAN 600681110 200 Cook 0 0 Neonatal-Perinatal Medicine 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 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9349.44 0 0 0 0 0 0 9349.44 0 0 0 1101298447 1013108422 10 Physicians LEE OTTO 604023471 200 Cook 0 1 Family Practice 0 1357 0 0 180 0 0 0 0 0 0 45 0 386 0 0 0 0 0 0 8174 0 0 550 0 0 0 0 0 0 57 0 793 0 0 0 0 0 0 8174 0 0 550 0 0 0 0 0 0 57 0 793 0 0 0 0 0 0 21042 0 0 20020.65 0 0 0 0 0 0 448.92 0 35901.67 0 0 0 0 0 0 77413.24 0 0 0 1101298449 1003820820 10 Physicians ZORETIC NICHOLAS 601082228 30 DuPage 0 1 Family Practice 0 18 0 0 7 0 0 0 0 0 0 12 0 46 0 0 0 0 0 0 77 0 0 12 0 0 0 0 0 0 15 0 141 0 0 0 0 0 0 77 0 0 12 0 0 0 0 0 0 15 0 141 0 0 0 0 0 0 199 0 0 590.22 0 0 0 0 0 0 59.21 0 3621.18 0 0 0 0 0 0 4469.61 0 0 0 1101298450 1801021258 63 Other Providers of Medical Equipment/Supplies (Non-registered) ADVANCED CLINICAL SOLUTIONS IN 600625474 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9602.85 0 0 0 0 0 0 9602.85 0 0 0 1101298463 92 Waiver service provider--Disability (DHS/DRS) 100 Vermilion 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 11455.86 0 0 0 0 0 0 0 0 0 0 0 0 0 11455.86 0 0 0 1101298470 1912000308 61 Independent Laboratories UNILAB INC 603022752 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 717 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5987 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5987 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46274.48 0 0 0 0 0 0 0 0 46274.48 0 0 0 1101298476 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 1974.21 0 0 0 0 0 0 0 0 0 0 0 0 0 1974.21 0 0 0 1101298494 1427183607 23 Occupational Therapists REDMOND MARGARITA 606455537 200 Cook 0 0 0 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2701.41 2701.41 0 0 0 1101298498 92 Waiver service provider--Disability (DHS/DRS) 100 Vermilion 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 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 3120.36 0 0 0 0 0 0 0 0 0 0 0 0 0 3120.36 0 0 0 1101298516 1396712451 10 Physicians ALWARSHETTY MAMATA 999999999 30 DuPage 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 7 0 468 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 971 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 971 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85.24 0 14361.22 0 0 0 0 0 0 14446.46 0 0 0 1101298522 1245206655 10 Physicians LEV WEISSBERG ANDREY 600532127 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 2 0 243 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 2279 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 2279 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9.44 0 12903.33 0 0 0 0 0 0 12912.77 0 0 0 1101298537 16 Nurse Practitioners 200 Cook 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 924.45 0 0 0 0 0 0 924.45 0 0 0 1101298543 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 185 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 185 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24288 0 0 0 0 0 0 0 0 0 0 0 0 0 24288 0 0 0 1101298544 1053540237 10 Physicians CONLEE ANNEVAY 614011251 56 Knox 0 0 Family Practice 0 387 0 0 214 0 0 0 0 0 0 250 0 743 0 0 0 0 0 0 3051 0 0 960 0 0 0 0 0 0 410 0 1521 0 0 0 0 0 0 3051 0 0 960 0 0 0 0 0 0 410 0 1521 0 0 0 0 0 0 6860 0 0 27425.96 0 0 0 0 0 0 3201.72 0 86767.64 0 0 0 0 0 0 124255.32 0 0 0 1101298552 1538186895 60 Pharmacies WALMART PHARMACY 10-0603 615549303 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 655 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3921 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105420 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 126558.56 0 0 0 126558.56 0 0 0 1101298557 1093720203 60 Pharmacies WALGREEN CO 01449 601552601 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 618 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2922 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72571 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 176435.83 0 0 0 176435.83 0 0 0 1101298568 1710072996 10 Physicians VANDUSEN LAURA 600341067 71 McHenry 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 42 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 0 0 0 0 0 0 0 0 0 0 0 0 295 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1414.06 0 0 0 0 0 0 1414.06 0 0 0 1101298570 1770784670 47 Local Education Agencies HARVEY SCHOOL DISTRICT 152 604264916 200 Cook 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 717 0 0 0 0 61 0 0 0 0 0 0 0 0 0 0 0 0 0 8559 0 0 0 0 61 0 0 0 0 0 0 0 0 0 0 0 0 0 8559 0 0 0 0 406.62 0 0 0 0 0 0 0 0 0 0 0 0 0 111083.68 0 111490.3 0 0 0 1101298584 1831311836 10 Physicians DIGNAN MOORE LESLIE 627949248 53 Kane 0 0 Obstetric-Gynecology 0 0 0 0 9 0 0 0 0 0 0 35 0 100 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 50 0 238 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 50 0 238 0 0 0 0 0 0 0 0 0 688.18 0 0 0 0 0 0 2973.57 0 15857.35 0 0 0 0 0 0 19519.1 0 0 0 1101298588 1740492628 91 Waiver service provider--Adults (DHS/DDD) BEHRENS CHARLES 606401199 200 Cook 0 0 0 0 0 0 0 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1064 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1064 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36546.12 0 0 0 0 0 0 0 0 0 0 0 0 0 36546.12 0 0 0 1101298595 98 Waiver service provider--TBI (DHS/DRS) 57 Lake 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 18160.94 0 0 0 0 0 0 0 0 0 0 0 0 0 18160.94 0 0 0 1101298598 1558464222 60 Pharmacies CVS PHARMACY 6866 622361996 841 Rhode Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 221 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1878 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48384 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103126.81 0 0 0 103126.81 0 0 0 1101298600 92 Waiver service provider--Disability (DHS/DRS) 17 Carroll 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 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 0 645.71 0 0 0 0 0 0 0 0 0 0 0 0 0 645.71 0 0 0 1101298602 2100289020 90 Waiver service provider--Elderly (DOA) UNITED REHAB PROVIDERS PC 999999999 200 Cook 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2965 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2965 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 158737.76 0 0 0 0 0 0 0 0 0 0 0 0 0 158737.76 0 0 0 1101298611 1801192406 10 Physicians BAYNESAGN WOLDEGABRIEL 612821899 89 Rock Island 0 0 Pediatrics 0 95 0 0 235 0 0 0 0 0 0 92 0 405 0 0 0 0 0 0 839 0 0 1032 0 0 0 0 0 0 112 0 688 0 0 0 0 0 0 839 0 0 1032 0 0 0 0 0 0 112 0 688 0 0 0 0 0 0 1678 0 0 30072.28 0 0 0 0 0 0 1589.9 0 34221.68 0 0 0 0 0 0 67561.86 0 0 0 1101298651 1033355631 46 Ambulatory Surgical Treatment Centers MARION EYE SURGERY CTR LLC 628642341 49 Jefferson ASTC Ambulatory Surgical Treatment Center. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 560 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 921 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 921 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 303260.37 0 0 0 0 0 303260.37 0 0 0 1101298654 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 288 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 288 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21677.5 0 0 0 0 0 0 0 0 0 0 0 0 0 21677.5 0 0 0 1101298659 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 1021.46 0 0 0 0 0 0 0 0 0 0 0 0 0 1021.46 0 0 0 1101298669 98 Waiver service provider--TBI (DHS/DRS) 80 Peoria 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 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 16056.03 0 0 0 0 0 0 0 0 0 0 0 0 0 16056.03 0 0 0 1101298677 1184898025 71 Medicar Provider PICKUP AND DROPOFF TRANSPORT 606513142 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 391 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13845 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13845 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94622.01 0 0 0 0 0 0 94622.01 0 0 0 1101298680 1477532018 10 Physicians HA RICHARD 634016749 826 Missouri 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 1 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 568.54 0 0 0 0 0 0 568.54 0 0 0 1101298688 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 362 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 362 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24538.8 0 0 0 0 0 0 0 0 0 0 0 0 0 24538.8 0 0 0 1101298700 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19278.54 0 0 0 0 0 0 0 0 0 0 0 0 0 19278.54 0 0 0 1101298719 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 21785.09 0 0 0 0 0 0 0 0 0 0 0 0 0 21785.09 0 0 0 1101298742 1215914288 61 Independent Laboratories LABORATORY CORPORATION AMERICA 277110001 834 North Carolina 0 0 0 0 0 0 0 0 0 0 0 0 0 2896 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3572 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3572 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41570.64 0 0 0 0 0 0 0 0 41570.64 0 0 0 1101298744 1659652253 10 Physicians HASAN SANA 606576274 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 349 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 349 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6336.61 0 0 0 0 0 0 6336.61 0 0 0 1101298760 92 Waiver service provider--Disability (DHS/DRS) 16 Calhoun 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 2106.58 0 0 0 0 0 0 0 0 0 0 0 0 0 2106.58 0 0 0 1101298770 98 Waiver service provider--TBI (DHS/DRS) 109 Winnebago 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 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36526.11 0 0 0 0 0 0 0 0 0 0 0 0 0 36526.11 0 0 0 1101298777 1669422333 10 Physicians CUTINELLO ANTHONY 615719239 98 Tazewell 0 1 Family Practice 0 115 0 0 6 0 0 0 0 0 0 24 0 117 0 0 0 0 0 0 882 0 0 19 0 0 0 0 0 0 27 0 267 0 0 0 0 0 0 882 0 0 19 0 0 0 0 0 0 27 0 267 0 0 0 0 0 0 2442 0 0 608.02 0 0 0 0 0 0 145.38 0 10391.4 0 0 0 0 0 0 13586.8 0 0 0 1101298781 1548393440 75 Department of Alcohol and Substance Abuse Provider MONTGOMERY COUNTY HEALTH DEPT 620490128 76 Montgomery 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 726 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 726 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34977.01 0 0 34977.01 0 0 0 1101298799 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1751.48 0 0 0 0 0 0 0 0 0 0 0 0 0 1751.48 0 0 0 1101298818 1669595690 11 Dentists DOCTOR JOSEF 606284206 200 Cook 0 0 General Dentistry 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 337 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 337 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6513.2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6513.2 0 0 0 1101298824 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 4792.11 0 0 0 0 0 0 0 0 0 0 0 0 0 4792.11 0 0 0 1101298833 10 Physicians 816 Iowa 0 0 Anesthesiology 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 278.66 0 0 0 0 0 0 278.66 0 0 0 1101298849 1235366873 23 Occupational Therapists BARNUM CONNIE 604302701 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 569 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 569 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28116.02 28116.02 0 0 0 1101298853 10 Physicians 200 Cook 0 0 Family Practice 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48.1 0 0 0 0 0 0 48.1 0 0 0 1101298872 94 Waiver service provider--Children's support (DHS/DDD) 109 Winnebago 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 0 213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15342.8 0 0 0 0 0 0 0 0 0 0 0 0 0 15342.8 0 0 0 1101298880 2100289298 92 Waiver service provider--Disability (DHS/DRS) PROJECT NOW INCORPORATED 612018123 89 Rock Island 0 0 0 0 0 0 0 0 6 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1383 0 0 0 0 0 0 0 0 0 0 0 0 0 1383 0 0 0 1101298882 91 Waiver service provider--Adults (DHS/DDD) 91 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 0 148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10807.5 0 0 0 0 0 0 0 0 0 0 0 0 0 10807.5 0 0 0 1101298887 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106.98 0 0 0 0 0 0 0 0 0 0 0 0 0 106.98 0 0 0 1101298891 23 Occupational Therapists 200 Cook 0 0 0 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 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7401.75 7401.75 0 0 0 1101298896 1174582670 10 Physicians NAND BELA 604532600 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5675.81 0 0 0 0 0 0 5675.81 0 0 0 1101298897 1548216435 10 Physicians CAICEDO RAMIREZ JUAN 606112991 200 Cook 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17493.87 0 0 0 0 0 0 17493.87 0 0 0 1101298919 92 Waiver service provider--Disability (DHS/DRS) 97 Stephenson 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 6357.55 0 0 0 0 0 0 0 0 0 0 0 0 0 6357.55 0 0 0 1101298926 1740491455 12 Optometrists NAKHLIS VLADA 606265300 200 Cook 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 536 0 193 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3156 0 208 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3156 0 208 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69746.55 0 5619.6 0 0 0 0 75366.15 0 0 0 1101298928 1750631727 10 Physicians DREVER ERIN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 665 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 665 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122.96 0 10751.16 0 0 0 0 0 0 10874.12 0 0 0 1101298940 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 251 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 251 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16390 0 0 0 0 0 0 0 0 0 0 0 0 0 16390 0 0 0 1101298977 1497928212 10 Physicians DONALDSON KRISTEN 479042134 815 Indiana 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 237 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 237 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8502.8 0 0 0 0 0 0 8502.8 0 0 0 1101298995 1760433387 47 Local Education Agencies BETHALTO CU SCHOOL DIST 8 620101754 65 Madison 0 0 0 0 0 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 191 0 0 0 0 226 0 0 0 0 0 0 0 0 0 0 0 0 0 8911 0 0 0 0 226 0 0 0 0 0 0 0 0 0 0 0 0 0 8911 0 0 0 0 889.52 0 0 0 0 0 0 0 0 0 0 0 0 0 99023.15 0 99912.67 0 0 0 1101299009 1013945849 16 Nurse Practitioners BEACH DEBRA 616157822 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 271 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 271 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7341.41 0 0 0 0 0 0 7341.41 0 0 0 1101299024 1013909563 10 Physicians SREEKANTH SHANTHA 604292029 200 Cook 0 0 Pathology 0 0 0 0 29 0 0 0 0 0 0 3247 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 24202 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 24202 0 0 0 0 0 0 0 0 0 0 0 169.99 0 0 0 0 0 0 91906.08 0 0 0 0 0 0 0 0 92076.07 0 0 0 1101299026 1295918019 10 Physicians MELLNICK VINCENT 631600352 10 Adams 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 264 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 400 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 400 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10312.12 0 538.52 0 0 0 0 0 0 10850.64 0 0 0 1101299027 1972736551 16 Nurse Practitioners BRISCOE JACOB 616360001 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13437.89 0 0 0 0 0 0 13437.89 0 0 0 1101299028 1982672275 10 Physicians SHOLL STEVEN 606118709 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 2 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2.18 0 139.46 0 0 0 0 0 0 141.64 0 0 0 1101299062 1720017296 10 Physicians CROSNOE JANNA REIMANN 637035056 826 Missouri 0 0 Family Practice 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 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1453.29 0 0 0 0 0 0 1453.29 0 0 0 1101299073 2100289491 71 Medicar Provider COURTYARD ESTATES OF CANTON 615202700 37 Fulton 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 459 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 459 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2137.15 0 0 0 0 0 0 2137.15 0 0 0 1101299074 30 General Hospitals 810 Florida NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 2 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 235.69 0 0 0 0 1289.62 0 0 0 0 0 0 0 0 0 1525.31 0 0 0 1101299078 1851386221 10 Physicians STOCKTON DONNA 604489381 107 Will 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 176.07 0 0 0 0 0 0 176.07 0 0 0 1101299079 1730408915 11 Dentists YARMOLYUK YAROSLAV 606084833 57 Lake 0 0 General Dentistry 0 0 0 1614 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4951 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4951 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 912179.55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 912179.55 0 0 0 1101299083 1427322577 91 Waiver service provider--Adults (DHS/DDD) MONAHAN KELLEY 627621000 53 Kane 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 0 611 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 611 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22584.34 0 0 0 0 0 0 0 0 0 0 0 0 0 22584.34 0 0 0 1101299086 1396798765 63 Other Providers of Medical Equipment/Supplies (Non-registered) BAAR HOME MEDICAL EQUIPMENT 604105191 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 615 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 615 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6174.91 0 0 0 0 0 0 6174.91 0 0 0 1101299087 1053349720 10 Physicians LLERENA REINHOLD 600104608 57 Lake 0 0 Family Practice 0 0 0 0 2 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 64.3 0 0 0 0 0 0 0 0 114.38 0 0 0 0 0 0 178.68 0 0 0 1101299094 91 Waiver service provider--Adults (DHS/DDD) 88 Richland 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 0 724 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 724 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38739.1 0 0 0 0 0 0 0 0 0 0 0 0 0 38739.1 0 0 0 1101299095 92 Waiver service provider--Disability (DHS/DRS) 62 Logan 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 3647.42 0 0 0 0 0 0 0 0 0 0 0 0 0 3647.42 0 0 0 1101299101 1982635678 70 Ambulance Service Providers SCHAUMBURG FIRE DEPT 601931881 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 334 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 920 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 920 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35998.43 0 0 0 0 0 0 35998.43 0 0 0 1101299107 1144336751 10 Physicians SCOCCIA HUMBERTO 606743463 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 4 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 217.49 0 2642.48 0 0 0 0 0 0 2859.97 0 0 0 1101299117 1730104076 10 Physicians MOURAD MAHER 611042315 109 Winnebago 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 248.98 0 0 0 0 0 0 248.98 0 0 0 1101299122 1043341928 16 Nurse Practitioners FAULKNER ANDREA 637034909 826 Missouri 0 0 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 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 0 426.88 0 0 0 0 0 0 426.88 0 0 0 1101299132 1316026420 10 Physicians LIM LAWRENCE 606223086 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 370 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 416 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 416 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11277.47 0 0 0 0 0 0 11277.47 0 0 0 1101299137 1699700989 16 Nurse Practitioners KASAMBIRA IRENE 616033802 80 Peoria 0 0 General Psychiatry Residency 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 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 829.45 0 0 0 0 0 0 829.45 0 0 0 1101299158 10 Physicians 852 Wisconsin 0 0 Cardiology 0 0 0 0 0 0 0 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 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1051.38 0 0 0 0 0 0 1051.38 0 0 0 1101299162 1538174677 60 Pharmacies WALGREEN CO 07419 601873144 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 567 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2595 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62515 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 150233.59 0 0 0 150233.59 0 0 0 1101299174 1881679090 10 Physicians POTTS MICHAEL 611076807 109 Winnebago 0 1 Pediatrics 0 34 0 0 44 0 0 0 0 0 0 9 0 89 0 0 0 0 0 0 187 0 0 123 0 0 0 0 0 0 10 0 121 0 0 0 0 0 0 187 0 0 123 0 0 0 0 0 0 10 0 121 0 0 0 0 0 0 374 0 0 4643.22 0 0 0 0 0 0 101.38 0 6870.11 0 0 0 0 0 0 11988.71 0 0 0 1101299191 1174759625 10 Physicians CHRISTOFF ANNA 999999999 200 Cook 0 0 0 519 0 0 584 0 0 0 0 0 0 205 0 847 0 0 0 0 0 0 3597 0 0 2002 0 0 0 0 0 0 256 0 1436 0 0 0 0 0 0 3597 0 0 2002 0 0 0 0 0 0 256 0 1436 0 0 0 0 0 0 7326 0 0 54558.07 0 0 0 0 0 0 1094.43 0 56374.1 0 0 0 0 0 0 119352.6 0 0 0 1101299196 1245281492 10 Physicians CHARBA DEANE 611075089 109 Winnebago 0 0 Nephrology 0 0 0 0 0 0 0 0 0 0 0 3 0 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 550 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 550 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7.43 0 13142.53 0 0 0 0 0 0 13149.96 0 0 0 1101299205 1366437287 10 Physicians BAUER BRUCE S. 607123318 200 Cook 0 0 Plastic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9922.67 0 0 0 0 0 0 9922.67 0 0 0 1101299206 1588650139 10 Physicians NELSON SUZANNE 600268045 200 Cook 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3609.52 0 0 0 0 0 0 3609.52 0 0 0 1101299208 1629372958 16 Nurse Practitioners PETRAITIS JENNIFER 604321439 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 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 0 225.7 0 0 0 0 0 0 225.7 0 0 0 1101299224 1962452193 10 Physicians OGANWU RITA 604222125 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 553 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 553 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1278.28 0 0 0 0 0 0 1278.28 0 0 0 1101299230 1750338935 13 Podiatrists COOPER WAYNE 600622322 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 730 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2575 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2575 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12735.33 0 0 0 0 0 0 12735.33 0 0 0 1101299231 1316978174 13 Podiatrists SMITH BLAKE 600622322 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 819 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11472.02 0 0 0 0 0 0 11472.02 0 0 0 1101299236 1770730343 10 Physicians BELL ANGELA 606123723 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 179.46 0 0 0 0 0 0 179.46 0 0 0 1101299247 1225054018 10 Physicians GRAMLICH LISA 601533328 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 190 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 216 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 216 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42938.49 0 0 0 0 0 0 42938.49 0 0 0 1101299270 1760437263 10 Physicians GANTNER OVERMYER CATHIE 603041022 200 Cook 0 1 Internal Medicine 0 18 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 1455.13 0 0 0 0 0 0 1571.13 0 0 0 1101299274 1770771024 48 Rural Health Clinics ALTAMONT CLINIC 624111408 33 Effingham 0 1 0 481 573 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4356 4279 0 226 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4356 4279 0 226 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10720 163762.82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 174482.82 0 0 0 1101299275 2100289693 98 Waiver service provider--TBI (DHS/DRS) ACCESS ELEVATOR INC 601061260 30 DuPage 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68042.01 0 0 0 0 0 0 0 0 0 0 0 0 0 68042.01 0 0 0 1101299277 1932452547 11 Dentists SILVA MARIA 627035758 91 Sangamon 0 0 General Dentistry 0 0 0 420 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1381 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1381 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38475.74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38475.74 0 0 0 1101299286 1811085053 10 Physicians SAMONTE FAYE 600313338 57 Lake 0 1 Pediatrics 0 15 0 0 169 0 0 0 0 0 0 69 0 169 0 0 0 0 0 0 92 0 0 371 0 0 0 0 0 0 112 0 203 0 0 0 0 0 0 92 0 0 371 0 0 0 0 0 0 112 0 203 0 0 0 0 0 0 184 0 0 18111.36 0 0 0 0 0 0 883.03 0 10174.84 0 0 0 0 0 0 29353.23 0 0 0 1101299291 1265465728 10 Physicians KOKO ISOKEN 603051920 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 652 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 652 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8055.88 0 0 0 0 0 0 8055.88 0 0 0 1101299297 1437357563 10 Physicians DEHOEK REBECCA 604021108 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 575.3 0 0 0 0 0 0 575.3 0 0 0 1101299301 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9504 0 0 0 0 0 0 0 0 0 0 0 0 0 9504 0 0 0 1101299316 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 21766.83 0 0 0 0 0 0 0 0 0 0 0 0 0 21766.83 0 0 0 1101299325 1457485906 14 Chiropractors ZIMMERMAN GREGORY 605102450 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 153.32 0 0 0 0 0 0 153.32 0 0 0 1101299331 1457301871 10 Physicians HERMAN GAIL 607143156 200 Cook 0 0 Internal Medicine 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 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 0 372.3 0 0 0 0 0 0 372.3 0 0 0 1101299336 1457342321 10 Physicians KUPTEL MIROSLAW 601761905 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 243.45 0 0 0 0 0 0 243.45 0 0 0 1101299339 94 Waiver service provider--Children's support (DHS/DDD) 109 Winnebago 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 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 7029 0 0 0 0 0 0 0 0 0 0 0 0 0 7029 0 0 0 1101299340 1023011798 63 Other Providers of Medical 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1289.78 0 0 0 0 0 0 1289.78 0 0 0 1101299852 1508845603 10 Physicians BAILA HOREA 616062038 80 Peoria 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 585 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2194 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2194 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11378.99 0 0 0 0 0 0 0 0 11378.99 0 0 0 1101299865 1104998459 10 Physicians PATEL BIRAJU 608052701 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 971 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1431 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1431 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22798.38 0 1049.75 0 0 0 0 0 0 23848.13 0 0 0 1101299879 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26792.05 0 0 0 0 0 0 0 0 0 0 0 0 0 26792.05 0 0 0 1101299890 1306908231 10 Physicians KUO REBECCA 604355487 107 Will 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 30 0 61 0 0 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823 Michigan NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 2 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 0 275.02 0 0 0 0 0 0 0 0 0 0 0 0 0 0 275.02 0 0 0 1101300832 1033476494 60 Pharmacies AMBOY HOMETOWN PHARMACY 613101440 60 Lee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1007 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26223 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32041.27 0 0 0 32041.27 0 0 0 1101300834 1528064052 10 Physicians LINDLEY JAMES 527226976 816 Iowa 0 0 Family Practice 0 0 0 0 8 0 0 0 0 0 0 67 0 237 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 74 0 263 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 74 0 263 0 0 0 0 0 0 0 0 0 402.76 0 0 0 0 0 0 776.8 0 8595.18 0 0 0 0 0 0 9774.74 0 0 0 1101300848 1508858424 10 Physicians MAJID ABDUL 629037605 47 Jackson 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 587 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 628 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 628 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90642.16 0 0 0 0 0 0 90642.16 0 0 0 1101300853 92 Waiver service provider--Disability (DHS/DRS) 79 Ogle 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 14 0 0 0 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 6695.68 0 0 0 0 0 0 0 0 0 0 0 0 0 6695.68 0 0 0 1101300856 1932208907 60 Pharmacies THE SULLIVAN PHARMACY 619512002 78 Moultrie 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 228 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79 0 0 4592 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79 0 0 118703 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4279.3 0 0 296343.93 0 0 0 300623.23 0 0 0 1101300871 1730269820 22 Physical Therapists FISCHER K MARK 611081673 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 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 97.43 97.43 0 0 0 1101300882 1508855354 11 Dentists SANAI NIMA 606601313 200 Cook 0 0 General Dentistry 0 0 0 371 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1487 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1487 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45659.18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45659.18 0 0 0 1101300894 1952430936 47 Local Education Agencies LYONS SCHOOL DIST 103 605341513 200 Cook 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 130 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 5125 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 5125 0 0 0 0 84.62 0 0 0 0 0 0 0 0 0 0 0 0 0 96552.66 0 96637.28 0 0 0 1101300915 1376527200 10 Physicians REID JOHN 477140518 815 Indiana 0 0 Obstetric-Gynecology 0 0 0 0 1 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 448 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 448 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 50249.28 0 0 0 0 0 0 50289.28 0 0 0 1101300916 1205857422 10 Physicians SAPIEGIENE LINA 606143363 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17266.46 0 0 0 0 0 0 17266.46 0 0 0 1101300920 1598711772 10 Physicians WEN WU 637014556 826 Missouri 0 0 Endocrinology 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 0 146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4216.82 0 0 0 0 0 0 4216.82 0 0 0 1101300923 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 35884.37 0 0 0 0 0 0 0 0 0 0 0 0 0 35884.37 0 0 0 1101300924 1013219427 16 Nurse Practitioners BARAN CHRISTOPHER 604355465 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 236 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 236 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28992.61 0 0 0 0 0 0 28992.61 0 0 0 1101300925 1548327323 10 Physicians PORTER GREGORY 600442203 57 Lake 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4615.07 0 0 0 0 0 0 4615.07 0 0 0 1101300948 1669466447 10 Physicians OLARU OANA 606781034 63 Macon 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 248 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 248 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3836.7 0 0 0 0 0 0 3836.7 0 0 0 1101300955 10 Physicians 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 1 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 236.6 0 0 0 0 0 0 236.6 0 0 0 1101300959 1427063650 60 Pharmacies WALGREEN CO 11542 619203022 24 Coles 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 3223 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 29984 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 730372 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34.97 0 0 1386278.23 0 0 0 1386313.2 0 0 0 1101300971 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 11386.35 0 0 0 0 0 0 0 0 0 0 0 0 0 11386.35 0 0 0 1101300979 1568531382 10 Physicians SHILE PETER 616147300 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 579 0 353 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 688 0 834 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 688 0 834 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6795.34 0 9021.87 0 0 0 0 0 0 15817.21 0 0 0 1101300990 1518975366 10 Physicians GAMMACK JULIE 631102515 826 Missouri 0 0 Internal Medicine 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 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91.32 0 0 0 0 0 0 91.32 0 0 0 1101300997 1972518124 60 Pharmacies BOND DRUG COMPANY OF ILLINOIS 600302205 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 596 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3382 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 181732.38 0 0 0 181732.38 0 0 0 1101301000 1164686218 10 Physicians ROMERO UBILLUS WILFREDO 601604100 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 224 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 356 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 356 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14804.42 0 0 0 0 0 0 14804.42 0 0 0 1101301006 1356337836 10 Physicians MILANI GREGORY 605063814 53 Kane 0 1 Family Practice 0 68 0 0 34 0 0 0 0 0 0 14 0 136 0 0 0 0 0 0 607 0 0 69 0 0 0 0 0 0 15 0 237 0 0 0 0 0 0 607 0 0 69 0 0 0 0 0 0 15 0 237 0 0 0 0 0 0 1481 0 0 2703.63 0 0 0 0 0 0 37.14 0 7990.62 0 0 0 0 0 0 12212.39 0 0 0 1101301009 1861417073 14 Chiropractors FREEDLUND HEATHER 610888582 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 913 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 913 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8981.1 0 0 0 0 0 0 8981.1 0 0 0 1101301010 1033422290 10 Physicians ROBERTS JOSEPH 999999999 30 DuPage 0 0 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 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20970.05 0 0 0 0 0 0 20970.05 0 0 0 1101301013 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 25410.3 0 0 0 0 0 0 0 0 0 0 0 0 0 25410.3 0 0 0 1101301015 92 Waiver service provider--Disability (DHS/DRS) 106 Whiteside 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 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 4788.64 0 0 0 0 0 0 0 0 0 0 0 0 0 4788.64 0 0 0 1101301030 92 Waiver service provider--Disability (DHS/DRS) 53 Kane 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 21393.74 0 0 0 0 0 0 0 0 0 0 0 0 0 21393.74 0 0 0 1101301032 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 22075.48 0 0 0 0 0 0 0 0 0 0 0 0 0 22075.48 0 0 0 1101301063 1366460933 10 Physicians GIRALDO ANDRES 607122527 200 Cook 0 1 Internal Medicine 0 35 0 0 2 0 0 0 0 0 0 3 0 52 0 0 0 0 0 0 64 0 0 2 0 0 0 0 0 0 3 0 141 0 0 0 0 0 0 64 0 0 2 0 0 0 0 0 0 3 0 141 0 0 0 0 0 0 180 0 0 9.82 0 0 0 0 0 0 7.8 0 1719.69 0 0 0 0 0 0 1917.31 0 0 0 1101301068 55 Early Intervention Services 109 Winnebago 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 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3304.33 0 0 0 0 0 0 3304.33 0 0 0 1101301078 1487641247 10 Physicians BENDER DAVID 522421009 816 Iowa 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 464.65 0 0 0 0 0 0 464.65 0 0 0 1101301088 92 Waiver service provider--Disability (DHS/DRS) 63 Macon 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 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 3130.01 0 0 0 0 0 0 0 0 0 0 0 0 0 3130.01 0 0 0 1101301097 1841225349 10 Physicians BUCH PIYUSH 604631151 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 494 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 494 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1766.34 0 0 0 0 0 0 1766.34 0 0 0 1101301110 1467726075 55 Early Intervention Services MILLER STEPHANIE L 606254039 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11023.34 0 0 0 0 0 0 11023.34 0 0 0 1101301120 1902912629 11 Dentists ROBINSON CURTIS 606374007 200 Cook 0 0 General Dentistry 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1152.33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1152.33 0 0 0 1101301121 11 Dentists 47 Jackson 0 0 Oral Surgery 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101301122 1619054228 10 Physicians REKHA SHARMA 604062428 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 8 0 238 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 1080 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 1080 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 163.78 0 18096.15 0 0 0 0 0 0 18259.93 0 0 0 1101301124 1013918929 10 Physicians MANGLANI KISHEN 600052349 200 Cook 0 0 Clinical Pathology 0 0 0 0 0 0 0 0 0 0 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 204 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 204 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1818.48 0 0 0 0 0 0 0 0 1818.48 0 0 0 1101301147 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 25736.6 0 0 0 0 0 0 0 0 0 0 0 0 0 25736.6 0 0 0 1101301150 10 Physicians 816 Iowa 0 0 Surgery General 0 0 0 0 0 0 0 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 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 0 690.6 0 0 0 0 0 0 690.6 0 0 0 1101301176 1134110786 36 Community mental health provider DUPAGE TRANS SERVICES CENTER 601875839 30 DuPage 0 0 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 213 0 0 11358 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11224 0 0 11358 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11224 0 0 14935.08 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 399386.41 0 0 414321.49 0 0 0 1101301200 1275517401 10 Physicians KOSANOVICH MARK 606123227 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 23 0 293 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 453 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 453 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 303.27 0 98693.93 0 0 0 0 0 0 98997.2 0 0 0 1101301205 1578556585 10 Physicians FREED MARC 605461166 200 Cook 0 1 Pediatrics 0 224 0 0 81 0 0 0 0 0 0 38 0 110 0 0 0 0 0 0 633 0 0 248 0 0 0 0 0 0 47 0 217 0 0 0 0 0 0 633 0 0 248 0 0 0 0 0 0 47 0 217 0 0 0 0 0 0 1266 0 0 7473.53 0 0 0 0 0 0 315.41 0 7891.89 0 0 0 0 0 0 16946.83 0 0 0 1101301217 2100291635 71 Medicar Provider DECATUR REHAB HLTH CARE CENTER 625221841 63 Macon 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 0 425 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 425 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4228.02 0 0 0 0 0 0 4228.02 0 0 0 1101301239 30 General Hospitals 836 Ohio NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 546.49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 546.49 0 0 0 1101301251 1750486528 16 Nurse Practitioners KLAPPERICH DAVID 612656138 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10664.87 0 0 0 0 0 0 10664.87 0 0 0 1101301257 1366493256 10 Physicians PARA PATRICK 600155234 53 Kane 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 561 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 961 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 961 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14266.13 0 871.9 0 0 0 0 0 0 15138.03 0 0 0 1101301266 1073551990 70 Ambulance Service Providers BERKELEY FIRE DEPARTMENT 601631522 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 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4876.75 0 0 0 0 0 0 4876.75 0 0 0 1101301269 1831135615 10 Physicians THACHENKERY MARIA 604671412 200 Cook 0 0 General Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 232 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 925 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 925 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1888.35 0 0 0 0 0 0 1888.35 0 0 0 1101301273 1558351791 10 Physicians KARKI PRAKASH 478042706 815 Indiana 0 0 Family Practice 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 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 598.24 0 0 0 0 0 0 598.24 0 0 0 1101301278 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7568.66 0 0 0 0 0 0 0 0 0 0 0 0 0 7568.66 0 0 0 1101301280 1154309821 10 Physicians SANTIAGO MANUEL 607074157 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 23 0 601 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 2668 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 2668 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 282.46 0 75915.57 0 0 0 0 0 0 76198.03 0 0 0 1101301281 1093944324 12 Optometrists ALI IMRAN 600333060 71 McHenry 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 306 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 306 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8415.35 0 0 0 0 0 0 8415.35 0 0 0 1101301287 1457517005 10 Physicians KUMAR ASHWIN 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 208 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 208 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 236.22 0 1322.79 0 0 0 0 0 0 1559.01 0 0 0 1101301289 1073718169 10 Physicians STULL BENJAMIN 535482940 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3529 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83275.9 0 0 0 0 0 0 0 0 0 0 0 0 0 83275.9 0 0 0 1101301488 1336272913 10 Physicians ALBISU JOSE A 606133077 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19318.19 0 0 0 0 0 0 19318.19 0 0 0 1101301493 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 25447.47 0 0 0 0 0 0 0 0 0 0 0 0 0 25447.47 0 0 0 1101301496 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 12138.14 0 0 0 0 0 0 0 0 0 0 0 0 0 12138.14 0 0 0 1101301503 1902897002 10 Physicians HWANG MING 606162477 200 Cook 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 0 0 656 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1048 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1048 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6089.88 0 0 0 0 0 0 6089.88 0 0 0 1101301512 92 Waiver service provider--Disability (DHS/DRS) 10 Adams 0 0 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 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13321.66 0 0 0 0 0 0 0 0 0 0 0 0 0 13321.66 0 0 0 1101301514 1831310226 10 Physicians GOODWIN SCOTT 605064356 53 Kane 0 0 Endocrinology 0 0 0 0 0 0 0 0 0 0 0 19 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 204 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 204 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 211.7 0 2617.81 0 0 0 0 0 0 2829.51 0 0 0 1101301521 1790719003 10 Physicians MOLLOY ROBERT 606114402 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4387.43 0 0 0 0 0 0 4387.43 0 0 0 1101301524 1780823724 10 Physicians LEE ADAM 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973 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 582012.49 0 0 0 0 0 0 0 0 0 0 0 0 0 582012.49 0 0 0 1101301992 1164501896 40 Federally Qualified Health Centers HAWTHORNE FAMILY HEALTH CENTER 608042451 200 Cook 0 1 0 2265 2086 0 800 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8213 8607 0 2608 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8213 8607 0 2608 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20262 558489.64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 578751.64 0 0 0 1101302012 1114924735 10 Physicians SUNDARAM MAGESH 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9546.03 0 0 0 0 0 0 9546.03 0 0 0 1101302021 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 25767.95 0 0 0 0 0 0 0 0 0 0 0 0 0 25767.95 0 0 0 1101302027 91 Waiver service provider--Adults (DHS/DDD) 79 Ogle 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2917.75 0 0 0 0 0 0 0 0 0 0 0 0 0 2917.75 0 0 0 1101302029 1457553919 47 Local Education Agencies BARTONVILLE GRADE SCH DIST 66 616072512 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 902 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 902 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14940.83 0 14940.83 0 0 0 1101302038 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 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 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20869.18 0 0 0 0 0 0 0 0 0 0 0 0 0 20869.18 0 0 0 1101302044 92 Waiver service provider--Disability (DHS/DRS) 30 DuPage 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 6904.33 0 0 0 0 0 0 0 0 0 0 0 0 0 6904.33 0 0 0 1101302050 94 Waiver service provider--Children's 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601484837 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 1 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 206.78 0 0 0 0 0 0 206.78 0 0 0 1101302077 92 Waiver service provider--Disability (DHS/DRS) 36 Franklin 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 1268.32 0 0 0 0 0 0 0 0 0 0 0 0 0 1268.32 0 0 0 1101302086 1700831328 10 Physicians MASCARELL SUSANA 606123723 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 45 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 91.33 0 0 0 0 0 0 91.33 0 0 0 1101302101 1124330873 70 Ambulance Service Providers DUFFY BAIER SNEDECOR AMB 617641920 61 Livingston 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 389 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1268 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1268 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66445.1 0 0 0 0 0 0 66445.1 0 0 0 1101302103 1215996756 10 Physicians KIJOWSKI RICHARD 535625531 852 Wisconsin 0 0 Radiology 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 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 0 329.9 0 0 0 0 0 0 0 0 329.9 0 0 0 1101302110 1063520336 10 Physicians SINHA UPENDRA 613644448 58 La Salle 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 167 0 338 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 336 0 1165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 336 0 1165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5156.69 0 69519.86 0 0 0 0 0 0 74676.55 0 0 0 1101302137 91 Waiver service provider--Adults (DHS/DDD) 40 Grundy 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 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2126 0 0 0 0 0 0 0 0 0 0 0 0 0 2126 0 0 0 1101302138 1033172655 10 Physicians FERNANDES PATRICK 617613813 72 McLean 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 0 7 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 330 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 330 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 509.78 0 19779.24 0 0 0 0 0 0 20289.02 0 0 0 1101302145 1790954436 29 ICF/MR HERITAGE FIFTY THREE 612658115 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 725 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14705 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1759030.29 0 0 0 0 0 0 0 0 0 0 1759030.29 0 0 0 1101302148 1043252075 10 Physicians GRAY DALE 611013542 109 Winnebago 0 1 Internal Medicine 0 8 0 0 0 0 0 0 0 0 0 2 0 14 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 2 0 27 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 2 0 27 0 0 0 0 0 0 219 0 0 0 0 0 0 0 0 0 4 0 1112.63 0 0 0 0 0 0 1335.63 0 0 0 1101302152 1578762464 10 Physicians ROGALSKI MARIUSZ 600044366 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 220 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 0 0 0 0 0 0 0 0 0 0 0 260 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8303.73 0 0 0 0 0 0 8303.73 0 0 0 1101302155 1396824942 10 Physicians STONE LAWRENCE 606405719 200 Cook 0 0 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CASTRO CABALLERO YESSENIA 999999999 200 Cook 0 0 0 369 0 0 152 0 0 0 0 0 0 64 0 160 0 0 0 0 0 0 762 0 0 469 0 0 0 0 0 0 93 0 216 0 0 0 0 0 0 762 0 0 469 0 0 0 0 0 0 93 0 216 0 0 0 0 0 0 1531 0 0 15837.97 0 0 0 0 0 0 445.57 0 7852.6 0 0 0 0 0 0 25667.14 0 0 0 1101302200 1649294950 10 Physicians GERMINO KEVIN 604778898 200 Cook 0 1 Pediatrics 0 164 0 0 93 0 0 0 0 0 0 18 0 132 0 0 0 0 0 0 1465 0 0 309 0 0 0 0 0 0 23 0 235 0 0 0 0 0 0 1465 0 0 309 0 0 0 0 0 0 23 0 235 0 0 0 0 0 0 2930 0 0 10331.04 0 0 0 0 0 0 141.14 0 10539.42 0 0 0 0 0 0 23941.6 0 0 0 1101302209 1275604498 10 Physicians WONG SCOTT 622072326 96 St Clair 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7990.64 0 0 0 0 0 0 7990.64 0 0 0 1101302212 1871687103 10 Physicians ROYAL HENRY 631101076 826 Missouri 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 0 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 119 0 0 0 0 0 0 0 0 0 0 0 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8991.67 0 0 0 0 0 0 0 0 0 0 0 0 0 8991.67 0 0 0 1101302922 1629195268 24 Speech Therapists JOHNSON TAMARA 600743701 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 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 0 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7471.34 7471.34 0 0 0 1101302925 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 0 174.65 0 0 0 0 0 0 0 0 0 0 0 0 0 174.65 0 0 0 1101302935 1003018573 47 Local Education Agencies NORTH BERWYN SCHOOL DIST 98 604021320 200 Cook 0 0 0 0 0 0 219 0 0 0 0 0 0 0 0 0 0 0 0 0 446 0 0 0 0 430 0 0 0 0 0 0 0 0 0 0 0 0 0 11692 0 0 0 0 430 0 0 0 0 0 0 0 0 0 0 0 0 0 11692 0 0 0 0 2665.18 0 0 0 0 0 0 0 0 0 0 0 0 0 169919.11 0 172584.29 0 0 0 1101302943 1447221312 30 General Hospitals GALESBURG HOSPITAL CORPORATION 614012807 56 Knox DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 0 0 0 0 0 2000 0 0 0 0 472 0 0 7 828 0 0 0 0 0 0 0 0 0 3270 0 0 0 0 522 0 0 7 1984 0 0 0 0 0 0 0 0 0 3272 0 0 0 0 1799 0 0 7 1985 0 0 0 0 0 0 0 0 0 395756.1 0 0 0 0 513076.35 0 0 13997.38 258413.78 0 0 0 0 0 1181243.61 0 0 0 1101302950 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 17620.42 0 0 0 0 0 0 0 0 0 0 0 0 0 17620.42 0 0 0 1101302974 94 Waiver service provider--Children's support (DHS/DDD) 107 Will 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 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6881.94 0 0 0 0 0 0 0 0 0 0 0 0 0 6881.94 0 0 0 1101302980 2100293398 90 Waiver service provider--Elderly (DOA) HELP AT HOME INC 606023206 200 Cook 0 0 0 0 0 0 0 0 310 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23981 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23981 0 0 0 0 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COMMUNITY HOSPITAL 463212901 815 Indiana DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 0 0 0 0 0 1405 0 0 0 0 243 0 0 0 311 0 0 0 0 0 0 0 0 0 1980 0 0 0 0 284 0 0 0 490 0 0 0 0 0 0 0 0 0 1980 0 0 0 0 1708 0 0 0 496 0 0 0 0 0 0 0 0 0 278477.11 0 0 0 0 594492.52 0 0 0 88949.42 0 0 0 0 0 961919.05 0 0 0 1101305277 98 Waiver service provider--TBI (DHS/DRS) 30 DuPage 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 0 532.5 0 0 0 0 0 0 0 0 0 0 0 0 0 532.5 0 0 0 1101305291 1306878558 10 Physicians IONESCU MADALINA 605462312 200 Cook 0 0 Endocrinology 0 0 0 0 0 0 0 0 0 0 0 13 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 302 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 302 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73.5 0 5041.74 0 0 0 0 0 0 5115.24 0 0 0 1101305295 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10895.89 0 0 0 0 0 0 0 0 0 0 0 0 0 10895.89 0 0 0 1101305300 1356309231 10 Physicians BARAGLIA JAMES 607074124 200 Cook 0 1 Family Practice 0 22 0 0 2 0 0 0 0 0 0 1 0 12 0 0 0 0 0 0 48 0 0 4 0 0 0 0 0 0 1 0 26 0 0 0 0 0 0 48 0 0 4 0 0 0 0 0 0 1 0 26 0 0 0 0 0 0 128 0 0 182.04 0 0 0 0 0 0 15.7 0 703.07 0 0 0 0 0 0 1028.81 0 0 0 1101305317 1942466156 10 Physicians UMAR SHAHEEN 604264267 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 1678 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2377 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2377 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63473.1 0 364.66 0 0 0 0 0 0 63837.76 0 0 0 1101305327 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8805.74 0 0 0 0 0 0 0 0 0 0 0 0 0 8805.74 0 0 0 1101305329 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 3358.4 0 0 0 0 0 0 0 0 0 0 0 0 0 3358.4 0 0 0 1101305345 92 Waiver service provider--Disability (DHS/DRS) 10 Adams 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3902.21 0 0 0 0 0 0 0 0 0 0 0 0 0 3902.21 0 0 0 1101305356 92 Waiver service provider--Disability (DHS/DRS) 97 Stephenson 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 27679.3 0 0 0 0 0 0 0 0 0 0 0 0 0 27679.3 0 0 0 1101305361 10 Physicians 852 Wisconsin 0 0 Pediatric Cardiology 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 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 335.22 0 0 0 0 0 0 335.22 0 0 0 1101305366 10 Physicians 826 Missouri 0 0 Endocrinology 0 0 0 0 0 0 0 0 0 0 0 2 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106.34 0 19.71 0 0 0 0 0 0 126.05 0 0 0 1101305386 92 Waiver service provider--Disability (DHS/DRS) 49 Jefferson 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 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 2575.97 0 0 0 0 0 0 0 0 0 0 0 0 0 2575.97 0 0 0 1101305395 1518064062 10 Physicians HELFER ERIC 619389258 24 Coles 0 0 Urology 0 0 0 0 0 0 0 0 0 0 0 36 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 217 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 217 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 328.46 0 17661.06 0 0 0 0 0 0 17989.52 0 0 0 1101305397 92 Waiver service provider--Disability (DHS/DRS) 10 Adams 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 14897.41 0 0 0 0 0 0 0 0 0 0 0 0 0 14897.41 0 0 0 1101305405 1861473225 10 Physicians ORZA DANIELA 606127239 200 Cook 0 0 Anesthesiology 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 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20613.32 0 0 0 0 0 0 20613.32 0 0 0 1101305417 92 Waiver service provider--Disability (DHS/DRS) 54 Kankakee 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 19 0 0 0 0 0 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 16391.92 0 0 0 0 0 0 0 0 0 0 0 0 0 16391.92 0 0 0 1101305426 1912973835 10 Physicians KUZYCZ GEORGE 601901295 30 DuPage 0 0 Thoracic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 6 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 0 394.61 0 0 0 0 0 0 394.61 0 0 0 1101305436 1609086750 10 Physicians SCHLAUTMAN JASON 631282106 826 Missouri 0 0 Emergency Medicine 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 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 495.4 0 0 0 0 0 0 495.4 0 0 0 1101305439 1518123520 10 Physicians SPENCER NICOLE 999999999 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 255 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 467 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 467 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8833.24 0 0 0 0 0 0 8833.24 0 0 0 1101305440 91 Waiver service provider--Adults (DHS/DDD) 65 Madison 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 0 286 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 286 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11596.2 0 0 0 0 0 0 0 0 0 0 0 0 0 11596.2 0 0 0 1101305446 1679770150 10 Physicians MCCOMB ERIN 606118709 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 315 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 420 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 420 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15960.49 0 0 0 0 0 0 0 0 15960.49 0 0 0 1101305454 1790848216 10 Physicians REDDY SHALINI 605276686 30 DuPage 0 1 Internal Medicine 0 4 0 0 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 161 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 161 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 1293.41 0 0 0 0 0 0 1309.41 0 0 0 1101305460 1780716662 10 Physicians SZMUILOWICZ EMILY 606112661 200 Cook 0 0 Endocrinology 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1938.24 0 0 0 0 0 0 1938.24 0 0 0 1101305463 1467547554 16 Nurse Practitioners LERCHER ANN 625264163 63 Macon 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 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 216.69 0 0 0 0 0 0 216.69 0 0 0 1101305471 91 Waiver service provider--Adults (DHS/DDD) 107 Will 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 0 359 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 359 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11387.2 0 0 0 0 0 0 0 0 0 0 0 0 0 11387.2 0 0 0 1101305475 1356486161 63 Other Providers of Medical Equipment/Supplies (Non-registered) RELIABLE MEDICAL SUPPLIES 600185909 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 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 4904.62 0 0 0 0 0 0 4904.62 0 0 0 1101305478 92 Waiver service provider--Disability (DHS/DRS) 19 Champaign 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 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 0 167.09 0 0 0 0 0 0 0 0 0 0 0 0 0 167.09 0 0 0 1101305480 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 18675.25 0 0 0 0 0 0 0 0 0 0 0 0 0 18675.25 0 0 0 1101305482 1699809806 10 Physicians PATEL SUNIL S 611072809 109 Winnebago 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 215 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 334 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 334 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15762.55 0 0 0 0 0 0 15762.55 0 0 0 1101305490 93 Waiver service provider--HIV/AIDS (DHS/DRS) 27 Dekalb 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 17580.87 0 0 0 0 0 0 0 0 0 0 0 0 0 17580.87 0 0 0 1101305505 94 Waiver service provider--Children's support (DHS/DDD) 79 Ogle 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 0 172.42 0 0 0 0 0 0 0 0 0 0 0 0 0 172.42 0 0 0 1101305525 98 Waiver service provider--TBI (DHS/DRS) 70 McDonough 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10479.51 0 0 0 0 0 0 0 0 0 0 0 0 0 10479.51 0 0 0 1101305530 94 Waiver service provider--Children's support (DHS/DDD) 91 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 0 234 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 234 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13657.05 0 0 0 0 0 0 0 0 0 0 0 0 0 13657.05 0 0 0 1101305536 1205818481 30 General Hospitals ST JOHNS HOSPITAL 627690002 91 Sangamon DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 0 0 0 0 0 0 0 0 0 0 0 3381 0 0 1049 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15430 0 0 4376 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15430 0 0 4376 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100345.55 0 0 300749.57 0 0 0 0 0 401095.12 0 0 0 1101305540 94 Waiver service provider--Children's support (DHS/DDD) 73 Menard 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 0 152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6026.04 0 0 0 0 0 0 0 0 0 0 0 0 0 6026.04 0 0 0 1101305544 92 Waiver service provider--Disability (DHS/DRS) 56 Knox 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 333.21 0 0 0 0 0 0 0 0 0 0 0 0 0 333.21 0 0 0 1101305547 1083620140 10 Physicians KHAN WAQQAS 619034310 80 Peoria 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5707.96 0 0 0 0 0 0 5707.96 0 0 0 1101305553 1093998502 10 Physicians SANTA EDWIN 601545716 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 324 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 324 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3276.04 0 0 0 0 0 0 3276.04 0 0 0 1101305569 1942266473 63 Other Providers of Medical Equipment/Supplies (Non-registered) ADVANCE MEDICAL EQUIPMENT INC 606082410 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 248 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3592 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3592 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 262411.04 0 7726.2 0 0 0 0 270137.24 0 0 0 1101305571 92 Waiver service provider--Disability (DHS/DRS) 34 Fayette 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 2395.59 0 0 0 0 0 0 0 0 0 0 0 0 0 2395.59 0 0 0 1101305572 1194823310 10 Physicians PETERSON RENUKA 631171811 826 Missouri 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 28 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 511 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 511 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1176.16 0 10539.06 0 0 0 0 0 0 11715.22 0 0 0 1101305575 1538329982 10 Physicians QATTASH ISMAIL 618203909 19 Champaign 0 1 Internal Medicine 0 133 0 0 0 0 0 0 0 0 0 14 0 164 0 0 0 0 0 0 1001 0 0 0 0 0 0 0 0 0 61 0 774 0 0 0 0 0 0 1001 0 0 0 0 0 0 0 0 0 61 0 774 0 0 0 0 0 0 2919 0 0 0 0 0 0 0 0 0 407.36 0 6983.42 0 0 0 0 0 0 10309.78 0 0 0 1101305577 1104835495 16 Nurse Practitioners FREY MARLISE 606123845 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 168 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 362 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 362 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3914.34 0 0 0 0 0 0 3914.34 0 0 0 1101305578 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5839.5 0 0 0 0 0 0 0 0 0 0 0 0 0 5839.5 0 0 0 1101305584 1891707998 10 Physicians INCIONG RAMON 613621512 200 Cook 0 1 Internal Medicine 0 188 0 0 0 0 0 0 0 0 0 0 0 476 0 0 0 0 0 0 1557 0 0 0 0 0 0 0 0 0 0 0 647 0 0 0 0 0 0 1557 0 0 0 0 0 0 0 0 0 0 0 647 0 0 0 0 0 0 4484 0 0 0 0 0 0 0 0 0 0 0 19090.45 0 0 0 0 0 0 23574.45 0 0 0 1101305590 24 Speech Therapists 200 Cook 0 0 0 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 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5326.12 5326.12 0 0 0 1101305600 1194891556 11 Dentists KARAR MAHA 606533030 200 Cook 0 0 General Dentistry 0 0 0 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 325 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 325 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8405.02 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8405.02 0 0 0 1101305616 1376687418 23 Occupational Therapists WALKER JESSICA 618012500 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5521.07 5521.07 0 0 0 1101305620 1568463826 12 Optometrists WILKINSON MARK 522421009 816 Iowa 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 7 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 0 119.24 0 0 0 0 0 0 119.24 0 0 0 1101305625 1447368949 10 Physicians AHMED NAILA 604353438 107 Will 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 724 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 724 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3609.79 0 0 0 0 0 0 3609.79 0 0 0 1101305641 1851386692 30 General Hospitals PALOS COMMUNITY HOSPITAL 604631256 200 Cook DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 0 0 0 0 28 0 0 0 0 0 0 1061 0 0 1127 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 3474 0 0 2000 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 3474 0 0 2000 0 0 0 0 0 0 0 0 171.32 0 0 0 0 0 0 18870 0 0 82600.9 0 0 0 0 0 101642.22 0 0 0 1101305647 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16156.8 0 0 0 0 0 0 0 0 0 0 0 0 0 16156.8 0 0 0 1101305650 1932110749 10 Physicians ALIKHAN NADIRA 606241732 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 703 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 703 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5927.85 0 0 0 0 0 0 5927.85 0 0 0 1101305651 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6942 0 0 0 0 0 0 0 0 0 0 0 0 0 6942 0 0 0 1101305656 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7159.87 0 0 0 0 0 0 0 0 0 0 0 0 0 7159.87 0 0 0 1101305657 1558459560 10 Physicians HASSAN RANDA 611072201 109 Winnebago 0 0 Obstetric-Gynecology 0 0 0 0 3 0 0 0 0 0 0 44 0 226 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 59 0 567 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 59 0 567 0 0 0 0 0 0 0 0 0 295.57 0 0 0 0 0 0 1141.91 0 65237.78 0 0 0 0 0 0 66675.26 0 0 0 1101305660 1487765319 10 Physicians GERBER MARK E. 602011718 57 Lake 0 0 Otorhinolaryngology 0 0 0 0 0 0 0 0 0 0 0 0 0 170 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 337 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 337 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29707.98 0 0 0 0 0 0 29707.98 0 0 0 1101305668 1063529071 47 Local Education Agencies MARTINSVILLE CUSD C 3 624420166 21 Clark 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 751 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 751 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5277.93 0 5277.93 0 0 0 1101305689 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 339 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 339 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18898 0 0 0 0 0 0 0 0 0 0 0 0 0 18898 0 0 0 1101305692 1649492620 10 Physicians ANSARI MOHAMMED 611033619 109 Winnebago 0 0 Family Practice 0 0 0 0 78 0 0 0 0 0 0 113 0 1081 0 0 0 0 0 0 0 0 0 152 0 0 0 0 0 0 148 0 1497 0 0 0 0 0 0 0 0 0 152 0 0 0 0 0 0 148 0 1497 0 0 0 0 0 0 0 0 0 2555.46 0 0 0 0 0 0 1324.25 0 39771.7 0 0 0 0 0 0 43651.41 0 0 0 1101305697 10 Physicians 65 Madison 0 0 Internal Medicine 0 0 0 0 0 0 0 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 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 36.1 0 0 0 0 0 0 36.1 0 0 0 1101305709 1952469454 63 Other Providers of Medical Equipment/Supplies (Non-registered) ORTHOPAEDIC ASSOCIATES OF RIVE 605462082 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6.95 0 2836.57 0 0 0 0 2843.52 0 0 0 1101305715 10 Physicians 30 DuPage 0 1 Family Practice 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 1101305716 1154336303 60 Pharmacies BOND DRUG COMPANY OF ILLINOIS 608052135 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 577 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2171 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53833 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105188.38 0 0 0 105188.38 0 0 0 1101305728 91 Waiver service provider--Adults (DHS/DDD) 96 St Clair 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 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12559.8 0 0 0 0 0 0 0 0 0 0 0 0 0 12559.8 0 0 0 1101305734 1316963531 10 Physicians BABCOCK HILARY 631101010 826 Missouri 0 0 Infectious Diseases 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 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 497.64 0 0 0 0 0 0 497.64 0 0 0 1101305740 92 Waiver service provider--Disability (DHS/DRS) 57 Lake 0 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106683.11 0 0 0 0 0 118798.51 0 0 0 1101306035 1316038938 22 Physical Therapists HOLDEN GORDON 629641022 85 Pulaski 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18167.45 18167.45 0 0 0 1101306055 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 296 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 296 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13983.75 0 0 0 0 0 0 0 0 0 0 0 0 0 13983.75 0 0 0 1101306056 10 Physicians 815 Indiana 0 0 Cardiology 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 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 7.66 0 0 0 0 0 0 7.66 0 0 0 1101306061 10 Physicians 852 Wisconsin 0 0 Neurology 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 148.32 0 0 0 0 0 0 148.32 0 0 0 1101306075 92 Waiver service provider--Disability (DHS/DRS) 88 Richland 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 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13882.38 0 0 0 0 0 0 0 0 0 0 0 0 0 13882.38 0 0 0 1101306077 1497913511 10 Physicians DESAI PARIN 605277594 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 195 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 542 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 542 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6662.76 0 0 0 0 0 0 6662.76 0 0 0 1101306079 92 Waiver service provider--Disability (DHS/DRS) 98 Tazewell 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9945.88 0 0 0 0 0 0 0 0 0 0 0 0 0 9945.88 0 0 0 1101306093 92 Waiver service provider--Disability (DHS/DRS) 93 Scott 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5559.46 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3260.58 0 0 0 0 0 0 0 0 3260.58 0 0 0 1101306119 34 State-operated facility (DHS) 57 Lake 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 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 450 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 348889.05 0 0 0 0 0 0 0 0 0 0 348889.05 0 0 0 1101306122 1174658629 55 Early Intervention Services OLSON KIYA 605634929 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 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 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6925.47 0 0 0 0 0 0 6925.47 0 0 0 1101306125 1063651909 10 Physicians CASTALDI ADELE 600055200 200 Cook 0 1 Family Practice 0 80 0 0 3 0 0 0 0 0 0 6 0 672 0 0 0 0 0 0 221 0 0 3 0 0 0 0 0 0 7 0 754 0 0 0 0 0 0 221 0 0 3 0 0 0 0 0 0 7 0 754 0 0 0 0 0 0 529 0 0 240.36 0 0 0 0 0 0 41.69 0 30231.62 0 0 0 0 0 0 31042.67 0 0 0 1101306137 30 General Hospitals 810 Florida NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 628.53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 628.53 0 0 0 1101306147 2100296565 72 Taxicabs and Livery Companies NORTH SHORE TRANSPORTATION 999999999 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 195 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4773 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4773 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48692.12 0 0 0 0 0 0 48692.12 0 0 0 1101306160 1417028168 28 Waiver service provider--Supportive living facility (HFS) OAKVIEW VILLA 628632455 101 Wabash 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 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3836 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 197162.25 0 0 0 0 0 0 0 0 0 0 0 0 0 197162.25 0 0 0 1101306170 92 Waiver service provider--Disability (DHS/DRS) 47 Jackson 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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DEBORAH 631082212 826 Missouri 0 0 Internal Medicine 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 1018.45 0 0 0 0 0 0 1018.45 0 0 0 1101307204 1386994051 16 Nurse Practitioners WANG HAILAN 600681342 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 409 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 409 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1184.4 0 0 0 0 0 0 1184.4 0 0 0 1101307206 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 429.91 0 0 0 0 0 0 0 0 0 0 0 0 0 429.91 0 0 0 1101307216 1003800129 10 Physicians KALLWITZ KARIN 600302076 57 Lake 0 1 Pediatrics 0 274 0 0 253 0 0 0 0 0 0 269 0 480 0 0 0 0 0 0 2307 0 0 807 0 0 0 0 0 0 342 0 714 0 0 0 0 0 0 2307 0 0 807 0 0 0 0 0 0 342 0 714 0 0 0 0 0 0 4622 0 0 25098.87 0 0 0 0 0 0 4517.13 0 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0 0 0 0 0 0 0 0 0 0 235 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17249.05 17249.05 0 0 0 1101307251 23 Occupational 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 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 58.12 58.12 0 0 0 1101307254 1912931825 10 Physicians KLEIN SUSAN 321621701 810 Florida 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 170 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6022.18 0 62.14 0 0 0 0 0 0 6084.32 0 0 0 1101307258 2100297676 28 Waiver service provider--Supportive living facility (HFS) RIVER TO RIVER COMM OF MARION 629595013 108 Williamson 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 0 509 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14294 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 697471.41 0 0 0 0 0 0 0 0 0 0 0 0 0 697471.41 0 0 0 1101307260 92 Waiver service provider--Disability (DHS/DRS) 37 Fulton 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 0 570.98 0 0 0 0 0 0 0 0 0 0 0 0 0 570.98 0 0 0 1101307266 1699001107 16 Nurse Practitioners OPPERT ELIZABETH 606405704 200 Cook 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 121 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 181 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 181 0 0 0 0 0 0 0 0 0 6.4 0 0 0 0 0 0 0 0 22921.28 0 0 0 0 0 0 22927.68 0 0 0 1101307272 1528012846 10 Physicians DAVIS ANN 605663226 30 DuPage 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3140.88 0 0 0 0 0 0 3140.88 0 0 0 1101307273 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 14 0 0 0 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 13287.06 0 0 0 0 0 0 0 0 0 0 0 0 0 13287.06 0 0 0 1101307277 1881698439 63 Other Providers of Medical Equipment/Supplies (Non-registered) LIBERATOR MEDICAL SUPPLY INC 349976715 810 Florida 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 338 0 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3519 0 193 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3519 0 193 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 249701.81 0 12406.64 0 0 0 0 262108.45 0 0 0 1101307279 1285620096 33 Nursing Facilities SALINE CARE CENTER 629461849 90 Saline 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1647 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39050 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3438226.31 0 0 0 0 0 0 0 3438226.31 0 0 0 1101307281 10 Physicians 852 Wisconsin 0 0 Anesthesiology 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 184.2 0 0 0 0 0 0 184.2 0 0 0 1101307286 91 Waiver service provider--Adults (DHS/DDD) 107 Will 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 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11196.72 0 0 0 0 0 0 0 0 0 0 0 0 0 11196.72 0 0 0 1101307298 1427023704 10 Physicians ZWILLING THOMAS J 627083428 62 Logan 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 11 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49.95 0 705.59 0 0 0 0 0 0 755.54 0 0 0 1101307314 1801949813 10 Physicians SIOMOPOULOS VASILIS 606412712 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 557 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 557 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11402.05 0 0 0 0 0 0 11402.05 0 0 0 1101307319 1790034387 16 Nurse Practitioners SHANOR ESTHER 600856165 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 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 0 340.15 0 0 0 0 0 0 340.15 0 0 0 1101307326 1003085770 36 Community mental health provider TRINITY SERVICES INC 604355481 107 Will 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4852 0 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4852 0 0 4506.62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 290607.84 0 0 295114.46 0 0 0 1101307340 1871566653 10 Physicians WALLACE ERNEST 623014038 10 Adams 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 10 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 594 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 594 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35.33 0 65267.85 0 0 0 0 0 0 65303.18 0 0 0 1101307345 92 Waiver service provider--Disability (DHS/DRS) 99 Union 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 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82414.31 0 0 0 0 0 0 0 0 0 0 0 0 0 82414.31 0 0 0 1101307347 1568661130 47 Local Education Agencies JAMP SPEC EDUCATION SERV 8600 629410107 85 Pulaski 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 244 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4507 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4507 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53430.71 0 53430.71 0 0 0 1101307349 1588751366 10 Physicians GLADSON MARINA 600464998 57 Lake 0 1 Family Practice 0 557 0 0 146 0 0 0 0 0 0 39 0 284 0 0 0 0 0 0 3642 0 0 354 0 0 0 0 0 0 49 0 567 0 0 0 0 0 0 3642 0 0 354 0 0 0 0 0 0 49 0 567 0 0 0 0 0 0 7368 0 0 14635.03 0 0 0 0 0 0 531.21 0 17029.03 0 0 0 0 0 0 39563.27 0 0 0 1101307370 94 Waiver service provider--Children's support (DHS/DDD) 94 Shelby 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 316.8 0 0 0 0 0 0 0 0 0 0 0 0 0 316.8 0 0 0 1101307371 1922107242 11 Dentists OLONO CHARLES 606234918 200 Cook 0 0 General Dentistry 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9300.27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9300.27 0 0 0 1101307378 1972693968 63 Other Providers of Medical Equipment/Supplies (Non-registered) MEDICAL SUPPLY INC 190291515 839 Pennsylvania 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 1272 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1272 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73754.82 0 0 0 0 0 0 73754.82 0 0 0 1101307387 1003019647 10 Physicians MULAMALLA SUMANTH 604511571 107 Will 0 0 Nephrology 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 0 273 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 273 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3754.37 0 0 0 0 0 0 3754.37 0 0 0 1101307393 1609866656 10 Physicians BENDRE ANUP 605553845 30 DuPage 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 42 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1949.8 0 8359.7 0 0 0 0 0 0 10309.5 0 0 0 1101307398 1093717449 10 Physicians VAJARIA YOGESH 605151500 30 DuPage 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 269 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 301 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 301 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9337.8 0 0 0 0 0 0 9337.8 0 0 0 1101307405 1427165752 63 Other Providers of Medical Equipment/Supplies (Non-registered) VISITING NURSES ASSOC 611082039 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 836 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6167 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6167 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 284395.08 0 1268.95 0 0 0 0 285664.03 0 0 0 1101307406 1598978645 34 State-operated facility (DHS) UNIT 0334 HOME 34 LUDEMAN 604661200 200 Cook 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 635 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 389153.44 0 0 0 0 0 0 0 0 0 0 389153.44 0 0 0 1101307418 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 0 436.91 0 0 0 0 0 0 0 0 0 0 0 0 0 436.91 0 0 0 1101307421 1922029594 10 Physicians MORRISSEY DAVID 601262966 30 DuPage 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 679 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 898 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 898 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13539.75 0 525.79 0 0 0 0 0 0 14065.54 0 0 0 1101307433 1841366556 30 General Hospitals CARLINVILLE AREA HOSPITAL 626261499 64 Macoupin DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 1 0 0 0 0 0 85 0 0 0 0 0 0 859 0 0 773 0 0 0 0 0 0 0 0 118 0 0 0 0 0 0 4086 0 0 1976 0 0 0 0 0 0 0 0 118 0 0 0 0 0 0 4086 0 0 1976 0 0 0 0 0 0 0 0 458.85 0 0 0 0 0 0 32006.99 0 0 194512.8 0 0 0 0 0 226978.64 0 0 0 1101307436 1700915915 23 Occupational Therapists JACKSON ROOKS LAKECIA 606282226 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 240 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1635 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1635 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 146739.21 146739.21 0 0 0 1101307452 1659525103 10 Physicians KAGZI YASMIN 605212962 30 DuPage 0 0 Internal Medicine 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 29 0 0 0 0 0 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 0 634.65 0 0 0 0 0 0 634.65 0 0 0 1101307462 1801886544 11 Dentists CONEN RICHARD 606512904 200 Cook 0 0 General Dentistry 0 0 0 238 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 948 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 948 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25736.33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25736.33 0 0 0 1101307465 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 1888.04 0 0 0 0 0 0 0 0 0 0 0 0 0 1888.04 0 0 0 1101307476 1144265711 70 Ambulance Service Providers MARTINS AMBULANCE INC 609501604 54 Kankakee 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 4472 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4472 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36028.29 0 0 0 0 0 0 36028.29 0 0 0 1101307480 1306028782 22 Physical Therapists MCGRIFF JILLIAN 617043630 72 McLean 0 0 0 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 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 8867.84 8867.84 0 0 0 1101307488 1962845115 16 Nurse Practitioners SASS SARAH 627023356 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 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 0 297.29 0 0 0 0 0 0 297.29 0 0 0 1101307491 1063552990 10 Physicians FLORIDO GONZALO 479511379 815 Indiana 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1666.81 0 0 0 0 0 0 1666.81 0 0 0 1101307493 1992840094 10 Physicians SIMON SHERRONE 601815247 30 DuPage 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 0 138 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 228 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 228 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11619.72 0 0 0 0 0 0 11619.72 0 0 0 1101307499 1174747885 10 Physicians MISCHLER MATTHEW 616370001 80 Peoria 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 157 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 468 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 468 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19273.89 0 0 0 0 0 0 19273.89 0 0 0 1101307517 1972604221 10 Physicians MAMMOLITO DENISE 616061276 80 Peoria 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14760.9 0 0 0 0 0 0 14760.9 0 0 0 1101307520 1730386020 25 Audiologists AITKEN JILL 616370001 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11796.76 11796.76 0 0 0 1101307531 1235105396 10 Physicians KICSAK KATHLEEN 601484932 30 DuPage 0 1 Internal Medicine 0 3 0 0 2 0 0 0 0 0 0 3 0 11 0 0 0 0 0 0 17 0 0 2 0 0 0 0 0 0 6 0 51 0 0 0 0 0 0 17 0 0 2 0 0 0 0 0 0 6 0 51 0 0 0 0 0 0 34 0 0 177.55 0 0 0 0 0 0 31.82 0 803.36 0 0 0 0 0 0 1046.73 0 0 0 1101307552 1114911377 10 Physicians STACHNIW MYRON B 614018524 56 Knox 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 82 0 208 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 143 0 542 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 143 0 542 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1814.75 0 39198.27 0 0 0 0 0 0 41013.02 0 0 0 1101307558 1427206895 16 Nurse Practitioners MORGAN PATRICIA 601691016 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 321 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 321 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 648.35 0 0 0 0 0 0 648.35 0 0 0 1101307559 1629360284 36 Community mental health provider ADAPT OF ILLINOIS INC 611082315 109 Winnebago 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 283 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12966 0 0 283 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12966 0 0 6192.56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 504764.43 0 0 510956.99 0 0 0 1101307569 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19315.17 0 0 0 0 0 0 0 0 0 0 0 0 0 19315.17 0 0 0 1101307799 1760430557 10 Physicians MAKDAH SALEM 604651971 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 221 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 221 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1125.32 0 0 0 0 0 0 1125.32 0 0 0 1101307809 1275519399 10 Physicians GUPTA RAJ 604292057 200 Cook 0 0 Pulmonary Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 195 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 195 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1839.35 0 0 0 0 0 0 1839.35 0 0 0 1101307816 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 20155.8 0 0 0 0 0 0 0 0 0 0 0 0 0 20155.8 0 0 0 1101307818 1770778607 10 Physicians CHAUDHRY FARIHA 604111748 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 335 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 594 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 594 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13023.31 0 0 0 0 0 0 13023.31 0 0 0 1101307822 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13822.83 0 0 0 0 0 0 0 0 0 0 0 0 0 13822.83 0 0 0 1101307836 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 14 0 0 0 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 6036.66 0 0 0 0 0 0 0 0 0 0 0 0 0 6036.66 0 0 0 1101307840 10 Physicians 200 Cook 0 0 Internal Medicine 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 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 0 0 0 0 0 0 0 0 0 0 0 1101307841 1750527172 48 Rural Health Clinics GRAHAM MEDICAL GROUP LEWISTOWN 615429625 37 Fulton 0 1 0 957 1217 0 285 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8167 5640 0 921 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8167 5640 0 921 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21967 232318.9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 254285.9 0 0 0 1101307861 1326269341 34 State-operated facility (DHS) UNIT 0229 HOME 29 LUDEMAN 604661200 200 Cook 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 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 900 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 565443.58 0 0 0 0 0 0 0 0 0 0 565443.58 0 0 0 1101307864 1710969563 60 Pharmacies ST JOHNS HOME INFUSION 627690002 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165 0 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1961 0 0 934 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1961 0 0 8480 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 327803.1 0 0 308391.72 0 0 0 636194.82 0 0 0 1101307865 1134280563 11 Dentists SINGH JASMEEN 604675407 200 Cook 0 0 General Dentistry 0 0 0 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1915 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1915 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45686.14 0 0 0 0 0 0 0 0 0 0 0 0 0 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rate." 0 0 General Hospital - Adult and Child 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 0 304.84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 304.84 0 0 0 1101308195 1477500056 10 Physicians MAZIN ABDUL 49155500 200 Cook 0 0 General Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 339 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 339 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17872.18 0 0 0 0 0 0 17872.18 0 0 0 1101308198 1265506638 10 Physicians RANA KISHOR 532222106 852 Wisconsin 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 85 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 9631.53 0 0 0 0 0 0 9631.53 0 0 0 1101308199 1891888608 10 Physicians SCHOPP JEFFREY 627023719 91 Sangamon 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 635 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 635 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20746.12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20746.12 0 0 0 1101308575 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 349 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 349 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13125.75 0 0 0 0 0 0 0 0 0 0 0 0 0 13125.75 0 0 0 1101308577 1336410836 55 Early Intervention Services MURIELLO BRITTANY 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6890.66 0 0 0 0 0 0 6890.66 0 0 0 1101308587 1275637118 60 Pharmacies CVS PHARMACY 5769 604092306 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 938 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4367 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104582 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 184447.67 0 0 0 184447.67 0 0 0 1101308594 10 Physicians 826 Missouri 0 0 Internal Medicine 0 0 0 0 0 0 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Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10355.18 0 0 0 0 0 0 0 0 0 0 0 0 0 10355.18 0 0 0 1101308639 1235210097 10 Physicians KHANKARI KISHORE 605232615 30 DuPage 0 1 Internal Medicine 0 203 0 0 29 0 0 0 0 0 0 23 0 269 0 0 0 0 0 0 451 0 0 79 0 0 0 0 0 0 26 0 969 0 0 0 0 0 0 451 0 0 79 0 0 0 0 0 0 26 0 969 0 0 0 0 0 0 1066 0 0 2747.59 0 0 0 0 0 0 78.1 0 23953.44 0 0 0 0 0 0 27845.13 0 0 0 1101308646 1912083601 10 Physicians GROSS THOMAS 616144896 80 Peoria 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 368 0 361 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 817 0 676 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 817 0 676 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19949.49 0 40872.7 0 0 0 0 0 0 60822.19 0 0 0 1101308658 1487645024 63 Other Providers of Medical Equipment/Supplies (Non-registered) MASON CITY AREA NURSING HOME 626649600 68 Mason 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4442.42 0 0 0 0 0 0 4442.42 0 0 0 1101308661 1407835176 10 Physicians GOLDBERG EDWARD 606123836 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 15 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90.1 0 897.32 0 0 0 0 0 0 987.42 0 0 0 1101308673 2100299091 72 Taxicabs and Livery Companies CAREGIVER TRANSPORTATION INC 606206012 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1798 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1798 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11993.6 0 0 0 0 0 0 11993.6 0 0 0 1101308686 1023143716 48 Rural Health Clinics ILLINI MEDICAL ASSOCIATES 620821322 39 Greene 0 1 0 2024 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10095 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10095 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26680 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26680 0 0 0 1101308706 92 Waiver service provider--Disability (DHS/DRS) 36 Franklin 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 2896.77 0 0 0 0 0 0 0 0 0 0 0 0 0 2896.77 0 0 0 1101308711 1043466576 10 Physicians SHARATH GOWDA 629023988 108 Williamson 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 460 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1251 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1251 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22734.78 0 0 0 0 0 0 22734.78 0 0 0 1101308715 1053547471 16 Nurse Practitioners GRETEMAN MARY 606123833 200 Cook 0 0 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1762.94 0 0 0 0 0 0 1762.94 0 0 0 1101308722 1043414113 61 Independent Laboratories WASH UNIV CLINICAL CYTO LAB 631082979 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10788.11 0 0 0 0 0 0 0 0 10788.11 0 0 0 1101308730 1609866326 10 Physicians NEMETH ALEXANDER 606118709 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 403 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 532 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 532 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19648.04 0 0 0 0 0 0 0 0 19648.04 0 0 0 1101308732 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 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 30967.72 0 0 0 0 0 0 0 0 0 0 0 0 0 30967.72 0 0 0 1101308734 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 21331.56 0 0 0 0 0 0 0 0 0 0 0 0 0 21331.56 0 0 0 1101308740 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 2292.58 0 0 0 0 0 0 0 0 0 0 0 0 0 2292.58 0 0 0 1101308746 91 Waiver service provider--Adults (DHS/DDD) 65 Madison 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 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 597 0 0 0 0 0 0 0 0 0 0 0 0 0 597 0 0 0 1101308756 10 Physicians 200 Cook 0 0 Surgery General 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 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 24.45 0 0 0 0 0 0 24.45 0 0 0 1101308758 1760427199 48 Rural Health Clinics FRANKLIN HOSP FAMILY HC CLINIC 628121969 36 Franklin 0 1 Direct Access 0 1252 2814 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9854 13640 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9854 13640 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27318 432230.82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 459548.82 0 0 0 1101308762 30 General Hospitals 801 Alabama NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 Children's Hospital 0 0 0 0 0 4 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 419.24 0 0 0 0 1176.44 0 0 0 0 0 0 0 0 0 1595.68 0 0 0 1101308764 1285762252 10 Physicians GASHTI CASEY 606071821 200 Cook 0 0 Nephrology 0 0 0 0 0 0 0 0 0 0 0 0 0 388 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1701 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1701 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10952.13 0 0 0 0 0 0 10952.13 0 0 0 1101308772 1346452174 10 Physicians JOHN ASHISH 627047401 91 Sangamon 0 1 Pediatrics 0 87 0 0 93 0 0 0 0 0 0 23 0 136 0 0 0 0 0 0 743 0 0 203 0 0 0 0 0 0 27 0 253 0 0 0 0 0 0 743 0 0 203 0 0 0 0 0 0 27 0 253 0 0 0 0 0 0 1486 0 0 11482.09 0 0 0 0 0 0 331.77 0 10612.74 0 0 0 0 0 0 23912.6 0 0 0 1101308777 1386600039 10 Physicians DAVALLE MICHAEL 605152075 30 DuPage 0 0 Cardiovascular Diseases 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 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12563.86 0 0 0 0 0 0 12563.86 0 0 0 1101308783 1356504278 10 Physicians TSONIS LAMBROS 600623012 200 Cook 0 0 Thoracic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 48 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 19551.92 0 0 0 0 0 0 19551.92 0 0 0 1101308794 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12826.21 0 0 0 0 0 0 0 0 0 0 0 0 0 12826.21 0 0 0 1101308795 1386647055 10 Physicians BARNES KARIN 637035049 826 Missouri 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2311.93 0 0 0 0 0 0 2311.93 0 0 0 1101308796 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 11091.47 0 0 0 0 0 0 0 0 0 0 0 0 0 11091.47 0 0 0 1101308799 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 290.39 0 0 0 0 0 0 0 0 0 0 0 0 0 290.39 0 0 0 1101308800 1437195500 10 Physicians DOTY DOUGLAS J 477313276 815 Indiana 0 0 Anesthesiology 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 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1982.97 0 0 0 0 0 0 1982.97 0 0 0 1101308804 1194937789 10 Physicians SHAIKH ARIF 602011718 200 Cook 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4375.8 0 0 0 0 0 0 4375.8 0 0 0 1101308829 1194749416 10 Physicians DENGLER GEORGE 606213114 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 788 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 884 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 884 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33452.47 0 0 0 0 0 0 33452.47 0 0 0 1101308830 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3618.71 0 0 0 0 0 0 0 0 0 0 0 0 0 3618.71 0 0 0 1101308833 1326032046 10 Physicians BORWICK ANNE 622461155 12 Bond 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 298 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 298 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3540.98 0 0 0 0 0 0 3540.98 0 0 0 1101308844 1578571972 10 Physicians MCCOY LOIS 629011467 47 Jackson 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 0 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 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3467.34 0 0 0 0 0 0 3467.34 0 0 0 1101308851 1134313299 22 Physical Therapists BADIOLA CHRISTINE 600532111 200 Cook 0 0 0 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 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1095.97 1095.97 0 0 0 1101308852 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 51226.01 0 0 0 0 0 0 0 0 0 0 0 0 0 51226.01 0 0 0 1101308859 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 2585.61 0 0 0 0 0 0 0 0 0 0 0 0 0 2585.61 0 0 0 1101308860 1245487610 10 Physicians ATIEH MOHAMMED 601533328 200 Cook 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 252 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 457 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 457 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6355.87 0 0 0 0 0 0 0 0 6355.87 0 0 0 1101308862 92 Waiver service provider--Disability (DHS/DRS) 97 Stephenson 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 2802.81 0 0 0 0 0 0 0 0 0 0 0 0 0 2802.81 0 0 0 1101308881 1083772511 10 Physicians SANAGALA THRIVENL 601533304 200 Cook 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 11 0 353 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 643 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 643 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 482.46 0 10058.94 0 0 0 0 0 0 10541.4 0 0 0 1101308887 1164457578 10 Physicians BELMARES AVALOS JAIME 601533328 200 Cook 0 0 Infectious Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 231 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15763.29 0 0 0 0 0 0 15763.29 0 0 0 1101308895 1346442852 47 Local Education Agencies SPOON RIVER VALLEY CUS DIST 4 615449801 37 Fulton 0 0 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 0 349 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 349 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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Physicians TOTONCHI EMIL 606103218 200 Cook 0 0 Urological Surgery 0 0 0 0 0 0 0 0 0 0 0 3 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6.7 0 994.5 0 0 0 0 0 0 1001.2 0 0 0 1101309778 1609943661 16 Nurse Practitioners DARBY DEGRAF JUNINE 602011718 200 Cook 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 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 3168.72 0 0 0 0 0 0 3168.72 0 0 0 1101309781 1609190024 16 Nurse Practitioners ANDERSON CRYSTAL 600442203 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 373.85 0 0 0 0 0 0 373.85 0 0 0 1101309788 94 Waiver service provider--Children's support (DHS/DDD) 69 Massac 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 0 148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15477 0 0 0 0 0 0 0 0 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Physicians RAO RUTA 606123841 200 Cook 0 0 Internal Medicine 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 0 287 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 287 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7340.05 0 0 0 0 0 0 7340.05 0 0 0 1101310660 91 Waiver service provider--Adults (DHS/DDD) 19 Champaign 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 0 318 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 318 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9312.99 0 0 0 0 0 0 0 0 0 0 0 0 0 9312.99 0 0 0 1101310663 92 Waiver service provider--Disability (DHS/DRS) 17 Carroll 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 19715.33 0 0 0 0 0 0 0 0 0 0 0 0 0 19715.33 0 0 0 1101310668 1558490433 10 Physicians POWITZ JACK 601545709 57 Lake 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 248 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1275 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1275 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2330.17 0 0 0 0 0 0 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0 0 0 0 0 0 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10770.79 0 0 0 0 0 0 10770.79 0 0 0 1101310707 1528201233 10 Physicians KOTISO FLORENCE 999999999 47 Jackson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1980.36 0 0 0 0 0 0 1980.36 0 0 0 1101310714 1730351115 10 Physicians JABBAR ZAID 605859509 107 Will 0 1 Internal Medicine 0 18 0 0 0 0 0 0 0 0 0 3 0 62 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 4 0 202 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 4 0 202 0 0 0 0 0 0 409 0 0 0 0 0 0 0 0 0 22.24 0 7225.21 0 0 0 0 0 0 7656.45 0 0 0 1101310717 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 16271.15 0 0 0 0 0 0 0 0 0 0 0 0 0 16271.15 0 0 0 1101310721 1689685612 10 Physicians BENVENUTO MARIA SERRATTO 606123445 200 Cook 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 10790.97 0 0 0 0 0 0 10790.97 0 0 0 1101310730 1942473327 29 ICF/MR PATTERSON HOUSE 619512029 78 Moultrie 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 0 434 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 718080.97 0 0 0 0 0 0 0 0 0 0 718080.97 0 0 0 1101310738 1891936969 10 Physicians ROUSSEAU JOANNE 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 316 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 341 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 341 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13754.41 0 0 0 0 0 0 13754.41 0 0 0 1101310750 1205892072 10 Physicians GIORDANO CARRIE 606313712 200 Cook 0 0 Obstetrics 0 0 0 0 3 0 0 0 0 0 0 46 0 143 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 71 0 281 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 71 0 281 0 0 0 0 0 0 0 0 0 294.54 0 0 0 0 0 0 3532.81 0 32806.79 0 0 0 0 0 0 36634.14 0 0 0 1101310763 1447487152 10 Physicians PARIKH NIKHIL 602023328 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 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Occupational Therapists 72 McLean 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 67.56 67.56 0 0 0 1101310974 1891766317 30 General Hospitals RED BUD REGIONAL HOSPITAL 622781194 87 Randolph DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 1 0 General Hospital - Adult and Child 0 0 0 0 7 0 0 0 0 0 0 487 0 0 177 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 2707 0 0 802 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 2707 0 0 802 0 0 0 0 0 0 0 0 63.47 0 0 0 0 0 0 18675.44 0 0 143703.71 0 0 0 0 0 162442.62 0 0 0 1101310976 1043375884 10 Physicians SONG DAVID 605276686 30 DuPage 0 0 Plastic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 8 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 1568.97 0 0 0 0 0 0 1568.97 0 0 0 1101310985 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 22573.71 0 0 0 0 0 0 0 0 0 0 0 0 0 22573.71 0 0 0 1101310988 92 Waiver service provider--Disability (DHS/DRS) 97 Stephenson 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 33949.83 0 0 0 0 0 0 0 0 0 0 0 0 0 33949.83 0 0 0 1101310991 1528003126 30 General Hospitals PRS LLC 600164904 200 Cook DIALYSIS Outpatient dialysis centers. 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1061 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28298.94 0 0 0 0 0 28298.94 0 0 0 1101311007 1932440427 12 Optometrists ANGELOPOULOS STACY 606165132 30 DuPage 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 420 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1012 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1012 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29881.31 0 4.64 0 0 0 0 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KAREN 999999999 79 Ogle 0 0 0 564 0 0 115 0 0 0 0 0 0 11 0 360 0 0 0 0 0 0 5192 0 0 372 0 0 0 0 0 0 11 0 933 0 0 0 0 0 0 5192 0 0 372 0 0 0 0 0 0 11 0 933 0 0 0 0 0 0 13253 0 0 13811.4 0 0 0 0 0 0 32.08 0 42878.98 0 0 0 0 0 0 69975.46 0 0 0 1101311161 1174678684 10 Physicians MCGINNIS PATRICK L 604322055 107 Will 0 0 Oncology 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2757.85 0 0 0 0 0 0 2757.85 0 0 0 1101311165 91 Waiver service provider--Adults (DHS/DDD) 83 Pike 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 0 203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23534.71 0 0 0 0 0 0 0 0 0 0 0 0 0 23534.71 0 0 0 1101311178 1003188913 28 Waiver service provider--Supportive living facility (HFS) EVERGREEN PLACE DECATUR 999999999 63 Macon 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 625 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15451 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 812704.22 0 0 0 0 0 0 0 0 0 0 0 0 0 812704.22 0 0 0 1101311182 1013170166 11 Dentists ASH SUSAN 600104822 200 Cook 0 0 General Dentistry 0 0 0 1066 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4599 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4599 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 113400.75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 113400.75 0 0 0 1101311192 92 Waiver service provider--Disability (DHS/DRS) 58 La Salle 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 18997.13 0 0 0 0 0 0 0 0 0 0 0 0 0 18997.13 0 0 0 1101311206 1306861091 10 Physicians COHN SUSAN 606118709 200 Cook 0 0 Infectious Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2213.12 0 0 0 0 0 0 2213.12 0 0 0 1101311211 1255388906 10 Physicians BOCHICCHIO GRANT 999999999 826 Missouri 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 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Practitioners WILLIAMS CYNTHIA 631415010 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 403.03 0 0 0 0 0 0 403.03 0 0 0 1101311242 1235331794 47 Local Education Agencies ECHO JOINT AGREEMENT 604731229 200 Cook 0 0 0 0 0 0 228 0 0 0 0 0 0 0 0 0 0 0 0 0 736 0 0 0 0 492 0 0 0 0 0 0 0 0 0 0 0 0 0 55928 0 0 0 0 492 0 0 0 0 0 0 0 0 0 0 0 0 0 55928 0 0 0 0 2941.94 0 0 0 0 0 0 0 0 0 0 0 0 0 2006839.59 0 2009781.53 0 0 0 1101311248 1386617249 10 Physicians SMITH LIONEL 623793011 42 Hancock 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 66 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 926.61 0 1097.88 0 0 0 0 0 0 2024.49 0 0 0 1101311249 1407949365 10 Physicians RYAN STEPHEN 627023719 91 Sangamon 0 0 Vascular Surgery 0 0 0 0 0 0 0 0 0 0 0 5 0 138 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 264 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 264 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59.46 0 11847.97 0 0 0 0 0 0 11907.43 0 0 0 1101311256 1235138546 10 Physicians NIELSEN THOMAS 606124861 200 Cook 0 0 Otorhinolaryngology 0 0 0 0 0 0 0 0 0 0 0 0 0 211 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 527 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 527 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13121.55 0 0 0 0 0 0 13121.55 0 0 0 1101311267 1932126208 60 Pharmacies WAL MART 10 1413 600148213 71 McHenry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 355 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1591 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40035 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69395.63 0 0 0 69395.63 0 0 0 1101311270 1083930861 22 Physical Therapists BARADZIEJ MICHAL 606382423 200 Cook 0 0 0 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 0 0 0 0 0 0 0 0 587 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 587 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3997.67 3997.67 0 0 0 1101311275 92 Waiver service provider--Disability (DHS/DRS) 63 Macon 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5378.25 0 0 0 0 0 0 0 0 0 0 0 0 0 5378.25 0 0 0 1101311281 1649279225 10 Physicians GELLER STEPHEN C 611114153 109 Winnebago 0 1 Internal Medicine 0 34 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 129 0 0 0 0 0 0 0 0 0 0 0 138 0 0 0 0 0 0 129 0 0 0 0 0 0 0 0 0 0 0 138 0 0 0 0 0 0 348 0 0 0 0 0 0 0 0 0 0 0 2019.22 0 0 0 0 0 0 2367.22 0 0 0 1101311282 22 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7002.04 7002.04 0 0 0 1101311287 1437314200 12 Optometrists NOAKES NATHAN 627044174 91 Sangamon 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 66 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1897.95 0 156.68 0 0 0 0 2054.63 0 0 0 1101311290 1316150121 10 Physicians PARIKH RHUTAV 600315709 57 Lake 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 0 26 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 259 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 259 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 361.78 0 1029.37 0 0 0 0 0 0 1391.15 0 0 0 1101311318 1114969136 10 Physicians MOLOKIE ROBERT 606743462 200 Cook 0 0 Hematology 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5749.6 0 0 0 0 0 0 5749.6 0 0 0 1101311331 92 Waiver service provider--Disability (DHS/DRS) 71 McHenry 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 563.27 0 0 0 0 0 0 0 0 0 0 0 0 0 563.27 0 0 0 1101311334 1811102940 10 Physicians WEISBURGER MICHAEL 604675541 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 45 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88 0 163 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88 0 163 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 771.5 0 9581.44 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6961.78 0 0 0 0 0 0 6961.78 0 0 0 1101312974 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 11796.1 0 0 0 0 0 0 0 0 0 0 0 0 0 11796.1 0 0 0 1101312978 1659446375 16 Nurse Practitioners DONOFRIO MAUREEN 618012529 100 Vermilion 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 201 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7373.76 0 0 0 0 0 0 7373.76 0 0 0 1101312995 1093754707 10 Physicians COTES ELIECER 606186421 200 Cook 0 1 Family Practice 0 83 0 0 8 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 137 0 0 14 0 0 0 0 0 0 0 0 126 0 0 0 0 0 0 137 0 0 14 0 0 0 0 0 0 0 0 126 0 0 0 0 0 0 328 0 0 684.24 0 0 0 0 0 0 0 0 2998.06 0 0 0 0 0 0 4010.3 0 0 0 1101312998 1568558484 10 Physicians CASTALDO RAYMOND 627042416 91 Sangamon 0 1 Pediatrics 0 22 0 0 47 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 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support (DHS/DDD) 53 Kane 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 3226.1 0 0 0 0 0 0 0 0 0 0 0 0 0 3226.1 0 0 0 1101313093 1457433237 10 Physicians ROPER PAMELA 606382039 200 Cook 0 0 Pediatrics 0 0 0 0 155 0 0 0 0 0 0 0 0 177 0 0 0 0 0 0 0 0 0 248 0 0 0 0 0 0 0 0 192 0 0 0 0 0 0 0 0 0 248 0 0 0 0 0 0 0 0 192 0 0 0 0 0 0 0 0 0 6532.43 0 0 0 0 0 0 0 0 19786.47 0 0 0 0 0 0 26318.9 0 0 0 1101313099 1114979143 47 Local Education Agencies GILLESPIE CUSD 7 620331167 64 Macoupin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3672 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3672 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41651.76 0 41651.76 0 0 0 1101313113 1184623746 10 Physicians PEACHEY KEITH 614012898 56 Knox 0 1 Family Practice 0 38 0 0 28 0 0 0 0 0 0 7 0 241 0 0 0 0 0 0 352 0 0 86 0 0 0 0 0 0 9 0 646 0 0 0 0 0 0 352 0 0 86 0 0 0 0 0 0 9 0 646 0 0 0 0 0 0 910 0 0 3448.42 0 0 0 0 0 0 26.22 0 14816.43 0 0 0 0 0 0 19201.07 0 0 0 1101313119 1790707735 10 Physicians VAN HARE GEORGE 631101002 826 Missouri 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 153 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 153 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8292.55 0 0 0 0 0 0 8292.55 0 0 0 1101313123 34 State-operated facility (DHS) 200 Cook 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 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14107.68 0 0 0 0 0 0 0 0 0 14107.68 0 0 0 1101313134 1902066798 10 Physicians SEBRO NADEW 605277594 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 336 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 768 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 768 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14664.45 0 0 0 0 0 0 14664.45 0 0 0 1101313135 1609948975 12 Optometrists GUSTAFSON STEVE 605439040 55 Kendall 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 688 0 467 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1330 0 477 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1330 0 477 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38085.98 0 13328.27 0 0 0 0 51414.25 0 0 0 1101313139 1508830456 10 Physicians FLANIGAN ROBERT 601533304 200 Cook 0 0 Urological Surgery 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 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1058.18 0 0 0 0 0 0 1058.18 0 0 0 1101313142 1891846911 10 Physicians MULLA IRENA 606407975 200 Cook 0 1 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 312 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 312 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7235.84 0 0 0 0 0 0 7235.84 0 0 0 1101313146 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 6950.64 0 0 0 0 0 0 0 0 0 0 0 0 0 6950.64 0 0 0 1101313149 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 211 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 211 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14245 0 0 0 0 0 0 0 0 0 0 0 0 0 14245 0 0 0 1101313159 1225243462 10 Physicians SHAKAIB MOHAMMED 616360001 80 Peoria 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 441 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 441 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6544.82 0 0 0 0 0 0 6544.82 0 0 0 1101313167 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 7165.68 0 0 0 0 0 0 0 0 0 0 0 0 0 7165.68 0 0 0 1101313187 1235202854 60 Pharmacies KROGER PHARMACY J 250 625221444 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 267 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1718 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44201 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65534.93 0 0 0 65534.93 0 0 0 1101313198 10 Physicians 200 Cook 0 0 Urology 0 0 0 0 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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 26639.02 0 0 0 0 0 0 0 0 0 0 0 0 0 26639.02 0 0 0 1101313238 1770592487 10 Physicians KIM DANIELLE 617016769 72 McLean 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 6 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39.92 0 452.47 0 0 0 0 0 0 492.39 0 0 0 1101313245 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5354.25 0 0 0 0 0 0 0 0 0 0 0 0 0 5354.25 0 0 0 1101313248 98 Waiver service provider--TBI (DHS/DRS) 98 Tazewell 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 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 2552.46 0 0 0 0 0 0 0 0 0 0 0 0 0 2552.46 0 0 0 1101313270 10 Physicians 816 Iowa 0 0 Psychiatry 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 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 0 446.99 0 0 0 0 0 0 446.99 0 0 0 1101313274 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 1931.24 0 0 0 0 0 0 0 0 0 0 0 0 0 1931.24 0 0 0 1101313288 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18761.87 0 0 0 0 0 0 0 0 0 0 0 0 0 18761.87 0 0 0 1101313306 1386838183 10 Physicians NAGPAL GEETA 606118709 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6869.96 0 0 0 0 0 0 6869.96 0 0 0 1101313309 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12015.43 0 0 0 0 0 0 0 0 0 0 0 0 0 12015.43 0 0 0 1101313310 92 Waiver service provider--Disability (DHS/DRS) 107 Will 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11714.8 0 0 0 0 0 0 0 0 0 0 0 0 0 11714.8 0 0 0 1101313317 22 Physical Therapists 24 Coles 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 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 0 126.98 126.98 0 0 0 1101313322 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12936 0 0 0 0 0 0 0 0 0 0 0 0 0 12936 0 0 0 1101313342 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 1165.33 0 0 0 0 0 0 0 0 0 0 0 0 0 1165.33 0 0 0 1101313344 1497764518 10 Physicians FORTSAS MICHAEL 600103049 57 Lake 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 247 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 247 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2216.98 0 0 0 0 0 0 2216.98 0 0 0 1101313357 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6217.9 0 0 0 0 0 0 0 0 0 0 0 0 0 6217.9 0 0 0 1101313365 1134336894 24 Speech Therapists TAYLOR SHAWNISE 604611571 200 Cook 0 0 0 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 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3026.4 3026.4 0 0 0 1101313371 1194715532 11 Dentists ZORIN OLEG 606263221 200 Cook 0 0 General Dentistry 0 0 0 584 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2312 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2312 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71869.56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71869.56 0 0 0 1101313379 1508807470 60 Pharmacies CVS PHARMACY 08517 606222940 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 368 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1405 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37289 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54200.64 0 0 0 54200.64 0 0 0 1101313383 10 Physicians 200 Cook 0 0 Obstetric-Gynecology 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 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 44.1 0 0 0 0 0 0 44.1 0 0 0 1101313384 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 3677.19 0 0 0 0 0 0 0 0 0 0 0 0 0 3677.19 0 0 0 1101313395 2100303813 90 Waiver service provider--Elderly (DOA) MEDTEC HEALTHCARE AND PRIVATE 999999999 200 Cook 0 0 0 0 0 0 0 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25359 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25359 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 886977.93 0 0 0 0 0 0 0 0 0 0 0 0 0 886977.93 0 0 0 1101313406 1932383973 28 Waiver service provider--Supportive living facility (HFS) COURTYARD ESTATES OF CANTON 615202700 37 Fulton 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 242 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5967 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 343409.36 0 0 0 0 0 0 0 0 0 0 0 0 0 343409.36 0 0 0 1101313421 92 Waiver service provider--Disability (DHS/DRS) 107 Will 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 13580.54 0 0 0 0 0 0 0 0 0 0 0 0 0 13580.54 0 0 0 1101313428 1831380583 10 Physicians SAJAN IMRAN 604532574 200 Cook 0 0 Pediatric Cardiology 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 186 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 186 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26325.99 0 0 0 0 0 0 26325.99 0 0 0 1101313442 30 General Hospitals 826 Missouri NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 769.42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 769.42 0 0 0 1101313447 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16339.92 0 0 0 0 0 0 0 0 0 0 0 0 0 16339.92 0 0 0 1101313468 1912162215 10 Physicians ARVA NICOLETA 999999999 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 273 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 500 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 500 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11224.83 0 0 0 0 0 0 0 0 11224.83 0 0 0 1101313485 1366422958 16 Nurse Practitioners LANE RICHARD 631101010 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 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1743.36 0 0 0 1101313505 1326072638 30 General Hospitals MOUNT VERNON DIALYSIS 628646583 49 Jefferson DIALYSIS Outpatient dialysis centers. 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 362 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3853 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53650.05 0 0 0 0 0 53650.05 0 0 0 1101313517 1922026186 10 Physicians JOHNSON ERIC K 631600352 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 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 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 870.77 0 0 0 0 0 0 870.77 0 0 0 1101313521 98 Waiver service provider--TBI (DHS/DRS) 76 Montgomery 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 22201.31 0 0 0 0 0 0 0 0 0 0 0 0 0 22201.31 0 0 0 1101313523 1982622403 10 Physicians BROWN ANGELA L. 631101010 826 Missouri 0 0 Internal Medicine 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 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 313.84 0 0 0 0 0 0 313.84 0 0 0 1101313544 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 42388.5 0 0 0 0 0 0 0 0 0 0 0 0 0 42388.5 0 0 0 1101313577 10 Physicians 826 Missouri 0 0 Anesthesiology 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230.1 0 0 0 0 0 0 230.1 0 0 0 1101313586 91 Waiver service provider--Adults (DHS/DDD) 96 St Clair 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 0 222 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 222 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16006.32 0 0 0 0 0 0 0 0 0 0 0 0 0 16006.32 0 0 0 1101313603 1619000932 10 Physicians HOLLOWAY LIANNE 604501463 40 Grundy 0 0 Family Practice 0 244 0 0 55 0 0 0 0 0 0 136 0 771 0 0 0 0 0 0 2160 0 0 189 0 0 0 0 0 0 154 0 964 0 0 0 0 0 0 2160 0 0 189 0 0 0 0 0 0 154 0 964 0 0 0 0 0 0 5226 0 0 6539.13 0 0 0 0 0 0 1504.01 0 30755.91 0 0 0 0 0 0 44025.05 0 0 0 1101313605 1619031036 10 Physicians QUINLAN KYRAN 606225646 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 163 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6885.77 0 0 0 0 0 0 6885.77 0 0 0 1101313606 1922203496 10 Physicians THOMAS STEPHEN 605276686 30 DuPage 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 868 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1273 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1273 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19813.55 0 322.19 0 0 0 0 0 0 20135.74 0 0 0 1101313609 1306869326 10 Physicians MAHONEY ROBERT 631101010 826 Missouri 0 0 Internal Medicine 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 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1615.04 0 0 0 0 0 0 1615.04 0 0 0 1101313620 1649220245 10 Physicians KLOEP MICHAEL 629011462 47 Jackson 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6036.68 0 0 0 0 0 0 6036.68 0 0 0 1101313623 1518911882 10 Physicians JOSEPH SUJA 606112991 200 Cook 0 0 Child Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7317.67 0 0 0 0 0 0 7317.67 0 0 0 1101313633 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6865.14 0 0 0 0 0 0 0 0 0 0 0 0 0 6865.14 0 0 0 1101313645 1588775696 10 Physicians PEOPLES CRYSTAL 604021007 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 113.51 0 0 0 0 0 0 113.51 0 0 0 1101313648 1184786634 10 Physicians BARON JOSEPH 605276686 30 DuPage 0 0 Hematology 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 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2875.55 0 0 0 0 0 0 2875.55 0 0 0 1101313653 10 Physicians 852 Wisconsin 0 0 Internal Medicine 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 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 94.11 0 0 0 0 0 0 94.11 0 0 0 1101313663 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101313674 1215148085 55 Early Intervention Services MEEHAN TRACY 601264366 30 DuPage 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 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8435.46 0 0 0 0 0 0 8435.46 0 0 0 1101313681 1295925600 10 Physicians CHUNG TAE 475911038 815 Indiana 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2969.25 0 0 0 0 0 0 2969.25 0 0 0 1101313684 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39679.02 0 0 0 0 0 0 0 0 0 0 0 0 0 39679.02 0 0 0 1101313705 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 5842.72 0 0 0 0 0 0 0 0 0 0 0 0 0 5842.72 0 0 0 1101313708 1194915413 10 Physicians OROURKE HOWARD 522421009 816 Iowa 0 0 Radiology Diagnosis 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 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 434.65 0 0 0 0 0 0 0 0 434.65 0 0 0 1101313709 1184629701 10 Physicians WELLMAN RICHARD 617013533 72 McLean 0 0 Obstetric-Gynecology 0 0 0 0 1 0 0 0 0 0 0 56 0 82 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 119 0 421 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 119 0 421 0 0 0 0 0 0 0 0 0 9.94 0 0 0 0 0 0 6554.86 0 42315.23 0 0 0 0 0 0 48880.03 0 0 0 1101313715 1447321542 63 Other Providers of Medical Equipment/Supplies (Non-registered) FINLEY HARTIG HOMECARE 520015772 816 Iowa 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1921.95 0 154.78 0 0 0 0 2076.73 0 0 0 1101313716 1508884602 10 Physicians REYES PEDRO 606414103 200 Cook 0 1 Family Practice 0 559 0 0 213 0 0 0 0 0 0 25 0 393 0 0 0 0 0 0 3219 0 0 544 0 0 0 0 0 0 30 0 871 0 0 0 0 0 0 3219 0 0 544 0 0 0 0 0 0 30 0 871 0 0 0 0 0 0 7178 0 0 18934.26 0 0 0 0 0 0 115.31 0 24515.26 0 0 0 0 0 0 50742.83 0 0 0 1101313718 1467689844 10 Physicians BICKING GRIFFIN K 420033802 200 Cook 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 73 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 4219.15 0 0 0 0 0 0 4219.15 0 0 0 1101313736 1891997870 10 Physicians SYED SALAHUDDIN 601691016 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 476.23 0 0 0 0 0 0 476.23 0 0 0 1101313747 1790724417 10 Physicians HENIFF MICHAEL 604399117 30 DuPage 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 261 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 261 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1718.55 0 0 0 0 0 0 1718.55 0 0 0 1101313759 1730110156 10 Physicians PATODIA SHOBHANA 601604156 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 12 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 1231 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 1231 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106.87 0 16309.39 0 0 0 0 0 0 16416.26 0 0 0 1101313760 1275656340 10 Physicians KOYNER JAY 605276686 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 356 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 356 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4720.22 0 0 0 0 0 0 4720.22 0 0 0 1101313765 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 1867.25 0 0 0 0 0 0 0 0 0 0 0 0 0 1867.25 0 0 0 1101313766 98 Waiver service provider--TBI (DHS/DRS) 61 Livingston 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6897.48 0 0 0 0 0 0 0 0 0 0 0 0 0 6897.48 0 0 0 1101313773 1841429479 10 Physicians BARTGEN DANIEL 999999999 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1083 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39038.07 0 0 0 0 0 0 39038.07 0 0 0 1101313775 1952318545 10 Physicians NELSON MILDRED 618203909 19 Champaign 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 109 0 314 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 810 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 810 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 307.76 0 123883.67 0 0 0 0 0 0 124191.43 0 0 0 1101313783 1508889908 10 Physicians VELEZ KENNETH 620404701 65 Madison 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 288 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 305 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 305 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7847.58 0 0 0 0 0 0 7847.58 0 0 0 1101313786 1235320011 48 Rural Health Clinics THE DOCTORS CLINIC 628211773 105 White 0 1 0 310 180 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2142 2132 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2142 2132 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6194 56503.98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62697.98 0 0 0 1101313789 1932331188 47 Local Education Agencies WEST NORTHFIELD SCHOOL DIST 31 600625857 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2797 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2797 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57497.14 0 57497.14 0 0 0 1101313793 91 Waiver service provider--Adults (DHS/DDD) 30 DuPage 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 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4042.5 0 0 0 0 0 0 0 0 0 0 0 0 0 4042.5 0 0 0 1101313795 1740230119 30 General Hospitals OAKWOOD HOSPITAL 481232500 823 Michigan ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 646.04 0 0 0 0 0 0 0 0 0 0 0 0 0 0 646.04 0 0 0 1101313809 92 Waiver service provider--Disability (DHS/DRS) 58 La Salle 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1861.4 0 0 0 0 0 0 0 0 0 0 0 0 0 1861.4 0 0 0 1101313811 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 18495.82 0 0 0 0 0 0 0 0 0 0 0 0 0 18495.82 0 0 0 1101313813 2100304231 28 Waiver service provider--Supportive living facility (HFS) PRAIRIE CROSSING 605509501 27 Dekalb 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 293 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7570 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 441447.28 0 0 0 0 0 0 0 0 0 0 0 0 0 441447.28 0 0 0 1101313819 1871582718 10 Physicians DALESSANDRO MICHAEL 522421082 816 Iowa 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 42 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2077.18 0 138.38 0 0 0 0 0 0 2215.56 0 0 0 1101313823 1760684237 47 Local Education Agencies LADD COMM CONS SCHOOL DIST 94 613290457 15 Bureau 0 0 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 0 605 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 605 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6430.32 0 6430.32 0 0 0 1101313841 1447330113 33 Nursing Facilities WEALSHIRE 600692119 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 886 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107774.82 0 0 0 0 0 0 0 107774.82 0 0 0 1101313861 10 Physicians 852 Wisconsin 0 0 Internal Medicine 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90.96 0 0 0 0 0 0 90.96 0 0 0 1101313869 1104931476 10 Physicians DHANANJAYAN BHUPESH 605212962 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 526 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 526 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5181.03 0 0 0 0 0 0 5181.03 0 0 0 1101313879 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 13375.38 0 0 0 0 0 0 0 0 0 0 0 0 0 13375.38 0 0 0 1101313888 1548225451 10 Physicians PESAVENTO DANIEL 600102396 57 Lake 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 24 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 238 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 238 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3139.18 0 20896.18 0 0 0 0 0 0 24035.36 0 0 0 1101313891 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 15636.73 0 0 0 0 0 0 0 0 0 0 0 0 0 15636.73 0 0 0 1101313896 1467433292 61 Independent Laboratories MIRACA LIFE SCIENCES INC 750392443 845 Texas 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3419 0 0 0 0 0 0 0 0 3419 0 0 0 1101313899 1922248970 11 Dentists LEAKE MAUREEN 606342618 200 Cook 0 0 General Dentistry 0 0 0 193 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1073 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1073 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29230.3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29230.3 0 0 0 1101313902 1245296979 10 Physicians YETTER TAD 626441243 68 Mason 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3693.67 0 0 0 0 0 0 3693.67 0 0 0 1101313914 1891817813 55 Early Intervention Services ELLIS PATRICIA 604231412 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12855.6 0 0 0 0 0 0 12855.6 0 0 0 1101313922 1295766871 10 Physicians GALLOWAY ANTHONY 612541091 45 Henry 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1198.47 0 0 0 0 0 0 1198.47 0 0 0 1101313927 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 1176.79 0 0 0 0 0 0 0 0 0 0 0 0 0 1176.79 0 0 0 1101313931 1073654885 24 Speech Therapists DUNGAN JULIA 627621000 77 Morgan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 874 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 874 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65629.77 65629.77 0 0 0 1101313932 10 Physicians 80 Peoria 0 0 Family Practice 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 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 0 0 0 0 0 0 0 0 0 0 0 1101313952 47 Local Education Agencies 66 Marion 0 0 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 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2272.74 0 2272.74 0 0 0 1101313954 1851433064 10 Physicians WATTS JEFFREY 606123723 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1648.42 0 0 0 0 0 0 1648.42 0 0 0 1101313959 1578563649 10 Physicians BURROWES DELILAH 605276686 30 DuPage 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 475 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 652 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 652 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55397.17 0 866.99 0 0 0 0 0 0 56264.16 0 0 0 1101313962 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11732.45 0 0 0 0 0 0 0 0 0 0 0 0 0 11732.45 0 0 0 1101313966 1497759898 10 Physicians RICKMAN CHRISTOPHER E 553445349 53 Kane 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 59 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3073.37 0 17.6 0 0 0 0 0 0 3090.97 0 0 0 1101313977 1952480295 10 Physicians THAKKER NITESH 604358200 107 Will 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 314 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 314 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5509.67 0 0 0 0 0 0 5509.67 0 0 0 1101313982 1912291279 63 Other Providers of Medical Equipment/Supplies (Non-registered) ALL CARE MEDICAL SUPPLY INC 600472275 57 Lake 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 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 934.23 0 0 0 0 0 0 934.23 0 0 0 1101313995 92 Waiver service provider--Disability (DHS/DRS) 63 Macon 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 4212.19 0 0 0 0 0 0 0 0 0 0 0 0 0 4212.19 0 0 0 1101314015 92 Waiver service provider--Disability (DHS/DRS) 107 Will 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17480.54 0 0 0 0 0 0 0 0 0 0 0 0 0 17480.54 0 0 0 1101314027 1679618151 60 Pharmacies ONCOMED PHARMACY 110215506 833 New York 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1214 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 254701.52 0 0 0 254701.52 0 0 0 1101314052 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10989 0 0 0 0 0 0 0 0 0 0 0 0 0 10989 0 0 0 1101314053 1013156926 16 Nurse Practitioners PATACSIL JASON 600442203 57 Lake 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 14 0 0 0 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 0 857.98 0 0 0 0 0 0 857.98 0 0 0 1101314066 1356563589 64 Imaging Services EFFINGHAM OPEN MRI LLC 624012005 33 Effingham 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 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2152.49 0 0 0 0 0 0 2152.49 0 0 0 1101314069 1336163484 11 Dentists IBRAHIM TAYSEER 600853601 57 Lake 0 0 General Dentistry 0 0 0 243 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 974 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 974 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31141.05 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31141.05 0 0 0 1101314070 1053516062 10 Physicians GUO AIBING 631102515 826 Missouri 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 0 4 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2.58 0 420.59 0 0 0 0 0 0 423.17 0 0 0 1101314072 1750308201 10 Physicians GREEN REBECCA 627949248 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 307 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 547 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 547 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49480.78 0 0 0 0 0 0 49480.78 0 0 0 1101314097 1164552055 10 Physicians ALI MOHAMMED 606244058 200 Cook 0 1 General Practice 0 1899 0 0 98 0 0 0 0 0 0 125 0 737 0 0 0 0 0 0 9552 0 0 160 0 0 0 0 0 0 214 0 3916 0 0 0 0 0 0 9552 0 0 160 0 0 0 0 0 0 214 0 3916 0 0 0 0 0 0 26198 0 0 7963.87 0 0 0 0 0 0 1275.42 0 160640.78 0 0 0 0 0 0 196078.07 0 0 0 1101314114 93 Waiver service provider--HIV/AIDS (DHS/DRS) 53 Kane 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 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 7110.19 0 0 0 0 0 0 0 0 0 0 0 0 0 7110.19 0 0 0 1101314132 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 1311.56 0 0 0 0 0 0 0 0 0 0 0 0 0 1311.56 0 0 0 1101314135 1750610648 55 Early Intervention Services ADAMS LETICIA 606532925 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 255 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3163 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3163 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 197726.27 0 0 0 0 0 0 197726.27 0 0 0 1101314140 1548207616 70 Ambulance Service Providers MOKENA FIRE PROTECTION DIST 604481315 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4063.51 0 0 0 0 0 0 4063.51 0 0 0 1101314196 1790750412 23 Occupational Therapists RAMIREZ MARIA 604362441 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 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 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4789.14 4789.14 0 0 0 1101314220 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24838 0 0 0 0 0 0 0 0 0 0 0 0 0 24838 0 0 0 1101314221 1801898010 16 Nurse Practitioners DOIRON JESSICA 631101010 826 Missouri 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 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 527.47 0 0 0 0 0 0 527.47 0 0 0 1101314234 10 Physicians 826 Missouri 0 0 Neurology 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 0 0 0 0 0 0 0 0 0 0 0 1101314247 1508986407 10 Physicians HOLLEY SUSAN 631101016 826 Missouri 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 6 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64.14 0 1049.02 0 0 0 0 0 0 1113.16 0 0 0 1101314249 1548433154 29 ICF/MR EMERALD ESTATES 615201520 37 Fulton 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 0 522 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8960 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 708906.16 0 0 0 0 0 0 0 0 0 0 708906.16 0 0 0 1101314259 1063499358 10 Physicians YATES MICHELLE 731435968 816 Iowa 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3818.22 0 0 0 0 0 0 3818.22 0 0 0 1101314262 1477565521 10 Physicians SUI DAVID 601783192 27 Dekalb 0 0 Obstetric-Gynecology 0 0 0 0 6 0 0 0 0 0 0 178 0 363 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 520 0 1617 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 520 0 1617 0 0 0 0 0 0 0 0 0 87.6 0 0 0 0 0 0 20791.34 0 138208.1 0 0 0 0 0 0 159087.04 0 0 0 1101314272 1275520553 63 Other Providers of Medical Equipment/Supplies (Non-registered) VITAL PRODUCTS LTD 606181514 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1531 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5994 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5994 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 394553.73 0 2859.4 0 0 0 0 397413.13 0 0 0 1101314277 1366594194 10 Physicians WEISS ALAN 600077313 200 Cook 0 0 Internal Medicine 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 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 0 338.53 0 0 0 0 0 0 338.53 0 0 0 1101314290 1316103559 10 Physicians HERZING RITA 601873112 30 DuPage 0 1 Internal Medicine 0 1 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 158.38 0 0 0 0 0 0 164.38 0 0 0 1101314296 1730135351 60 Pharmacies OSCO DRUG 3302 606091044 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 463 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 2802 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 72581 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48.75 0 0 159974.4 0 0 0 160023.15 0 0 0 1101314297 1962689117 10 Physicians PATEL PURVI 604675561 200 Cook 0 1 Internal Medicine 0 50 0 0 0 0 0 0 0 0 0 42 0 130 0 0 0 0 0 0 447 0 0 0 0 0 0 0 0 0 70 0 343 0 0 0 0 0 0 447 0 0 0 0 0 0 0 0 0 70 0 343 0 0 0 0 0 0 1340 0 0 0 0 0 0 0 0 0 603.13 0 11609.74 0 0 0 0 0 0 13552.87 0 0 0 1101314298 92 Waiver service provider--Disability (DHS/DRS) 30 DuPage 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 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 8028.39 0 0 0 0 0 0 0 0 0 0 0 0 0 8028.39 0 0 0 1101314305 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 3075.71 0 0 0 0 0 0 0 0 0 0 0 0 0 3075.71 0 0 0 1101314307 1235108820 10 Physicians SONG JAMES 60453 200 Cook 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 1834 0 174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2333 0 181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2333 0 181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69956.83 0 1101.81 0 0 0 0 0 0 71058.64 0 0 0 1101314315 1134177447 10 Physicians DELAHERA ARISTIDES 604322065 107 Will 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 279 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 784 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 784 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22207.7 0 0 0 0 0 0 22207.7 0 0 0 1101314320 1720174246 10 Physicians ORTEGA PEREZ WILMAN 622265359 96 St Clair 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 426 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 426 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1926.6 0 0 0 0 0 0 1926.6 0 0 0 1101314338 1629137914 10 Physicians FELDMAN ROBERT 606123723 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 394 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 401 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 401 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14792.91 0 0 0 0 0 0 14792.91 0 0 0 1101314344 1720016306 10 Physicians RYDZYNSKI ROBB 610213083 60 Lee 0 0 Obstetric-Gynecology 0 0 0 0 5 0 0 0 0 0 0 0 0 193 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 584 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 584 0 0 0 0 0 0 0 0 0 411.85 0 0 0 0 0 0 0 0 50813.63 0 0 0 0 0 0 51225.48 0 0 0 1101314348 1922032093 10 Physicians BLOCK ROMY JILL 600771057 200 Cook 0 0 Endocrinology 0 0 0 0 0 0 0 0 0 0 0 37 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 207 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 207 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121.95 0 8142.72 0 0 0 0 0 0 8264.67 0 0 0 1101314353 1598942245 10 Physicians CHEN ELAINE 999999999 200 Cook 0 0 Pulmonary Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 481 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 481 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9210.65 0 0 0 0 0 0 9210.65 0 0 0 1101314364 10 Physicians 852 Wisconsin 0 0 Ophthalmology 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95.96 0 0 0 0 0 0 95.96 0 0 0 1101314387 1578565701 10 Physicians COSTERISAN DENNIS 625491224 63 Macon 0 1 Family Practice 0 172 0 0 66 0 0 0 0 0 0 41 0 198 0 0 0 0 0 0 1441 0 0 144 0 0 0 0 0 0 147 0 469 0 0 0 0 0 0 1441 0 0 144 0 0 0 0 0 0 147 0 469 0 0 0 0 0 0 3395 0 0 8915.55 0 0 0 0 0 0 339.72 0 25963.63 0 0 0 0 0 0 38613.9 0 0 0 1101314402 1588662605 36 Community mental health provider EGYPTIAN PUBLIC MENTAL HLTH 628211821 105 White 0 0 0 371 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 446 0 0 2938 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7021 0 0 2938 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7021 0 0 83731.32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 442339.61 0 0 526070.93 0 0 0 1101314403 2100304821 90 Waiver service provider--Elderly (DOA) EUROPEAN SERVICE AT HOME INC 600670415 200 Cook 0 0 0 0 0 0 0 0 406 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45773 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45773 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3288670.05 0 0 0 0 0 0 0 0 0 0 0 0 0 3288670.05 0 0 0 1101314405 98 Waiver service provider--TBI (DHS/DRS) 97 Stephenson 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 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 8541.06 0 0 0 0 0 0 0 0 0 0 0 0 0 8541.06 0 0 0 1101314412 1194704262 10 Physicians MELLOTT ANN 606118709 200 Cook 0 0 Hematology 0 0 0 0 0 0 0 0 0 0 0 15 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 0 781 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 0 781 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 889.67 0 90600.41 0 0 0 0 0 0 91490.08 0 0 0 1101314417 1780650739 16 Nurse Practitioners MALEY JULIE 625266329 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 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 0 0 0 0 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1207.09 0 0 0 0 0 0 1207.09 0 0 0 1101314422 1548243694 10 Physicians STEELE HELEN 600681110 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 153 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 153 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2242.17 0 0 0 0 0 0 2242.17 0 0 0 1101314423 1992818827 10 Physicians JOBANPUTRA KETAN 606291813 200 Cook 0 0 Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 0 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40514.91 0 0 0 0 0 0 40514.91 0 0 0 1101314445 1376504829 60 Pharmacies ELGIN CENTER PHARMACY INC 601202120 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 288 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 1205 0 0 0 0 0 0 0 0 0 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1101314911 2100305329 71 Medicar Provider SUNSET REHAB AND HEALTH CARE 615202612 37 Fulton 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 331 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 331 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2430.46 0 0 0 0 0 0 2430.46 0 0 0 1101314926 91 Waiver service provider--Adults (DHS/DDD) 30 DuPage 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 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24528.96 0 0 0 0 0 0 0 0 0 0 0 0 0 24528.96 0 0 0 1101314944 1619191319 11 Dentists DONG GARY 606593271 200 Cook 0 0 General Dentistry 0 0 0 8 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 0 760.25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 760.25 0 0 0 1101314947 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 281 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 281 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24767.28 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1540.71 0 0 0 0 0 0 1540.71 0 0 0 1101315418 98 Waiver service provider--TBI (DHS/DRS) 56 Knox 0 0 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 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12208.01 0 0 0 0 0 0 0 0 0 0 0 0 0 12208.01 0 0 0 1101315421 10 Physicians 815 Indiana 0 0 Pediatrics 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 242.83 0 0 0 0 0 0 242.83 0 0 0 1101315442 1811210909 24 Speech Therapists GUNDERSON TRACY 618748815 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7479.63 7479.63 0 0 0 1101315447 1669524401 29 ICF/MR OAK TERRACE 628642157 49 Jefferson 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 405 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7109 0 0 0 0 0 0 0 0 0 0 0 0 0 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618321440 100 Vermilion 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 5 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 282 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 282 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74.7 0 10091.99 0 0 0 0 0 0 10166.69 0 0 0 1101315539 1649366568 10 Physicians LEWIS STEVEN M 601342584 53 Kane 0 0 Infectious Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 462 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 462 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8670.2 0 0 0 0 0 0 8670.2 0 0 0 1101315543 92 Waiver service provider--Disability (DHS/DRS) 97 Stephenson 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 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18557.34 0 0 0 0 0 0 0 0 0 0 0 0 0 18557.34 0 0 0 1101315553 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 18603.18 0 0 0 0 0 0 0 0 0 0 0 0 0 18603.18 0 0 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Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 250 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 250 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21735.71 0 0 0 0 0 0 21735.71 0 0 0 1101315856 1467768358 16 Nurse Practitioners SCOTT LAURA 999999999 107 Will 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 197.5 0 0 0 0 0 0 197.5 0 0 0 1101315862 91 Waiver service provider--Adults (DHS/DDD) 57 Lake 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 0 109 0 0 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 3314.84 0 0 0 0 0 0 0 0 0 0 0 0 0 3314.84 0 0 0 1101315876 1730362815 36 Community mental health provider NORTHPOINTE RESOURCES INC 600993662 57 Lake 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 0 741 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2977 0 0 741 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2977 0 0 47622.92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 226127.45 0 0 273750.37 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 197.59 0 0 0 0 0 0 197.59 0 0 0 1101316660 1396991378 10 Physicians BRASHER AIMEE 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 334.59 0 19228.74 0 0 0 0 0 0 19563.33 0 0 0 1101316677 30 General Hospitals 850 Washington NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 513.05 0 0 0 0 0 0 0 0 0 0 0 0 0 0 513.05 0 0 0 1101316681 1831124585 10 Physicians PERSELL STEPHEN 606118709 200 Cook 0 1 Internal Medicine 0 3 0 0 0 0 0 0 0 0 0 2 0 39 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 3 0 89 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 3 0 89 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 12.7 0 1583.45 0 0 0 0 0 0 1608.15 0 0 0 1101316685 94 Waiver service provider--Children's support (DHS/DDD) 107 Will 0 0 0 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0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 369.66 0 0 0 0 0 0 369.66 0 0 0 1101316806 1760561872 10 Physicians RIM CHONG S 606253657 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 168 0 314 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 297 0 1434 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 297 0 1434 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20178.66 0 136125.22 0 0 0 0 0 0 156303.88 0 0 0 1101316810 1679608822 25 Audiologists KLODD DAVID A 602023477 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 163 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 163 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3009.86 3009.86 0 0 0 1101316817 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28369.76 0 0 0 0 0 0 0 0 0 0 0 0 0 28369.76 0 0 0 1101316820 1700991551 30 General Hospitals FRESENIUS MEDICAL CARE PRAIRIE 606161219 803 Arizona DIALYSIS Outpatient dialysis centers. 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 296 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3518 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30082.08 0 0 0 0 0 30082.08 0 0 0 1101316841 1689601510 10 Physicians BHATT KIRIT 606234936 200 Cook 0 1 General Practice 0 262 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 459 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 459 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1050 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1050 0 0 0 1101316847 1235351818 10 Physicians LACK JODY 627949639 91 Sangamon 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 364 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 364 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49114.71 0 0 0 0 0 0 49114.71 0 0 0 1101316849 1861409971 10 Physicians PARVATHALA PRAVEEN 605212962 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 231 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 231 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3841.55 0 0 0 0 0 0 3841.55 0 0 0 1101316850 2100307268 90 Waiver service provider--Elderly (DOA) FRIENDSHIP MANOR INC 61201 89 Rock Island 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3846 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3846 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156017.98 0 0 0 0 0 0 0 0 0 0 0 0 0 156017.98 0 0 0 1101316853 1801062955 10 Physicians SHERIFF NAZIA 601691065 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2747.37 0 0 0 0 0 0 2747.37 0 0 0 1101316874 1376671115 23 Occupational Therapists REYES MARIA 606082647 200 Cook 0 0 0 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 1342 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1342 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94603.91 94603.91 0 0 0 1101316878 1447283015 10 Physicians KANTAMNENI ANURADHA 616151941 72 McLean 0 1 Internal Medicine 0 10 0 0 0 0 0 0 0 0 0 4 0 53 0 0 0 0 0 0 55 0 0 0 0 0 0 0 0 0 20 0 98 0 0 0 0 0 0 55 0 0 0 0 0 0 0 0 0 20 0 98 0 0 0 0 0 0 155 0 0 0 0 0 0 0 0 0 73.63 0 2106.7 0 0 0 0 0 0 2335.33 0 0 0 1101316890 1225347362 16 Nurse Practitioners KAPLON JONES MICHELE 605277594 30 DuPage 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 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 80.52 0 0 0 0 0 0 80.52 0 0 0 1101316891 1013919976 10 Physicians DADDONO ANTHONY 600854960 57 Lake 0 0 Allergy 0 0 0 0 0 0 0 0 0 0 0 1 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15.7 0 2432.21 0 0 0 0 0 0 2447.91 0 0 0 1101316915 1326165846 10 Physicians STOCK ERIN 629037647 47 Jackson 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 459 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 497 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 497 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94697.19 0 0 0 0 0 0 94697.19 0 0 0 1101316933 92 Waiver service provider--Disability (DHS/DRS) 49 Jefferson 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 19 0 0 0 0 0 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 11308.81 0 0 0 0 0 0 0 0 0 0 0 0 0 11308.81 0 0 0 1101316939 1013185024 47 Local Education Agencies EAST DUBUQUE UNIT 119 610259548 51 Jo Daviess 0 0 0 0 0 0 61 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 1039 0 0 0 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 1039 0 0 0 0 716.95 0 0 0 0 0 0 0 0 0 0 0 0 0 18284.46 0 19001.41 0 0 0 1101316940 1336107937 10 Physicians CYBULSKI GEORGE 606118709 200 Cook 0 0 Neurology Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3039.72 0 0 0 0 0 0 3039.72 0 0 0 1101316947 1245266766 10 Physicians GOVINDAIAH RAJESH 627032403 91 Sangamon 0 0 Internal Medicine 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 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 526.14 0 0 0 0 0 0 526.14 0 0 0 1101316948 63 Other Providers of Medical Equipment/Supplies (Non-registered) 815 Indiana 0 0 0 0 0 0 0 0 0 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 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 1441.28 0 0 0 0 0 0 1441.28 0 0 0 1101316949 1093770257 10 Physicians MEHDIRAD ALI 631102515 826 Missouri 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 236 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 350 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 350 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5115.31 0 0 0 0 0 0 5115.31 0 0 0 1101316954 1851302871 10 Physicians RUO KONNY 601181416 53 Kane 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16768.76 0 0 0 0 0 0 16768.76 0 0 0 1101316959 91 Waiver service provider--Adults (DHS/DDD) 52 Johnson 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 0 253 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 253 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13586.7 0 0 0 0 0 0 0 0 0 0 0 0 0 13586.7 0 0 0 1101316962 91 Waiver service provider--Adults (DHS/DDD) 54 Kankakee 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 0 240 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 240 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24396.4 0 0 0 0 0 0 0 0 0 0 0 0 0 24396.4 0 0 0 1101316963 1144554338 63 Other Providers of Medical Equipment/Supplies (Non-registered) NUTREX LLC 531039452 852 Wisconsin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 201 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 581 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 581 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 193825.34 0 0 0 0 0 0 193825.34 0 0 0 1101316965 92 Waiver service provider--Disability (DHS/DRS) 37 Fulton 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 16708.06 0 0 0 0 0 0 0 0 0 0 0 0 0 16708.06 0 0 0 1101316972 1578574869 16 Nurse Practitioners HAWKINS JAMIE 618323752 100 Vermilion 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1744.11 0 0 0 0 0 0 1744.11 0 0 0 1101316983 1750322640 10 Physicians ALBERT HOWARD 601901237 30 DuPage 0 0 Anesthesiology 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 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2622.84 0 0 0 0 0 0 2622.84 0 0 0 1101317013 1033101274 10 Physicians GITTLER MICHELLE 605276686 30 DuPage 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 0 0 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 626 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 626 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10887.95 0 0 0 0 0 0 10887.95 0 0 0 1101317016 10 Physicians 200 Cook 0 0 Psychiatry 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 212.44 0 0 0 0 0 0 212.44 0 0 0 1101317034 1841463437 47 Local Education Agencies MOMENCE COMM UNIT DIST NO 1 609541221 54 Kankakee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25082.18 0 25082.18 0 0 0 1101317043 1942311956 10 Physicians ANSARI SOBIA 606233596 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 530 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 641 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 641 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14583.07 0 0 0 0 0 0 14583.07 0 0 0 1101317045 10 Physicians 816 Iowa 0 0 Internal Medicine 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 219 0 0 0 0 0 0 219 0 0 0 1101317046 1144236985 22 Physical Therapists LIEBREICH MARGARET BRACCO 603041429 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 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 7419.35 7419.35 0 0 0 1101317055 1104002690 10 Physicians STRUNIN VLADIMIR 614011251 56 Knox 0 0 Obstetric-Gynecology 0 0 0 0 20 0 0 0 0 0 0 262 0 420 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 627 0 1199 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 627 0 1199 0 0 0 0 0 0 0 0 0 456.07 0 0 0 0 0 0 16695.47 0 79549.65 0 0 0 0 0 0 96701.19 0 0 0 1101317061 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 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 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23989.96 0 0 0 0 0 0 0 0 0 0 0 0 0 23989.96 0 0 0 1101317063 1932392032 28 Waiver service provider--Supportive living facility (HFS) KENSINGTON OF GALESBURG 614014797 56 Knox 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 279 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7513 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 377650.6 0 0 0 0 0 0 0 0 0 0 0 0 0 377650.6 0 0 0 1101317070 1629063169 10 Physicians DAVIS TODD 601262973 200 Cook 0 0 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0 0 0 0 0 0 0 49867.03 49867.03 0 0 0 1101317942 1588662605 36 Community mental health provider EGYPTIAN PUBLIC MENTAL HLTH 629303766 90 Saline 0 0 Childrens mental health 0 1062 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1325 0 0 9930 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17248 0 0 9930 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17248 0 0 278227.4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1349809.2 0 0 1628036.6 0 0 0 1101317943 1326238106 10 Physicians CHRISTIANS MELODY 606123723 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 235.31 0 0 0 0 0 0 235.31 0 0 0 1101317950 1053338582 10 Physicians AVIDAN MICHAEL 631101093 826 Missouri 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4091.6 0 0 0 0 0 0 4091.6 0 0 0 1101317986 10 Physicians 96 St Clair 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 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Equipment/Supplies (Non-registered) MEDICAL DIRECT CLUB LLC 372035509 844 Tennessee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 733 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 733 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41178.24 0 0 0 0 0 0 41178.24 0 0 0 1101318089 1811981251 12 Optometrists SCHLANGE DARRELL 606163878 200 Cook 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 293 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 293 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8479.17 0 0 0 0 0 0 8479.17 0 0 0 1101318090 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 20279.16 0 0 0 0 0 0 0 0 0 0 0 0 0 20279.16 0 0 0 1101318094 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 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Physicians REASONER ANDREA 522421009 816 Iowa 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 634.07 0 0 0 0 0 0 634.07 0 0 0 1101318176 1376587030 10 Physicians GIKAS ELIAS 606253657 200 Cook 0 0 Plastic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 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 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1896.99 0 0 0 0 0 0 1896.99 0 0 0 1101318182 1841297413 10 Physicians SETTLEMOIR HYET 628811028 66 Marion 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4651.44 0 0 0 0 0 0 4651.44 0 0 0 1101318184 94 Waiver service provider--Children's support (DHS/DDD) 62 Logan 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 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10034.74 0 0 0 0 0 0 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0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29474.38 0 0 0 0 0 0 0 0 0 0 0 0 0 29474.38 0 0 0 1101318232 1467450056 10 Physicians SCHIEBLER MARK 535625531 852 Wisconsin 0 0 Radiology 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 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1768.89 0 0 0 0 0 0 0 0 1768.89 0 0 0 1101318236 1518907211 33 Nursing Facilities SHELDON HEALTH CARE CENTER 609668058 46 Iroquois 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 272 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7307 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 591538.55 0 0 0 0 0 0 0 591538.55 0 0 0 1101318240 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 17861.05 0 0 0 0 0 0 0 0 0 0 0 0 0 17861.05 0 0 0 1101318246 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 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Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 497 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 543 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 543 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20254.85 0 0 0 0 0 0 20254.85 0 0 0 1101318299 91 Waiver service provider--Adults (DHS/DDD) 72 McLean 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 0 109 0 0 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 4211 0 0 0 0 0 0 0 0 0 0 0 0 0 4211 0 0 0 1101318303 91 Waiver service provider--Adults (DHS/DDD) 24 Coles 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 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 1540.8 0 0 0 0 0 0 0 0 0 0 0 0 0 1540.8 0 0 0 1101318304 1558369371 10 Physicians FERLMANN JAMES 605406560 30 DuPage 0 0 Plastic Surgery 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 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6723.14 0 0 0 0 0 0 6723.14 0 0 0 1101318309 1457328874 10 Physicians MUZYKANSKY 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0 0 0 0 0 0 0 0 0 0 0 0 0 109 0 419 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 187 0 1190 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 187 0 1190 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17632.47 0 283081.46 0 0 0 0 300713.93 0 0 0 1101318351 1821023391 64 Imaging Services LAK IMAGING INC 60614 200 Cook 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 0 377 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 377 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 280.23 0 0 0 0 0 0 0 0 280.23 0 0 0 1101318361 1881730620 75 Department of Alcohol and Substance Abuse Provider PEER SERVICES 602013608 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1435 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1435 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76051.83 0 0 76051.83 0 0 0 1101318367 92 Waiver service provider--Disability (DHS/DRS) 100 Vermilion 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 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 4375.39 0 0 0 0 0 0 0 0 0 0 0 0 0 4375.39 0 0 0 1101318374 1700032646 10 Physicians LANOUE DOUGLAS 609551401 46 Iroquois 0 1 Family Practice 0 84 0 0 2 0 0 0 0 0 0 1 0 46 0 0 0 0 0 0 84 0 0 2 0 0 0 0 0 0 2 0 104 0 0 0 0 0 0 84 0 0 2 0 0 0 0 0 0 2 0 104 0 0 0 0 0 0 216 0 0 91.9 0 0 0 0 0 0 18.1 0 13703.78 0 0 0 0 0 0 14029.78 0 0 0 1101318379 1386600864 10 Physicians FLECKENSTEIN JAQUELYN 631101010 826 Missouri 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6501.96 0 0 0 0 0 0 6501.96 0 0 0 1101318381 1285715136 10 Physicians HAIDO SUSAN 606253500 200 Cook 0 1 Family Practice 0 811 0 0 307 0 0 0 0 0 0 219 0 555 0 0 0 0 0 0 5873 0 0 1283 0 0 0 0 0 0 375 0 1275 0 0 0 0 0 0 5873 0 0 1283 0 0 0 0 0 0 375 0 1275 0 0 0 0 0 0 14343 0 0 42936.81 0 0 0 0 0 0 2439.67 0 61951.66 0 0 0 0 0 0 121671.14 0 0 0 1101318382 1609930528 22 Physical Therapists HILL REBEKAH 605062494 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 707 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 707 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52488.85 52488.85 0 0 0 1101318384 1881601243 10 Physicians MOLNAR ROBERT 600532128 200 Cook 0 0 General Practice 0 0 0 0 0 0 0 0 0 0 0 2 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19312.01 0 0 0 0 0 0 19312.01 0 0 0 1101318385 92 Waiver service provider--Disability (DHS/DRS) 66 Marion 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 4831.04 0 0 0 0 0 0 0 0 0 0 0 0 0 4831.04 0 0 0 1101318391 1134197957 10 Physicians GRUBER BEN 600760307 200 Cook 0 0 Emergency Medicine 0 0 0 0 5 0 0 0 0 0 0 0 0 285 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 625 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 625 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 22183.54 0 0 0 0 0 0 22259.54 0 0 0 1101318394 92 Waiver service provider--Disability (DHS/DRS) 79 Ogle 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9136.29 0 0 0 0 0 0 0 0 0 0 0 0 0 9136.29 0 0 0 1101318397 1336114818 10 Physicians ALVARADO JANET 622491658 65 Madison 0 1 Internal Medicine 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 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1334.69 0 0 0 0 0 0 1334.69 0 0 0 1101318402 1366481426 10 Physicians ELLIOTT GLYNN 600911824 200 Cook 0 0 Internal Medicine 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 23 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 0 0 0 0 0 0 0 0 775.95 0 0 0 0 0 0 775.95 0 0 0 1101318405 1154679116 40 Federally Qualified Health Centers AUNT MARTHAS WESTSIDE HEALTH 999999999 107 Will 0 0 0 0 844 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5291 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5291 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 330956.57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 330956.57 0 0 0 1101318416 1447201132 10 Physicians ALIKAKOS ZOE 604631571 200 Cook 0 1 Pediatrics 0 334 0 0 113 0 0 0 0 0 0 67 0 212 0 0 0 0 0 0 1655 0 0 328 0 0 0 0 0 0 101 0 452 0 0 0 0 0 0 1655 0 0 328 0 0 0 0 0 0 101 0 452 0 0 0 0 0 0 3310 0 0 10926.57 0 0 0 0 0 0 1335.62 0 18133.39 0 0 0 0 0 0 33705.58 0 0 0 1101318437 1114174075 36 Community mental health provider COMMUNITY ELEMENTS INC 618204716 19 Champaign 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 332 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2747 0 0 332 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2747 0 0 539.25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88839.68 0 0 89378.93 0 0 0 1101318452 1871773879 16 Nurse Practitioners CAIN THOMAS 629595259 108 Williamson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21177.39 0 0 0 0 0 0 21177.39 0 0 0 1101318455 10 Physicians 815 Indiana 0 0 Obstetrics 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 69 0 0 0 1101318457 10 Physicians 836 Ohio 0 0 General Practice 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115.41 0 0 0 0 0 0 115.41 0 0 0 1101318464 1639172331 63 Other Providers of Medical Equipment/Supplies (Non-registered) JOINT ACTIVE SYSTEMS INC 624011367 33 Effingham 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 229 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 229 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1309.28 0 9175.11 0 0 0 0 10484.39 0 0 0 1101318466 1386865244 10 Physicians KHOKHAR OMAR 614438354 45 Henry 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 1 0 271 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 485 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 485 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8.62 0 38494.85 0 0 0 0 0 0 38503.47 0 0 0 1101318503 1699898106 10 Physicians LABRADOR ANDREW 605595574 30 DuPage 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 345 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13433.36 0 0 0 0 0 0 13433.36 0 0 0 1101318510 1134305238 47 Local Education Agencies SKOKIE FAIRVIEW ELEM DIST 72 600773443 200 Cook 0 0 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 0 646 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 646 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8161.96 0 8161.96 0 0 0 1101318513 1063550895 11 Dentists PSCHIRRER JACOB 619389313 24 Coles 0 0 General Dentistry 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 869.04 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 869.04 0 0 0 1101318530 1801856836 10 Physicians STORY RACHEL 600261314 200 Cook 0 0 Pediatrics 0 0 0 0 3 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 326 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 326 0 0 0 0 0 0 0 0 0 19.2 0 0 0 0 0 0 0 0 14955.01 0 0 0 0 0 0 14974.21 0 0 0 1101318554 1184611766 12 Optometrists RICHMOND RONALD 617612896 72 McLean 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 739 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 739 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20728.22 0 0 0 0 0 0 20728.22 0 0 0 1101318567 1295825594 10 Physicians CAFFERY DENNIS 617479801 98 Tazewell 0 1 Family Practice 0 213 0 0 27 0 0 0 0 0 0 23 0 215 0 0 0 0 0 0 1717 0 0 55 0 0 0 0 0 0 35 0 683 0 0 0 0 0 0 1717 0 0 55 0 0 0 0 0 0 35 0 683 0 0 0 0 0 0 4510 0 0 2080.31 0 0 0 0 0 0 132.84 0 22857.68 0 0 0 0 0 0 29580.83 0 0 0 1101318574 1740249259 10 Physicians KUMAR ARUN 605657201 30 DuPage 0 1 Internal Medicine 0 212 0 0 3 0 0 0 0 0 0 15 0 214 0 0 0 0 0 0 1318 0 0 3 0 0 0 0 0 0 20 0 634 0 0 0 0 0 0 1318 0 0 3 0 0 0 0 0 0 20 0 634 0 0 0 0 0 0 3871 0 0 275.23 0 0 0 0 0 0 50.72 0 13401.27 0 0 0 0 0 0 17598.22 0 0 0 1101318584 10 Physicians 826 Missouri 0 0 Internal Medicine 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 82.6 0 0 0 0 0 0 82.6 0 0 0 1101318600 1831189455 33 Nursing Facilities GOOD SAM SOCIETY MT CARROLL 610539476 17 Carroll 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 348 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9378 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 811443.3 0 0 0 0 0 0 0 811443.3 0 0 0 1101318620 10 Physicians 826 Missouri 0 0 Internal Medicine 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87.1 0 0 0 0 0 0 87.1 0 0 0 1101318631 1205002052 10 Physicians MAPUE RENAN 620161436 39 Greene 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 145.64 0 0 0 0 0 0 145.64 0 0 0 1101318642 1841354453 24 Speech Therapists NORRMAN STACIE 605102478 53 Kane 0 0 0 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 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9305.91 9305.91 0 0 0 1101318647 1700936234 63 Other Providers of Medical Equipment/Supplies (Non-registered) KOEBERS PROS AND ORTHO LAB 606183122 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 164 0 363 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 164 0 363 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5323.94 0 66686.02 0 0 0 0 72009.96 0 0 0 1101318648 1316160823 36 Community mental health provider BRIDGEWAY INC 614629794 102 Warren 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 192 0 0 495 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1213 0 0 495 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1213 0 0 11048.7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79197.64 0 0 90246.34 0 0 0 1101318654 1700806700 10 Physicians WY JOHN 477140541 815 Indiana 0 0 Internal Medicine 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 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 950.36 0 0 0 0 0 0 950.36 0 0 0 1101318657 1811275597 12 Optometrists DOHRMAN KYLE 622262302 96 St Clair 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 113 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 113 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1672.54 0 87.84 0 0 0 0 1760.38 0 0 0 1101318662 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23018.55 0 0 0 0 0 0 0 0 0 0 0 0 0 23018.55 0 0 0 1101318668 1548247349 75 Department of Alcohol and Substance Abuse Provider ROSECRANCE HARRISON - MEN'S 611087631 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 212 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2453 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2671 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 188429.06 0 0 188429.06 0 0 0 1101318673 10 Physicians 90 Saline 0 0 Family Practice 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 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 1.67 0 0 0 0 0 0 1.67 0 0 0 1101318674 1568497691 10 Physicians GALATANU MIRELA 604532504 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 657 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 657 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5983.03 0 0 0 0 0 0 5983.03 0 0 0 1101318676 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 20489.06 0 0 0 0 0 0 0 0 0 0 0 0 0 20489.06 0 0 0 1101318685 1568630549 47 Local Education Agencies SOUTH BERWYN SCHOOL DIST 100 604022903 200 Cook 0 0 0 0 0 0 420 0 0 0 0 0 0 0 0 0 0 0 0 0 401 0 0 0 0 657 0 0 0 0 0 0 0 0 0 0 0 0 0 12970 0 0 0 0 657 0 0 0 0 0 0 0 0 0 0 0 0 0 12970 0 0 0 0 3869.62 0 0 0 0 0 0 0 0 0 0 0 0 0 247737.4 0 251607.02 0 0 0 1101318705 1467475749 60 Pharmacies TARGET STORE T 1912 600604267 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71287.96 0 0 0 71287.96 0 0 0 1101318709 1801991815 47 Local Education Agencies ARTHUR C U SCHOOL DIST 305 619111403 29 Douglas 0 0 0 0 0 0 294 0 0 0 0 0 0 0 0 0 0 0 0 0 103 0 0 0 0 614 0 0 0 0 0 0 0 0 0 0 0 0 0 3295 0 0 0 0 614 0 0 0 0 0 0 0 0 0 0 0 0 0 3295 0 0 0 0 3858.07 0 0 0 0 0 0 0 0 0 0 0 0 0 46242.47 0 50100.54 0 0 0 1101318713 1821042433 11 Dentists GORDON MICHAEL E E 606093844 200 Cook 0 0 General Dentistry 0 0 0 560 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2417 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2417 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76714.67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76714.67 0 0 0 1101318715 91 Waiver service provider--Adults (DHS/DDD) 15 Bureau 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 0 717 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 717 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25915.45 0 0 0 0 0 0 0 0 0 0 0 0 0 25915.45 0 0 0 1101318716 1437186095 10 Physicians VARGAS SERGIO 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 655.27 0 0 0 0 0 0 655.27 0 0 0 1101318724 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 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 41427.23 0 0 0 0 0 0 0 0 0 0 0 0 0 41427.23 0 0 0 1101318757 91 Waiver service provider--Adults (DHS/DDD) 47 Jackson 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 0 325 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 325 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12338.31 0 0 0 0 0 0 0 0 0 0 0 0 0 12338.31 0 0 0 1101318760 1114910528 10 Physicians PATEL KETAN 613562538 15 Bureau 0 1 Internal Medicine 0 95 0 0 10 0 0 0 0 0 0 7 0 686 0 0 0 0 0 0 811 0 0 10 0 0 0 0 0 0 12 0 1378 0 0 0 0 0 0 811 0 0 10 0 0 0 0 0 0 12 0 1378 0 0 0 0 0 0 2282 0 0 853.04 0 0 0 0 0 0 8.36 0 22643.43 0 0 0 0 0 0 25786.83 0 0 0 1101318763 2100309181 92 Waiver service provider--Disability (DHS/DRS) LUTHERAN SOCIAL SERVICES OF IL 618213061 19 Champaign 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 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61654.31 0 0 0 0 0 0 0 0 0 0 0 0 0 61654.31 0 0 0 1101318766 1598803033 10 Physicians KONONOVA LARISA 604358200 107 Will 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 465 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 465 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10693.21 0 0 0 0 0 0 10693.21 0 0 0 1101318772 1649343864 60 Pharmacies ILLINOIS CANCER SPECLSTS PHARM 607145905 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 492 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5320 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 627511.87 0 0 0 627511.87 0 0 0 1101318782 1790734069 10 Physicians POLLAK ALAN 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Boone 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 294 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 294 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 818.62 0 0 0 0 0 0 818.62 0 0 0 1101319350 1578670543 30 General Hospitals GOOD SAMARITAN HOSPITAL 605151500 30 DuPage DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 Perinatal Level II Center 0 0 17 0 0 2944 0 0 0 0 1244 0 0 11 1429 0 0 0 0 0 0 47 0 0 4086 0 0 0 0 1478 0 0 11 2661 0 0 0 0 0 0 122 0 0 4193 0 0 0 0 6966 0 0 11 2689 0 0 0 0 0 0 8979.9 0 0 946337.24 0 0 0 0 6845553.96 0 0 15761.43 526983.82 0 0 0 0 0 8343616.35 0 0 0 1101319356 1851495899 30 General Hospitals RUSH UNIVERSITY MEDICAL CENTER 606123839 200 Cook DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 0 0 0 0 624 0 0 0 0 0 0 5349 0 0 1512 0 0 0 0 0 0 0 0 634 0 0 0 0 0 0 33627 0 0 3806 0 0 0 0 0 0 0 0 634 0 0 0 0 0 0 33627 0 0 3806 0 0 0 0 0 0 0 0 3703.31 0 0 0 0 0 0 191008.7 0 0 223001.38 0 0 0 0 0 417713.39 0 0 0 1101319382 92 Waiver service provider--Disability (DHS/DRS) 63 Macon 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 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 3360.08 0 0 0 0 0 0 0 0 0 0 0 0 0 3360.08 0 0 0 1101319386 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23232 0 0 0 0 0 0 0 0 0 0 0 0 0 23232 0 0 0 1101319389 1154454635 10 Physicians DOMB BENJAMIN 605596135 30 DuPage 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 10 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 214.59 0 1450.86 0 0 0 0 0 0 1665.45 0 0 0 1101319407 1679654040 10 Physicians BARKAN GULIZ 601533328 200 Cook 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 301 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 470 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 470 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6308.14 0 49.8 0 0 0 0 0 0 6357.94 0 0 0 1101319408 1942208087 10 Physicians OLTMAN PAUL 624012187 33 Effingham 0 1 Family Practice 0 21 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 108 0 0 0 0 0 0 0 0 0 0 0 204 0 0 0 0 0 0 108 0 0 0 0 0 0 0 0 0 0 0 204 0 0 0 0 0 0 270 0 0 0 0 0 0 0 0 0 0 0 5660.82 0 0 0 0 0 0 5930.82 0 0 0 1101319410 1104845908 12 Optometrists BAUER DEAN 603051817 200 Cook 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 7 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 0.78 0 0 0 0 0 0 0.78 0 0 0 1101319431 1265681597 10 Physicians GUJJA SAPNA 601604100 200 Cook 0 1 Family Practice 0 6 0 0 0 0 0 0 0 0 0 0 0 1423 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 2517 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 2517 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 113506.92 0 0 0 0 0 0 113560.92 0 0 0 1101319433 92 Waiver service provider--Disability (DHS/DRS) 96 St Clair 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 13623.01 0 0 0 0 0 0 0 0 0 0 0 0 0 13623.01 0 0 0 1101319439 2100309857 10 Physicians VAN UYEN 610681734 79 Ogle 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 94 0 252 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135 0 524 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135 0 524 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1379.36 0 20282.11 0 0 0 0 0 0 21661.47 0 0 0 1101319442 1013294271 36 Community mental health provider ARDEN SHORE CHILD AND FAMILY S 600854205 57 Lake 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 247 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 247 0 0 616.05 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15630.77 0 0 16246.82 0 0 0 1101319456 1851371249 25 Audiologists FISHER RONNA 606112818 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 619.79 619.79 0 0 0 1101319457 1093809402 60 Pharmacies THE APOTHECARY SHOPPE 624761202 32 Edwards 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 298 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 3443 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 84739 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 806.57 0 0 121238.6 0 0 0 122045.17 0 0 0 1101319473 1902839541 70 Ambulance Service Providers WATERMAN FIRE PROTECTION DIST 605566072 27 Dekalb 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 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1978.32 0 0 0 0 0 0 1978.32 0 0 0 1101319474 91 Waiver service provider--Adults (DHS/DDD) 89 Rock Island 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 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 0 890.91 0 0 0 0 0 0 0 0 0 0 0 0 0 890.91 0 0 0 1101319482 1114971652 10 Physicians DEMONT BRUCE 617613551 72 McLean 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 348 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 399 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 399 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14380.72 0 0 0 0 0 0 14380.72 0 0 0 1101319483 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 14530.32 0 0 0 0 0 0 0 0 0 0 0 0 0 14530.32 0 0 0 1101319511 1447461744 10 Physicians FULLER BRIAN 631081341 826 Missouri 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 26 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 2630.82 0 0 0 0 0 0 2630.82 0 0 0 1101319532 1104928498 10 Physicians MERHI NAHLA 604519508 107 Will 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 0 31 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 3276.88 0 0 0 0 0 0 3276.88 0 0 0 1101319549 1508021171 10 Physicians ELLIS MARCO 606127322 200 Cook 0 0 Plastic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 207 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 207 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 119909.5 0 0 0 0 0 0 119909.5 0 0 0 1101319566 91 Waiver service provider--Adults (DHS/DDD) 71 McHenry 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 0 272 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 272 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11860.61 0 0 0 0 0 0 0 0 0 0 0 0 0 11860.61 0 0 0 1101319587 1427167360 10 Physicians MORSE JOHN 478074214 815 Indiana 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 6 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 203.48 0 6817.14 0 0 0 0 0 0 7020.62 0 0 0 1101319592 1033304373 40 Federally Qualified Health Centers ACCESS ADDISON FMLY HLTH CTR 601011101 30 DuPage 0 1 0 2433 1100 0 346 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17195 5398 0 986 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17195 5398 0 986 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43495 351545.86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 395040.86 0 0 0 1101319600 1164634531 10 Physicians ALMONAJED MOHAMMAD 611042315 109 Winnebago 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 293 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 399 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 399 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15842.4 0 0 0 0 0 0 15842.4 0 0 0 1101319606 30 General Hospitals 811 Georgia NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 99.26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99.26 0 0 0 1101319620 1013963669 60 Pharmacies OSCO DRUG 3344 606081402 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 643 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3296 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 213476.19 0 0 0 213476.19 0 0 0 1101319621 1912196734 10 Physicians SHAH OJAS 601374464 30 DuPage 0 0 Otorhinolaryngology 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 47 0 0 0 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 0 829.92 0 0 0 0 0 0 829.92 0 0 0 1101319624 1245203512 10 Physicians PARKS CLARENCE 610324864 97 Stephenson 0 0 Pediatrics 0 0 0 0 1 0 0 0 0 0 0 6 0 324 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 6 0 724 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 6 0 724 0 0 0 0 0 0 0 0 0 84.62 0 0 0 0 0 0 19.41 0 18938.8 0 0 0 0 0 0 19042.83 0 0 0 1101319625 1982780094 30 General Hospitals BELOIT HEALTH SYSTEM 535112230 852 Wisconsin DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 0 0 0 0 0 0 0 0 0 0 0 174 0 0 267 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 610 0 0 388 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 610 0 0 388 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3106.57 0 0 8628.89 0 0 0 0 0 11735.46 0 0 0 1101319634 91 Waiver service provider--Adults (DHS/DDD) 107 Will 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 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2732.35 0 0 0 0 0 0 0 0 0 0 0 0 0 2732.35 0 0 0 1101319636 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 19 0 0 0 0 0 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 22299.84 0 0 0 0 0 0 0 0 0 0 0 0 0 22299.84 0 0 0 1101319645 1174771836 10 Physicians CANFIELD KIMBERLY 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 218 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 218 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19701.65 0 0 0 0 0 0 19701.65 0 0 0 1101319653 1245333152 10 Physicians HAGEN COLLEEN 605256554 200 Cook 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8135.98 0 0 0 0 0 0 8135.98 0 0 0 1101319658 1609974922 10 Physicians GONZALES RUBEN B 475914853 815 Indiana 0 0 Internal Medicine 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 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1016.87 0 0 0 0 0 0 1016.87 0 0 0 1101319666 1588631378 10 Physicians SHAH ASAD 601783185 27 Dekalb 0 1 Internal Medicine 0 28 0 0 0 0 0 0 0 0 0 4 0 433 0 0 0 0 0 0 228 0 0 0 0 0 0 0 0 0 4 0 2255 0 0 0 0 0 0 228 0 0 0 0 0 0 0 0 0 4 0 2255 0 0 0 0 0 0 679 0 0 0 0 0 0 0 0 0 12.2 0 28555.79 0 0 0 0 0 0 29246.99 0 0 0 1101319683 1982963724 11 Dentists ROWAN SUSAN A 606127210 200 Cook 0 0 General Dentistry 0 0 0 4229 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18367 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18367 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 931418.17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 931418.17 0 0 0 1101319686 92 Waiver service provider--Disability (DHS/DRS) 56 Knox 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 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 4977.28 0 0 0 0 0 0 0 0 0 0 0 0 0 4977.28 0 0 0 1101319696 1326129883 10 Physicians FALCONE MARIA 629011414 47 Jackson 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 10 0 1789 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 3929 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 3929 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122.13 0 109772.77 0 0 0 0 0 0 109894.9 0 0 0 1101319705 1508831918 10 Physicians MITCHELL CHARLOTTE 604113459 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 186 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 186 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1448.43 0 0 0 0 0 0 1448.43 0 0 0 1101319707 1477640449 11 Dentists MAIER DAVID 622344372 65 Madison 0 0 General Dentistry 0 0 0 244 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40249.45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40249.45 0 0 0 1101319712 1790787679 33 Nursing Facilities OUR LADY OF ANGELS RETIREMENT 604353718 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 341 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9016 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 922112.58 0 0 0 0 0 0 0 922112.58 0 0 0 1101319715 1407826829 10 Physicians URAL NIL 601533328 200 Cook 0 0 Anesthesiology 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 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21408.02 0 0 0 0 0 0 21408.02 0 0 0 1101319727 1578881611 16 Nurse Practitioners ALLEN STEPHEN 618012529 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 155.66 0 0 0 0 0 0 155.66 0 0 0 1101319732 1306931951 10 Physicians JONES MONIQUE 604292080 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 8 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 138 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 138 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22.86 0 12903.81 0 0 0 0 0 0 12926.67 0 0 0 1101319734 91 Waiver service provider--Adults (DHS/DDD) 109 Winnebago 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 0 295 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 0 0 0 0 0 0 0 0 0 0 0 0 13290.71 0 0 0 0 0 0 0 0 0 0 0 0 0 13290.71 0 0 0 1101319736 1427017599 10 Physicians VERMEER RICHARD 528032459 816 Iowa 0 0 Emergency Medicine 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 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 620.22 0 0 0 0 0 0 620.22 0 0 0 1101319737 92 Waiver service provider--Disability (DHS/DRS) 63 Macon 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 24344.24 0 0 0 0 0 0 0 0 0 0 0 0 0 24344.24 0 0 0 1101319744 94 Waiver service provider--Children's support (DHS/DDD) 30 DuPage 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 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5158.6 0 0 0 0 0 0 0 0 0 0 0 0 0 5158.6 0 0 0 1101319746 1285675157 60 Pharmacies CVS PHARMACY 08683 618205213 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1069 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114383 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 239287.77 0 0 0 239287.77 0 0 0 1101319765 1558388017 10 Physicians WHITE NEIL H 631101077 826 Missouri 0 0 Pediatric Endocrinology 0 0 0 0 0 0 0 0 0 0 0 12 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91.35 0 2744.93 0 0 0 0 0 0 2836.28 0 0 0 1101319796 1376620047 10 Physicians CORREIA RANDALL 611112754 109 Winnebago 0 0 Anesthesiology 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 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16432.12 0 0 0 0 0 0 16432.12 0 0 0 1101319805 1831292507 60 Pharmacies CVS PHARMACY 6930 622462211 12 Bond 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1880 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17071 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 416109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 821952.53 0 0 0 821952.53 0 0 0 1101319807 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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provider ASSOC FOR IND DEVELOPMENT MDT 605051600 53 Kane 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 4885 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4680 0 0 4885 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4680 0 0 33423.65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 155905.76 0 0 189329.41 0 0 0 1101322919 16 Nurse Practitioners 53 Kane 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101322942 1750304226 70 Ambulance Service Providers LYNNVILLE SCOTT WHITE ROCK FPD 610490101 79 Ogle 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 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3269.7 0 0 0 0 0 0 3269.7 0 0 0 1101322950 1316007131 10 Physicians TSENG MICHAEL 601901222 30 DuPage 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 584 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 809 0 185 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 809 0 185 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12610.9 0 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0 0 0 0 0 0 0 18810.25 0 0 0 0 0 0 0 0 0 0 0 0 0 18810.25 0 0 0 1101322993 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17974 0 0 0 0 0 0 0 0 0 0 0 0 0 17974 0 0 0 1101323012 1881804847 10 Physicians LYON CRAIG 531472655 852 Wisconsin 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 4 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55.27 0 3366.9 0 0 0 0 0 0 3422.17 0 0 0 1101323020 1821202524 10 Physicians RATTANSI SAJJAD 616370001 80 Peoria 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 290 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 290 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4429.39 0 0 0 0 0 0 4429.39 0 0 0 1101323027 91 Waiver service provider--Adults (DHS/DDD) 61 Livingston 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 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 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622233801 96 St Clair ASTC Ambulatory Surgical Treatment Center. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3516.21 0 0 0 0 0 3516.21 0 0 0 1101323054 1235213174 10 Physicians SALDAN ROMAN 600508419 71 McHenry 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 1 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5953.23 0 0 0 0 0 0 5953.23 0 0 0 1101323057 1609032549 10 Physicians PETROVIC BOJAN 600257657 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 446 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 552 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 552 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22732.82 0 152.11 0 0 0 0 0 0 22884.93 0 0 0 1101323058 1598988438 24 Speech Therapists FIGUEREDO YVONNE 606404007 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 281 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 281 0 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"Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4188.75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4188.75 0 0 0 1101323090 1376595025 10 Physicians BENNETT ADAM W. 600911457 200 Cook 0 0 Family Practice 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 77 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 0 0 0 1832.53 0 0 0 0 0 0 1832.53 0 0 0 1101323093 1245239540 63 Other Providers of Medical Equipment/Supplies (Non-registered) HOME CARE DELIVERED INC 230603344 848 Virginia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 891 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 891 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3425.09 0 0 0 0 0 0 3425.09 0 0 0 1101323094 1144486416 10 Physicians RABBAT JOYCE 606910263 30 DuPage 0 0 Pediatric Allergies 0 0 0 0 0 0 0 0 0 0 0 0 0 342 0 0 0 0 0 0 0 0 0 0 0 0 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SOLUTIONS SUPPLIER 193421062 839 Pennsylvania 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13277.53 0 0 0 0 0 0 13277.53 0 0 0 1101324154 1629356068 36 Community mental health provider TRILOGY INC 606262755 200 Cook 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 2677 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3205 0 0 2677 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3205 0 0 770.53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 164746.14 0 0 165516.67 0 0 0 1101324158 1700135274 22 Physical Therapists HELTON NICHOLAS 999999999 27 Dekalb 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 431 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 431 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10268.99 10268.99 0 0 0 1101324160 1972619302 10 Physicians SHYKEN JAYE 630262391 826 Missouri 0 0 Maternal and Fetal Medicine 0 0 0 0 0 0 0 0 0 0 0 42 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 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628642402 36 Franklin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1517.7 0 0 0 0 0 0 1517.7 0 0 0 1101324260 10 Physicians 816 Iowa 0 0 Internal Medicine 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 173.6 0 0 0 0 0 0 173.6 0 0 0 1101324266 55 Early Intervention Services 200 Cook 0 0 0 0 0 0 0 0 0 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 19 0 0 0 0 0 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 1349.01 0 0 0 0 0 0 1349.01 0 0 0 1101324269 1225013998 10 Physicians JOHN ANNIE 600257635 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 320 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 320 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 544.73 0 0 0 0 0 0 544.73 0 0 0 1101324275 92 Waiver service provider--Disability (DHS/DRS) 96 St Clair 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 19541.78 0 0 0 0 0 0 0 0 0 0 0 0 0 19541.78 0 0 0 1101324277 1043419526 60 Pharmacies WALMART PHARAMCY 10-4286 605381028 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 803 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 171111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 246804.39 0 0 0 246804.39 0 0 0 1101324279 1053405399 10 Physicians MIDDLETON WILLIAM 631101076 826 Missouri 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 176 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 218 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 218 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3553.88 0 1371.75 0 0 0 0 0 0 4925.63 0 0 0 1101324307 1124029277 10 Physicians MOK YOUNG 606221797 200 Cook 0 1 Pediatrics 0 1546 0 0 1162 0 0 0 0 0 0 810 0 1613 0 0 0 0 0 0 15415 0 0 3307 0 0 0 0 0 0 1236 0 2950 0 0 0 0 0 0 15415 0 0 3307 0 0 0 0 0 0 1236 0 2950 0 0 0 0 0 0 30977 0 0 93465.47 0 0 0 0 0 0 10322.5 0 113643.5 0 0 0 0 0 0 248408.47 0 0 0 1101324309 1710159645 29 ICF/MR EFFINGHAM TERRACE 624014022 33 Effingham 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 494 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8808 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 599864.24 0 0 0 0 0 0 0 0 0 0 599864.24 0 0 0 1101324324 92 Waiver service provider--Disability (DHS/DRS) 97 Stephenson 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 5801.82 0 0 0 0 0 0 0 0 0 0 0 0 0 5801.82 0 0 0 1101324327 92 Waiver service provider--Disability (DHS/DRS) 56 Knox 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14341.15 0 0 0 0 0 0 0 0 0 0 0 0 0 14341.15 0 0 0 1101324328 1740395581 30 General Hospitals WEST METRO DIALYSIS CENTER 606224477 200 Cook DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 0 1 0 0 0 0 0 0 0 0 0 0 0 0 118 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 952 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 12141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 238751.29 0 0 0 0 0 238751.29 0 0 0 1101324349 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3112.37 0 0 0 0 0 0 0 0 0 0 0 0 0 3112.37 0 0 0 1101324359 1083737993 55 Early Intervention Services DALEY CHERYL 605613915 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 431 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 431 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27192.53 0 0 0 0 0 0 27192.53 0 0 0 1101324362 1811141906 16 Nurse Practitioners GIGLIO MAUREEN 604488208 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 780.8 0 0 0 0 0 0 780.8 0 0 0 1101324363 1962417105 60 Pharmacies WALGREEN CO 05670 605252001 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 394 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1614 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 41654 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3.93 0 0 81935.29 0 0 0 81939.22 0 0 0 1101324391 30 General Hospitals 801 Alabama NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 0 748.75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 748.75 0 0 0 1101324399 98 Waiver service provider--TBI (DHS/DRS) 71 McHenry 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 14730.73 0 0 0 0 0 0 0 0 0 0 0 0 0 14730.73 0 0 0 1101324403 1447222146 10 Physicians HARRIS ANDREW 613501604 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 517 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 599 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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1101324528 1972623536 10 Physicians TAYLOR JASON 631102515 826 Missouri 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 6 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57.84 0 4400.39 0 0 0 0 0 0 4458.23 0 0 0 1101324553 1063520021 10 Physicians QUINONES JOHN 615202607 37 Fulton 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 361 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 444 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 444 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12651.78 0 0 0 0 0 0 12651.78 0 0 0 1101324554 1285728691 60 Pharmacies MEDICINE SHOPPE OF SALEM INC 628811511 66 Marion 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177 0 0 1117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 833 0 0 13493 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 833 0 0 330121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35491.53 0 0 693433.52 0 0 0 728925.05 0 0 0 1101324576 1497965842 29 ICF/MR SHADY OAKS EAST 604919081 107 Will 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 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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provider--Children's support (DHS/DDD) 200 Cook 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 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3103.62 0 0 0 0 0 0 0 0 0 0 0 0 0 3103.62 0 0 0 1101325995 1316171317 10 Physicians GARRETTO ROBERT 610324864 97 Stephenson 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 1044 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1254 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1254 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52312.64 0 0 0 0 0 0 52312.64 0 0 0 1101326001 10 Physicians 815 Indiana 0 0 Cardiovascular Diseases 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 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 55.25 0 0 0 0 0 0 55.25 0 0 0 1101326004 1053391359 10 Physicians DAYON DOMINADOR L 606171146 200 Cook 0 1 General Practice 0 551 0 0 121 0 0 0 0 0 0 9 0 246 0 0 0 0 0 0 4027 0 0 295 0 0 0 0 0 0 9 0 557 0 0 0 0 0 0 4027 0 0 295 0 0 0 0 0 0 9 0 557 0 0 0 0 0 0 9102 0 0 11860.87 0 0 0 0 0 0 35.33 0 18127.78 0 0 0 0 0 0 39125.98 0 0 0 1101326005 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 19 0 0 0 0 0 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 11593.33 0 0 0 0 0 0 0 0 0 0 0 0 0 11593.33 0 0 0 1101326012 92 Waiver service provider--Disability (DHS/DRS) 22 Clay 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 11106.99 0 0 0 0 0 0 0 0 0 0 0 0 0 11106.99 0 0 0 1101326020 92 Waiver service provider--Disability (DHS/DRS) 77 Morgan 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 14450.02 0 0 0 0 0 0 0 0 0 0 0 0 0 14450.02 0 0 0 1101326023 1154348720 10 Physicians SNOW JULIE 600681126 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 3 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85.74 0 1100.36 0 0 0 0 0 0 1186.1 0 0 0 1101326026 1629233713 55 Early Intervention Services MAZZEFFI JENNIFER 605172176 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 222 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 222 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16305.83 0 0 0 0 0 0 16305.83 0 0 0 1101326030 1821020124 10 Physicians OMASTIAK PAUL 604532670 71 McHenry 0 1 Family Practice 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 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2026.38 0 0 0 0 0 0 2026.38 0 0 0 1101326032 98 Waiver service provider--TBI (DHS/DRS) 28 De Witt 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 1315.15 0 0 0 0 0 0 0 0 0 0 0 0 0 1315.15 0 0 0 1101326041 92 Waiver service provider--Disability (DHS/DRS) 57 Lake 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17742.05 0 0 0 0 0 0 0 0 0 0 0 0 0 17742.05 0 0 0 1101326073 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 20716.48 0 0 0 0 0 0 0 0 0 0 0 0 0 20716.48 0 0 0 1101326077 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 1982.6 0 0 0 0 0 0 0 0 0 0 0 0 0 1982.6 0 0 0 1101326086 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2936.89 0 0 0 0 0 0 0 0 0 0 0 0 0 2936.89 0 0 0 1101326091 1497874325 43 Encounter rate clinic WOODLAWN ADULT HEALTH CENTER 606373707 200 Cook ARS-C.O.P. "JH Stroger, Oak Forest and Provident Hospitals, paid under an alternate reimbursement system" 0 1 Direct Access 0 140 824 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 327 2320 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 327 2320 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 981 479205.21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 480186.21 0 0 0 1101326099 16 Nurse Practitioners 826 Missouri 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106.06 0 0 0 0 0 0 106.06 0 0 0 1101326101 1154491959 11 Dentists HIRSCH GERALD 601101674 53 Kane 0 0 General Dentistry 0 0 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 343 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 343 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9161.08 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9161.08 0 0 0 1101326106 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 61 0 0 0 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 1120.08 0 0 0 0 0 0 0 0 0 0 0 0 0 1120.08 0 0 0 1101326109 1497732028 60 Pharmacies WILLIAMS BROS HLTH CARE PHARM 475014535 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1760.89 0 0 8.56 0 0 0 1769.45 0 0 0 1101326120 98 Waiver service provider--TBI (DHS/DRS) 55 Kendall 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 23 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 0 0 0 0 0 0 0 0 32051.51 0 0 0 0 0 0 0 0 0 0 0 0 0 32051.51 0 0 0 1101326126 1700084811 12 Optometrists NARBONE KATHERINE 604532701 200 Cook 0 0 Therapeutic Pharmaceutical Agents 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 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1156.31 0 0 0 0 0 0 1156.31 0 0 0 1101326130 1346277480 16 Nurse Practitioners HEALY LAURA 604321439 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 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 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1711.76 0 0 0 0 0 0 1711.76 0 0 0 1101326140 1194902353 28 Waiver service provider--Supportive living facility (HFS) BETH ANNE PLACE 606513117 200 Cook 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 675 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13377 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 992121.43 0 0 0 0 0 0 0 0 0 0 0 0 0 992121.43 0 0 0 1101326148 1609032150 10 Physicians POWELL EMILIE 604404906 107 Will 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 321 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 344 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 344 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10416.1 0 0 0 0 0 0 10416.1 0 0 0 1101326159 1508991282 30 General Hospitals OTTAWA REG HOSP AND HEALTHCARE 613501604 58 La Salle ARS-PD Hospitals paid a Per Diem rate. 0 0 General Hospital - Adult and Child 0 3 991 0 0 4618 0 0 0 0 1424 0 0 0 2301 0 0 0 0 0 5 6184 0 0 9135 0 0 0 0 1781 0 0 0 5397 0 0 0 0 0 5 6777 0 0 9153 0 0 0 0 5916 0 0 0 5497 0 0 0 0 0 0.21 250849.85 0 0 1516931.29 0 0 0 0 2956384.59 0 0 0 1379645.52 0 0 0 0 0 6103811.46 0 0 0 1101326161 91 Waiver service provider--Adults (DHS/DDD) 30 DuPage 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 0 352 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 352 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24229.76 0 0 0 0 0 0 0 0 0 0 0 0 0 24229.76 0 0 0 1101326166 1750397204 10 Physicians GYNN THOMAS 602023442 200 Cook 0 0 Oncology 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 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 536.44 0 0 0 0 0 0 536.44 0 0 0 1101326167 1740314913 22 Physical Therapists GALINSKI JANUSZ 607073730 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1436 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1436 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120253.03 120253.03 0 0 0 1101326172 1568455327 10 Physicians KHAN RAZA M 600992676 57 Lake 0 0 Urological Surgery 0 0 0 0 0 0 0 0 0 0 0 24 0 128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 406 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 406 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76.86 0 7736.5 0 0 0 0 0 0 7813.36 0 0 0 1101326201 10 Physicians 852 Wisconsin 0 0 Emergency Medicine 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56.2 0 0 0 0 0 0 56.2 0 0 0 1101326206 1376672212 10 Physicians ALEKSANDROVICH ELLEN 601232305 53 Kane 0 1 Internal Medicine 0 31 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 175 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 175 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 506 0 0 0 0 0 0 0 0 0 0 0 1786.96 0 0 0 0 0 0 2292.96 0 0 0 1101326207 1033148457 10 Physicians RHOADES WILLIAM D 606313222 57 Lake 0 0 Geriatrics 0 0 0 0 0 0 0 0 0 0 0 3 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3.33 0 169.65 0 0 0 0 0 0 172.98 0 0 0 1101326214 91 Waiver service provider--Adults (DHS/DDD) 53 Kane 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 14 0 0 0 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 0 829.93 0 0 0 0 0 0 0 0 0 0 0 0 0 829.93 0 0 0 1101326225 91 Waiver service provider--Adults (DHS/DDD) 76 Montgomery 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 0 349 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 349 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9885.7 0 0 0 0 0 0 0 0 0 0 0 0 0 9885.7 0 0 0 1101326234 1790819118 22 Physical Therapists ADAMS SARAH M 620253010 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6545.52 6545.52 0 0 0 1101326252 1073759825 75 Department of Alcohol and Substance Abuse Provider STEPPING STONES INC 604351902 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 750 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 750 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40279.94 0 0 40279.94 0 0 0 1101326258 1467452573 10 Physicians CIECHANOWSKI ZBIGNIEW 601741665 53 Kane 0 1 Pediatrics 0 36 0 0 15 0 0 0 0 0 0 7 0 42 0 0 0 0 0 0 261 0 0 42 0 0 0 0 0 0 12 0 144 0 0 0 0 0 0 261 0 0 42 0 0 0 0 0 0 12 0 144 0 0 0 0 0 0 627 0 0 1463.39 0 0 0 0 0 0 63.02 0 6424.18 0 0 0 0 0 0 8577.59 0 0 0 1101326263 1942311972 10 Physicians BERRY JENNETTE L 606313222 200 Cook 0 1 Family Practice 0 343 0 0 49 0 0 0 0 0 0 67 0 217 0 0 0 0 0 0 2510 0 0 85 0 0 0 0 0 0 96 0 466 0 0 0 0 0 0 2510 0 0 85 0 0 0 0 0 0 96 0 466 0 0 0 0 0 0 6233 0 0 4126.55 0 0 0 0 0 0 508.3 0 17533.72 0 0 0 0 0 0 28401.57 0 0 0 1101326269 1407853435 10 Physicians ALI MIR 600672414 200 Cook 0 1 Internal Medicine 0 0 0 0 4 0 0 0 0 0 0 36 0 65 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 67 0 193 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 67 0 193 0 0 0 0 0 0 0 0 0 399.5 0 0 0 0 0 0 784.81 0 6940.82 0 0 0 0 0 0 8125.13 0 0 0 1101326319 10 Physicians 852 Wisconsin 0 0 Pediatric Cardiology 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 249.2 0 0 0 0 0 0 249.2 0 0 0 1101326326 1720079015 10 Physicians KOSIERKIEWICZ TOMASZ 628646736 49 Jefferson 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 53 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 112 0 370 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 112 0 370 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3707.21 0 2596.67 0 0 0 0 0 0 6303.88 0 0 0 1101326343 10 Physicians 852 Wisconsin 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24.2 0 0 0 0 0 0 24.2 0 0 0 1101326349 92 Waiver service provider--Disability (DHS/DRS) 91 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 1298.97 0 0 0 0 0 0 0 0 0 0 0 0 0 1298.97 0 0 0 1101326356 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 349 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 349 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23548.25 0 0 0 0 0 0 0 0 0 0 0 0 0 23548.25 0 0 0 1101326364 1952335192 48 Rural Health Clinics CORK MEDICAL CENTER 624411010 21 Clark 0 1 0 2615 1825 0 550 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21535 14049 0 2046 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21535 14049 0 2046 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54039 545332.53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 599371.53 0 0 0 1101326368 91 Waiver service provider--Adults (DHS/DDD) 90 Saline 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 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4631 0 0 0 0 0 0 0 0 0 0 0 0 0 4631 0 0 0 1101326369 1720017262 10 Physicians CHACKO SIJU 463222500 815 Indiana 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 157 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 157 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 808.33 0 0 0 0 0 0 808.33 0 0 0 1101326370 1316988694 10 Physicians BECKER JOHN 627046924 91 Sangamon 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 862 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1110 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1110 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25415.23 0 1771.97 0 0 0 0 0 0 27187.2 0 0 0 1101326374 1063605814 10 Physicians BRANDON EDEN 606176605 200 Cook 0 1 Internal Medicine 0 9 0 0 0 0 0 0 0 0 0 2 0 189 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 4 0 813 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 4 0 813 0 0 0 0 0 0 148 0 0 0 0 0 0 0 0 0 15.28 0 10078.14 0 0 0 0 0 0 10241.42 0 0 0 1101326379 91 Waiver service provider--Adults (DHS/DDD) 96 St Clair 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 0 315 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 315 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9555.73 0 0 0 0 0 0 0 0 0 0 0 0 0 9555.73 0 0 0 1101326382 1205944394 52 Certified local public health department KNOX COUNTY HEALTH DEPT 614012436 56 Knox 0 0 General Practice 0 0 268 0 268 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 336 0 436 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 336 0 436 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4879.27 0 4958.07 0 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0 0 0 0 0 0 0 26395 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56572.26 0 0 0 56572.26 0 0 0 1101326394 2100316812 71 Medicar Provider HADAD MEDICAL CARE SERVICES 604782169 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17753.13 0 0 0 0 0 0 17753.13 0 0 0 1101326403 1053450601 75 Department of Alcohol and Substance Abuse Provider CENTRAL EAST ALCOHOL AND DRUG 619201902 24 Coles 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 296 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4363 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4364 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 547324.64 0 0 547324.64 0 0 0 1101326422 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 7541.51 0 0 0 0 0 0 0 0 0 0 0 0 0 7541.51 0 0 0 1101326423 1609832153 12 Optometrists RIMBERGAS SYLVIA 610213083 60 Lee 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 348 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43058.68 0 0 0 0 0 0 43058.68 0 0 0 1101326780 1417967589 16 Nurse Practitioners PAPINEAU ELAINE 606127322 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 290 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 290 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7424.58 0 0 0 0 0 0 7424.58 0 0 0 1101326784 1609920768 10 Physicians PALMER DENNIS 612311209 74 Mercer 0 0 General Practice 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 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 379.48 0 0 0 0 0 0 379.48 0 0 0 1101326797 1275663445 33 Nursing Facilities CEDAR RIDGE HEALTH REHAB CTR 622541356 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 942 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23373 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2010533.2 0 0 0 0 0 0 0 2010533.2 0 0 0 1101326800 1235151861 10 Physicians LIM MICHAEL 631102515 826 Missouri 0 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0 0 0 0 0 4891.23 0 0 0 1101326817 1821051608 36 Community mental health provider ALLENDALE ASSOCIATION 531020317 852 Wisconsin 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 315 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5659 0 0 315 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5659 0 0 13074.78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 202486.48 0 0 215561.26 0 0 0 1101326821 1346403664 10 Physicians BRADFORD CARRIE 604631256 200 Cook 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 315 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 315 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2244.2 0 0 0 0 0 0 0 0 2244.2 0 0 0 1101326827 1194791459 10 Physicians BERNSTEIN MATTHEW 601953203 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 30 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 247.44 0 1978.08 0 0 0 0 0 0 2225.52 0 0 0 1101326832 1770738007 63 Other Providers of Medical Equipment/Supplies (Non-registered) D V JAHN INC 600483798 57 Lake 0 0 0 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0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 745 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 745 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12466.07 0 0 0 0 0 0 12466.07 0 0 0 1101327400 1134126949 10 Physicians NIELSEN DIANE C 601344209 53 Kane 0 1 Pediatrics 0 191 0 0 159 0 0 0 0 0 0 148 0 208 0 0 0 0 0 0 1534 0 0 602 0 0 0 0 0 0 240 0 458 0 0 0 0 0 0 1534 0 0 602 0 0 0 0 0 0 240 0 458 0 0 0 0 0 0 3077 0 0 16539.32 0 0 0 0 0 0 1458.86 0 26414.64 0 0 0 0 0 0 47489.82 0 0 0 1101327402 1164440855 10 Physicians BRODY DAVID 631101010 826 Missouri 0 0 Neurology 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 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 436.22 0 0 0 0 0 0 436.22 0 0 0 1101327413 1326197971 10 Physicians ESPOSITO PATRICK 601204301 53 Kane 0 1 Pediatrics 0 218 0 0 280 0 0 0 0 0 0 91 0 379 0 0 0 0 0 0 1916 0 0 1066 0 0 0 0 0 0 100 0 557 0 0 0 0 0 0 1916 0 0 1066 0 0 0 0 0 0 100 0 557 0 0 0 0 0 0 3832 0 0 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0 0 0 0 0 21.29 0 0 0 1101327472 1497759260 30 General Hospitals SULLIVAN CO COMM HOSPITAL 478820010 815 Indiana NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 12 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 4634.76 0 0 0 0 0 0 0 0 88.04 0 0 0 0 0 4722.8 0 0 0 1101327486 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 14003.86 0 0 0 0 0 0 0 0 0 0 0 0 0 14003.86 0 0 0 1101327493 1912979147 10 Physicians BAIN JAMES 612653700 89 Rock Island 0 0 Family Practice 0 0 0 0 25 0 0 0 0 0 0 206 0 541 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 250 0 651 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 250 0 651 0 0 0 0 0 0 0 0 0 834.95 0 0 0 0 0 0 2584.89 0 14264.97 0 0 0 0 0 0 17684.81 0 0 0 1101327498 1093715237 52 Certified local public health 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7578.92 0 0 0 0 0 0 7578.92 0 0 0 1101327786 1801927371 47 Local Education Agencies TOWNSHIP H S DIST 214 600054205 200 Cook 0 0 0 0 0 0 183 0 0 0 0 0 0 0 0 0 0 0 0 0 235 0 0 0 0 380 0 0 0 0 0 0 0 0 0 0 0 0 0 4017 0 0 0 0 380 0 0 0 0 0 0 0 0 0 0 0 0 0 4017 0 0 0 0 2347.81 0 0 0 0 0 0 0 0 0 0 0 0 0 116129.3 0 118477.11 0 0 0 1101327801 1154400513 10 Physicians BAUTISTA MARIA RIZA 606213114 200 Cook 0 1 Family Practice 0 162 0 0 0 0 0 0 0 0 0 6 0 202 0 0 0 0 0 0 1044 0 0 0 0 0 0 0 0 0 8 0 727 0 0 0 0 0 0 1044 0 0 0 0 0 0 0 0 0 8 0 727 0 0 0 0 0 0 3263 0 0 0 0 0 0 0 0 0 32 0 13208.49 0 0 0 0 0 0 16503.49 0 0 0 1101327812 2100318230 91 Waiver service provider--Adults (DHS/DDD) CENTER ON DEAFNESS 600622201 200 Cook 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 5856 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5856 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 633621.04 0 0 0 0 0 0 0 0 0 0 0 0 0 633621.04 0 0 0 1101327814 1487817607 10 Physicians LAPETINO SHAWN 605064356 107 Will 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 141.02 0 0 0 0 0 0 0 0 141.02 0 0 0 1101327819 1144398520 10 Physicians JACKSON ALAN 605276686 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 1098 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2286 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2286 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20298.44 0 0 0 0 0 0 20298.44 0 0 0 1101327830 10 Physicians 97 Stephenson 0 0 Radiation Oncology 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24.45 0 0 0 0 0 0 24.45 0 0 0 1101327837 1679599815 10 Physicians TOLLEFSEN DOUGLAS 631082212 826 Missouri 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 13 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 0 300.86 0 0 0 0 0 0 300.86 0 0 0 1101327846 1295759645 10 Physicians SHARON PINHAS 604433806 200 Cook 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5527.02 0 0 0 0 0 0 5527.02 0 0 0 1101327852 10 Physicians 852 Wisconsin 0 1 Pediatrics 0 0 0 0 2 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 76.84 0 0 0 0 0 0 0 0 83.12 0 0 0 0 0 0 159.96 0 0 0 1101327857 1861689903 16 Nurse Practitioners FUSS BRENDA 617610016 72 McLean 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 117 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 202 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 202 0 0 0 0 0 0 0 0 0 173.55 0 0 0 0 0 0 0 0 4244.57 0 0 0 0 0 0 4418.12 0 0 0 1101327861 1679673164 10 Physicians ALI ARIF 600681459 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 41 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 221 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 221 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 671.3 0 15796.32 0 0 0 0 0 0 16467.62 0 0 0 1101327865 1164546438 47 Local Education Agencies AERO SPECIAL EDUCATION COOP 604591200 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 443 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11642 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11642 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 264470.65 0 264470.65 0 0 0 1101327915 1184767444 10 Physicians GIDRON ADI 602022430 57 Lake 0 0 Hematology 0 0 0 0 0 0 0 0 0 0 0 6 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 279 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 279 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 144.92 0 2708.54 0 0 0 0 0 0 2853.46 0 0 0 1101327924 92 Waiver service provider--Disability (DHS/DRS) 68 Mason 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 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 11960.43 0 0 0 0 0 0 0 0 0 0 0 0 0 11960.43 0 0 0 1101327928 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 17589.57 0 0 0 0 0 0 0 0 0 0 0 0 0 17589.57 0 0 0 1101327932 92 Waiver service provider--Disability (DHS/DRS) 98 Tazewell 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36.11 0 0 0 0 0 0 0 0 0 0 0 0 0 36.11 0 0 0 1101327937 1407079205 24 Speech Therapists PETERSON KRISTIN 606132561 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 204 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 204 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30765.53 30765.53 0 0 0 1101327951 1417055922 10 Physicians GARWACKI DENNIS J 616061919 80 Peoria 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 354 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 492 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 492 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18212.34 0 0 0 0 0 0 18212.34 0 0 0 1101327971 1952671752 60 Pharmacies MEIJER PHARMACY 239 999999999 55 Kendall 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 484 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3380 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87440 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 138563.09 0 0 0 138563.09 0 0 0 1101327972 1770744476 10 Physicians MATHEN SHAUN 601232300 53 Kane 0 1 Family Practice 0 557 0 0 108 0 0 0 0 0 0 76 0 280 0 0 0 0 0 0 3563 0 0 128 0 0 0 0 0 0 94 0 532 0 0 0 0 0 0 3563 0 0 128 0 0 0 0 0 0 94 0 532 0 0 0 0 0 0 8821 0 0 11303.85 0 0 0 0 0 0 332.68 0 25415.34 0 0 0 0 0 0 45872.87 0 0 0 1101327976 1093775751 10 Physicians NARAYANAN JAISHREE 602011777 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 523 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 523 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15677.31 0 0 0 0 0 0 15677.31 0 0 0 1101327984 1467453951 10 Physicians BOURTSOS ELENI 605213829 30 DuPage 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 882.9 0 0 0 0 0 0 0 0 882.9 0 0 0 1101327997 1720196876 10 Physicians DAVE PINAKINPRASAD 604092252 200 Cook 0 1 Internal Medicine 0 18 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 797.67 0 0 0 0 0 0 886.67 0 0 0 1101327998 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 15213.15 0 0 0 0 0 0 0 0 0 0 0 0 0 15213.15 0 0 0 1101327999 1255597779 10 Physicians PERSAK JOSEPH 601691019 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 523 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 557 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 557 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23372.98 0 0 0 0 0 0 23372.98 0 0 0 1101328000 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 41211.85 0 0 0 0 0 0 0 0 0 0 0 0 0 41211.85 0 0 0 1101328009 1154514867 10 Physicians WILLIAMSON MARGARET 606118709 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 539 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 564 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 564 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20324.96 0 0 0 0 0 0 20324.96 0 0 0 1101328011 92 Waiver service provider--Disability (DHS/DRS) 70 McDonough 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 23809.28 0 0 0 0 0 0 0 0 0 0 0 0 0 23809.28 0 0 0 1101328034 1548419849 11 Dentists SANGHAVI AVANTI 604402852 107 Will 0 0 General Dentistry 0 0 0 356 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2265 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2265 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57879.4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57879.4 0 0 0 1101328037 1922135441 34 State-operated facility (DHS) UNIT 3263 HOME 13 KILEY 600856263 57 Lake 0 0 0 0 0 0 0 0 0 0 0 7 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 0 630 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 481437.79 0 0 0 0 0 0 0 0 0 0 481437.79 0 0 0 1101328039 1588781173 10 Physicians BHATTACHARJEE RAKESH 605277594 30 DuPage 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 196 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 196 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11425.2 0 0 0 0 0 0 11425.2 0 0 0 1101328042 1790838514 14 Chiropractors BARRETT JEFF 613501040 58 La Salle 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 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 457.27 0 0 0 0 0 0 457.27 0 0 0 1101328050 1316971005 10 Physicians SHAH BHARAT 606593447 40 Grundy 0 1 Internal Medicine 0 88 0 0 0 0 0 0 0 0 0 0 0 1043 0 0 0 0 0 0 264 0 0 0 0 0 0 0 0 0 0 0 4087 0 0 0 0 0 0 264 0 0 0 0 0 0 0 0 0 0 0 4087 0 0 0 0 0 0 1039 0 0 0 0 0 0 0 0 0 0 0 51494.92 0 0 0 0 0 0 52533.92 0 0 0 1101328052 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6952 0 0 0 0 0 0 0 0 0 0 0 0 0 6952 0 0 0 1101328059 1134147382 10 Physicians SCHROEDER JAMES 606112991 200 Cook 0 0 Otolaryngology 0 0 0 0 0 0 0 0 0 0 0 0 0 201 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 419 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 419 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38935.83 0 0 0 0 0 0 38935.83 0 0 0 1101328075 1770649063 63 Other Providers of Medical Equipment/Supplies (Non-registered) CAREFREE HEALTH SERVICES INC 334834652 810 Florida 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 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 0 367.53 0 0 0 0 0 0 367.53 0 0 0 1101328083 91 Waiver service provider--Adults (DHS/DDD) 65 Madison 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 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15445.65 0 0 0 0 0 0 0 0 0 0 0 0 0 15445.65 0 0 0 1101328093 2100318511 91 Waiver service provider--Adults (DHS/DDD) CIRCLE OF SUPPORT INC 600685000 200 Cook 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20848 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20848 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1318500.2 0 0 0 0 0 0 0 0 0 0 0 0 0 1318500.2 0 0 0 1101328125 1396854592 10 Physicians TEWIS HUEY 637020751 826 Missouri 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 635.23 0 0 0 0 0 0 635.23 0 0 0 1101328126 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 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 32644.81 0 0 0 0 0 0 0 0 0 0 0 0 0 32644.81 0 0 0 1101328133 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3792.92 0 0 0 0 0 0 0 0 0 0 0 0 0 3792.92 0 0 0 1101328150 1972881977 55 Early Intervention Services KNOX NAOMI 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 693 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 693 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40301.56 0 0 0 0 0 0 40301.56 0 0 0 1101328154 91 Waiver service provider--Adults (DHS/DDD) 30 DuPage 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 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11298.35 0 0 0 0 0 0 0 0 0 0 0 0 0 11298.35 0 0 0 1101328158 1134148919 16 Nurse Practitioners ELLIOTT ZIPPE CYNTHIA 611042333 109 Winnebago 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 29.2 0 0 0 0 0 0 0 0 2434.42 0 0 0 0 0 0 2463.62 0 0 0 1101328164 1164436689 16 Nurse Practitioners WARNER LORI 622265360 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3296.32 0 0 0 0 0 0 3296.32 0 0 0 1101328165 1649287947 10 Physicians SAMUEL BENJAMIN 606401945 200 Cook 0 0 Infectious Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 993 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 993 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5903.14 0 0 0 0 0 0 5903.14 0 0 0 1101328166 1811121361 10 Physicians RUSHFORTH NEAL 616370001 80 Peoria 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 651 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 724 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 724 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25784.93 0 0 0 0 0 0 25784.93 0 0 0 1101328169 24 Speech Therapists 53 Kane 0 0 0 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 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 0 595.28 595.28 0 0 0 1101328172 1376533612 11 Dentists YONG TONY 600609438 57 Lake 0 0 General Dentistry 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3713.93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3713.93 0 0 0 1101328173 1780663690 10 Physicians DELLA VALLE CRAIG 606124861 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 72 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 174 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 174 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 858.48 0 6603.44 0 0 0 0 0 0 7461.92 0 0 0 1101328175 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 214 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 214 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13134 0 0 0 0 0 0 0 0 0 0 0 0 0 13134 0 0 0 1101328176 1275724809 10 Physicians MENDI RAMIT 604532600 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 92 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9961.5 0 1921.29 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 178 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 178 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4252.91 0 0 0 0 0 0 0 0 4252.91 0 0 0 1101330784 91 Waiver service provider--Adults (DHS/DDD) 53 Kane 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 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22411.06 0 0 0 0 0 0 0 0 0 0 0 0 0 22411.06 0 0 0 1101330798 1568499770 10 Physicians MOCHARNUK ROBERT 627949639 91 Sangamon 0 0 Hematology 0 0 0 0 0 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15818.54 0 0 0 0 0 0 15818.54 0 0 0 1101330807 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 20292 0 0 0 0 0 0 0 0 0 0 0 0 0 20292 0 0 0 1101330820 92 Waiver service provider--Disability (DHS/DRS) 30 DuPage 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 29383.68 0 0 0 0 0 0 0 0 0 0 0 0 0 29383.68 0 0 0 1101330826 1104033042 63 Other Providers of Medical Equipment/Supplies (Non-registered) INTEGRA HEALTHCARE EQUIPMENT 601261435 30 DuPage 0 0 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 0 183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15952.35 0 0 0 0 0 0 15952.35 0 0 0 1101330828 98 Waiver service provider--TBI (DHS/DRS) 107 Will 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1780.94 0 0 0 0 0 0 0 0 0 0 0 0 0 1780.94 0 0 0 1101330834 1841398468 16 Nurse Practitioners YOCOM ANGELA 624012258 33 Effingham 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 634 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 634 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6636.98 0 0 0 0 0 0 6636.98 0 0 0 1101330835 1407075468 91 Waiver service provider--Adults (DHS/DDD) HAWK PHILLIP 604431762 200 Cook 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 513 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 513 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95986.73 0 0 0 0 0 0 0 0 0 0 0 0 0 95986.73 0 0 0 1101330836 1740213149 10 Physicians DODHIA NAVINCHANDRA 605064355 53 Kane 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 2 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 937 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 937 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43.52 0 8293.48 0 0 0 0 0 0 8337 0 0 0 1101330839 1619212107 16 Nurse Practitioners HAUBRICH NICOLLETTE 623012715 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 632 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 632 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81749.12 0 0 0 0 0 0 81749.12 0 0 0 1101330840 12 Optometrists 200 Cook 0 0 Diagnostic Pharmaceutical Agents 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73.73 0 0 0 0 0 0 73.73 0 0 0 1101330846 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 21098.67 0 0 0 0 0 0 0 0 0 0 0 0 0 21098.67 0 0 0 1101330858 1952631269 10 Physicians PATEL DUSHYANTKUMAR 627949248 91 Sangamon 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 483 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 483 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4501.13 0 0 0 0 0 0 4501.13 0 0 0 1101330860 1265579262 10 Physicians NIZAM MAIMANAT 606363271 200 Cook 0 1 Family Practice 0 342 0 0 42 0 0 0 0 0 0 4 0 185 0 0 0 0 0 0 1007 0 0 92 0 0 0 0 0 0 5 0 357 0 0 0 0 0 0 1007 0 0 92 0 0 0 0 0 0 5 0 357 0 0 0 0 0 0 2421 0 0 4277.83 0 0 0 0 0 0 19.33 0 14559.47 0 0 0 0 0 0 21277.63 0 0 0 1101330865 1649213539 33 Nursing Facilities MANORCARE OF PALOS HTS EAST 604631010 200 Cook 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 0 383 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7739 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 624362.19 0 0 0 0 0 0 0 624362.19 0 0 0 1101330866 1851387120 10 Physicians ZARET PHILLIP 606081610 200 Cook 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 171 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 473 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 473 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22823.75 0 0 0 0 0 0 22823.75 0 0 0 1101330871 1013230119 16 Nurse Practitioners BLUE DAVID 622861820 87 Randolph 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20998.42 0 0 0 0 0 0 20998.42 0 0 0 1101330873 1730298886 10 Physicians MILLER JAMES L 603041098 200 Cook 0 1 Internal Medicine 0 23 0 0 0 0 0 0 0 0 0 6 0 117 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 6 0 414 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 6 0 414 0 0 0 0 0 0 265 0 0 0 0 0 0 0 0 0 18.76 0 2942.54 0 0 0 0 0 0 3226.3 0 0 0 1101330894 1841347069 16 Nurse Practitioners CLAY TRACY 610326600 97 Stephenson 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 512 0 0 0 0 0 0 0 0 0 207 0 0 0 0 0 0 0 0 1301 0 0 0 0 0 0 0 0 0 207 0 0 0 0 0 0 0 0 1301 0 0 0 0 0 0 0 0 0 8724.22 0 0 0 0 0 0 0 0 58552.42 0 0 0 0 0 0 67276.64 0 0 0 1101330900 1841237658 10 Physicians ROLDAN MARIO A 606225297 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1920.88 0 0 0 0 0 0 1920.88 0 0 0 1101330902 1861410268 10 Physicians HARRIS SANDRA 605066222 53 Kane 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 16 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 197.74 0 4066.72 0 0 0 0 0 0 4264.46 0 0 0 1101330904 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 2238 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72746.19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72746.19 0 0 0 1101330995 1801928320 10 Physicians HOOVER ADINA 605595573 30 DuPage 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 530 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 567 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 567 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23381.46 0 0 0 0 0 0 23381.46 0 0 0 1101331006 98 Waiver service provider--TBI (DHS/DRS) 91 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 5554.43 0 0 0 0 0 0 0 0 0 0 0 0 0 5554.43 0 0 0 1101331012 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 24592.55 0 0 0 0 0 0 0 0 0 0 0 0 0 24592.55 0 0 0 1101331028 1922070457 10 Physicians AHMAD IFTIKHAR 606611296 200 Cook 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 124 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 217 0 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 217 0 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1024.22 0 4867.94 0 0 0 0 0 0 5892.16 0 0 0 1101331029 1053541318 10 Physicians JAMEN ERIN M 606294417 200 Cook 0 1 Pediatrics 0 715 0 0 369 0 0 0 0 0 0 19 0 298 0 0 0 0 0 0 5423 0 0 1355 0 0 0 0 0 0 19 0 501 0 0 0 0 0 0 5423 0 0 1355 0 0 0 0 0 0 19 0 501 0 0 0 0 0 0 10846 0 0 43450.6 0 0 0 0 0 0 71.33 0 20874.8 0 0 0 0 0 0 75242.73 0 0 0 1101331031 94 Waiver service provider--Children's support (DHS/DDD) 97 Stephenson 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 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1560.11 0 0 0 0 0 0 0 0 0 0 0 0 0 1560.11 0 0 0 1101331041 1760705834 10 Physicians BUCHA JURATE M 611081673 109 Winnebago 0 1 Internal Medicine 0 1 0 0 0 0 0 0 0 0 0 15 0 76 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 31 0 217 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 31 0 217 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 215.15 0 1905.34 0 0 0 0 0 0 2156.49 0 0 0 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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 25603.39 0 0 0 0 0 0 0 0 0 0 0 0 0 25603.39 0 0 0 1101331141 1487732939 63 Other Providers of Medical Equipment/Supplies (Non-registered) ABC MEDICAL SUPPLY INC 600672605 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 261 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4925 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4925 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 385466.7 0 138.54 0 0 0 0 385605.24 0 0 0 1101331144 10 Physicians 852 Wisconsin 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 322.2 0 0 0 0 0 0 322.2 0 0 0 1101331147 1255315867 10 Physicians LITCHFIELD ROBERT L 604611184 200 Cook 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87.67 0 0 0 0 0 0 87.67 0 0 0 1101331153 10 Physicians 200 Cook 0 0 Family Practice 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 2633 0 0 0 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 6678 0 0 0 0 0 0 0 0 0 0 0 553.44 0 0 0 0 0 0 7231.44 0 0 0 1101331727 10 Physicians 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 1 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71.9 0 238.77 0 0 0 0 0 0 310.67 0 0 0 1101331734 1790091809 10 Physicians POLUPAN LYUDMYLA 600442203 57 Lake 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 3 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30088.78 0 0 0 0 0 0 30088.78 0 0 0 1101331745 1083686158 10 Physicians BECK JOHN 629602467 69 Massac 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 957 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1205 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1205 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45574.82 0 0 0 0 0 0 45574.82 0 0 0 1101331746 10 Physicians 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 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0 308 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15250.82 0 0 0 0 0 0 15250.82 0 0 0 1101331764 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2358.76 0 0 0 0 0 0 0 0 0 0 0 0 0 2358.76 0 0 0 1101331779 1467405662 10 Physicians POLLAK MARTIN J 600161667 200 Cook 0 0 Otolaryngology 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8544.33 0 0 0 0 0 0 8544.33 0 0 0 1101331784 1376835850 70 Ambulance Service Providers LAKE ZURICH RURAL FIRE PROT 999999999 57 Lake 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 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2760.86 0 0 0 0 0 0 2760.86 0 0 0 1101331795 1669469276 10 Physicians SMOOKLER ALAN 600257635 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 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0 201634.77 0 0 0 0 0 224301.17 0 0 0 1101331826 2100322244 94 Waiver service provider--Children's support (DHS/DDD) MH CENTERS OF CENTRAL IL 626562237 62 Logan 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4081.02 0 0 0 0 0 0 0 0 0 0 0 0 0 4081.02 0 0 0 1101331830 92 Waiver service provider--Disability (DHS/DRS) 79 Ogle 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101331835 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 0 169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10753.38 0 0 0 0 0 0 0 0 0 0 0 0 0 10753.38 0 0 0 1101331841 1629140892 10 Physicians PATEL BHUPENDRA 601312719 200 Cook 0 0 Internal Medicine 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 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 203.16 0 0 0 0 0 0 203.16 0 0 0 1101331845 1982948634 91 Waiver service provider--Adults (DHS/DDD) ALPHA OMEGA CONSULTING INC 999999999 63 Macon 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1779037.03 0 0 0 0 0 0 0 0 0 0 0 0 0 1779037.03 0 0 0 1101331853 91 Waiver service provider--Adults (DHS/DDD) 97 Stephenson 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 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5251.29 0 0 0 0 0 0 0 0 0 0 0 0 0 5251.29 0 0 0 1101331855 1578666541 52 Certified local public health department WINNEBAGO COUNTY HEALTH DEPT 611100509 109 Winnebago 0 0 0 0 495 0 691 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2324 0 1758 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2324 0 1758 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51777.86 0 17091.28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68869.14 0 0 0 1101331859 92 Waiver service provider--Disability (DHS/DRS) 106 Whiteside 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 17679.5 0 0 0 0 0 0 0 0 0 0 0 0 0 17679.5 0 0 0 1101331869 92 Waiver service provider--Disability (DHS/DRS) 31 Edgar 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2147.73 0 0 0 0 0 0 0 0 0 0 0 0 0 2147.73 0 0 0 1101331889 1669644308 10 Physicians NORTHERN LUKE 999999999 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6256.63 0 0 0 0 0 0 6256.63 0 0 0 1101331898 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11979 0 0 0 0 0 0 0 0 0 0 0 0 0 11979 0 0 0 1101331902 1255308334 10 Physicians IVANENKO ANNA 601322776 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 373 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 373 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12963.49 0 0 0 0 0 0 12963.49 0 0 0 1101331917 91 Waiver service provider--Adults (DHS/DDD) 91 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 847 0 0 0 0 0 0 0 0 0 0 0 0 0 847 0 0 0 1101331926 1669516670 34 State-operated facility (DHS) UNIT 4380 PAVILION 2 MADDEN 601417000 200 Cook 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 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 127985.52 0 0 0 0 0 0 0 0 0 127985.52 0 0 0 1101331932 1619972999 10 Physicians BODE DAWN 612655016 89 Rock Island 0 1 Family Practice 0 112 0 0 22 0 0 0 0 0 0 1 0 45 0 0 0 0 0 0 845 0 0 29 0 0 0 0 0 0 1 0 118 0 0 0 0 0 0 845 0 0 29 0 0 0 0 0 0 1 0 118 0 0 0 0 0 0 1985 0 0 2284.01 0 0 0 0 0 0 15.7 0 3646.81 0 0 0 0 0 0 7931.52 0 0 0 1101331935 1285917377 12 Optometrists YIN HUIZI 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 333 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 646 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 646 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18419.67 0 0 0 0 0 0 18419.67 0 0 0 1101331936 1487610572 30 General Hospitals CRAWFORD MEMORIAL HOSPITAL 624540151 25 Crawford DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 1 0 0 0 0 0 12 0 0 0 0 0 0 1763 0 0 805 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 11193 0 0 2577 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 11193 0 0 2577 0 0 0 0 0 0 0 0 150.02 0 0 0 0 0 0 132478.59 0 0 262689.79 0 0 0 0 0 395318.4 0 0 0 1101331938 1578583340 10 Physicians HAGGAR ALLAN 605213829 30 DuPage 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 539 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 692 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 692 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13599.46 0 1972.59 0 0 0 0 0 0 15572.05 0 0 0 1101331945 92 Waiver service 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(DHS/DRS) 200 Cook 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 15106.55 0 0 0 0 0 0 0 0 0 0 0 0 0 15106.55 0 0 0 1101332639 1578685558 16 Nurse Practitioners PETERS LISY 607141156 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 352 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 420 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 420 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62332.41 0 0 0 0 0 0 62332.41 0 0 0 1101332646 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 47 0 0 0 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 3168 0 0 0 0 0 0 0 0 0 0 0 0 0 3168 0 0 0 1101332655 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 3620.53 0 0 0 0 0 0 0 0 0 0 0 0 0 3620.53 0 0 0 1101332674 1134213051 10 Physicians VOIRIN TIMOTHY L 613621512 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 446 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 506 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 506 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14096.05 0 0 0 0 0 0 14096.05 0 0 0 1101332681 1467485276 10 Physicians YEDIDAG AZADE 601533328 200 Cook 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9925.41 0 0 0 0 0 0 9925.41 0 0 0 1101332686 1023084712 10 Physicians FARRAR CHRISTOPHER 620628500 65 Madison 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 465 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 465 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3833.42 0 0 0 0 0 0 3833.42 0 0 0 1101332691 91 Waiver service provider--Adults (DHS/DDD) 107 Will 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 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5995 0 0 0 0 0 0 0 0 0 0 0 0 0 5995 0 0 0 1101332697 1710042833 60 Pharmacies WAL MART PHARMACY 10 4259 625650000 94 Shelby 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 569 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6255 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165830 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 228740.15 0 0 0 228740.15 0 0 0 1101332720 1427168616 10 Physicians WEISS SHELDON A 611033619 109 Winnebago 0 1 Internal Medicine 0 186 0 0 0 0 0 0 0 0 0 0 0 124 0 0 0 0 0 0 1609 0 0 0 0 0 0 0 0 0 0 0 344 0 0 0 0 0 0 1609 0 0 0 0 0 0 0 0 0 0 0 344 0 0 0 0 0 0 4665 0 0 0 0 0 0 0 0 0 0 0 8142.48 0 0 0 0 0 0 12807.48 0 0 0 1101332734 1972764900 10 Physicians GUPTA ASHIMA 999999999 53 Kane 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 629 0 0 0 0 0 0 0 0 153 0 0 0 0 0 0 0 0 0 629 0 0 0 0 0 0 0 0 153 0 0 0 0 0 0 0 0 0 16289.7 0 0 0 0 0 0 0 0 6173.57 0 0 0 0 0 0 22463.27 0 0 0 1101332742 92 Waiver service provider--Disability (DHS/DRS) 10 Adams 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4113.11 0 0 0 0 0 0 0 0 0 0 0 0 0 4113.11 0 0 0 1101332747 1679505051 10 Physicians CHALUPCZAK ROBERT 604532670 200 Cook 0 1 Internal Medicine 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 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1753.89 0 0 0 0 0 0 1753.89 0 0 0 1101332748 1679735369 11 Dentists DANG PRITAM 999999999 53 Kane 0 0 0 0 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 752 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 752 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24801.8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24801.8 0 0 0 1101332764 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 15975.14 0 0 0 0 0 0 0 0 0 0 0 0 0 15975.14 0 0 0 1101332765 1477581650 10 Physicians PISANO MATTHEW 601262989 30 DuPage 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 434 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 459 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 459 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14981.43 0 0 0 0 0 0 14981.43 0 0 0 1101332766 24 Speech Therapists 107 Will 0 0 0 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 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7375.94 7375.94 0 0 0 1101332767 1427360809 16 Nurse Practitioners MILLER LAURIE 600442203 57 Lake 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 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 620.5 0 0 0 0 0 0 620.5 0 0 0 1101332786 92 Waiver service provider--Disability (DHS/DRS) 98 Tazewell 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 35832.07 0 0 0 0 0 0 0 0 0 0 0 0 0 35832.07 0 0 0 1101332790 1952521031 34 State-operated facility (DHS) UNIT 0224 HOME 24 LUDEMAN 604661200 200 Cook 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 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 990 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 626041.01 0 0 0 0 0 0 0 0 0 0 626041.01 0 0 0 1101332791 1902130032 13 Podiatrists SANTANGELO LOUIS 609141918 54 Kankakee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 338 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 338 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1461 0 0 0 0 0 0 1461 0 0 0 1101332804 10 Physicians 816 Iowa 0 0 Nuclear Medicine 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 7.69 0 0 0 0 0 0 7.69 0 0 0 1101332806 1720353691 16 Nurse Practitioners NEYS TAMMY 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2091.84 0 0 0 0 0 0 2091.84 0 0 0 1101332811 91 Waiver service provider--Adults (DHS/DDD) 63 Macon 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 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12226.18 0 0 0 0 0 0 0 0 0 0 0 0 0 12226.18 0 0 0 1101332812 1548288624 16 Nurse Practitioners BARNES LOIS 605231706 30 DuPage 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 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101332819 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 25300.56 0 0 0 0 0 0 0 0 0 0 0 0 0 25300.56 0 0 0 1101332827 1518050319 10 Physicians PONCHER JOHN 606112991 200 Cook 0 1 Pediatrics 0 11 0 0 3 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 64 0 0 9 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 64 0 0 9 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 128 0 0 261.97 0 0 0 0 0 0 0 0 186.24 0 0 0 0 0 0 576.21 0 0 0 1101332831 1467668285 10 Physicians HEENAN THERESE 463113065 815 Indiana 0 1 Family Practice 0 0 0 0 8 0 0 0 0 0 0 12 0 27 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 16 0 47 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 16 0 47 0 0 0 0 0 0 0 0 0 640.12 0 0 0 0 0 0 200.16 0 2097.25 0 0 0 0 0 0 2937.53 0 0 0 1101332836 92 Waiver service provider--Disability (DHS/DRS) 71 McHenry 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 6337.7 0 0 0 0 0 0 0 0 0 0 0 0 0 6337.7 0 0 0 1101332838 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5615.43 0 0 0 0 0 0 0 0 0 0 0 0 0 5615.43 0 0 0 1101332846 1912909615 10 Physicians RYABOV YAKOV 600902979 200 Cook 0 1 Internal Medicine 0 17 0 0 0 0 0 0 0 0 0 78 0 585 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 194 0 4191 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 194 0 4191 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 1298.83 0 22022.06 0 0 0 0 0 0 23394.89 0 0 0 1101332848 1104837285 10 Physicians MEHTA HARSHA 614017609 56 Knox 0 1 General Practice 0 2 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 126.85 0 0 0 0 0 0 198.85 0 0 0 1101332853 92 Waiver service provider--Disability (DHS/DRS) 89 Rock Island 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 30891.71 0 0 0 0 0 0 0 0 0 0 0 0 0 30891.71 0 0 0 1101332857 98 Waiver service provider--TBI (DHS/DRS) 53 Kane 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21849.64 0 0 0 0 0 0 0 0 0 0 0 0 0 21849.64 0 0 0 1101332876 1962478271 10 Physicians STADLAN NOAM 606405930 200 Cook 0 0 Neurology 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 0 199 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 199 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28924.12 0 0 0 0 0 0 28924.12 0 0 0 1101332878 1225063399 22 Physical Therapists DELACRUZ JEOFREY 609509392 54 Kankakee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 724.54 724.54 0 0 0 1101332879 91 Waiver service provider--Adults (DHS/DDD) 96 St Clair 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 0 323 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 323 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8061.9 0 0 0 0 0 0 0 0 0 0 0 0 0 8061.9 0 0 0 1101332888 1568634913 29 ICF/MR HAMMETT HOUSE 610811201 106 Whiteside 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 0 430 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8473 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 725469.49 0 0 0 0 0 0 0 0 0 0 725469.49 0 0 0 1101332890 92 Waiver service provider--Disability (DHS/DRS) 42 Hancock 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 13371.37 0 0 0 0 0 0 0 0 0 0 0 0 0 13371.37 0 0 0 1101332904 1497737175 11 Dentists JOHN GLORIA 606053249 200 Cook 0 0 General Dentistry 0 0 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 176 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 176 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5487.29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5487.29 0 0 0 1101332909 1164484267 10 Physicians WILSON CHARLES 627949248 200 Cook 0 0 Urological Surgery 0 0 0 0 0 0 0 0 0 0 0 53 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 152 0 283 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 152 0 283 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 837.96 0 18791.95 0 0 0 0 0 0 19629.91 0 0 0 1101332912 1346237534 10 Physicians PERALTA ENRIQUE 629594437 108 Williamson 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 234 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 234 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10659.46 0 0 0 0 0 0 10659.46 0 0 0 1101332918 94 Waiver service provider--Children's support (DHS/DDD) 15 Bureau 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 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 0 960.24 0 0 0 0 0 0 0 0 0 0 0 0 0 960.24 0 0 0 1101332922 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 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 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 2436.45 0 0 0 0 0 0 0 0 0 0 0 0 0 2436.45 0 0 0 1101332923 1912925488 10 Physicians RICH MICHAEL 631082212 826 Missouri 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 923.24 0 0 0 0 0 0 923.24 0 0 0 1101332929 1063652394 60 Pharmacies CVS PHARMACY 05602 627032536 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 520 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2392 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55607 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86646 0 0 0 86646 0 0 0 1101332930 1578719381 10 Physicians KORDIK ZACHARY 63141 826 Missouri 0 0 Psychiatry 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 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1537.02 0 0 0 0 0 0 1537.02 0 0 0 1101332941 11 Dentists 74 Mercer 0 0 General Dentistry 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131.1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131.1 0 0 0 1101332943 1174554125 10 Physicians GORELICK GLEB 606744736 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 909 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1275 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1275 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37413.19 0 325.47 0 0 0 0 0 0 37738.66 0 0 0 1101332945 1194792358 10 Physicians HERNANDEZ GONZALO 605232229 30 DuPage 0 0 Neonatology 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 668 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 668 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 92700.65 0 0 0 0 0 0 92700.65 0 0 0 1101332948 1568766509 12 Optometrists TO ANGELA 606163878 200 Cook 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 313 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 598 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 598 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17165.15 0 0 0 0 0 0 17165.15 0 0 0 1101332954 16 Nurse Practitioners 53 Kane 0 0 0 0 0 0 0 0 0 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 17.93 0 0 0 0 0 0 17.93 0 0 0 1101332973 1023059177 10 Physicians BRAUWEILER MARTIN 605481395 27 Dekalb 0 1 Family Practice 0 131 0 0 36 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 1411 0 0 38 0 0 0 0 0 0 0 0 361 0 0 0 0 0 0 1411 0 0 38 0 0 0 0 0 0 0 0 361 0 0 0 0 0 0 3373 0 0 3040.14 0 0 0 0 0 0 0 0 12390.21 0 0 0 0 0 0 18803.35 0 0 0 1101332985 1619983384 10 Physicians MUELLNER MICHELLE 606112654 200 Cook 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 257 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 257 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1872.5 0 0 0 0 0 0 1872.5 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 142964 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13760727.26 0 0 0 0 0 0 0 0 0 0 0 0 0 13760727.26 0 0 0 1101334832 1841451903 10 Physicians TURNER HANG 999999999 200 Cook 0 0 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 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 895.89 0 0 0 0 0 0 895.89 0 0 0 1101334840 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 16416.93 0 0 0 0 0 0 0 0 0 0 0 0 0 16416.93 0 0 0 1101334847 1164605119 10 Physicians CHADAGA AMAR 604532600 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 294 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 294 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5916.01 0 0 0 0 0 0 5916.01 0 0 0 1101334859 1184637639 10 Physicians LAU PATRICK 600441421 57 Lake 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4194.99 0 0 0 0 0 0 4194.99 0 0 0 1101336915 1639291735 16 Nurse Practitioners YEE MICHELLE 606112615 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11193.53 0 0 0 0 0 0 11193.53 0 0 0 1101336918 1265487508 10 Physicians PORTLAND GREGORY 600257645 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 13 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 253.8 0 631.08 0 0 0 0 0 0 884.88 0 0 0 1101336921 1588720999 10 Physicians VELAGAPUDI ANITA 60554 53 Kane 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 5 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79.73 0 4152.82 0 0 0 0 0 0 4232.55 0 0 0 1101336926 1669469300 10 Physicians ANDERSON PHILIP 420037901 818 Kentucky 0 0 Emergency Medicine 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 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3401.06 0 0 0 0 0 0 3401.06 0 0 0 1101336937 24 Speech Therapists 200 Cook 0 0 0 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 29 0 0 0 0 0 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 2046.48 2046.48 0 0 0 1101336942 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 18005.02 0 0 0 0 0 0 0 0 0 0 0 0 0 18005.02 0 0 0 1101336948 92 Waiver service provider--Disability (DHS/DRS) 57 Lake 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 10207.15 0 0 0 0 0 0 0 0 0 0 0 0 0 10207.15 0 0 0 1101336953 1760464762 11 Dentists PAJAK ELIZABETH 607141154 200 Cook 0 0 General Dentistry 0 0 0 337 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2032 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2032 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58375.77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58375.77 0 0 0 1101336955 1588625875 10 Physicians PRIEST EDWIN 600077301 200 Cook 0 0 Oncology 0 0 0 0 0 0 0 0 0 0 0 4 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 225 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 225 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46.96 0 6640.39 0 0 0 0 0 0 6687.35 0 0 0 1101336961 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 14 0 0 0 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 6873.02 0 0 0 0 0 0 0 0 0 0 0 0 0 6873.02 0 0 0 1101336962 1467662080 10 Physicians TIGRANI DEAN YAR 532272409 852 Wisconsin 0 0 Pathology 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 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 149.04 0 0 0 0 0 0 0 0 149.04 0 0 0 1101336966 1770565947 10 Physicians BATTISTA ROBERT 605212902 30 DuPage 0 0 Otorhinolaryngology 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 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 590.53 0 0 0 0 0 0 590.53 0 0 0 1101336968 1821098542 10 Physicians BLEDSOE SHELLY 606493306 200 Cook 0 0 Vascular Surgery 0 0 0 0 0 0 0 0 0 0 0 2 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32.64 0 537.45 0 0 0 0 0 0 570.09 0 0 0 1101336976 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12313.33 0 0 0 0 0 0 0 0 0 0 0 0 0 12313.33 0 0 0 1101337005 92 Waiver service provider--Disability (DHS/DRS) 91 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 18616.58 0 0 0 0 0 0 0 0 0 0 0 0 0 18616.58 0 0 0 1101337009 1851411920 10 Physicians FERRER KAREN 606123723 200 Cook 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 329.15 0 0 0 0 0 0 0 0 329.15 0 0 0 1101337028 1134456320 91 Waiver service provider--Adults (DHS/DDD) CAUSEY MEAGAN E 628320060 200 Cook 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 1409 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1409 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76242.59 0 0 0 0 0 0 0 0 0 0 0 0 0 76242.59 0 0 0 1101337030 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 268 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 268 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12963.5 0 0 0 0 0 0 0 0 0 0 0 0 0 12963.5 0 0 0 1101337041 1437299815 10 Physicians KHATOON ASMA 606233105 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 814 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 909 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 909 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36978.76 0 0 0 0 0 0 36978.76 0 0 0 1101337042 1851332993 10 Physicians WILLIAMS FELICIA 606431740 200 Cook 0 0 Family Practice 0 0 0 0 1 0 0 0 0 0 0 178 0 449 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 305 0 566 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 305 0 566 0 0 0 0 0 0 0 0 0 76.84 0 0 0 0 0 0 1943.89 0 22392.43 0 0 0 0 0 0 24413.16 0 0 0 1101337065 1851304901 10 Physicians WILLIAMS KEITH 604776213 200 Cook 0 1 Pediatrics 0 691 0 0 540 0 0 0 0 0 0 85 0 555 0 0 0 0 0 0 6361 0 0 1392 0 0 0 0 0 0 109 0 975 0 0 0 0 0 0 6361 0 0 1392 0 0 0 0 0 0 109 0 975 0 0 0 0 0 0 12722 0 0 56351.76 0 0 0 0 0 0 923.86 0 40772.26 0 0 0 0 0 0 110769.88 0 0 0 1101337082 1497766042 10 Physicians SONDHEIMER STUART 600761770 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 1 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 221 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 221 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2223.69 0 0 0 0 0 0 2223.69 0 0 0 1101337083 1982779047 10 Physicians FITCHEV ELENA 602023445 200 Cook 0 1 Family Practice 0 306 0 0 82 0 0 0 0 0 0 2 0 144 0 0 0 0 0 0 1457 0 0 230 0 0 0 0 0 0 2 0 336 0 0 0 0 0 0 1457 0 0 230 0 0 0 0 0 0 2 0 336 0 0 0 0 0 0 3419 0 0 8803.1 0 0 0 0 0 0 8 0 17390.61 0 0 0 0 0 0 29620.71 0 0 0 1101337086 1538221858 16 Nurse Practitioners DALTON PETERS MARILEE 625266380 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 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 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 270.26 0 0 0 0 0 0 270.26 0 0 0 1101337090 11 Dentists 27 Dekalb 0 0 General Dentistry 0 0 0 3 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 0 243.05 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 243.05 0 0 0 1101337094 1760709851 16 Nurse Practitioners DAILY TAMERA 616157822 80 Peoria 0 0 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 0 298 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 298 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38056.58 0 0 0 0 0 0 38056.58 0 0 0 1101337104 1497752752 16 Nurse Practitioners GALLAGHER SUSAN 612656138 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9349.73 0 0 0 0 0 0 9349.73 0 0 0 1101337111 30 General Hospitals 831 New Jersey NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103.46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103.46 0 0 0 1101337121 1790717502 10 Physicians KAWADRY BASSAM 606112991 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 932 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1022 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1022 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35850.43 0 0 0 0 0 0 35850.43 0 0 0 1101337128 1801933304 22 Physical Therapists LEVIE HEATHER 604487501 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3668.52 3668.52 0 0 0 1101337129 1629068150 10 Physicians POMA PEDRO 604023429 200 Cook 0 0 Obstetrics 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 14 0 0 0 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 10664.51 0 0 0 0 0 0 10664.51 0 0 0 1101337142 92 Waiver service provider--Disability (DHS/DRS) 26 Cumberland 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 30286.52 0 0 0 0 0 0 0 0 0 0 0 0 0 30286.52 0 0 0 1101337145 1073528394 60 Pharmacies WALGREEN CO STORE 06046 601622107 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 291 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1187 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30974 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53679.72 0 0 0 53679.72 0 0 0 1101337150 1366462475 10 Physicians JONES GLYN 616062036 80 Peoria 0 0 Plastic Surgery 0 0 0 0 0 0 0 0 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FCC - H" 604302633 200 Cook 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 1563 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4694 0 0 1563 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4694 0 0 907.57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 267845.39 0 0 268752.96 0 0 0 1101337178 1215020573 13 Podiatrists FRANK KELLEY 600054281 200 Cook 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 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 808 0 0 0 0 0 0 808 0 0 0 1101337182 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15125 0 0 0 0 0 0 0 0 0 0 0 0 0 15125 0 0 0 1101337188 36 Community mental health provider 107 Will 0 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 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 986.04 0 0 986.04 0 0 0 1101337198 1700912409 10 Physicians SANTANIELLO JOHN 601533304 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9102.85 0 0 0 0 0 0 9102.85 0 0 0 1101337203 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 12492.87 0 0 0 0 0 0 0 0 0 0 0 0 0 12492.87 0 0 0 1101337205 1861493793 16 Nurse Practitioners BEASLEY SHEILA 370689022 99 Union 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 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7174.78 0 0 0 0 0 0 7174.78 0 0 0 1101337206 1548276256 10 Physicians HANSON MARK 617043738 72 McLean 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 17 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1395.07 0 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Pulmonary 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 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 58.36 0 0 0 0 0 0 58.36 0 0 0 1101337368 1356549323 10 Physicians PRESTON MATTHEW 616025003 80 Peoria 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 436 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 436 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5419.43 0 0 0 0 0 0 5419.43 0 0 0 1101337370 1366534448 63 Other Providers of Medical Equipment/Supplies (Non-registered) IN HOME MEDICAL 624012689 33 Effingham 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 439 0 440 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1762 0 478 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1762 0 478 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79776.36 0 26605.27 0 0 0 0 106381.63 0 0 0 1101337372 1881759967 16 Nurse Practitioners UNZICKER MARK 609361477 35 Ford 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 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18969.26 0 0 0 0 0 0 0 0 0 0 0 0 0 18969.26 0 0 0 1101337419 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 15477.33 0 0 0 0 0 0 0 0 0 0 0 0 0 15477.33 0 0 0 1101337426 1760470553 63 Other Providers of Medical Equipment/Supplies (Non-registered) ALDEN OF WATERFORD LLC 605044758 30 DuPage 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 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7004.8 0 0 0 0 0 0 7004.8 0 0 0 1101337436 1861612475 10 Physicians RAGHAVENDRA SUSHMA 604613168 200 Cook 0 1 Family Practice 0 140 0 0 85 0 0 0 0 0 0 135 0 301 0 0 0 0 0 0 1156 0 0 140 0 0 0 0 0 0 203 0 625 0 0 0 0 0 0 1156 0 0 140 0 0 0 0 0 0 203 0 625 0 0 0 0 0 0 2875 0 0 7981.63 0 0 0 0 0 0 922.23 0 19516.68 0 0 0 0 0 0 31295.54 0 0 0 1101337439 1457372724 10 Physicians KENNEASTER DEREK 629483150 108 Williamson 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 45 0 1848 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 4215 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 4215 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220.14 0 157737.33 0 0 0 0 0 0 157957.47 0 0 0 1101337472 1689785305 10 Physicians SWEARINGEN JEFFREY V 618011112 19 Champaign 0 1 Family Practice 0 99 0 0 0 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 631 0 0 0 0 0 0 0 0 0 0 0 108 0 0 0 0 0 0 631 0 0 0 0 0 0 0 0 0 0 0 108 0 0 0 0 0 0 1724 0 0 0 0 0 0 0 0 0 0 0 4228.29 0 0 0 0 0 0 5952.29 0 0 0 1101337476 1215978473 10 Physicians RASHEED MEHMOODUR 618012529 19 Champaign 0 0 Rheumatology 0 0 0 0 0 0 0 0 0 0 0 1 0 285 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 450 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 450 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3.33 0 18735.36 0 0 0 0 0 0 18738.69 0 0 0 1101337481 1457517039 10 Physicians OSAYIMWEN UCHENNA 999999999 57 Lake 0 0 0 101 0 0 45 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 837 0 0 120 0 0 0 0 0 0 0 0 119 0 0 0 0 0 0 837 0 0 120 0 0 0 0 0 0 0 0 119 0 0 0 0 0 0 1674 0 0 4461.41 0 0 0 0 0 0 0 0 5872.74 0 0 0 0 0 0 12008.15 0 0 0 1101337483 55 Early Intervention Services 91 Sangamon 0 0 0 0 0 0 0 0 0 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 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 2174.74 0 0 0 0 0 0 2174.74 0 0 0 1101337487 91 Waiver service provider--Adults (DHS/DDD) 107 Will 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 0 285 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 285 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18282.5 0 0 0 0 0 0 0 0 0 0 0 0 0 18282.5 0 0 0 1101337510 98 Waiver service provider--TBI (DHS/DRS) 53 Kane 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2255.08 0 0 0 0 0 0 0 0 0 0 0 0 0 2255.08 0 0 0 1101337516 93 Waiver service provider--HIV/AIDS (DHS/DRS) 97 Stephenson 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 14939.54 0 0 0 0 0 0 0 0 0 0 0 0 0 14939.54 0 0 0 1101337518 46 Ambulatory Surgical Treatment Centers 80 Peoria ASTC Ambulatory Surgical Treatment Center. 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 1101337525 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14345.87 0 0 0 0 0 0 0 0 0 0 0 0 0 14345.87 0 0 0 1101337535 1316293863 22 Physical Therapists NEWTON COLLEEN 999999999 200 Cook 0 0 0 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 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11450.13 11450.13 0 0 0 1101337555 98 Waiver service provider--TBI (DHS/DRS) 63 Macon 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17963.49 0 0 0 0 0 0 0 0 0 0 0 0 0 17963.49 0 0 0 1101337557 1588672802 10 Physicians REGAN JOHN 618203909 19 Champaign 0 0 Urological Surgery 0 0 0 0 0 0 0 0 0 0 0 27 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 353.63 0 7169.08 0 0 0 0 0 0 7522.71 0 0 0 1101337562 1255495701 10 Physicians ABBASI TAHIR A 604678490 200 Cook 0 1 Internal Medicine 0 2 0 0 0 0 0 0 0 0 0 0 0 225 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 788 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 788 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 4301.14 0 0 0 0 0 0 4310.14 0 0 0 1101337574 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 28100.65 0 0 0 0 0 0 0 0 0 0 0 0 0 28100.65 0 0 0 1101337578 1174607568 16 Nurse Practitioners ZINDEL ELLEN 625264163 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1351.86 0 0 0 0 0 0 1351.86 0 0 0 1101337580 91 Waiver service provider--Adults (DHS/DDD) 71 McHenry 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 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22360.8 0 0 0 0 0 0 0 0 0 0 0 0 0 22360.8 0 0 0 1101337581 1861645905 16 Nurse Practitioners WESZELITS SANDRA M 606116649 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 0 109 0 0 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 5110.37 0 0 0 0 0 0 5110.37 0 0 0 1101337582 1811026362 16 Nurse Practitioners ARENDS DANIELLE 606123806 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 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 81.1 0 0 0 0 0 0 81.1 0 0 0 1101337593 92 Waiver service provider--Disability (DHS/DRS) 102 Warren 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 4659.19 0 0 0 0 0 0 0 0 0 0 0 0 0 4659.19 0 0 0 1101337599 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 28738.24 0 0 0 0 0 0 0 0 0 0 0 0 0 28738.24 0 0 0 1101337600 1699974279 11 Dentists REYNOLDS PAMELA 603024111 200 Cook 0 0 General Dentistry 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 223 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 223 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6852.76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6852.76 0 0 0 1101337601 1437255460 22 Physical Therapists WROBEL BARBARA 605419125 55 Kendall 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 573 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 573 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44864.88 44864.88 0 0 0 1101337614 11 Dentists 200 Cook 0 0 General Dentistry 0 0 0 2 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 0 540.3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 540.3 0 0 0 1101337615 11 Dentists 200 Cook 0 0 General Dentistry 0 0 0 3 0 0 0 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 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 303.2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 303.2 0 0 0 1101337638 1801181037 10 Physicians JABSHETTY SANGMESH 463201931 815 Indiana 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1691.07 0 0 0 0 0 0 1691.07 0 0 0 1101337651 98 Waiver service provider--TBI (DHS/DRS) 100 Vermilion 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 0 522.27 0 0 0 0 0 0 0 0 0 0 0 0 0 522.27 0 0 0 1101337655 1386637106 10 Physicians NELSON NEIL 609362000 35 Ford 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0 0 2056 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58543.48 0 0 0 0 58543.48 0 0 0 1101338771 1033149158 60 Pharmacies ENLOE PCI CENTER OF PEORIA 616151809 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1349 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9533 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 158788 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 380447.42 0 0 0 380447.42 0 0 0 1101338795 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 2248.91 0 0 0 0 0 0 0 0 0 0 0 0 0 2248.91 0 0 0 1101338802 60 Pharmacies 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 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 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 864.11 0 0 0 864.11 0 0 0 1101338806 1851460737 10 Physicians FABI ERNESTO N 625571605 20 Christian 0 1 Family Practice 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319 0 0 0 1101338816 1851564074 29 ICF/MR SPAULDING TERRACE 604285438 200 Cook 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3276 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 447970.71 0 0 0 0 0 0 0 0 0 0 447970.71 0 0 0 1101338820 1821056540 10 Physicians PIETA JACEK 601485396 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1308.4 0 0 0 0 0 0 1308.4 0 0 0 1101338843 1639104615 10 Physicians CADMAN CHRISTOPHER 625264163 63 Macon 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 0 0 168 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 314 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 314 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6999.79 0 0 0 0 0 0 6999.79 0 0 0 1101338844 1033289970 40 Federally Qualified Health Centers PLAZA MEDICAL CENTER 606083719 200 Cook 0 1 0 1560 1533 0 587 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6813 6973 0 1601 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6813 6973 0 1601 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14881 444735.2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 459616.2 0 0 0 1101338852 1376704320 10 Physicians MILLER AMANDA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1407 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1407 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47256.34 0 0 0 0 0 0 47256.34 0 0 0 1101338889 1083630388 10 Physicians KANIA AGNIESZKA 600681188 200 Cook 0 1 Family Practice 0 400 0 0 187 0 0 0 0 0 0 51 0 281 0 0 0 0 0 0 2315 0 0 857 0 0 0 0 0 0 65 0 717 0 0 0 0 0 0 2315 0 0 857 0 0 0 0 0 0 65 0 717 0 0 0 0 0 0 4885 0 0 26252.79 0 0 0 0 0 0 865.67 0 35927.03 0 0 0 0 0 0 67930.49 0 0 0 1101338895 1972814267 10 Physicians SENEVIRATNE KRISHANTHI 600146248 71 McHenry 0 0 Family Practice 0 31 0 0 34 0 0 0 0 0 0 68 0 143 0 0 0 0 0 0 106 0 0 70 0 0 0 0 0 0 351 0 426 0 0 0 0 0 0 106 0 0 70 0 0 0 0 0 0 351 0 426 0 0 0 0 0 0 261 0 0 3204.13 0 0 0 0 0 0 5135.9 0 12053.09 0 0 0 0 0 0 20654.12 0 0 0 1101338901 92 Waiver service provider--Disability (DHS/DRS) 60 Lee 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 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 3210 0 0 0 0 0 0 0 0 0 0 0 0 0 3210 0 0 0 1101338909 1144204769 10 Physicians RAJANAHALLY RATNAKAR 604611184 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1125.51 0 0 0 0 0 0 1125.51 0 0 0 1101338918 1033323902 10 Physicians APRAHAMIAN CHARLES 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 291 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 641 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 641 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75608.61 0 0 0 0 0 0 75608.61 0 0 0 1101338924 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 0 0 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 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36165.34 0 0 0 0 0 0 0 0 0 0 0 0 0 36165.34 0 0 0 1101338927 1932117819 10 Physicians OSMAN MEDHAT 631102515 826 Missouri 0 0 Nuclear Medicine 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 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1129.14 0 0 0 0 0 0 1129.14 0 0 0 1101338940 60 Pharmacies 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 310 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77095.09 0 0 0 77095.09 0 0 0 1101338945 93 Waiver service provider--HIV/AIDS (DHS/DRS) 71 McHenry 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 4861.09 0 0 0 0 0 0 0 0 0 0 0 0 0 4861.09 0 0 0 1101338949 1225013840 10 Physicians PODZAMSKY JOHN 613642998 58 La Salle 0 1 Family Practice 0 0 0 0 0 0 0 0 0 0 0 10 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 164.5 0 1429.66 0 0 0 0 0 0 1594.16 0 0 0 1101338950 10 Physicians 200 Cook 0 0 Radiology Diagnosis 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1.34 0 0 0 0 0 0 0 0 1.34 0 0 0 1101338957 92 Waiver service provider--Disability (DHS/DRS) 60 Lee 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 4815.53 0 0 0 0 0 0 0 0 0 0 0 0 0 4815.53 0 0 0 1101338984 1679773980 10 Physicians NIELSEN JANET 601533328 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 670 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 739 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 739 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21881.41 0 0 0 0 0 0 21881.41 0 0 0 1101339013 1427174341 23 Occupational Therapists TOOHILL CHRISTINA 617046362 72 McLean 0 0 0 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 0 216 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 216 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11307.89 11307.89 0 0 0 1101339014 1386635225 10 Physicians WUJEK ROGER 620561778 76 Montgomery 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12876.03 0 0 0 0 0 0 12876.03 0 0 0 1101339018 1063465466 10 Physicians VOGLER CAROLE 631102515 826 Missouri 0 0 Pathology 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 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2232.51 0 0 0 0 0 0 0 0 2232.51 0 0 0 1101339043 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 334 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 334 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15639.77 0 0 0 0 0 0 0 0 0 0 0 0 0 15639.77 0 0 0 1101339049 1649349259 10 Physicians HOLLEY JEAN 618012500 19 Champaign 0 0 Nephrology 0 0 0 0 0 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 412 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 412 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6056.01 0 0 0 0 0 0 6056.01 0 0 0 1101339062 1942238514 63 Other Providers of Medical Equipment/Supplies (Non-registered) KINEX MEDICAL COMPANY LLC 531882477 852 Wisconsin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 178 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 178 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4308.13 0 668.94 0 0 0 0 4977.07 0 0 0 1101339067 94 Waiver service provider--Children's support (DHS/DDD) 815 Indiana 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 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10024.52 0 0 0 0 0 0 0 0 0 0 0 0 0 10024.52 0 0 0 1101339077 92 Waiver service provider--Disability (DHS/DRS) 66 Marion 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 16165.61 0 0 0 0 0 0 0 0 0 0 0 0 0 16165.61 0 0 0 1101339087 1912927385 70 Ambulance Service Providers UNITED LIFECARE AMBULANCE SRVC 624543339 25 Crawford 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 304 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1377 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1377 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68493.93 0 0 0 0 0 0 68493.93 0 0 0 1101339090 1619149325 10 Physicians JOSEPH DEEPA MATHEW 605615038 30 DuPage 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 27 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 0 936.51 0 0 0 0 0 0 936.51 0 0 0 1101339094 1376790071 10 Physicians GOSKA GREGORY 999999999 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 414 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 414 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6557.11 0 0 0 0 0 0 6557.11 0 0 0 1101339095 1366604340 10 Physicians MENON GAYATRI 999999999 200 Cook 0 0 0 0 0 0 1 0 0 0 0 0 0 2 0 55 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 2 0 56 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 2 0 56 0 0 0 0 0 0 0 0 0 69.52 0 0 0 0 0 0 4.09 0 5994.59 0 0 0 0 0 0 6068.2 0 0 0 1101339102 91 Waiver service provider--Adults (DHS/DDD) 107 Will 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 0 259 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 259 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41250 0 0 0 0 0 0 0 0 0 0 0 0 0 41250 0 0 0 1101339103 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44206.54 0 0 0 0 0 0 0 0 0 0 0 0 0 44206.54 0 0 0 1101339104 1235128554 10 Physicians BIGHAM BETH 620628500 65 Madison 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3485.15 0 0 0 0 0 0 3485.15 0 0 0 1101339106 1790913044 11 Dentists KO JUNGAH 604061493 200 Cook 0 0 General Dentistry 0 0 0 545 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3779 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3779 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114793.39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114793.39 0 0 0 1101339111 1912953191 10 Physicians URBAN MARTIN 610324864 97 Stephenson 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 2029 0 174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3114 0 273 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3114 0 273 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75910.75 0 4791.68 0 0 0 0 0 0 80702.43 0 0 0 1101339112 10 Physicians 200 Cook 0 0 Pediatrics 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72.21 0 0 0 0 0 0 72.21 0 0 0 1101339120 1457413908 10 Physicians ARORA VINEET 605276686 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 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 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1086.35 0 0 0 0 0 0 1086.35 0 0 0 1101339124 1487643573 10 Physicians PORTO SUSAN 605462312 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 2 0 0 0 0 0 0 108 0 212 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 264 0 487 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 264 0 487 0 0 0 0 0 0 0 0 0 190.61 0 0 0 0 0 0 1284.52 0 47078.37 0 0 0 0 0 0 48553.5 0 0 0 1101339125 1407820228 63 Other Providers of Medical Equipment/Supplies (Non-registered) CAHOKIA NURSING AND REHAB CTR 622062204 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9349.52 0 0 0 0 0 0 9349.52 0 0 0 1101339129 1679781355 10 Physicians LEVI ROBERTO 606595113 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 265 0 418 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 554 0 2625 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 554 0 2625 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4405.11 0 35837.18 0 0 0 0 0 0 40242.29 0 0 0 1101339135 91 Waiver service provider--Adults (DHS/DDD) 30 DuPage 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 0 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12955.8 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4708.12 0 0 0 1101339161 1437382959 10 Physicians CAPRIO TIMOTHY 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 287 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 287 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4247.7 0 0 0 0 0 0 4247.7 0 0 0 1101339168 10 Physicians 200 Cook 0 0 Dermatology 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 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 0 0 0 0 0 0 0 0 0 0 0 1101339189 1255329546 10 Physicians PIERSON JANICE 604095459 200 Cook 0 1 Internal Medicine 0 155 0 0 0 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 1242 0 0 0 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 1242 0 0 0 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 3609 0 0 0 0 0 0 0 0 0 0 0 4394.27 0 0 0 0 0 0 8003.27 0 0 0 1101339190 1023017019 10 Physicians NGUYEN PAUL 601783180 200 Cook 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 318 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2615 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2615 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39520.58 0 0 0 0 0 0 39520.58 0 0 0 1101339209 1528097136 10 Physicians SANCHEZ JUAN 462025109 815 Indiana 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 781.98 0 0 0 0 0 0 781.98 0 0 0 1101339216 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15257 0 0 0 0 0 0 0 0 0 0 0 0 0 15257 0 0 0 1101339226 1952312498 70 Ambulance Service Providers "A-TEC AMBULANCE, INC" 601247827 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1521 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9378 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9378 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111934.5 0 0 0 0 0 0 111934.5 0 0 0 1101339229 1023349081 36 Community mental health provider CAMELOT CARE CENTERS INC 999999999 109 Winnebago 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 406.2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3524.28 0 0 3930.48 0 0 0 1101339236 1235198235 30 General Hospitals ROCKFORD DIALYSIS 611032839 109 Winnebago DIALYSIS Outpatient dialysis centers. 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 493 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62262.71 0 0 0 0 0 62262.71 0 0 0 1101339243 1407899198 10 Physicians PETRICH ADAM 606118709 200 Cook 0 0 Oncology 0 0 0 0 0 0 0 0 0 0 0 14 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 285 0 265 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 285 0 265 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1597.04 0 15502.14 0 0 0 0 0 0 17099.18 0 0 0 1101339266 29 ICF/MR 63 Macon 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2421 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 250225.71 0 0 0 0 0 0 0 0 0 0 250225.71 0 0 0 1101339267 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 23239.97 0 0 0 0 0 0 0 0 0 0 0 0 0 23239.97 0 0 0 1101339269 2100329687 71 Medicar Provider ACCESS ONE TRANSPORTATION CORP 601041646 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10235 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10235 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64310.75 0 0 0 0 0 0 64310.75 0 0 0 1101339270 94 Waiver service provider--Children's support (DHS/DDD) 52 Johnson 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 234 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 234 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5760.58 0 0 0 0 0 0 0 0 0 0 0 0 0 5760.58 0 0 0 1101339274 1316018138 11 Dentists TRAKAKIS GEORGE 604356675 107 Will 0 0 General Practice 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 236 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 236 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9256.48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9256.48 0 0 0 1101339275 10 Physicians 816 Iowa 0 0 Surgery General 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 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 98.4 0 0 0 0 0 0 98.4 0 0 0 1101339276 1396753059 12 Optometrists EDWARDS ROBERT 627021448 91 Sangamon 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 308 0 800 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 602 0 821 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 602 0 821 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17818.1 0 23460.68 0 0 0 0 41278.78 0 0 0 1101339281 1306004148 12 Optometrists FORECKI DIANE G 339051805 63 Macon 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 1359 0 3256 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2703 0 3340 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2703 0 3340 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82697.63 0 94992.4 0 0 0 0 177690.03 0 0 0 1101339284 1639261621 10 Physicians ENG EUDORA 606118702 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 33 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 2693.9 0 0 0 0 0 0 2693.9 0 0 0 1101339296 1497757165 10 Physicians LEE RICHARD 600077331 200 Cook 0 0 Nephrology 0 0 0 0 0 0 0 0 0 0 0 40 0 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82 0 609 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82 0 609 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6145.76 0 0 0 0 0 0 6145.76 0 0 0 1101339297 92 Waiver service provider--Disability (DHS/DRS) 26 Cumberland 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 16926.17 0 0 0 0 0 0 0 0 0 0 0 0 0 16926.17 0 0 0 1101339325 1912062340 60 Pharmacies MEDICAP PHARMACY 637013500 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2243 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1756.74 0 0 0 1756.74 0 0 0 1101339328 1265454896 10 Physicians SAUERBERG STEVEN K 605256539 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123.76 0 0 0 0 0 0 123.76 0 0 0 1101339339 1811204076 16 Nurse Practitioners MCINTYRE MEGAN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 255 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 255 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2047.07 0 0 0 0 0 0 2047.07 0 0 0 1101339345 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 268.83 0 0 0 0 0 0 0 0 0 0 0 0 0 268.83 0 0 0 1101339349 63 Other Providers of Medical Equipment/Supplies (Non-registered) 816 Iowa 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 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 1265.08 0 0 0 0 0 0 1265.08 0 0 0 1101339353 91 Waiver service provider--Adults (DHS/DDD) 57 Lake 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 0 331 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 331 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10770.4 0 0 0 0 0 0 0 0 0 0 0 0 0 10770.4 0 0 0 1101339362 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11784.91 0 0 0 0 0 0 0 0 0 0 0 0 0 11784.91 0 0 0 1101339367 1730168816 10 Physicians CAMACHO PAULINE 601533304 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2089.25 0 0 0 0 0 0 2089.25 0 0 0 1101339378 1417969833 10 Physicians MESS DENNIS 600162359 27 Dekalb 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 50 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85 0 304 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85 0 304 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1285.73 0 6976.53 0 0 0 0 0 0 8262.26 0 0 0 1101339399 1104830876 16 Nurse Practitioners BERRY THOMAS 604626523 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 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 24.09 0 0 0 0 0 0 24.09 0 0 0 1101339400 1578577201 22 Physical Therapists FALCONER CHAD 999999999 10 Adams 0 0 0 0 0 0 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 0 272 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 272 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4428.6 4428.6 0 0 0 1101339410 10 Physicians 852 Wisconsin 0 0 Obstetric-Gynecology 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101339411 10 Physicians 815 Indiana 0 0 Anesthesiology 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 0 537.25 0 0 0 0 0 0 537.25 0 0 0 1101339422 1932276672 10 Physicians BAUMGARTEL PETER 600485261 57 Lake 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 773 0 436 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 961 0 533 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 961 0 533 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16059.35 0 15206.94 0 0 0 0 0 0 31266.29 0 0 0 1101339423 1639143787 10 Physicians STOEFFLER AMY 601082227 30 DuPage 0 0 Obstetric-Gynecology 0 0 0 0 1 0 0 0 0 0 0 8 0 20 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 10 0 30 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 10 0 30 0 0 0 0 0 0 0 0 0 104.96 0 0 0 0 0 0 160.58 0 1443.54 0 0 0 0 0 0 1709.08 0 0 0 1101339426 1629003058 10 Physicians CURRIE LAVERNE 606195613 200 Cook 0 1 Internal Medicine 0 34 0 0 0 0 0 0 0 0 0 15 0 130 0 0 0 0 0 0 253 0 0 0 0 0 0 0 0 0 17 0 257 0 0 0 0 0 0 253 0 0 0 0 0 0 0 0 0 17 0 257 0 0 0 0 0 0 739 0 0 0 0 0 0 0 0 0 19.21 0 7402.04 0 0 0 0 0 0 8160.25 0 0 0 1101339432 1780681700 10 Physicians FRANCZYK ELIZABETH 628013060 66 Marion 0 1 Pediatrics 0 1561 0 0 964 0 0 0 0 0 0 280 0 1182 0 0 0 0 0 0 15035 0 0 5252 0 0 0 0 0 0 373 0 3214 0 0 0 0 0 0 15035 0 0 5252 0 0 0 0 0 0 373 0 3214 0 0 0 0 0 0 30091 0 0 147488.61 0 0 0 0 0 0 1223 0 155600.08 0 0 0 0 0 0 334402.69 0 0 0 1101339442 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 13182.78 0 0 0 0 0 0 0 0 0 0 0 0 0 13182.78 0 0 0 1101339444 1215148952 10 Physicians MOORE SATHEAVY 63090 826 Missouri 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 8 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 0 196.95 0 0 0 0 0 0 0 0 196.95 0 0 0 1101339445 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14146.19 0 0 0 0 0 0 0 0 0 0 0 0 0 14146.19 0 0 0 1101339448 1912127234 10 Physicians OZCAKIR LULU 601975997 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 971 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1080 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1080 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39032.56 0 0 0 0 0 0 39032.56 0 0 0 1101339454 10 Physicians 200 Cook 0 0 Family Practice 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20.35 0 0 0 0 0 0 20.35 0 0 0 1101339459 1104848241 10 Physicians DOCHERTY MARTIN 631052565 826 Missouri 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 3 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67.22 0 1335.11 0 0 0 0 0 0 1402.33 0 0 0 1101339464 11 Dentists 200 Cook 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 192.1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 192.1 0 0 0 1101339470 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 21395.49 0 0 0 0 0 0 0 0 0 0 0 0 0 21395.49 0 0 0 1101339482 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14556.23 0 0 0 0 0 0 0 0 0 0 0 0 0 14556.23 0 0 0 1101339484 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 25820.33 0 0 0 0 0 0 0 0 0 0 0 0 0 25820.33 0 0 0 1101339498 1851395578 10 Physicians BERKENBILE DAVID 622492898 65 Madison 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 248 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 259 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 259 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7378.78 0 0 0 0 0 0 7378.78 0 0 0 1101339515 1588610257 60 Pharmacies OSCO DRUG 3348 601034547 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 880 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22847 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65132.7 0 0 0 65132.7 0 0 0 1101339518 1235107731 10 Physicians SCHWARTZERS DEBRA 606740018 200 Cook 0 1 Pediatrics 0 8 0 0 7 0 0 0 0 0 0 7 0 22 0 0 0 0 0 0 63 0 0 9 0 0 0 0 0 0 9 0 43 0 0 0 0 0 0 63 0 0 9 0 0 0 0 0 0 9 0 43 0 0 0 0 0 0 127 0 0 552.02 0 0 0 0 0 0 50.89 0 446.16 0 0 0 0 0 0 1176.07 0 0 0 1101339521 98 Waiver service provider--TBI (DHS/DRS) 30 DuPage 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12033.11 0 0 0 0 0 0 0 0 0 0 0 0 0 12033.11 0 0 0 1101339522 10 Physicians 107 Will 0 0 Family Practice 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 14 0 0 0 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 0 136.31 0 0 0 0 0 0 136.31 0 0 0 1101339523 1003942764 10 Physicians GRAETZ THOMAS 631600352 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5382.81 0 0 0 0 0 0 5382.81 0 0 0 1101339535 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7352.4 0 0 0 0 0 0 0 0 0 0 0 0 0 7352.4 0 0 0 1101339537 1801847017 12 Optometrists RADDATZ MAUREEN 629463334 90 Saline 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 1389 0 850 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2941 0 869 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2941 0 869 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60180.73 0 24751.18 0 0 0 0 84931.91 0 0 0 1101339542 1497952816 11 Dentists DELAFUENTE CARLA 606233548 200 Cook 0 0 General Dentistry 0 0 0 407 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1905 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1905 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56773.18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56773.18 0 0 0 1101339549 1962613612 60 Pharmacies CUB PHARMACY 341 625264733 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1415 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34826 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101341.28 0 0 0 101341.28 0 0 0 1101339577 1467486902 10 Physicians BAILEY DONALD M 477140556 815 Indiana 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 22 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 4300.67 0 0 0 0 0 0 4300.67 0 0 0 1101339587 1689927857 16 Nurse Practitioners DESY JENNIFER 999999999 826 Missouri 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 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 280.81 0 0 0 0 0 0 280.81 0 0 0 1101339603 1518984061 10 Physicians BROWN STEVEN 604622266 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 1 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 457.05 0 0 0 0 0 0 457.05 0 0 0 1101339607 1922172881 63 Other Providers of Medical Equipment/Supplies (Non-registered) HANGER PROSTHETICS ORTHOTICS 629483762 108 Williamson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 112 0 284 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 211 0 675 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 211 0 675 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14619.14 0 155133.17 0 0 0 0 169752.31 0 0 0 1101339620 63 Other Providers of Medical Equipment/Supplies (Non-registered) 826 Missouri 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 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39594.7 0 0 0 0 39594.7 0 0 0 1101339628 1902922115 30 General Hospitals ADOLESCENT FAMILY CENTER 606123227 200 Cook DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 0 0 0 0 35 0 0 0 0 0 0 208 0 0 258 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 397 0 0 882 0 0 0 0 0 0 0 0 36 0 0 0 0 0 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47 Local Education Agencies NILES ELEMENTARY DIST 71 607143024 200 Cook 0 0 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 1199 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1199 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19585.09 0 19585.09 0 0 0 1101340760 1134375520 55 Early Intervention Services MERCADO VERONICA 605405500 30 DuPage 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 0 870 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 870 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50628.03 0 0 0 0 0 0 50628.03 0 0 0 1101340763 1912123340 10 Physicians KAHN STACY 605276686 30 DuPage 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 216 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 216 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8597.27 0 0 0 0 0 0 8597.27 0 0 0 1101340767 10 Physicians 30 DuPage 0 0 Admitting Privileges 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 11.71 0 0 0 0 0 0 11.71 0 0 0 1101340769 91 Waiver service provider--Adults (DHS/DDD) 54 Kankakee 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 511.5 0 0 0 0 0 0 0 0 0 0 0 0 0 511.5 0 0 0 1101340777 1265443477 11 Dentists MARIMUTHU SUBBASHINI 601393508 30 DuPage 0 0 General Dentistry 0 0 0 310 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1500 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1500 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53803.21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53803.21 0 0 0 1101340779 1871519926 30 General Hospitals BUFFALO GROVE DIALYSIS 600894009 200 Cook DIALYSIS Outpatient dialysis centers. 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1410 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31835.57 0 0 0 0 0 31835.57 0 0 0 1101340788 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 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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 0.81 0.81 0 0 0 1101340848 1245408491 75 Department of Alcohol and Substance Abuse Provider COMMUNITY RESOURCE CENTER 624712214 34 Fayette 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 571 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 571 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31316.74 0 0 31316.74 0 0 0 1101340873 1790715092 10 Physicians SNYDER LISA 616142932 80 Peoria 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 0 0 0 216 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 795 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 795 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65899.85 0 0 0 0 0 0 65899.85 0 0 0 1101340882 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 29955.14 0 0 0 0 0 0 0 0 0 0 0 0 0 29955.14 0 0 0 1101340883 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1906.74 0 0 0 0 0 0 1906.74 0 0 0 1101340939 1477797041 10 Physicians BOTTARI DIANA 606313222 30 DuPage 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 280 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 280 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11095.73 0 0 0 0 0 0 11095.73 0 0 0 1101340958 1194028761 60 Pharmacies CVS PHARMACY 07788 600604232 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 176 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 970 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25848 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34862.42 0 0 0 34862.42 0 0 0 1101340960 1649265448 10 Physicians KALISH STEVE 606252519 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 478 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 478 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5783.14 0 0 0 0 0 0 5783.14 0 0 0 1101340971 36 Community mental health provider 71 McHenry 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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999999999 107 Will 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 0 533 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 533 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46547.52 0 0 0 0 0 0 0 0 0 0 0 0 0 46547.52 0 0 0 1101341011 1356468961 34 State-operated facility (DHS) UNIT 4590 BLDG 502A SHAPIRO 609015099 54 Kankakee 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 895071.61 0 0 0 0 0 0 0 0 0 0 895071.61 0 0 0 1101341013 1154384261 10 Physicians JAIRATH UMESH C 476309460 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 211 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 211 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7497.07 0 0 0 0 0 0 7497.07 0 0 0 1101341033 91 Waiver service provider--Adults (DHS/DDD) 107 Will 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 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10561.92 0 0 0 0 0 0 0 0 0 0 0 0 0 10561.92 0 0 0 1101341040 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 1986.66 0 0 0 0 0 0 0 0 0 0 0 0 0 1986.66 0 0 0 1101341046 1871593574 33 Nursing Facilities BETHANY REHAB AND HCC 601155331 27 Dekalb 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 0 665 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15886 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1507843.24 0 0 0 0 0 0 0 1507843.24 0 0 0 1101341049 1194947002 10 Physicians BOWERS JOSHUA 616151410 80 Peoria 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 265 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 265 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11183.08 0 0 0 0 0 0 11183.08 0 0 0 1101341059 1760442511 10 Physicians KOSMALA WILLIAM 604631435 200 Cook 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 142 0 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0 0 1101341672 2100332090 71 Medicar Provider ALMIGHTY ONE LITTLE HELPERS 604661304 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14339.56 0 0 0 0 0 0 14339.56 0 0 0 1101341685 10 Physicians 836 Ohio 0 0 Radiology Diagnosis 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 195.76 0 0 0 0 0 0 0 0 195.76 0 0 0 1101341687 92 Waiver service provider--Disability (DHS/DRS) 28 De Witt 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 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 0 611.84 0 0 0 0 0 0 0 0 0 0 0 0 0 611.84 0 0 0 1101341691 1306949078 60 Pharmacies CVS PHARMACY 2863 600081992 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 881 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22563 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38867.25 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44155.14 0 0 0 0 0 0 44155.14 0 0 0 1101341752 92 Waiver service provider--Disability (DHS/DRS) 55 Kendall 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 36473.55 0 0 0 0 0 0 0 0 0 0 0 0 0 36473.55 0 0 0 1101341756 1851385520 10 Physicians PHILOBOS MEDHAT 606112991 200 Cook 0 0 Neonatology 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19609.89 0 0 0 0 0 0 19609.89 0 0 0 1101341757 1528271582 94 Waiver service provider--Children's support (DHS/DDD) LESTER AND ROSALIE ANIXTER CTR 606264062 200 Cook 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 0 506 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 506 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29386.64 0 0 0 0 0 0 0 0 0 0 0 0 0 29386.64 0 0 0 1101341758 1821021064 10 Physicians PROPP DOUGLAS 600681005 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 219 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 219 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7164.02 0 0 0 0 0 0 7164.02 0 0 0 1101341774 1932248424 10 Physicians SEMKIU ELIZABETH 604401518 107 Will 0 0 Occupational Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 216.38 0 0 0 0 0 0 216.38 0 0 0 1101341776 91 Waiver service provider--Adults (DHS/DDD) 80 Peoria 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 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14260.14 0 0 0 0 0 0 0 0 0 0 0 0 0 14260.14 0 0 0 1101341796 1922168095 23 Occupational Therapists SANGHVI NISHA 605036761 30 DuPage 0 0 0 0 0 0 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 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101341813 92 Waiver service provider--Disability (DHS/DRS) 57 Lake 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4956.43 0 0 0 0 0 0 0 0 0 0 0 0 0 4956.43 0 0 0 1101341815 1962508523 10 Physicians LEDDELL COURTNEY 600442203 57 Lake 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10141.69 0 0 0 0 0 0 10141.69 0 0 0 1101341819 92 Waiver service provider--Disability (DHS/DRS) 37 Fulton 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 12199.97 0 0 0 0 0 0 0 0 0 0 0 0 0 12199.97 0 0 0 1101341828 1760427827 33 Nursing Facilities HALLMARK HOUSE NURSING CENTER 615549401 98 Tazewell 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 0 0 0 0 0 0 0 0 224 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6072 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 409448.84 0 0 0 0 0 0 0 409448.84 0 0 0 1101341838 2100332256 91 Waiver service provider--Adults (DHS/DDD) HUMAN RESOURCES CENTER 619442460 31 Edgar 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6737 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6737 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 404839.67 0 0 0 0 0 0 0 0 0 0 0 0 0 404839.67 0 0 0 1101341848 1679847479 55 Early Intervention Services BLAUSTEIN MARA 606141290 200 Cook 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 0 145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9325.4 0 0 0 0 0 0 9325.4 0 0 0 1101341853 1417125428 16 Nurse Practitioners GORDON KIMBERLY 627810001 91 Sangamon 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 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 189.11 0 0 0 0 0 0 189.11 0 0 0 1101341863 92 Waiver service provider--Disability (DHS/DRS) 97 Stephenson 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 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30296.81 0 0 0 0 0 0 0 0 0 0 0 0 0 30296.81 0 0 0 1101341869 91 Waiver service provider--Adults (DHS/DDD) 20 Christian 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 0 189 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 189 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16131.5 0 0 0 0 0 0 0 0 0 0 0 0 0 16131.5 0 0 0 1101341885 1891711958 10 Physicians DORMAN DOUGLAS 605064356 53 Kane 0 0 Family Practice 0 0 0 0 2 0 0 0 0 0 0 9 0 38 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 40 0 113 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 40 0 113 0 0 0 0 0 0 0 0 0 96.45 0 0 0 0 0 0 278.32 0 1482.8 0 0 0 0 0 0 1857.57 0 0 0 1101341894 1174802482 16 Nurse Practitioners ELLEGOOD MICHELENE 601533328 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 199.24 0 0 0 0 0 0 199.24 0 0 0 1101341899 1265471486 10 Physicians FOSS JONATHAN 617612281 72 McLean 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 661 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 927 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 927 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15211.2 0 1572.79 0 0 0 0 0 0 16783.99 0 0 0 1101341902 1518953330 10 Physicians BHUVA MANISH 600102541 200 Cook 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 279 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 279 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6486.23 0 0 0 0 0 0 6486.23 0 0 0 1101341903 1295770550 63 Other Providers of Medical Equipment/Supplies (Non-registered) APRIA HEALTHCARE INC 617049061 72 McLean 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 397 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 397 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13707.7 0 0 0 0 0 0 13707.7 0 0 0 1101341905 1407976285 36 Community mental health provider NORTH CENTRAL BEHAVIORAL HLTH 615202520 37 Fulton 0 0 0 311 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 694 0 0 1402 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7672 0 0 1402 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7672 0 0 46086.38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 473794.67 0 0 519881.05 0 0 0 1101341913 1245219443 10 Physicians OLIVER RANDY 629602433 69 Massac 0 1 Family Practice 0 332 0 0 46 0 0 0 0 0 0 48 0 248 0 0 0 0 0 0 3144 0 0 66 0 0 0 0 0 0 81 0 533 0 0 0 0 0 0 3144 0 0 66 0 0 0 0 0 0 81 0 533 0 0 0 0 0 0 8139 0 0 5139.64 0 0 0 0 0 0 327.61 0 19740.22 0 0 0 0 0 0 33346.47 0 0 0 1101341914 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 33968.41 0 0 0 0 0 0 0 0 0 0 0 0 0 33968.41 0 0 0 1101341916 1558370825 33 Nursing Facilities SNYDER VILLAGE 615489670 110 Woodford 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 320 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8318 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 610697.1 0 0 0 0 0 0 0 610697.1 0 0 0 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Cook 0 1 Family Practice 0 9 0 0 9 0 0 0 0 0 0 4 0 72 0 0 0 0 0 0 9 0 0 10 0 0 0 0 0 0 5 0 297 0 0 0 0 0 0 9 0 0 10 0 0 0 0 0 0 5 0 297 0 0 0 0 0 0 22 0 0 121.56 0 0 0 0 0 0 13.02 0 12599.26 0 0 0 0 0 0 12755.84 0 0 0 1101343053 1114191061 11 Dentists STINAUER JESSE 615429624 37 Fulton 0 0 General Dentistry 0 0 0 7 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 0 454.3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 454.3 0 0 0 1101343058 1720199334 10 Physicians LIN MICHAEL 631101010 826 Missouri 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1075.01 0 0 0 0 0 0 1075.01 0 0 0 1101343066 10 Physicians 852 Wisconsin 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 1 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71.9 0 366.1 0 0 0 0 0 0 438 0 0 0 1101343068 1528149721 24 Speech Therapists YOUNGREN LAURA 606141281 200 Cook 0 0 0 0 0 0 0 0 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 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11189.94 11189.94 0 0 0 1101343101 92 Waiver service provider--Disability (DHS/DRS) 47 Jackson 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 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10705.88 0 0 0 0 0 0 0 0 0 0 0 0 0 10705.88 0 0 0 1101343110 1043598576 33 Nursing Facilities TOWER HILL HEALTHCARE CENTER 601771418 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 185 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1775 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46938 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4251423.13 0 0 0 0 0 0 0 4251423.13 0 0 0 1101343121 91 Waiver service provider--Adults (DHS/DDD) 852 Wisconsin 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 0 258 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 258 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27474.38 0 0 0 0 0 0 0 0 0 0 0 0 0 27474.38 0 0 0 1101343123 1982879441 10 Physicians WALLIA AMISHA 606118709 200 Cook 0 0 Endocrinology 0 0 0 0 0 0 0 0 0 0 0 0 0 41 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 0 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1877.46 0 0 0 0 0 0 1877.46 0 0 0 1101343129 1558533596 10 Physicians URBANOWICZ CYNTHIA 605151594 30 DuPage 0 1 Pediatrics 0 3 0 0 8 0 0 0 0 0 0 2 0 10 0 0 0 0 0 0 15 0 0 16 0 0 0 0 0 0 2 0 14 0 0 0 0 0 0 15 0 0 16 0 0 0 0 0 0 2 0 14 0 0 0 0 0 0 30 0 0 573.98 0 0 0 0 0 0 6.89 0 377.46 0 0 0 0 0 0 988.33 0 0 0 1101343132 1992740328 10 Physicians FINTEL DAN 606112914 200 Cook 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 12 0 515 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 741 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 741 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86.6 0 5852.95 0 0 0 0 0 0 5939.55 0 0 0 1101343147 34 State-operated facility (DHS) 57 Lake 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 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 450 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 343371.8 0 0 0 0 0 0 0 0 0 0 343371.8 0 0 0 1101343159 1144549494 75 Department of Alcohol and Substance Abuse Provider HUMAN SERVICE CENTER EI 616041035 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 555 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 555 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16457.59 0 0 16457.59 0 0 0 1101343172 1760448096 10 Physicians STRYKER STEVEN 606112921 200 Cook 0 0 Surgery General 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 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 422.4 0 0 0 0 0 0 422.4 0 0 0 1101343176 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6100.85 0 0 0 0 0 0 0 0 0 0 0 0 0 6100.85 0 0 0 1101343183 1790912830 10 Physicians PONUGOTI PRASANNA 631280000 826 Missouri 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 214.04 0 0 0 0 0 0 214.04 0 0 0 1101343187 1225083199 70 Ambulance Service Providers MARENGO RESCUE SQUAD DIST 601523155 71 McHenry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 542 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 542 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2767.55 0 0 0 0 0 0 2767.55 0 0 0 1101343197 1790703460 70 Ambulance Service Providers CRETE TOWNSHIP F P D 604174746 107 Will 0 0 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 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3952.87 0 0 0 0 0 0 3952.87 0 0 0 1101343217 91 Waiver service provider--Adults (DHS/DDD) 107 Will 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 0 287 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 287 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14300.62 0 0 0 0 0 0 0 0 0 0 0 0 0 14300.62 0 0 0 1101343237 92 Waiver service provider--Disability (DHS/DRS) 78 Moultrie 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 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 7385.04 0 0 0 0 0 0 0 0 0 0 0 0 0 7385.04 0 0 0 1101343254 16 Nurse Practitioners 826 Missouri 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 168.85 0 0 0 0 0 0 168.85 0 0 0 1101343256 92 Waiver service provider--Disability (DHS/DRS) 63 Macon 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130.15 0 0 0 0 0 0 0 0 0 0 0 0 0 130.15 0 0 0 1101343258 1942473525 10 Physicians MALIK RENUKA 606777007 200 Cook 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 600 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 600 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7563.34 0 0 0 0 0 0 7563.34 0 0 0 1101343260 1972590230 63 Other Providers of Medical Equipment/Supplies (Non-registered) ALDEN LONG GROVE REHAB HLTH 600478346 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15306.7 0 0 0 0 0 0 15306.7 0 0 0 1101343261 1386738375 10 Physicians RAINO WILLIAM 617043566 72 McLean 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 310 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 489 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 489 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12713.88 0 0 0 0 0 0 12713.88 0 0 0 1101343269 10 Physicians 826 Missouri 0 0 Radiology Diagnosis 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 2.31 0 0 0 0 0 0 0 0 2.31 0 0 0 1101343278 92 Waiver service provider--Disability (DHS/DRS) 93 Scott 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 12573.37 0 0 0 0 0 0 0 0 0 0 0 0 0 12573.37 0 0 0 1101343285 92 Waiver service provider--Disability (DHS/DRS) 91 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 777.82 0 0 0 0 0 0 0 0 0 0 0 0 0 777.82 0 0 0 1101343312 1992908586 10 Physicians DESANTO JEFFREY 616147300 80 Peoria 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 1490 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1896 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1896 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73369.22 0 635.78 0 0 0 0 0 0 74005 0 0 0 1101343333 1003831751 10 Physicians APPELBAUM WILLIAM A 606253547 200 Cook 0 1 Internal Medicine 0 19 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 286 0 0 0 0 0 0 0 0 0 0 0 1304.81 0 0 0 0 0 0 1590.81 0 0 0 1101343338 1760453187 10 Physicians GARG AMIT 613509214 58 La Salle 0 0 Family Practice 0 0 0 0 6 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 168 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 168 0 0 0 0 0 0 0 0 0 192.9 0 0 0 0 0 0 0 0 4932.75 0 0 0 0 0 0 5125.65 0 0 0 1101343352 1437310729 10 Physicians HSU VINCENT 609361477 35 Ford 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4467.57 0 0 0 0 0 0 4467.57 0 0 0 1101343354 1487768552 10 Physicians OYASU KENJI 478042706 815 Indiana 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 5 0 1327 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 1424 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 1424 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 167.71 0 48322.69 0 0 0 0 0 0 48490.4 0 0 0 1101343358 91 Waiver service provider--Adults (DHS/DDD) 79 Ogle 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 0 245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21463.2 0 0 0 0 0 0 0 0 0 0 0 0 0 21463.2 0 0 0 1101343363 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 5029.08 0 0 0 0 0 0 0 0 0 0 0 0 0 5029.08 0 0 0 1101343365 10 Physicians 836 Ohio 0 0 Otorhinolaryngology 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 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 1712.48 0 0 0 0 0 0 1712.48 0 0 0 1101343391 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19067.4 0 0 0 0 0 0 0 0 0 0 0 0 0 19067.4 0 0 0 1101343394 2100333812 90 Waiver service provider--Elderly (DOA) ADVOCATE HEALTH AND HOSP CORP 600164271 200 Cook 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3270 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3270 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106295.47 0 0 0 0 0 0 0 0 0 0 0 0 0 106295.47 0 0 0 1101343413 1922114297 10 Physicians KOENIG PETER 606112991 200 Cook 0 0 Pediatric Cardiology 0 0 0 0 0 0 0 0 0 0 0 0 0 581 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1454 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1454 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37171.55 0 0 0 0 0 0 37171.55 0 0 0 1101343419 1932110145 16 Nurse Practitioners THOMAS CELIA 605407430 30 DuPage 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 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118.13 0 0 0 0 0 0 118.13 0 0 0 1101343421 1023064698 60 Pharmacies FRESENIUS MEDICAL CARE RX LLC 372281322 844 Tennessee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 269 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1387 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41677 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 846018.62 0 0 0 846018.62 0 0 0 1101343427 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 1306.8 0 0 0 0 0 0 0 0 0 0 0 0 0 1306.8 0 0 0 1101343429 1447485693 10 Physicians CHAMBERS DAMM KRISTEN 61615 80 Peoria 0 0 Internal Medicine 0 44 0 0 3 0 0 0 0 0 0 10 0 81 0 0 0 0 0 0 350 0 0 5 0 0 0 0 0 0 15 0 189 0 0 0 0 0 0 350 0 0 5 0 0 0 0 0 0 15 0 189 0 0 0 0 0 0 1049 0 0 211.54 0 0 0 0 0 0 152.56 0 6500.7 0 0 0 0 0 0 7913.8 0 0 0 1101343431 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 0 292 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 292 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16128.75 0 0 0 0 0 0 0 0 0 0 0 0 0 16128.75 0 0 0 1101343448 1811024508 10 Physicians CUNNINGTON WALTER 625571716 20 Christian 0 1 Emergency Medicine 0 235 0 0 28 0 0 0 0 0 0 0 0 134 0 0 0 0 0 0 2234 0 0 47 0 0 0 0 0 0 0 0 259 0 0 0 0 0 0 2234 0 0 47 0 0 0 0 0 0 0 0 259 0 0 0 0 0 0 5608 0 0 2001.98 0 0 0 0 0 0 0 0 8102.35 0 0 0 0 0 0 15712.33 0 0 0 1101343457 1285634618 63 Other Providers of Medical Equipment/Supplies (Non-registered) HERITAGE DIABETIC SUPPLY INC 287527792 834 North Carolina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 247 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 211 0 437 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 211 0 437 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6910.44 0 42579.92 0 0 0 0 49490.36 0 0 0 1101343462 1750410429 24 Speech Therapists DOVERI RITA 604329613 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 613 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 613 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36089.36 36089.36 0 0 0 1101343472 1659506939 40 Federally Qualified Health Centers SIHF BUNKER HILL HEALTH CTR 620141316 64 Macoupin 0 1 0 557 487 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4611 2417 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4611 2417 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12659 148140.33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160799.33 0 0 0 1101343476 1811153406 10 Physicians HUNNIFORD JOHN 606133099 200 Cook 0 1 Family Practice 0 66 0 0 4 0 0 0 0 0 0 4 0 282 0 0 0 0 0 0 380 0 0 8 0 0 0 0 0 0 4 0 950 0 0 0 0 0 0 380 0 0 8 0 0 0 0 0 0 4 0 950 0 0 0 0 0 0 942 0 0 51.2 0 0 0 0 0 0 16 0 19437.1 0 0 0 0 0 0 20446.3 0 0 0 1101343480 1124391552 16 Nurse Practitioners BEDNARCHIK MATTHEW 626501136 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17397.13 0 0 0 0 0 0 17397.13 0 0 0 1101343484 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 5622.3 0 0 0 0 0 0 0 0 0 0 0 0 0 5622.3 0 0 0 1101343499 1588656557 10 Physicians SOWINSKI ANDRZEJ 601933746 200 Cook 0 0 General Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88.46 0 0 0 0 0 0 88.46 0 0 0 1101343507 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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"JH Stroger, Oak Forest and Provident Hospitals, paid under an alternate reimbursement system" 0 1 Direct Access 0 194 1987 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 548 6432 0 237 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 548 6432 0 237 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1330 1332218.15 0 42839.48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1376387.63 0 0 0 1101344184 1801908991 47 Local Education Agencies IROQUOIS SPECIAL ED ASSOC 609280400 46 Iroquois 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39522.05 0 39522.05 0 0 0 1101344187 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 14 0 0 0 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 5925.62 0 0 0 0 0 0 0 0 0 0 0 0 0 5925.62 0 0 0 1101344190 1053388520 10 Physicians LAGATTUTA JOSEPH 601082143 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 344 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 344 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5890.66 0 0 0 0 0 0 5890.66 0 0 0 1101344195 1659593234 34 State-operated facility (DHS) UNIT 0219 HOME 19 LUDEMAN 604661200 200 Cook 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 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 810 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 463033.8 0 0 0 0 0 0 0 0 0 0 463033.8 0 0 0 1101344202 1831235209 10 Physicians YEMUL MADHURI 605648044 107 Will 0 1 Family Practice 0 84 0 0 16 0 0 0 0 0 0 7 0 58 0 0 0 0 0 0 491 0 0 28 0 0 0 0 0 0 7 0 105 0 0 0 0 0 0 491 0 0 28 0 0 0 0 0 0 7 0 105 0 0 0 0 0 0 1234 0 0 1263.89 0 0 0 0 0 0 49.62 0 4698.35 0 0 0 0 0 0 7245.86 0 0 0 1101344219 1003862772 60 Pharmacies OSCO DRUG 3223 603051819 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 171 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1087 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28747 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49662.02 0 0 0 49662.02 0 0 0 1101344235 1003851460 10 Physicians MAITLAND MICHAEL 605276686 30 DuPage 0 0 Hematology 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1454.41 0 0 0 0 0 0 1454.41 0 0 0 1101344236 1881768729 11 Dentists KLERONOMOS STEVE 606172656 200 Cook 0 0 General Dentistry 0 0 0 276 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 993 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 993 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27034.29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27034.29 0 0 0 1101344239 1013163252 36 Community mental health provider HEARTLAND HUMAN SERVICES 624014261 33 Effingham 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 1399 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3050 0 0 1399 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3050 0 0 174.48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 128340.93 0 0 128515.41 0 0 0 1101344244 1679566707 10 Physicians MALHES ABDUL 600672414 200 Cook 0 1 Pediatrics 0 406 0 0 216 0 0 0 0 0 0 24 0 212 0 0 0 0 0 0 1080 0 0 673 0 0 0 0 0 0 31 0 360 0 0 0 0 0 0 1080 0 0 673 0 0 0 0 0 0 31 0 360 0 0 0 0 0 0 2205 0 0 23670.79 0 0 0 0 0 0 432.04 0 13449.74 0 0 0 0 0 0 39757.57 0 0 0 1101344253 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 15683.79 0 0 0 0 0 0 0 0 0 0 0 0 0 15683.79 0 0 0 1101344254 10 Physicians 826 Missouri 0 0 Anesthesiology 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101344268 91 Waiver service provider--Adults (DHS/DDD) 98 Tazewell 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 0 288 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 288 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12190.75 0 0 0 0 0 0 0 0 0 0 0 0 0 12190.75 0 0 0 1101344271 1013917574 10 Physicians RIFENBURG ROBERT 606313707 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 355 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 391 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 391 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13095.24 0 0 0 0 0 0 13095.24 0 0 0 1101344278 24 Speech Therapists 200 Cook 0 0 0 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1919.23 1919.23 0 0 0 1101344281 1790704435 10 Physicians STEFFEN SAMUEL 606313222 72 McLean 0 1 Family Practice 0 84 0 0 14 0 0 0 0 0 0 2 0 39 0 0 0 0 0 0 472 0 0 40 0 0 0 0 0 0 4 0 115 0 0 0 0 0 0 472 0 0 40 0 0 0 0 0 0 4 0 115 0 0 0 0 0 0 1161 0 0 1501.88 0 0 0 0 0 0 0 0 2154.35 0 0 0 0 0 0 4817.23 0 0 0 1101344286 1871538033 10 Physicians DANON SAAR 999999999 826 Missouri 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 0 227 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 227 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18057.38 0 0 0 0 0 0 18057.38 0 0 0 1101344292 1679566400 10 Physicians PARIKH AJAY 604292082 200 Cook 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 966 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1604 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1604 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13002.42 0 0 0 0 0 0 13002.42 0 0 0 1101344293 1710903331 10 Physicians ROSENZWEIG BELLA 606601903 200 Cook 0 1 Internal Medicine 0 172 0 0 0 0 0 0 0 0 0 0 0 354 0 0 0 0 0 0 1201 0 0 0 0 0 0 0 0 0 0 0 2388 0 0 0 0 0 0 1201 0 0 0 0 0 0 0 0 0 0 0 2388 0 0 0 0 0 0 3795 0 0 0 0 0 0 0 0 0 0 0 19084.19 0 0 0 0 0 0 22879.19 0 0 0 1101344295 1912107053 11 Dentists PHAN TRAN XUAN 606403610 200 Cook 0 0 General Dentistry 0 0 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 307 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 307 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7454.46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7454.46 0 0 0 1101344296 10 Physicians 826 Missouri 0 0 Cardiology 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22.1 0 0 0 0 0 0 22.1 0 0 0 1101344323 1952455362 10 Physicians CHUGH RAKESH 604113459 200 Cook 0 1 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 1 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 305 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 305 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61.87 0 1475.17 0 0 0 0 0 0 1537.04 0 0 0 1101344329 1063423549 10 Physicians PAPPA AZRA 609141465 54 Kankakee 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 375 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1536 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1536 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13074.74 0 0 0 0 0 0 13074.74 0 0 0 1101344342 1972866135 60 Pharmacies WELL FUTURE PHARMACY LLC 606052811 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1193 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32968 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120180.7 0 0 0 120180.7 0 0 0 1101344344 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 2464.85 0 0 0 0 0 0 0 0 0 0 0 0 0 2464.85 0 0 0 1101344350 1134456270 16 Nurse Practitioners BROWN MICHELLE 601029402 71 McHenry 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 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 370 0 0 0 0 0 0 370 0 0 0 1101344355 1770656514 10 Physicians TALWAR PARKASH 606127232 30 DuPage 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 1971 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3173 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3173 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37718.84 0 4153.04 0 0 0 0 0 0 41871.88 0 0 0 1101344356 90 Waiver service provider--Elderly (DOA) 65 Madison 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 1026 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1026 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39713 0 0 0 0 0 0 0 0 0 0 0 0 0 39713 0 0 0 1101344363 1477549889 10 Physicians FLORENCE KATHLEEN 604532600 200 Cook 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2961.66 0 0 0 0 0 0 2961.66 0 0 0 1101344364 16 Nurse Practitioners 101 Wabash 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 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101344366 11 Dentists 200 Cook 0 0 General Dentistry 0 0 0 4 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 0 714.6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 714.6 0 0 0 1101344368 2100334786 90 Waiver service provider--Elderly (DOA) HOME CARE PERSONAL SERVICES 605634871 30 DuPage 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 0 398 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 398 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30694.1 0 0 0 0 0 0 0 0 0 0 0 0 0 30694.1 0 0 0 1101344369 1104028679 47 Local Education Agencies MINOOKA COMM CUSD 201 604479585 40 Grundy 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2380 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2380 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40954.31 0 40954.31 0 0 0 1101344375 10 Physicians 39 Greene 0 0 Family Practice 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 0 111.73 0 0 0 0 0 0 111.73 0 0 0 1101344379 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 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 1978.97 0 0 0 0 0 0 0 0 0 0 0 0 0 1978.97 0 0 0 1101344396 30 General Hospitals 806 Colorado NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 559.15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 559.15 0 0 0 1101344398 1174541635 16 Nurse Practitioners EBERT ALAN 631101010 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3829.89 0 0 0 0 0 0 3829.89 0 0 0 1101344401 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15420.97 0 0 0 0 0 0 0 0 0 0 0 0 0 15420.97 0 0 0 1101344406 1962475988 70 Ambulance Service Providers CITY OF DEKALB FIRE DEPT 601153733 27 Dekalb 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 574 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1883 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1883 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85885.82 0 0 0 0 0 0 85885.82 0 0 0 1101344407 1982651741 33 Nursing Facilities PLEASANT VIEW LUTHER HOME 613503865 58 La Salle 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 0 278 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7583 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 575762.5 0 0 0 0 0 0 0 575762.5 0 0 0 1101344411 1558451716 36 Community mental health provider MENTAL HEALTH CENTERS W IL 623211266 42 Hancock 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 357 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 357 0 0 33.3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9855.04 0 0 9888.34 0 0 0 1101344419 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13128.9 0 0 0 0 0 0 0 0 0 0 0 0 0 13128.9 0 0 0 1101344426 92 Waiver service provider--Disability (DHS/DRS) 34 Fayette 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 31517.71 0 0 0 0 0 0 0 0 0 0 0 0 0 31517.71 0 0 0 1101344428 92 Waiver service provider--Disability (DHS/DRS) 72 McLean 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 27136.54 0 0 0 0 0 0 0 0 0 0 0 0 0 27136.54 0 0 0 1101344433 1619964467 64 Imaging Services ADVANCED IMAGING CENTER LLC 612656150 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 401 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 679 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 679 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13807.25 0 0 0 0 0 0 13807.25 0 0 0 1101344444 1245279181 10 Physicians BOGOLUB DAVID 617014364 72 McLean 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 247 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 273 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 273 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8136.72 0 0 0 0 0 0 8136.72 0 0 0 1101344456 1821391178 16 Nurse Practitioners DROEGE JAN 620628500 65 Madison 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 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2177.99 0 0 0 0 0 0 2177.99 0 0 0 1101344458 1356418446 10 Physicians WATSON CARLA 601876078 200 Cook 0 0 Physical Medicine/Rehabilitation 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 0 235 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 235 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1153.34 0 0 0 0 0 0 1153.34 0 0 0 1101344476 1093761918 60 Pharmacies OSCO DRUG 3425 600181517 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 299 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1514 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36297 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82216.71 0 0 0 82216.71 0 0 0 1101344480 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 168 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 168 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10612.8 0 0 0 0 0 0 0 0 0 0 0 0 0 10612.8 0 0 0 1101344484 92 Waiver service provider--Disability (DHS/DRS) 99 Union 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 17994.3 0 0 0 0 0 0 0 0 0 0 0 0 0 17994.3 0 0 0 1101344491 1396769055 10 Physicians RAMADAN RAFIQ 631366111 826 Missouri 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 1 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 393 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 393 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3.82 0 5377.75 0 0 0 0 0 0 5381.57 0 0 0 1101344494 1134139785 39 Hospice GRAHAM HOSPITAL HOSPICE 615202444 37 Fulton 0 0 0 0 0 0 0 0 0 0 7 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 0 394 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35085.82 0 0 0 0 0 0 0 0 0 0 0 35085.82 0 0 0 1101344496 1427169127 10 Physicians STRIEGEL JANE 618215923 19 Champaign 0 1 Pediatrics 0 65 0 0 20 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 495 0 0 28 0 0 0 0 0 0 0 0 123 0 0 0 0 0 0 495 0 0 28 0 0 0 0 0 0 0 0 123 0 0 0 0 0 0 1041 0 0 365.03 0 0 0 0 0 0 0 0 4706.34 0 0 0 0 0 0 6112.37 0 0 0 1101344514 1235408527 16 Nurse Practitioners POOVATHUR TINCY 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 188 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 249 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 249 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3986.15 0 0 0 0 0 0 3986.15 0 0 0 1101344518 92 Waiver service provider--Disability (DHS/DRS) 107 Will 0 0 0 0 0 0 0 0 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Equipment/Supplies (Non-registered) MP TOTALCARE SERVICES INC 752346069 845 Texas 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 176 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1495 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1495 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 196389.32 0 0 0 0 0 0 196389.32 0 0 0 1101344556 1508858226 10 Physicians VAINDER JOHN 600315711 57 Lake 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 264 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 0 0 0 0 0 673 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15899.05 0 0 0 0 0 0 15899.05 0 0 0 1101344557 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 6898.76 0 0 0 0 0 0 0 0 0 0 0 0 0 6898.76 0 0 0 1101344561 1346406253 10 Physicians CONNERS JAMES 606123845 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 288 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 288 0 0 0 0 0 0 0 0 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0 0 0 0 117 0 0 1 0 0 0 0 0 0 5 0 63 0 0 0 0 0 0 376 0 0 76.84 0 0 0 0 0 0 27.44 0 2321.3 0 0 0 0 0 0 2801.58 0 0 0 1101344587 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 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 6908.58 0 0 0 0 0 0 0 0 0 0 0 0 0 6908.58 0 0 0 1101344600 1891867156 10 Physicians JANKOWSKI CHRISTINE 601265658 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2630.51 0 0 0 0 0 0 2630.51 0 0 0 1101344601 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 18941.26 0 0 0 0 0 0 0 0 0 0 0 0 0 18941.26 0 0 0 1101344620 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 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 2369.97 0 0 0 0 0 0 0 0 0 0 0 0 0 2369.97 0 0 0 1101344621 1083661797 63 Other Providers of Medical Equipment/Supplies (Non-registered) BALLERT ORTHOPEDIC 606594113 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 109 0 307 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 197 0 556 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 197 0 556 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19532.65 0 72814.55 0 0 0 0 92347.2 0 0 0 1101344624 1740257559 10 Physicians SHIEH CAROLINE 606162013 200 Cook 0 1 Pediatrics 0 0 0 0 5 0 0 0 0 0 0 2 0 4 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 2 0 4 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 2 0 4 0 0 0 0 0 0 0 0 0 379.35 0 0 0 0 0 0 6.32 0 186.24 0 0 0 0 0 0 571.91 0 0 0 1101344636 1164550042 34 State-operated facility (DHS) UNIT 3570 HOME 50 KILEY 600856263 57 Lake 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 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 810 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 619164.3 0 0 0 0 0 0 0 0 0 0 619164.3 0 0 0 1101344645 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8899 0 0 0 0 0 0 0 0 0 0 0 0 0 8899 0 0 0 1101344664 1114172004 10 Physicians BOYD KEVIN 999999999 852 Wisconsin 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 219.35 0 0 0 0 0 0 0 0 219.35 0 0 0 1101344675 1053499053 22 Physical Therapists RYBA DANIEL 604239491 107 Will 0 0 0 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 0 222 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 222 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7910.45 7910.45 0 0 0 1101344687 14 Chiropractors 20 Christian 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102.64 0 0 0 0 0 0 102.64 0 0 0 1101344701 93 Waiver service 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1912001405 10 Physicians ROBYN RANDALL 610081742 13 Boone 0 1 Family Practice 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 1101344778 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 364 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 364 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18205 0 0 0 0 0 0 0 0 0 0 0 0 0 18205 0 0 0 1101344786 91 Waiver service provider--Adults (DHS/DDD) 53 Kane 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 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2971.28 0 0 0 0 0 0 0 0 0 0 0 0 0 2971.28 0 0 0 1101344787 10 Physicians 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 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 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 0 174.2 0 0 0 0 0 0 174.2 0 0 0 1101344790 10 Physicians 815 Indiana 0 0 Anesthesiology 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 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 0 425.21 0 0 0 0 0 0 425.21 0 0 0 1101344797 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12916.2 0 0 0 0 0 0 0 0 0 0 0 0 0 12916.2 0 0 0 1101344798 1114902814 10 Physicians DECRESCE ROBERT 606123833 200 Cook 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 11744 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133614 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133614 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 530772.53 0 0 0 0 0 0 0 0 530772.53 0 0 0 1101344834 1083713978 10 Physicians HYRE MICHAEL 604689590 107 Will 0 1 Internal Medicine 0 48 0 0 1 0 0 0 0 0 0 15 0 93 0 0 0 0 0 0 310 0 0 1 0 0 0 0 0 0 19 0 257 0 0 0 0 0 0 310 0 0 1 0 0 0 0 0 0 19 0 257 0 0 0 0 0 0 918 0 0 85.65 0 0 0 0 0 0 87.17 0 7194.89 0 0 0 0 0 0 8285.71 0 0 0 1101344845 1326147240 10 Physicians JENSEN JULIE 605406538 30 DuPage 0 0 Obstetrics 0 0 0 0 0 0 0 0 0 0 0 2 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.32 0 44.1 0 0 0 0 0 0 44.42 0 0 0 1101344848 92 Waiver service provider--Disability (DHS/DRS) 58 La Salle 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11665.78 0 0 0 0 0 0 0 0 0 0 0 0 0 11665.78 0 0 0 1101344857 1730129537 12 Optometrists SILVESTROS NICHOLAS 631101002 826 Missouri 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4271.09 0 0 0 0 0 0 4271.09 0 0 0 1101344859 1730475617 11 Dentists NEWELL KELLI 999999999 34 Fayette 0 0 0 0 0 908 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 2186 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 2186 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 75498.59 0 0 0 0 0 0 0 0 0 0 0 7150.65 0 0 0 0 82649.24 0 0 0 1101344861 1437323896 10 Physicians VASSAIWALA ROSHNI 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 278 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 436 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 436 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 404.63 0 15918.21 0 0 0 0 0 0 16322.84 0 0 0 1101344863 1326103540 10 Physicians MINHAJ MOHAMMED 605276686 30 DuPage 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16365.58 0 0 0 0 0 0 16365.58 0 0 0 1101344866 10 Physicians 200 Cook 0 0 Family Practice 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93.45 0 0 0 0 0 0 93.45 0 0 0 1101344870 1538380837 62 Opticians / Optical Companies CHRISTIAN COUNTY HEALTH DEPT 625681213 20 Christian 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 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2529.68 0 0 0 0 2529.68 0 0 0 1101344873 1568551042 10 Physicians MONEM GAMAL 476308947 815 Indiana 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 6 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 0 500.51 0 0 0 0 0 0 500.51 0 0 0 1101344884 1649244187 48 Rural Health Clinics MT STERLING RURAL HEALTH 623531442 14 Brown 0 1 0 1066 1168 0 187 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9658 6011 0 489 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9658 6011 0 489 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25009 244449.71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 269458.71 0 0 0 1101344885 1841434024 10 Physicians CHAPTINI NAYLA 600681130 200 Cook 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 21 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 251 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 251 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1132.95 0 2875.69 0 0 0 0 0 0 4008.64 0 0 0 1101344891 1811965239 36 Community mental health provider KEMMERER VILLAGE 625108026 20 Christian 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 1015 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6614 0 0 1015 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6614 0 0 297313.42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 294406.67 0 0 591720.09 0 0 0 1101344895 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 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 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6185.78 0 0 0 0 0 0 0 0 0 0 0 0 0 6185.78 0 0 0 1101344899 1801070370 10 Physicians IDA JONATHAN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 414 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 897 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 897 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83444.36 0 0 0 0 0 0 83444.36 0 0 0 1101344917 1740326537 11 Dentists WINE GERALD 606222850 200 Cook 0 0 General Dentistry 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 128 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 128 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 3967.11 0 0 0 0 0 0 0 0 0 0 0 35753.25 0 0 0 0 39720.36 0 0 0 1101344919 1194789404 10 Physicians DEWOLF ANDRE 606118709 57 Lake 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5287.06 0 0 0 0 0 0 5287.06 0 0 0 1101344920 1902956956 10 Physicians SCHREIBER MICHAEL 605275993 30 DuPage 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 280 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 256680.79 0 0 0 0 0 0 256680.79 0 0 0 1101344930 1154336691 10 Physicians NOOKALA SHOBHA 616025019 80 Peoria 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 876 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 876 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22232.98 0 0 0 0 0 0 22232.98 0 0 0 1101344942 1245266675 10 Physicians MEZIERE MICHELLE 601262966 30 DuPage 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 461 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 495 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 495 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15957.14 0 0 0 0 0 0 15957.14 0 0 0 1101344946 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 2778.6 0 0 0 0 0 0 0 0 0 0 0 0 0 2778.6 0 0 0 1101344952 1881893303 10 Physicians BONCZAK BOGUSLAW 600508409 53 Kane 0 1 Family Practice 0 314 0 0 44 0 0 0 0 0 0 30 0 175 0 0 0 0 0 0 2563 0 0 89 0 0 0 0 0 0 42 0 552 0 0 0 0 0 0 2563 0 0 89 0 0 0 0 0 0 42 0 552 0 0 0 0 0 0 6562 0 0 4159.09 0 0 0 0 0 0 281.72 0 25606.32 0 0 0 0 0 0 36609.13 0 0 0 1101344974 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 241 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 241 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22951.5 0 0 0 0 0 0 0 0 0 0 0 0 0 22951.5 0 0 0 1101345001 1477587921 10 Physicians BARNHART H TRENT 611076303 109 Winnebago 0 1 Family Practice 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 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 886.75 0 0 0 0 0 0 886.75 0 0 0 1101345018 1255302501 10 Physicians MCLACHLAN DANIEL L 605152865 30 DuPage 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 1 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1691.89 0 0 0 0 0 0 1691.89 0 0 0 1101345040 10 Physicians 80 Peoria 0 0 Internal Medicine 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42.66 0 0 0 0 0 0 42.66 0 0 0 1101345045 1669456729 10 Physicians LEWIS BERRY 628121969 36 Franklin 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 961 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1030 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1030 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30305.39 0 0 0 0 0 0 30305.39 0 0 0 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Adult and Child 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 0 602.37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 602.37 0 0 0 1101345098 1942413026 10 Physicians LAMBERT ANDREW 627023719 91 Sangamon 0 0 Vascular Surgery 0 0 0 0 0 0 0 0 0 0 0 9 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 323 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 323 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91.8 0 13302.08 0 0 0 0 0 0 13393.88 0 0 0 1101345101 92 Waiver service provider--Disability (DHS/DRS) 57 Lake 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 9972.1 0 0 0 0 0 0 0 0 0 0 0 0 0 9972.1 0 0 0 1101345111 1639385651 10 Physicians PATEL DIPTI 605064356 53 Kane 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 37 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 134 0 273 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 134 0 273 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1908.67 0 20806.03 0 0 0 0 0 0 22714.7 0 0 0 1101345117 1669532651 60 Pharmacies HODELS RUBENS PHARMACY 611011417 109 Winnebago 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 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3085 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1191.81 0 0 0 1191.81 0 0 0 1101345130 1003975558 10 Physicians MARTIN LYNN 600251777 200 Cook 0 1 Internal Medicine 0 27 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 177 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 177 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 535 0 0 0 0 0 0 0 0 0 0 0 1666.15 0 0 0 0 0 0 2201.15 0 0 0 1101345134 1679689988 10 Physicians HEGARTY KATHLEEN 601533328 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 549 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 569 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 569 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16912.5 0 0 0 0 0 0 16912.5 0 0 0 1101345140 1902112840 10 Physicians GASTEVSKI DRAGAN 604532600 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7881.49 0 0 0 0 0 0 7881.49 0 0 0 1101345141 1093798662 10 Physicians ALBOVIAS MICHELLE 606082014 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 4 0 0 0 0 0 0 12 0 202 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 12 0 343 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 12 0 343 0 0 0 0 0 0 0 0 0 182.17 0 0 0 0 0 0 386.75 0 38513.74 0 0 0 0 0 0 39082.66 0 0 0 1101345147 1194836924 10 Physicians SABBAGH HAISSAM 604022217 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 657 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 657 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1161.39 0 0 0 0 0 0 1161.39 0 0 0 1101345153 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 110 0 0 0 1101345154 1184604282 10 Physicians MCCLURKIN CLARK 608052814 200 Cook 0 0 Nephrology 0 0 0 0 0 0 0 0 0 0 0 0 0 204 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1031 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1031 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21785.46 0 0 0 0 0 0 21785.46 0 0 0 1101345166 1669582698 10 Physicians ALFRHAN ALMUHANNAD 623012834 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 332.8 0 0 0 0 0 0 332.8 0 0 0 1101345169 1306865084 10 Physicians SMITH BONNIE 617391516 61 Livingston 0 0 Family Practice 0 0 0 0 4 0 0 0 0 0 0 13 0 38 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 17 0 131 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 17 0 131 0 0 0 0 0 0 0 0 0 330.91 0 0 0 0 0 0 113.29 0 3523.74 0 0 0 0 0 0 3967.94 0 0 0 1101345174 1194775445 10 Physicians LUNDEEN BRIAN 606118709 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 323 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 406 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 406 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7902.33 0 198.69 0 0 0 0 0 0 8101.02 0 0 0 1101345196 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 930.15 0 0 0 0 0 0 0 0 0 0 0 0 0 930.15 0 0 0 1101345208 1366439267 63 Other Providers of Medical Equipment/Supplies (Non-registered) ALDEN NURSING CTR OF POPLAR CR 601941018 200 Cook 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 0 0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15132.68 0 0 0 0 0 0 15132.68 0 0 0 1101345229 1821007212 11 Dentists MCLEOD YVONNE 606313557 200 Cook 0 0 General Dentistry 0 0 0 409 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1888 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1888 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48044.35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48044.35 0 0 0 1101345233 1679573323 10 Physicians NIJENSOHN EDUARDO 606081732 200 Cook 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 410 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 521 0 3 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 16406 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19999.68 0 0 0 19999.68 0 0 0 1101345323 2100335741 25 Audiologists WALLACE BETH 613643332 58 La Salle 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 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 15929.15 15929.15 0 0 0 1101345327 1104815596 10 Physicians ROSI DAVID 601533328 200 Cook 0 0 Oncology 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 171 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 171 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2101.8 0 0 0 0 0 0 2101.8 0 0 0 1101345329 91 Waiver service provider--Adults (DHS/DDD) 30 DuPage 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 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16959.25 0 0 0 0 0 0 0 0 0 0 0 0 0 16959.25 0 0 0 1101345353 1700980653 60 Pharmacies CVS PHARMACY 7199 605049091 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 479 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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1101345410 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15199.98 0 0 0 0 0 0 0 0 0 0 0 0 0 15199.98 0 0 0 1101345419 1114129921 10 Physicians NAZEER ABID 605462387 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 462 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 462 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10061.38 0 0 0 0 0 0 10061.38 0 0 0 1101345425 1386950319 10 Physicians BRANDIS OLESYA 611076807 109 Winnebago 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16797.34 0 0 0 0 0 0 16797.34 0 0 0 1101345443 36 Community mental health provider 200 Cook 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 287 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 287 0 0 165.43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17384.59 0 0 17550.02 0 0 0 1101345444 92 Waiver service provider--Disability (DHS/DRS) 89 Rock Island 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 0 141.34 0 0 0 0 0 0 0 0 0 0 0 0 0 141.34 0 0 0 1101345445 1598869133 70 Ambulance Service Providers KIRBY MEDICAL CENTER 999999999 82 Piatt 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 274 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 274 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10736.64 0 0 0 0 0 0 10736.64 0 0 0 1101345450 1215240247 24 Speech Therapists CREHAN KATHERINE 603021704 200 Cook 0 0 0 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 0 0 0 0 0 0 0 0 381 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 381 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24273.09 24273.09 0 0 0 1101345457 1962569178 23 Occupational Therapists MANUS ROBIN 601622110 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 6760.76 0 0 0 0 0 0 0 0 0 0 0 0 0 6760.76 0 0 0 1101345562 1407138480 60 Pharmacies SCHNUCKS PHARMACY 756 610737777 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 775 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20939 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25628.56 0 0 0 25628.56 0 0 0 1101345564 1386748903 10 Physicians MOHAMMADI REZA G 477470001 815 Indiana 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 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 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3502.75 0 0 0 0 0 0 3502.75 0 0 0 1101345566 1881759009 10 Physicians KLOCK PETER 605276686 30 DuPage 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9984.13 0 0 0 0 0 0 9984.13 0 0 0 1101345581 1124064696 10 Physicians TKACHENKO IGOR 605276686 30 DuPage 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 176 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42881.86 0 0 0 0 0 0 42881.86 0 0 0 1101345587 1558399949 10 Physicians BURANOSKY MARK 606344401 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 12 0 326 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 817 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 817 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30.7 0 17911.19 0 0 0 0 0 0 17941.89 0 0 0 1101345591 1831150036 10 Physicians TOMASZEWSKI JEFFREY 601374418 30 DuPage 0 1 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 235.57 0 0 0 0 0 0 235.57 0 0 0 1101345592 98 Waiver service provider--TBI (DHS/DRS) 107 Will 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12085.9 0 0 0 0 0 0 0 0 0 0 0 0 0 12085.9 0 0 0 1101345600 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2548.7 0 0 0 0 0 0 0 0 0 0 0 0 0 2548.7 0 0 0 1101345602 1235188152 70 Ambulance Service Providers ITASCA FIRE PROTECTION DIST 601432018 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3872.93 0 0 0 0 0 0 3872.93 0 0 0 1101345609 1346354099 10 Physicians SHARMA VRITTI 601072418 200 Cook 0 1 Pediatrics 0 59 0 0 107 0 0 0 0 0 0 60 0 108 0 0 0 0 0 0 333 0 0 479 0 0 0 0 0 0 83 0 188 0 0 0 0 0 0 333 0 0 479 0 0 0 0 0 0 83 0 188 0 0 0 0 0 0 666 0 0 12933.49 0 0 0 0 0 0 547.68 0 7519.6 0 0 0 0 0 0 21666.77 0 0 0 1101345615 1871508010 60 Pharmacies BOND DRUG COMPANY OF IL 02584 610323973 97 Stephenson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 2941 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 24442 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 583525 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20015.16 0 0 0 0 0 0 20015.16 0 0 0 1101345659 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 21177.44 0 0 0 0 0 0 0 0 0 0 0 0 0 21177.44 0 0 0 1101345667 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 233 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 233 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24733.5 0 0 0 0 0 0 0 0 0 0 0 0 0 24733.5 0 0 0 1101345674 1538138748 10 Physicians PHILLIPS KENNETH 601871040 30 DuPage 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3099.45 0 0 0 0 0 0 3099.45 0 0 0 1101345680 1568476117 10 Physicians ANSEEUW BRIAN 612015351 89 Rock Island 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 15 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 0 0 0 0 0 0 0 0 0 0 0 1101345688 1487669784 60 Pharmacies BOND DRUG COMPANY OF ILLINOIS 622264618 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1659 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6712 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 144951 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 303019.96 0 0 0 303019.96 0 0 0 1101345694 1104817816 63 Other Providers of Medical Equipment/Supplies (Non-registered) HERITAGE MANOR PANA LLC 625571870 20 Christian 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 66 0 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 9833.66 0 0 0 0 0 0 9833.66 0 0 0 1101345703 10 Physicians 815 Indiana 0 0 Internal Medicine 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101345710 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 0 0 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 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3094.92 0 0 0 0 0 0 0 0 0 0 0 0 0 3094.92 0 0 0 1101345713 1326351438 55 Early Intervention Services PASLEY SARA 610211453 60 Lee 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 0 731 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 731 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45392.14 0 0 0 0 0 0 45392.14 0 0 0 1101345721 1700997012 10 Physicians CARDWELL ANNE 606123881 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 32 0 148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 393.24 0 3161.82 0 0 0 0 0 0 3555.06 0 0 0 1101345730 92 Waiver service provider--Disability (DHS/DRS) 30 DuPage 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 26859.53 0 0 0 0 0 0 0 0 0 0 0 0 0 26859.53 0 0 0 1101345741 1457349334 10 Physicians MORITANI TOSHIO 522421009 816 Iowa 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1765.48 0 0 0 0 0 0 0 0 1765.48 0 0 0 1101345755 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 630.03 0 0 0 0 0 0 0 0 0 0 0 0 0 630.03 0 0 0 1101345763 1184674236 10 Physicians KEMPF ROBERT 606941400 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 730 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 932 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 932 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27196.28 0 0 0 0 0 0 27196.28 0 0 0 1101345790 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 26207.07 0 0 0 0 0 0 0 0 0 0 0 0 0 26207.07 0 0 0 1101345791 30 General Hospitals 848 Virginia NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 71.12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71.12 0 0 0 1101345796 55 Early Intervention Services 107 Will 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 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 0 362.8 0 0 0 0 0 0 362.8 0 0 0 1101345814 1942207949 63 Other Providers of Medical Equipment/Supplies (Non-registered) MCKESSON MED SURGICAL MEDIMART 554274460 824 Minnesota 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 367 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 367 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5695.29 0 0 0 0 0 0 5695.29 0 0 0 1101345817 1649460510 48 Rural Health Clinics CARLINVILLE FAMILY PRACTICE 626264091 64 Macoupin 0 1 0 965 818 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8011 6331 0 317 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8011 6331 0 317 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21165 246650.39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 267815.39 0 0 0 1101345837 1831391176 10 Physicians MEUNIER JOHN 477470001 815 Indiana 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 769.27 0 0 0 0 0 0 769.27 0 0 0 1101345838 1528089067 10 Physicians JOHNSTON MCNUSSEN PATRICIA 618012529 19 Champaign 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6810.52 0 0 0 0 0 0 6810.52 0 0 0 1101345841 1801830021 10 Physicians BOKHARI SAMINA 606127330 200 Cook 0 0 Neurology 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 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 667.77 0 0 0 0 0 0 667.77 0 0 0 1101345847 1063537223 11 Dentists WEINFIELD HERBERT 606593270 200 Cook 0 0 General Dentistry 0 0 0 442 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1867 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1867 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46931 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46931 0 0 0 1101345854 92 Waiver service provider--Disability (DHS/DRS) 53 Kane 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 6494.79 0 0 0 0 0 0 0 0 0 0 0 0 0 6494.79 0 0 0 1101345861 92 Waiver service provider--Disability (DHS/DRS) 36 Franklin 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 840.65 0 0 0 0 0 0 0 0 0 0 0 0 0 840.65 0 0 0 1101345871 1174541627 10 Physicians MURRAY DAVID J 191787642 65 Madison 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4681.16 0 0 0 0 0 0 4681.16 0 0 0 1101345875 1588753693 10 Physicians KURTZMAN DANIEL M 604023483 200 Cook 0 0 Otolaryngology 0 0 0 0 0 0 0 0 0 0 0 5 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125.4 0 5226.78 0 0 0 0 0 0 5352.18 0 0 0 1101345885 1649299843 70 Ambulance Service Providers EAST DUNDEE AND CNTRY FPD 601181638 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4762.73 0 0 0 0 0 0 4762.73 0 0 0 1101345907 1699890145 70 Ambulance Service Providers CALHOUN COUNTY AMBULANCE SERV 620471002 16 Calhoun 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3416.56 0 0 0 0 0 0 3416.56 0 0 0 1101345909 1851394522 10 Physicians DELANEY MICHAEL K 629595897 108 Williamson 0 0 Otorhinolaryngology 0 0 0 0 121 0 0 0 0 0 0 0 0 791 0 0 0 0 0 0 0 0 0 158 0 0 0 0 0 0 0 0 2538 0 0 0 0 0 0 0 0 0 158 0 0 0 0 0 0 0 0 2538 0 0 0 0 0 0 0 0 0 2127.84 0 0 0 0 0 0 0 0 81605.67 0 0 0 0 0 0 83733.51 0 0 0 1101345942 10 Physicians 852 Wisconsin 0 0 Geriatrics 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 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 0 209.75 0 0 0 0 0 0 209.75 0 0 0 1101345961 1790739977 30 General Hospitals ST ANTHONY MEDICAL CENTER 611082425 109 Winnebago DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 0 0 0 0 0 3455 0 0 0 0 1210 0 0 0 2754 0 0 0 0 0 0 0 0 0 5287 0 0 0 0 1508 0 0 0 6513 0 0 0 0 0 0 0 0 0 5287 0 0 0 0 6543 0 0 0 6785 0 0 0 0 0 0 0 0 0 637319.07 0 0 0 0 4900508.46 0 0 0 1146936.75 0 0 0 0 0 6684764.28 0 0 0 1101345964 1023090578 10 Physicians LOWER TRACY 627949639 91 Sangamon 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 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0 0 1101346593 98 Waiver service provider--TBI (DHS/DRS) 107 Will 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 14780.41 0 0 0 0 0 0 0 0 0 0 0 0 0 14780.41 0 0 0 1101346596 63 Other Providers of Medical Equipment/Supplies (Non-registered) 826 Missouri 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15.69 0 0 0 0 15.69 0 0 0 1101346604 1164437778 60 Pharmacies GORDONO PHARMACY INC 606401213 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 430 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12193 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43734.88 0 0 0 43734.88 0 0 0 1101346605 1700089729 10 Physicians ANTON OSCAR 611042200 109 Winnebago 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 67 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107 0 340 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107 0 340 0 0 0 0 0 0 0 0 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242 0 822 0 0 0 0 0 0 0 0 0 96.45 0 0 0 0 0 0 6566.46 0 130188.64 0 0 0 0 0 0 136851.55 0 0 0 1101346939 1003903899 10 Physicians DIXIT RAJEEN 605213829 30 DuPage 0 0 Neonatal-Perinatal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 294 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 294 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38003.94 0 0 0 0 0 0 38003.94 0 0 0 1101346942 1912020934 70 Ambulance Service Providers MARION COUNTY EMS 628700207 66 Marion 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 587 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2537 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2537 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125157.2 0 0 0 0 0 0 125157.2 0 0 0 1101346944 1104024991 55 Early Intervention Services OH ANDREW 601736591 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 559 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 559 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33095.76 0 0 0 0 0 0 33095.76 0 0 0 1101346949 92 Waiver service provider--Disability (DHS/DRS) 53 Kane 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 2468.07 0 0 0 0 0 0 0 0 0 0 0 0 0 2468.07 0 0 0 1101346978 92 Waiver service provider--Disability (DHS/DRS) 70 McDonough 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 0 459.72 0 0 0 0 0 0 0 0 0 0 0 0 0 459.72 0 0 0 1101346981 1952386161 11 Dentists CHEHAIBER MANHEIR 606293304 200 Cook 0 0 General Dentistry 0 0 0 700 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2205 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2205 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67933.87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67933.87 0 0 0 1101347004 92 Waiver service provider--Disability (DHS/DRS) 66 Marion 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 4208.84 0 0 0 0 0 0 0 0 0 0 0 0 0 4208.84 0 0 0 1101347005 1366425449 13 Podiatrists NELSON DAVID 612541236 45 Henry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 323 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 323 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3060.47 0 0 0 0 0 0 3060.47 0 0 0 1101347006 1356664262 16 Nurse Practitioners KELSO LAURA 420037942 818 Kentucky 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 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 394.98 0 0 0 0 0 0 394.98 0 0 0 1101347008 2100337426 91 Waiver service provider--Adults (DHS/DDD) JEFFERSON CO. COMP. SERVICES 628640428 49 Jefferson 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10274 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10274 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 521277.54 0 0 0 0 0 0 0 0 0 0 0 0 0 521277.54 0 0 0 1101347010 92 Waiver service provider--Disability (DHS/DRS) 100 Vermilion 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 14299.13 0 0 0 0 0 0 0 0 0 0 0 0 0 14299.13 0 0 0 1101347012 1811950595 63 Other Providers of Medical Equipment/Supplies (Non-registered) DURALINE MEDICAL PRODUCTS INC 458560067 836 Ohio 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 0 145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11721.67 0 0 0 0 0 0 11721.67 0 0 0 1101347013 1801801568 16 Nurse Practitioners DECLUE MARY 628646736 49 Jefferson 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 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1118.32 0 0 0 0 0 0 1118.32 0 0 0 1101347018 1336326453 47 Local Education Agencies POLO COMM UNIT SCHOOL DIST 222 610641724 79 Ogle 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 606 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 606 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6498.36 0 6498.36 0 0 0 1101347027 1265626105 10 Physicians HUMPHREY ANDREA 629011474 47 Jackson 0 0 Family Practice 0 0 0 0 13 0 0 0 0 0 0 129 0 296 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 328 0 1101 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 328 0 1101 0 0 0 0 0 0 0 0 0 233.44 0 0 0 0 0 0 2151.69 0 95643.53 0 0 0 0 0 0 98028.66 0 0 0 1101347039 1841256377 10 Physicians OLEARY SHAUN 600261339 200 Cook 0 0 Neurology Surgery 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 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3681.87 0 0 0 0 0 0 3681.87 0 0 0 1101347045 1609935584 63 Other Providers of Medical Equipment/Supplies (Non-registered) HOME HEALTH DEPOT INC 462601832 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156730.68 0 0 0 0 0 0 156730.68 0 0 0 1101347058 1669566782 16 Nurse Practitioners POPE NINA 606493954 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 153 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 199 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 199 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6796.09 0 0 0 0 0 0 6796.09 0 0 0 1101347091 16 Nurse Practitioners 96 St Clair 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24.9 0 0 0 0 0 0 24.9 0 0 0 1101347105 1427041243 10 Physicians HABBAL BASSAM 604532401 200 Cook 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 237 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 758 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 758 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27798.08 0 0 0 0 0 0 27798.08 0 0 0 1101347106 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 1091.57 0 0 0 0 0 0 0 0 0 0 0 0 0 1091.57 0 0 0 1101347144 1295825586 10 Physicians HARRIS JEANNE 616154868 80 Peoria 0 0 Pediatrics 0 0 0 0 20 0 0 0 0 0 0 15 0 59 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 17 0 66 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 17 0 66 0 0 0 0 0 0 0 0 0 1712.87 0 0 0 0 0 0 201.4 0 2453.67 0 0 0 0 0 0 4367.94 0 0 0 1101347146 1952311565 10 Physicians KING ERNST VALERIE 601691010 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 452 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 452 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40.49 0 0 0 0 0 0 40.49 0 0 0 1101347147 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 28515.36 0 0 0 0 0 0 0 0 0 0 0 0 0 28515.36 0 0 0 1101347152 1821026725 10 Physicians CHIEN EDWARD 618012530 19 Champaign 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 41 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1629.01 0 1775.28 0 0 0 0 0 0 3404.29 0 0 0 1101347160 10 Physicians 852 Wisconsin 0 0 Emergency Medicine 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 0 117.26 0 0 0 0 0 0 117.26 0 0 0 1101347164 1437246865 63 Other Providers of Medical Equipment/Supplies (Non-registered) DMH MEDICAL EQUIPMENT CO 625266377 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 435 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 435 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8983.53 0 2086.85 0 0 0 0 11070.38 0 0 0 1101347180 92 Waiver service provider--Disability (DHS/DRS) 56 Knox 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 5504.46 0 0 0 0 0 0 0 0 0 0 0 0 0 5504.46 0 0 0 1101347187 1821177411 16 Nurse Practitioners HOFMASTER KARA E 610320268 97 Stephenson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 733 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 733 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1149.2 0 0 0 0 0 0 1149.2 0 0 0 1101347197 2100337615 92 Waiver service provider--Disability (DHS/DRS) FAMILY HOME SERVICE INC 606428025 200 Cook 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114577.64 0 0 0 0 0 0 0 0 0 0 0 0 0 114577.64 0 0 0 1101347218 1598988446 24 Speech Therapists RICHMAN ANN 600253022 200 Cook 0 0 0 0 0 0 0 0 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 0 622 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 622 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31700.46 31700.46 0 0 0 1101347220 1487920153 91 Waiver service provider--Adults (DHS/DDD) LATANYA MASON INONGE 604383732 200 Cook 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1045 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1045 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29168.73 0 0 0 0 0 0 0 0 0 0 0 0 0 29168.73 0 0 0 1101347222 1295858694 10 Physicians LOPEZ JOAQUIN 604022319 200 Cook 0 1 Pediatrics 0 605 0 0 144 0 0 0 0 0 0 0 0 185 0 0 0 0 0 0 1144 0 0 398 0 0 0 0 0 0 0 0 315 0 0 0 0 0 0 1144 0 0 398 0 0 0 0 0 0 0 0 315 0 0 0 0 0 0 2295 0 0 13008.67 0 0 0 0 0 0 0 0 13445.64 0 0 0 0 0 0 28749.31 0 0 0 1101347234 11 Dentists 200 Cook 0 0 General Dentistry 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 947.5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 947.5 0 0 0 1101347261 1780678524 33 Nursing Facilities LEXINGTON OF WHEELING 600905501 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 227 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1911 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50079 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5382655.04 0 0 0 0 0 0 0 5382655.04 0 0 0 1101347276 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 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 3387.38 0 0 0 0 0 0 0 0 0 0 0 0 0 3387.38 0 0 0 1101347278 1255503603 29 ICF/MR GORDON JONES TERRACE 610461135 17 Carroll 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 0 483 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9422 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 765612.31 0 0 0 0 0 0 0 0 0 0 765612.31 0 0 0 1101347282 1033133111 10 Physicians RUZUMNA PAUL 600052407 200 Cook 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 0 0 242 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 402 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 402 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2244.32 0 0 0 0 0 0 2244.32 0 0 0 1101347285 1255308193 10 Physicians MAKIELSKI JONATHAN 535625531 852 Wisconsin 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 351.65 0 0 0 0 0 0 351.65 0 0 0 1101347303 1831154053 10 Physicians LI TINGTING 631600352 200 Cook 0 0 Nephrology 0 0 0 0 0 0 0 0 0 0 0 2 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 591.12 0 0 0 0 0 0 591.12 0 0 0 1101347306 10 Physicians 852 Wisconsin 0 0 Emergency Medicine 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 0 104.83 0 0 0 0 0 0 104.83 0 0 0 1101347319 1902833759 10 Physicians FRANKLIN MARK L. 606132806 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17648.26 0 0 0 0 0 0 17648.26 0 0 0 1101347326 29 ICF/MR 65 Madison 0 0 0 0 0 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 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2398 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 322739.58 0 0 0 0 0 0 0 0 0 0 322739.58 0 0 0 1101347331 1407806730 10 Physicians DIXON JOHN 527325032 816 Iowa 0 1 Family Practice 0 10 0 0 7 0 0 0 0 0 0 43 0 88 0 0 0 0 0 0 90 0 0 25 0 0 0 0 0 0 121 0 133 0 0 0 0 0 0 90 0 0 25 0 0 0 0 0 0 121 0 133 0 0 0 0 0 0 227 0 0 730.03 0 0 0 0 0 0 1385.89 0 5901.58 0 0 0 0 0 0 8244.5 0 0 0 1101347338 98 Waiver service provider--TBI (DHS/DRS) 72 McLean 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 5240.96 0 0 0 0 0 0 0 0 0 0 0 0 0 5240.96 0 0 0 1101347354 92 Waiver service provider--Disability (DHS/DRS) 23 Clinton 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 33461.01 0 0 0 0 0 0 0 0 0 0 0 0 0 33461.01 0 0 0 1101347368 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24090 0 0 0 0 0 0 0 0 0 0 0 0 0 24090 0 0 0 1101347369 10 Physicians 826 Missouri 0 0 Emergency Medicine 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 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 0 918.1 0 0 0 0 0 0 918.1 0 0 0 1101347377 1528237153 36 Community mental health provider TRINITY SERVICES INC 604416518 107 Will 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 554 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1242 0 0 554 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1242 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40255.06 0 0 40255.06 0 0 0 1101347380 92 Waiver service provider--Disability (DHS/DRS) 30 DuPage 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 25959.85 0 0 0 0 0 0 0 0 0 0 0 0 0 25959.85 0 0 0 1101347394 1841210275 10 Physicians STOLAR CARY 631102539 826 Missouri 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 426 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1169 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1169 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10731.4 0 434.54 0 0 0 0 0 0 11165.94 0 0 0 1101347402 1114271418 16 Nurse Practitioners STALLEY ROBERT 601034748 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2841.35 0 0 0 0 0 0 2841.35 0 0 0 1101347411 1417185588 10 Physicians NGUYEN KIM 999999999 826 Missouri 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 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1450.03 0 0 0 0 0 0 1450.03 0 0 0 1101347413 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 1667.58 0 0 0 0 0 0 0 0 0 0 0 0 0 1667.58 0 0 0 1101347423 1184634685 10 Physicians AHMAD SHAHNAZ 631102515 826 Missouri 0 1 Pediatrics 0 5 0 0 79 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Physicians STEPHENS JOHN 630451315 826 Missouri 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 47 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1564.6 0 67.46 0 0 0 0 0 0 1632.06 0 0 0 1101348888 92 Waiver service provider--Disability (DHS/DRS) 17 Carroll 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4147.55 0 0 0 0 0 0 0 0 0 0 0 0 0 4147.55 0 0 0 1101348896 1689628745 10 Physicians UPCHURCH TIMOTHY P 600508409 63 Macon 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1230.33 0 0 0 0 0 0 1230.33 0 0 0 1101348903 1316948912 33 Nursing Facilities WINCHESTER HOUSE 600481399 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26068 0 0 0 0 0 0 0 0 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826 Missouri 0 0 Oncology 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 0 255 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 255 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47312.61 0 0 0 0 0 0 47312.61 0 0 0 1101348966 1194004408 30 General Hospitals ST MARYS JANESVILLE HOSPITAL 535462344 852 Wisconsin NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 10 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 1711.57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1711.57 0 0 0 1101348988 1508924101 22 Physical Therapists ORIORDAN ELIZABETH 606143363 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 232 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 232 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31494.74 31494.74 0 0 0 1101348996 10 Physicians 66 Marion 0 0 Pediatrics 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 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Therapists LUTES KELSEY 627621000 72 McLean 0 0 0 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 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9855.43 9855.43 0 0 0 1101349128 1053436345 10 Physicians SCHAFER EWA 600261314 200 Cook 0 0 Allergy-Immunization 0 0 0 0 4 0 0 0 0 0 0 0 0 118 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 461 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 461 0 0 0 0 0 0 0 0 0 25.6 0 0 0 0 0 0 0 0 12650.05 0 0 0 0 0 0 12675.65 0 0 0 1101349138 1013906890 10 Physicians ABUYOUSEF MONZER 522421007 816 Iowa 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 18 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 295.26 0 297.79 0 0 0 0 0 0 593.05 0 0 0 1101349140 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 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 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 0 462.09 0 0 0 0 0 0 0 0 0 0 0 0 0 462.09 0 0 0 1101349143 1437119997 10 Physicians BRUIN MICHAEL 625265858 63 Macon 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 0 2 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20.72 0 6664.31 0 0 0 0 0 0 6685.03 0 0 0 1101349145 1265616536 28 Waiver service provider--Supportive living facility (HFS) SUPPORTIVE LIVING WASHINGTON 615711244 98 Tazewell 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 251 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7193 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 348782.54 0 0 0 0 0 0 0 0 0 0 0 0 0 348782.54 0 0 0 1101349156 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 9713.15 0 0 0 0 0 0 0 0 0 0 0 0 0 9713.15 0 0 0 1101349167 1891740148 10 Physicians STULBERG S DAVID 606114451 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14984.78 0 0 0 0 0 0 0 0 0 0 0 0 0 14984.78 0 0 0 1101349606 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 242 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 242 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16950.26 0 0 0 0 0 0 0 0 0 0 0 0 0 16950.26 0 0 0 1101349607 91 Waiver service provider--Adults (DHS/DDD) 65 Madison 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 0 187 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 187 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19012.09 0 0 0 0 0 0 0 0 0 0 0 0 0 19012.09 0 0 0 1101349609 1477548782 10 Physicians LYNCH DANIEL 600485355 57 Lake 0 0 Family Practice 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 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 203.14 0 0 0 0 0 0 203.14 0 0 0 1101349618 16 Nurse Practitioners 816 Iowa 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 2 0 0 0 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provider--Disability (DHS/DRS) 109 Winnebago 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6898.19 0 0 0 0 0 0 0 0 0 0 0 0 0 6898.19 0 0 0 1101349771 1437167541 10 Physicians ISKANDER ASHRAF 606321849 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 212 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 212 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2761.58 0 0 0 0 0 0 2761.58 0 0 0 1101349781 1316064637 10 Physicians RAJPUT MAHEEN 522421009 816 Iowa 0 0 Radiology Diagnosis 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 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 935.9 0 0 0 0 0 0 0 0 935.9 0 0 0 1101349786 1255387007 10 Physicians GOEL RAM 613621512 15 Bureau 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 403 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 403 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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90 Waiver service provider--Elderly (DOA) LUTHERAN SOCIAL SERVICES OF IL 618213061 19 Champaign 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3461 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3461 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166877.75 0 0 0 0 0 0 0 0 0 0 0 0 0 166877.75 0 0 0 1101349821 1730224080 22 Physical Therapists WLODARKIEWICZ JOLANTA 601013172 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 254 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4772 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4772 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 343681.99 343681.99 0 0 0 1101349824 94 Waiver service provider--Children's support (DHS/DDD) 57 Lake 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 0 253 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 253 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20300.5 0 0 0 0 0 0 0 0 0 0 0 0 0 20300.5 0 0 0 1101349826 1164518049 10 Physicians RABIN MICHAEL 605630137 30 DuPage 0 0 Neurology Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 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601391405 30 DuPage DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 0 0 0 0 10 0 0 0 0 0 0 269 0 0 141 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 988 0 0 435 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 988 0 0 435 0 0 0 0 0 0 0 0 66.72 0 0 0 0 0 0 4891.68 0 0 40786.76 0 0 0 0 0 45745.16 0 0 0 1101351681 1598746083 10 Physicians ANDRESS JOHN 604611173 200 Cook 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1801.97 0 0 0 0 0 0 1801.97 0 0 0 1101351684 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 7364.18 0 0 0 0 0 0 0 0 0 0 0 0 0 7364.18 0 0 0 1101351686 1346243979 63 Other Providers of Medical Equipment/Supplies (Non-registered) CENTRAD HEALTHCARE LLC 605638475 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 333 0 0 0 0 0 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Williamson 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 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51166.26 0 0 0 0 0 0 0 0 0 0 0 0 0 51166.26 0 0 0 1101351797 1639240104 23 Occupational Therapists PETUCHOWSKI JANESE 606143363 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 311.76 311.76 0 0 0 1101351800 1740400878 11 Dentists MATKE GREGORY 999999999 200 Cook 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2397.98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2397.98 0 0 0 1101351820 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 10079.11 0 0 0 0 0 0 0 0 0 0 0 0 0 10079.11 0 0 0 1101351834 1396720694 10 Physicians MCCREARY 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McHenry 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 8 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75.24 0 1595.81 0 0 0 0 0 0 1671.05 0 0 0 1101351941 1235115338 12 Optometrists LUDFORD DAVID 613543309 58 La Salle 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 233 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 233 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5567.76 0 0 0 0 0 0 5567.76 0 0 0 1101351952 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 256 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 256 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19987 0 0 0 0 0 0 0 0 0 0 0 0 0 19987 0 0 0 1101351964 1104825967 10 Physicians FOX MICHAEL 600101919 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5478.97 0 0 0 0 0 0 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Kane 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 31138.22 0 0 0 0 0 0 0 0 0 0 0 0 0 31138.22 0 0 0 1101354107 1508891367 70 Ambulance Service Providers TRI COUNTY AMBULANCE DISTRICT 614720166 56 Knox 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 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 2370.8 0 0 0 0 0 0 2370.8 0 0 0 1101354111 1356514343 16 Nurse Practitioners PARROTT ANDREA 601901295 30 DuPage 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 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 234.5 0 0 0 0 0 0 234.5 0 0 0 1101354118 1861613408 10 Physicians RAPTIS CONSTANTINE 631101016 826 Missouri 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 261 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 406 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 406 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8014.42 0 0 0 0 0 0 0 0 8014.42 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Physicians 826 Missouri 0 0 Oncology 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 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 0 400.25 0 0 0 0 0 0 400.25 0 0 0 1101359304 1104932326 10 Physicians NEWHALL KELLY 606146680 200 Cook 0 0 Allergy-Immunization 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 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 1494.24 0 0 0 0 0 0 1494.24 0 0 0 1101359327 1851348916 10 Physicians ALRASHID ARKAN 600485336 57 Lake 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5886.93 0 0 0 0 0 0 5886.93 0 0 0 1101359330 10 Physicians 852 Wisconsin 0 0 Internal Medicine 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78.43 0 0 0 0 0 0 78.43 0 0 0 1101359382 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0 0 0 0 0 0 0 0 0 0 0 78582.59 0 0 0 0 0 0 0 0 0 0 0 0 0 78582.59 0 0 0 1101359501 1801856638 10 Physicians RHEINGANS PATRICK 527227565 816 Iowa 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 219 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 294 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 294 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5636.16 0 156.8 0 0 0 0 0 0 5792.96 0 0 0 1101359503 1194892232 10 Physicians MAUCH STEPHANIE 605213637 30 DuPage 0 1 Family Practice 0 9 0 0 3 0 0 0 0 0 0 4 0 23 0 0 0 0 0 0 62 0 0 7 0 0 0 0 0 0 5 0 41 0 0 0 0 0 0 62 0 0 7 0 0 0 0 0 0 5 0 41 0 0 0 0 0 0 147 0 0 256.58 0 0 0 0 0 0 6.51 0 590.16 0 0 0 0 0 0 1000.25 0 0 0 1101359505 1508843194 10 Physicians PONGLORPISIT SUPORN 476701043 815 Indiana 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2256.82 0 0 0 0 0 0 2256.82 0 0 0 1101359508 1659312924 10 Physicians MESTAN ROBERT 613562538 15 Bureau 0 1 Family 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25368.79 0 0 0 1101359526 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3055.57 0 0 0 0 0 0 0 0 0 0 0 0 0 3055.57 0 0 0 1101359536 91 Waiver service provider--Adults (DHS/DDD) 30 DuPage 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 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13945.25 0 0 0 0 0 0 0 0 0 0 0 0 0 13945.25 0 0 0 1101359544 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11288.75 0 0 0 0 0 0 0 0 0 0 0 0 0 11288.75 0 0 0 1101359558 75 Department of Alcohol and Substance Abuse Provider 57 Lake 0 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 47 0 0 0 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 3260.76 0 0 3260.76 0 0 0 1101359571 1992798417 10 Physicians KARACIC JOSEPH 606118709 57 Lake 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2309.13 0 0 0 0 0 0 2309.13 0 0 0 1101359578 1235119538 25 Audiologists JONES-FASSETT MICHELE 616151941 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 366 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 366 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5683.44 5683.44 0 0 0 1101359581 1134141104 16 Nurse Practitioners TYLKA ANGELA 604355765 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89.44 0 0 0 0 0 0 89.44 0 0 0 1101359589 1407841372 10 Physicians NGUYAN QUYNH 606162333 200 Cook 0 1 Pediatrics 0 25 0 0 38 0 0 0 0 0 0 1 0 11 0 0 0 0 0 0 93 0 0 104 0 0 0 0 0 0 1 0 11 0 0 0 0 0 0 93 0 0 104 0 0 0 0 0 0 1 0 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0 0 0 0 0 0 0 0 6682.5 0 0 0 0 0 0 0 0 0 0 0 0 0 6682.5 0 0 0 1101359658 1407888142 10 Physicians SANCHEZ FRANCISCO 606404510 200 Cook 0 0 Family Practice 0 0 0 0 82 0 0 0 0 0 0 6 0 175 0 0 0 0 0 0 0 0 0 175 0 0 0 0 0 0 6 0 211 0 0 0 0 0 0 0 0 0 175 0 0 0 0 0 0 6 0 211 0 0 0 0 0 0 0 0 0 5325.57 0 0 0 0 0 0 24.6 0 7672.61 0 0 0 0 0 0 13022.78 0 0 0 1101359660 1124065453 10 Physicians CAMPBELL DAVID 600151857 57 Lake 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 535.31 0 0 0 0 0 0 535.31 0 0 0 1101359662 1265440945 16 Nurse Practitioners DITTMAR MARGARET 610289425 51 Jo Daviess 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1378.23 0 0 0 0 0 0 1378.23 0 0 0 1101359673 1992864102 10 Physicians CLAVERIA RAFAEL 606222996 200 Cook 0 1 Internal Medicine 0 16 0 0 0 0 0 0 0 0 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dialysis centers. 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 279 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2362 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40643.27 0 0 0 0 0 40643.27 0 0 0 1101359799 1659501112 11 Dentists PATEL CHIRAG 606293325 200 Cook 0 0 General Dentistry 0 0 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 842 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 842 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23737.03 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23737.03 0 0 0 1101359815 1194743906 10 Physicians RUSSELL TONYA D 631101010 826 Missouri 0 0 Pulmonary Diseases 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 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1483.32 0 0 0 0 0 0 1483.32 0 0 0 1101359818 1053397851 10 Physicians CUDECKI JOHN 606162491 200 Cook 0 0 Urological Surgery 0 0 0 0 0 0 0 0 0 0 0 17 0 264 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 821 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 821 0 0 0 0 0 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Physical Therapists 106 Whiteside 0 0 0 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 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 318.7 318.7 0 0 0 1101360093 1245469725 91 Waiver service provider--Adults (DHS/DDD) RICHARDSON JEAN 600674791 200 Cook 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1462 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1462 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67912.05 0 0 0 0 0 0 0 0 0 0 0 0 0 67912.05 0 0 0 1101360096 1912932831 10 Physicians ELLENS JENNIFER 601374622 30 DuPage 0 1 Family Practice 0 39 0 0 11 0 0 0 0 0 0 6 0 53 0 0 0 0 0 0 253 0 0 11 0 0 0 0 0 0 7 0 147 0 0 0 0 0 0 253 0 0 11 0 0 0 0 0 0 7 0 147 0 0 0 0 0 0 681 0 0 957.25 0 0 0 0 0 0 25.7 0 3894.39 0 0 0 0 0 0 5558.34 0 0 0 1101360099 1487823019 29 ICF/MR TRINITY LIVING CENTER 3 604329645 107 Will 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 340 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7761 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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service provider--Disability (DHS/DRS) 200 Cook 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 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 0 977.51 0 0 0 0 0 0 0 0 0 0 0 0 0 977.51 0 0 0 1101361280 92 Waiver service provider--Disability (DHS/DRS) 98 Tazewell 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 1100.26 0 0 0 0 0 0 0 0 0 0 0 0 0 1100.26 0 0 0 1101361286 1720150303 10 Physicians LEONARD DEENA FINTEL 600891970 57 Lake 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3394.42 0 0 0 0 0 0 3394.42 0 0 0 1101361294 1073717443 10 Physicians TODOROVA KOTEVA KRISTINA 606123861 200 Cook 0 0 Endocrinology 0 0 0 0 0 0 0 0 0 0 0 0 0 249 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 602 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 602 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5677.03 0 0 0 0 0 0 5677.03 0 0 0 1101361303 1932294618 10 Physicians GONZALEZ DIAZ GISELA 601081522 30 DuPage 0 1 Pediatrics 0 268 0 0 148 0 0 0 0 0 0 0 0 205 0 0 0 0 0 0 783 0 0 444 0 0 0 0 0 0 0 0 351 0 0 0 0 0 0 783 0 0 444 0 0 0 0 0 0 0 0 351 0 0 0 0 0 0 1566 0 0 15057.1 0 0 0 0 0 0 0 0 14194.46 0 0 0 0 0 0 30817.56 0 0 0 1101361318 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 0 262 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 262 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15763.99 0 0 0 0 0 0 0 0 0 0 0 0 0 15763.99 0 0 0 1101361344 1174688667 10 Physicians KEYROUZ SALAH 999999999 826 Missouri 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 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3534.28 0 0 0 0 0 0 3534.28 0 0 0 1101361347 1053531129 34 State-operated facility (DHS) UNIT 0221 HOME 21 LUDEMAN 604661200 200 Cook 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 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 900 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 562695.43 0 0 0 0 0 0 0 0 0 0 562695.43 0 0 0 1101361353 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 9590.59 0 0 0 0 0 0 0 0 0 0 0 0 0 9590.59 0 0 0 1101361357 1962670091 47 Local Education Agencies COMM UNIT SCH DIST 300 601101943 53 Kane 0 0 0 0 0 0 2563 0 0 0 0 0 0 0 0 0 0 0 0 0 1389 0 0 0 0 4420 0 0 0 0 0 0 0 0 0 0 0 0 0 80097 0 0 0 0 4420 0 0 0 0 0 0 0 0 0 0 0 0 0 80097 0 0 0 0 32102.53 0 0 0 0 0 0 0 0 0 0 0 0 0 2014774.86 0 2046877.39 0 0 0 1101361368 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26955.83 0 0 0 0 0 0 0 0 0 0 0 0 0 26955.83 0 0 0 1101361378 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16434.87 0 0 0 0 0 0 0 0 0 0 0 0 0 16434.87 0 0 0 1101361382 1346434446 16 Nurse Practitioners OMALLEY CHRISTINE 601533328 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3852.84 0 0 0 0 0 0 3852.84 0 0 0 1101361392 63 Other Providers of Medical Equipment/Supplies (Non-registered) 816 Iowa 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 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 47.77 0 0 0 0 47.77 0 0 0 1101361400 92 Waiver service provider--Disability (DHS/DRS) 25 Crawford 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 1225.07 0 0 0 0 0 0 0 0 0 0 0 0 0 1225.07 0 0 0 1101361407 1518117852 10 Physicians DESROSIERS FLORENCE 606127324 200 Cook 0 1 Adolescent-Medicine 0 178 0 0 221 0 0 0 0 0 0 0 0 279 0 0 0 0 0 0 1301 0 0 331 0 0 0 0 0 0 0 0 336 0 0 0 0 0 0 1301 0 0 331 0 0 0 0 0 0 0 0 336 0 0 0 0 0 0 2602 0 0 18452.46 0 0 0 0 0 0 0 0 38426.84 0 0 0 0 0 0 59481.3 0 0 0 1101361409 1285764878 22 Physical Therapists GAD KHALED 604532778 200 Cook 0 0 0 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 0 392 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 0 0 0 0 0 0 0 0 0 0 0 0 1619.27 1619.27 0 0 0 1101361412 1932196698 10 Physicians LINDYKEN DEBORAH 522421082 816 Iowa 0 0 Pediatrics 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 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1277.7 0 0 0 0 0 0 1277.7 0 0 0 1101361413 1548594070 10 Physicians MILLER JESSICA 535482940 852 Wisconsin 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 126.85 0 0 0 0 0 0 126.85 0 0 0 1101361417 1033203013 10 Physicians BAIG MIRZA 620023915 65 Madison 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 244 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 722 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 722 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10235.47 0 0 0 0 0 0 10235.47 0 0 0 1101361418 1053368456 10 Physicians SHORT DANIEL 601181416 53 Kane 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4463.49 0 0 0 0 0 0 4463.49 0 0 0 1101361419 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 16630.41 0 0 0 0 0 0 0 0 0 0 0 0 0 16630.41 0 0 0 1101361421 1740316942 10 Physicians LIANG STEPHEN 631101010 826 Missouri 0 0 Infectious Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1254.71 0 0 0 0 0 0 1254.71 0 0 0 1101361434 91 Waiver service provider--Adults (DHS/DDD) 63 Macon 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 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6441.6 0 0 0 0 0 0 0 0 0 0 0 0 0 6441.6 0 0 0 1101361443 1073581971 10 Physicians RIVERA MARIA 610213075 60 Lee 0 1 Pediatrics 0 399 0 0 330 0 0 0 0 0 0 0 0 473 0 0 0 0 0 0 4107 0 0 990 0 0 0 0 0 0 0 0 1310 0 0 0 0 0 0 4107 0 0 990 0 0 0 0 0 0 0 0 1310 0 0 0 0 0 0 8226 0 0 35987.87 0 0 0 0 0 0 0 0 64651.77 0 0 0 0 0 0 108865.64 0 0 0 1101361446 13 Podiatrists 815 Indiana 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 90.5 0 0 0 0 0 0 90.5 0 0 0 1101361473 91 Waiver service provider--Adults (DHS/DDD) 91 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 0 252 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 252 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7637.18 0 0 0 0 0 0 0 0 0 0 0 0 0 7637.18 0 0 0 1101361477 1184625766 10 Physicians MENDENHALL JAMES 618012530 19 Champaign 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 307 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 321 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 321 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36235.43 0 0 0 0 0 0 36235.43 0 0 0 1101361484 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 4540.66 0 0 0 0 0 0 0 0 0 0 0 0 0 4540.66 0 0 0 1101361489 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 27200.05 0 0 0 0 0 0 0 0 0 0 0 0 0 27200.05 0 0 0 1101361491 92 Waiver service provider--Disability (DHS/DRS) 53 Kane 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 23637.45 0 0 0 0 0 0 0 0 0 0 0 0 0 23637.45 0 0 0 1101361518 1881614998 10 Physicians PITTMAN SCOTT 606123833 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14540.64 0 0 0 0 0 0 14540.64 0 0 0 1101361532 1992939995 24 Speech Therapists DAVIS TENIKA 606151924 200 Cook 0 0 0 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 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6688.2 6688.2 0 0 0 1101361539 1003997560 10 Physicians COELLO CESAR E 622743342 200 Cook 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 4 0 1462 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 2940 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 2940 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33.53 0 60265.9 0 0 0 0 0 0 60299.43 0 0 0 1101361542 1023049574 39 Hospice OSF HOSPICE 616151807 80 Peoria 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 193 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 193 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12959.03 0 0 0 0 0 0 0 0 0 0 0 0 0 12959.03 0 0 0 1101361565 92 Waiver service provider--Disability (DHS/DRS) 91 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 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 1114.41 0 0 0 0 0 0 0 0 0 0 0 0 0 1114.41 0 0 0 1101361568 1487689816 10 Physicians OMI ELLEN 606127322 200 Cook 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 270 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 618 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 618 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53651.53 0 0 0 0 0 0 53651.53 0 0 0 1101361571 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 609.6 0 0 0 0 0 0 0 0 0 0 0 0 0 609.6 0 0 0 1101361573 1538119938 10 Physicians SHELNITZ LORI 601262816 30 DuPage 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1207.43 0 0 0 0 0 0 1207.43 0 0 0 1101361586 2100352004 10 Physicians SIMON MARK 606601017 200 Cook 0 0 Family Practice 0 0 0 0 7 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 0 131.86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131.86 0 0 0 1101361606 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 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 1851.05 0 0 0 0 0 0 0 0 0 0 0 0 0 1851.05 0 0 0 1101361609 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39966.28 0 0 0 0 0 0 0 0 0 0 0 0 0 39966.28 0 0 0 1101361611 1669488946 10 Physicians WAGNER RICHARD 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0 0 0 0 0 158577.2 0 0 0 158577.2 0 0 0 1101362076 1578682464 10 Physicians POLUDASU RAJARAM 600681173 200 Cook 0 0 Nuclear Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 487 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 600 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 600 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7300.99 0 0 0 0 0 0 7300.99 0 0 0 1101362091 1760645279 10 Physicians MAYHEW RYAN 601533328 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 249 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 249 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3807.78 0 0 0 0 0 0 3807.78 0 0 0 1101362097 1093756256 10 Physicians LEE RAYMOND 627044183 91 Sangamon 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 1079 0 229 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1416 0 366 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1416 0 366 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19848.51 0 8045.56 0 0 0 0 0 0 27894.07 0 0 0 1101362103 92 Waiver service provider--Disability (DHS/DRS) 107 Will 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5759.72 0 0 0 0 0 0 0 0 0 0 0 0 0 5759.72 0 0 0 1101362107 1356543235 10 Physicians CHEKKA KIRAN K 600162359 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 4 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28.59 0 583.42 0 0 0 0 0 0 612.01 0 0 0 1101362110 1891710257 10 Physicians CASTILLO BIENVENIDO 605064356 53 Kane 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 5 0 178 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 325 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 325 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14.56 0 5689.24 0 0 0 0 0 0 5703.8 0 0 0 1101362134 1649270729 52 Certified local public health department JERSEY COUNTY HEALTH DEPT 620522396 50 Jersey 0 0 0 0 426 0 834 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 1112 0 4525 0 0 248 0 0 0 0 0 0 0 0 0 0 0 0 0 1112 0 4525 0 0 248 0 0 0 0 0 0 0 0 0 0 0 0 0 29779.75 0 66293.7 0 0 17856 0 0 0 0 0 0 0 0 0 0 0 0 113929.45 0 0 0 1101362138 1003093279 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0 0 0 0 0 0 0 0 0 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20717.67 0 0 0 0 0 0 20717.67 0 0 0 1101362176 1962490805 10 Physicians THOMPSON BRAD 522421082 816 Iowa 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 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 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 593.57 0 0 0 0 0 0 0 0 593.57 0 0 0 1101362182 10 Physicians 30 DuPage 0 1 Family Practice 0 0 0 0 0 0 0 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 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 14.47 0 0 0 0 0 0 14.47 0 0 0 1101362193 1992721120 10 Physicians BULLOCK ARNOLD 631101036 826 Missouri 0 0 Urological Surgery 0 0 0 0 0 0 0 0 0 0 0 3 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.14 0 1345.24 0 0 0 0 0 0 1345.38 0 0 0 1101362202 1336132620 10 Physicians KRAFT BERTRAM 600893758 57 Lake 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 4 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6.58 0 405.09 0 0 0 0 0 0 411.67 0 0 0 1101362204 1699864124 10 Physicians CARLOS IMELDA SANTOS 601882795 30 DuPage 0 1 Pediatrics 0 70 0 0 145 0 0 0 0 0 0 48 0 184 0 0 0 0 0 0 380 0 0 829 0 0 0 0 0 0 71 0 473 0 0 0 0 0 0 380 0 0 829 0 0 0 0 0 0 71 0 473 0 0 0 0 0 0 760 0 0 22620.93 0 0 0 0 0 0 832.35 0 17309.03 0 0 0 0 0 0 41522.31 0 0 0 1101362208 1598878373 10 Physicians HARMS CRAIG 620101801 65 Madison 0 1 Family Practice 0 5 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 124 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 124 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 477.36 0 0 0 0 0 0 519.36 0 0 0 1101362212 1497875298 43 Encounter rate clinic CICERO HEALTH CENTER 608042135 200 Cook ARS-C.O.P. "JH Stroger, Oak Forest and Provident Hospitals, paid under an alternate reimbursement system" 0 1 Direct Access 0 1173 899 0 394 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1942 3484 0 910 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1942 3484 0 910 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4213 697953.85 0 136496.34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 838663.19 0 0 0 1101362217 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 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 2041.23 0 0 0 0 0 0 0 0 0 0 0 0 0 2041.23 0 0 0 1101362219 1063528255 10 Physicians HILL CARL E 602021552 200 Cook 0 1 Family Practice 0 3116 0 0 176 0 0 0 0 0 0 17 0 303 0 0 0 0 0 0 19062 0 0 353 0 0 0 0 0 0 17 0 519 0 0 0 0 0 0 19062 0 0 353 0 0 0 0 0 0 17 0 519 0 0 0 0 0 0 49065 0 0 17822.58 0 0 0 0 0 0 45.08 0 35931.03 0 0 0 0 0 0 102863.69 0 0 0 1101362222 10 Physicians 30 DuPage 0 0 Plastic Surgery 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 491.5 0 0 0 0 0 0 491.5 0 0 0 1101362244 1912990268 70 Ambulance Service Providers CITY OF TERRE HAUTE 478071924 815 Indiana 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 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3995.5 0 0 0 0 0 0 3995.5 0 0 0 1101362260 1467529545 10 Physicians MUPPAVARAPU SATHEESH 601876078 30 DuPage 0 0 Physical Medicine/Rehabilitation 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 0 0 0 344 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 344 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1029.49 0 0 0 0 0 0 1029.49 0 0 0 1101362262 94 Waiver service provider--Children's support (DHS/DDD) 30 DuPage 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 0 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5500 0 0 0 0 0 0 0 0 0 0 0 0 0 5500 0 0 0 1101362267 1629096177 10 Physicians LEWIS LAWRENCE M 631193031 826 Missouri 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 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 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 406.51 0 0 0 0 0 0 406.51 0 0 0 1101362276 92 Waiver service provider--Disability (DHS/DRS) 66 Marion 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 3799.92 0 0 0 0 0 0 0 0 0 0 0 0 0 3799.92 0 0 0 1101362281 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 20755.49 0 0 0 0 0 0 0 0 0 0 0 0 0 20755.49 0 0 0 1101362287 30 General Hospitals 824 Minnesota NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 794.91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 794.91 0 0 0 1101362292 1992021729 10 Physicians STEPHENS ARCHER CHANTALE 606740018 65 Madison 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2266.92 0 0 0 0 0 0 2266.92 0 0 0 1101362293 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 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 12791.95 0 0 0 0 0 0 0 0 0 0 0 0 0 12791.95 0 0 0 1101362294 23 Occupational Therapists 200 Cook 0 0 0 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 19 0 0 0 0 0 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 1348.8 1348.8 0 0 0 1101362305 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1531.75 0 0 0 0 0 0 0 0 0 0 0 0 0 1531.75 0 0 0 1101362314 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 277 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 277 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5308.74 0 0 0 0 0 0 0 0 0 0 0 0 0 5308.74 0 0 0 1101362317 1376731448 10 Physicians PAPASSAVAS ANGELA 600162335 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1594.04 0 0 0 0 0 0 1594.04 0 0 0 1101362345 1629247283 28 Waiver service provider--Supportive living facility (HFS) EVERGREEN VILLAGE SUPPORTIVE 617617800 72 McLean 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 489 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12252 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 563534.37 0 0 0 0 0 0 0 0 0 0 0 0 0 563534.37 0 0 0 1101362366 1346256245 10 Physicians DINI KOUROSH 606036264 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 328 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 328 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11235.92 0 0 0 0 0 0 11235.92 0 0 0 1101362367 1174748354 23 Occupational Therapists FONNER KIM 619389253 24 Coles 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 645 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 645 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53049.84 53049.84 0 0 0 1101362368 1346231610 11 Dentists PATEL AMRIT J 601931602 200 Cook 0 0 General Dentistry 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 311 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 311 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8384.59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8384.59 0 0 0 1101362377 1972541712 10 Physicians SHARP LYDIA 605047222 30 DuPage 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 187 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 194 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 194 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6380.87 0 0 0 0 0 0 6380.87 0 0 0 1101362403 91 Waiver service provider--Adults (DHS/DDD) 47 Jackson 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 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6965.01 0 0 0 0 0 0 0 0 0 0 0 0 0 6965.01 0 0 0 1101362409 1528181997 10 Physicians CYR AMY 631600352 66 Marion 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 23 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 1028.42 0 0 0 0 0 0 1028.42 0 0 0 1101362412 1871560623 10 Physicians JINN OLEARY MINNA 616360001 80 Peoria 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4388.9 0 0 0 0 0 0 4388.9 0 0 0 1101362418 1548251382 33 Nursing Facilities HERITAGE HEALTH LITCHFIELD 620562716 76 Montgomery 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 647 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16405 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1419957.79 0 0 0 0 0 0 0 1419957.79 0 0 0 1101362433 2100352851 90 Waiver service provider--Elderly (DOA) LIFECARE IN HOME SERVICES INC 600622365 200 Cook 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2403 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2403 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 175294.26 0 0 0 0 0 0 0 0 0 0 0 0 0 175294.26 0 0 0 1101362435 10 Physicians 200 Cook 0 0 Internal Medicine 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23.4 0 0 0 0 0 0 23.4 0 0 0 1101362442 92 Waiver service provider--Disability (DHS/DRS) 97 Stephenson 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 27682.24 0 0 0 0 0 0 0 0 0 0 0 0 0 27682.24 0 0 0 1101362449 34 State-operated facility (DHS) 53 Kane 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 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122659.78 0 0 0 0 0 0 0 0 0 122659.78 0 0 0 1101362451 16 Nurse Practitioners 57 Lake 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 307 0 0 0 0 0 0 307 0 0 0 1101362457 1891878856 63 Other Providers of Medical Equipment/Supplies (Non-registered) A Z MEDICAL SUPPLY INC 600053165 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 494 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7829 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7829 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 652885.28 0 972.39 0 0 0 0 653857.67 0 0 0 1101362490 1851366967 10 Physicians ARNOLD JON 625213810 63 Macon 0 0 Pulmonary Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 264 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 532 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 532 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7968.61 0 0 0 0 0 0 7968.61 0 0 0 1101362499 1760496103 10 Physicians ORHAN SUSAN 601691065 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 29 0 0 0 0 0 0 507 0 732 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 1554 0 3391 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 1554 0 3391 0 0 0 0 0 0 0 0 0 1583.19 0 0 0 0 0 0 66024.1 0 267214.17 0 0 0 0 0 0 334821.46 0 0 0 1101362511 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 21476.37 0 0 0 0 0 0 0 0 0 0 0 0 0 21476.37 0 0 0 1101362513 1730108804 10 Physicians AL SHARIF NABIL 629011414 47 Jackson 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 5 0 1451 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 2973 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 2973 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94.58 0 65668.31 0 0 0 0 0 0 65762.89 0 0 0 1101362516 92 Waiver service provider--Disability (DHS/DRS) 49 Jefferson 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 11589.96 0 0 0 0 0 0 0 0 0 0 0 0 0 11589.96 0 0 0 1101362522 1164482295 10 Physicians BRODD ANDERS 612654856 89 Rock Island 0 1 Pediatrics 0 12 0 0 42 0 0 0 0 0 0 35 0 70 0 0 0 0 0 0 85 0 0 91 0 0 0 0 0 0 46 0 103 0 0 0 0 0 0 85 0 0 91 0 0 0 0 0 0 46 0 103 0 0 0 0 0 0 170 0 0 3447.27 0 0 0 0 0 0 428.46 0 3104.29 0 0 0 0 0 0 7150.02 0 0 0 1101362527 1710070057 10 Physicians KENNEY TOM 617013514 72 McLean 0 1 Family Practice 0 167 0 0 31 0 0 0 0 0 0 44 0 311 0 0 0 0 0 0 1144 0 0 33 0 0 0 0 0 0 58 0 879 0 0 0 0 0 0 1144 0 0 33 0 0 0 0 0 0 58 0 879 0 0 0 0 0 0 3212 0 0 2243.61 0 0 0 0 0 0 490.33 0 22298.17 0 0 0 0 0 0 28244.11 0 0 0 1101362531 1437146594 63 Other Providers of Medical Equipment/Supplies (Non-registered) KCI USA INC 462781959 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 829 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 829 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68471.74 0 0 0 0 0 0 68471.74 0 0 0 1101362542 1467574558 55 Early Intervention Services RAZER BARBARA 622861054 87 Randolph 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 325 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 325 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20129.86 0 0 0 0 0 0 20129.86 0 0 0 1101362543 92 Waiver service provider--Disability (DHS/DRS) 77 Morgan 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 14 0 0 0 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 13439.62 0 0 0 0 0 0 0 0 0 0 0 0 0 13439.62 0 0 0 1101362550 92 Waiver service provider--Disability (DHS/DRS) 91 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 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 3614.51 0 0 0 0 0 0 0 0 0 0 0 0 0 3614.51 0 0 0 1101362554 1376656538 30 General Hospitals SHRINERS HOSPITAL FOR CHILDREN 607073392 200 Cook CHILDRENS Hospital designated as childrens hospitals and paid a Per Diem rate. 0 0 Children's Hospital 0 0 0 0 30 0 0 0 0 0 0 703 0 0 528 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 1312 0 0 1845 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 1312 0 0 1845 0 0 0 0 0 0 0 0 458.49 0 0 0 0 0 0 44748.57 0 0 134030.49 0 0 0 0 0 179237.55 0 0 0 1101362558 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 6307.33 0 0 0 0 0 0 0 0 0 0 0 0 0 6307.33 0 0 0 1101362568 1164626537 16 Nurse Practitioners SHADER NORENE 606123833 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25.03 0 0 0 0 0 0 25.03 0 0 0 1101362574 92 Waiver service provider--Disability (DHS/DRS) 91 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1943 0 0 0 0 0 0 0 0 0 0 0 0 0 1943 0 0 0 1101362584 1477530426 33 Nursing Facilities PARK RIDGE CARE CENTER 600682523 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 377 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9232 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1036070.72 0 0 0 0 0 0 0 1036070.72 0 0 0 1101362587 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 30951.74 0 0 0 0 0 0 0 0 0 0 0 0 0 30951.74 0 0 0 1101362590 1144227521 10 Physicians GERBER GAIL 601945029 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 0 8 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 0 736.91 0 0 0 0 0 0 736.91 0 0 0 1101362594 1194817080 11 Dentists FLYNN DENISE 615544570 98 Tazewell 0 0 Orthodontist 0 0 0 523 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2218 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2218 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 321470.07 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 321470.07 0 0 0 1101362603 1205190113 22 Physical Therapists MCARTHUR SHANNON 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 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 0 374.24 374.24 0 0 0 1101362610 1669420766 74 Hospital-Based Transportation Providers MCDONOUGH DISTRICT HOSP 614553313 70 McDonough 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 280 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 846 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 846 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63100.12 0 0 0 0 0 0 63100.12 0 0 0 1101362611 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 14 0 0 0 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 8570.76 0 0 0 0 0 0 0 0 0 0 0 0 0 8570.76 0 0 0 1101362621 1104013762 11 Dentists VIJ KAPIL 600562184 200 Cook 0 0 General Dentistry 0 0 0 303 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2065 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2065 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72899.54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72899.54 0 0 0 1101362623 1548277676 63 Other Providers of Medical Equipment/Supplies (Non-registered) J D RESTORATIVE PRODUCTS INC 601199185 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2306.38 0 666.13 0 0 0 0 2972.51 0 0 0 1101362627 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 1765.55 0 0 0 0 0 0 0 0 0 0 0 0 0 1765.55 0 0 0 1101362634 92 Waiver service provider--Disability (DHS/DRS) 63 Macon 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 310.26 0 0 0 0 0 0 0 0 0 0 0 0 0 310.26 0 0 0 1101362648 1639437924 60 Pharmacies KOMED HOLMAN PHARMACY 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 2055 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 8606 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 260567 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1836.65 0 0 693680.93 0 0 0 695517.58 0 0 0 1101362651 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1641.75 0 0 0 0 0 0 0 0 0 0 0 0 0 1641.75 0 0 0 1101362670 1770705949 16 Nurse Practitioners GRUBER MICHAEL 601181454 53 Kane 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 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 431.42 0 0 0 0 0 0 431.42 0 0 0 1101362671 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31628.02 0 0 0 0 0 0 0 0 0 0 0 0 0 31628.02 0 0 0 1101362672 2100353090 10 Physicians CONTERUSSIAN AMELIA 600531546 200 Cook 0 0 General Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 168 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10678.63 0 0 0 0 0 0 10678.63 0 0 0 1101362680 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 287 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 287 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23276 0 0 0 0 0 0 0 0 0 0 0 0 0 23276 0 0 0 1101362688 1639390230 10 Physicians BROWN SARA 601533328 200 Cook 0 0 Family Practice 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 703.75 0 0 0 0 0 0 703.75 0 0 0 1101362694 1548464266 97 Waiver service provider--Children's residential (DHS/DDD) GILBERT JEFFREY 610329630 97 Stephenson 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1276.74 0 0 0 0 0 0 0 0 0 0 0 0 0 1276.74 0 0 0 1101362703 1073509824 10 Physicians CRABB JEREMIAH 616062035 80 Peoria 0 0 Pulmonary Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 395 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 932 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 932 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14007.54 0 0 0 0 0 0 14007.54 0 0 0 1101362705 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 23974.41 0 0 0 0 0 0 0 0 0 0 0 0 0 23974.41 0 0 0 1101362709 1023183431 33 Nursing Facilities WHITE HALL NURSING AND REHAB C 620921001 39 Greene 0 0 0 0 0 0 0 0 0 0 0 0 0 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29353 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2511948.29 0 0 0 0 0 0 0 2511948.29 0 0 0 1101362714 24 Speech Therapists 80 Peoria 0 0 0 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319.66 319.66 0 0 0 1101362721 1043207251 10 Physicians MANJUNATH RAJINI 601239400 53 Kane 0 0 Oncology 0 0 0 0 0 0 0 0 0 0 0 0 0 138 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 491 0 0 0 0 0 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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 72.62 0 0 0 0 0 0 72.62 0 0 0 1101362823 1528193257 24 Speech Therapists DIAK KATHRYN 620024427 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 693 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 693 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51332.49 51332.49 0 0 0 1101362829 1407853856 16 Nurse Practitioners WHITE FRANCIS 381480001 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 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 2192.26 0 0 0 0 0 0 2192.26 0 0 0 1101362832 1710292727 16 Nurse Practitioners HOURSELT SARAH 601788757 27 Dekalb 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 330 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 330 0 0 0 0 0 0 0 0 0 5403.96 0 0 0 0 0 0 0 0 14707.1 0 0 0 0 0 0 20111.06 0 0 0 1101362835 1659352656 10 Physicians YOUNKIN CASEY 627949639 91 Sangamon 0 0 Obstetric-Gynecology 0 0 0 0 8 0 0 0 0 0 0 65 0 324 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 153 0 497 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 153 0 497 0 0 0 0 0 0 0 0 0 322.15 0 0 0 0 0 0 4259.18 0 110093.95 0 0 0 0 0 0 114675.28 0 0 0 1101362846 1578553822 10 Physicians ALAM MURAD 606115183 200 Cook 0 0 Dermatology 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 0 141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5702.51 0 0 0 0 0 0 5702.51 0 0 0 1101362865 1750430104 13 Podiatrists SPENCER FREDERICK 605581476 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 772 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3510 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3510 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5107.27 0 0 0 0 0 0 5107.27 0 0 0 1101362866 1740242122 16 Nurse Practitioners WILSON JENNIFER 627810001 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17132.09 0 0 0 0 0 0 17132.09 0 0 0 1101362903 1578661161 10 Physicians 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0 0 25 0 0 0 0 0 0 30 0 235 0 0 0 0 0 0 561 0 0 759.26 0 0 0 0 0 0 84.75 0 4745.22 0 0 0 0 0 0 6150.23 0 0 0 1101363032 30 General Hospitals 851 West Virginia NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 0 230.59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230.59 0 0 0 1101363070 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8431.83 0 0 0 0 0 0 0 0 0 0 0 0 0 8431.83 0 0 0 1101363074 1659535409 10 Physicians ROMINE SPENCER 999999999 818 Kentucky 0 0 0 0 0 0 0 0 0 0 0 0 0 55 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 272 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 272 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3350.68 0 21772.3 0 0 0 0 0 0 25122.98 0 0 0 1101363082 91 Waiver service provider--Adults (DHS/DDD) 55 Kendall 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 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13992 0 0 0 0 0 0 0 0 0 0 0 0 0 13992 0 0 0 1101363089 1932245149 60 Pharmacies SCHOTTS PHARMACY INC 613411342 58 La Salle 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 900 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9778 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 254119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 469878.36 0 0 0 469878.36 0 0 0 1101363091 92 Waiver service provider--Disability (DHS/DRS) 91 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 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 1683.82 0 0 0 0 0 0 0 0 0 0 0 0 0 1683.82 0 0 0 1101363103 1548365752 10 Physicians GOLDSTEIN JAY 602011777 200 Cook 0 0 Gastroenterology 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 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4923.86 0 0 0 0 0 0 4923.86 0 0 0 1101363109 1881633204 70 Ambulance Service Providers NEWPORT FIRE PROTECTION DIST 600838923 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3878.3 0 0 0 0 0 0 3878.3 0 0 0 1101363147 1912971227 10 Physicians CLIFFORD BRADLEY 601533304 200 Cook 0 1 Internal Medicine 0 79 0 0 0 0 0 0 0 0 0 2 0 200 0 0 0 0 0 0 651 0 0 0 0 0 0 0 0 0 2 0 309 0 0 0 0 0 0 651 0 0 0 0 0 0 0 0 0 2 0 309 0 0 0 0 0 0 1925 0 0 0 0 0 0 0 0 0 24.54 0 7363.04 0 0 0 0 0 0 9312.58 0 0 0 1101363156 1720026321 12 Optometrists SNEDDON GEOFFREY 629594437 108 Williamson 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 1585 0 832 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3176 0 865 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3176 0 865 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61955.94 0 24793.1 0 0 0 0 86749.04 0 0 0 1101363159 1598987307 10 Physicians STANKIEWICZ KELLY 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 17 0 0 0 0 0 0 0 0 0 0 0 0 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provider--Disability (DHS/DRS) 200 Cook 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 17637.25 0 0 0 0 0 0 0 0 0 0 0 0 0 17637.25 0 0 0 1101363206 1699763433 10 Physicians MADALA RAMAKRISHNA 626501136 77 Morgan 0 0 Neuropathology 0 0 0 0 0 0 0 0 0 0 0 0 0 229 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 237 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 237 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37452.24 0 0 0 0 0 0 37452.24 0 0 0 1101363207 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 41871.4 0 0 0 0 0 0 0 0 0 0 0 0 0 41871.4 0 0 0 1101363231 1578581310 16 Nurse Practitioners JOHNSTON STEVEN B 605638669 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 602.34 0 0 0 0 0 0 602.34 0 0 0 1101363237 1922177468 22 Physical Therapists TRAVERS KEITH 606141925 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1065.31 1065.31 0 0 0 1101363243 10 Physicians 57 Lake 0 0 Obstetric-Gynecology 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 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 566.76 0 0 0 0 0 0 566.76 0 0 0 1101363247 1629328836 40 Federally Qualified Health Centers ERIE EVANSTON HEALTH CENTER 602021056 200 Cook 0 0 0 0 2366 0 1372 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14369 0 8899 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14369 0 8899 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 714101.5 0 293045.93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1007147.43 0 0 0 1101363268 1851462063 10 Physicians QALBANI MAHMOOD A. 631102539 826 Missouri 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 50 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 5272.52 0 0 0 0 0 0 5272.52 0 0 0 1101363271 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22228.3 0 0 0 0 0 0 0 0 0 0 0 0 0 22228.3 0 0 0 1101363273 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 11975.78 0 0 0 0 0 0 0 0 0 0 0 0 0 11975.78 0 0 0 1101363290 1467477869 10 Physicians JOHNSON PATRICIA 618012530 19 Champaign 0 0 Oncology 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2145.14 0 0 0 0 0 0 2145.14 0 0 0 1101363295 1740269620 10 Physicians SHARMA VIBHU 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 326 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 326 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 119.91 0 7649.12 0 0 0 0 0 0 7769.03 0 0 0 1101363318 92 Waiver service provider--Disability (DHS/DRS) 54 Kankakee 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 12964.17 0 0 0 0 0 0 0 0 0 0 0 0 0 12964.17 0 0 0 1101363322 1033392766 10 Physicians ANANIA NICOLE 606491003 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 318 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 414 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 414 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18023.75 0 0 0 0 0 0 18023.75 0 0 0 1101363329 1992959076 10 Physicians BEALS CLAUDIA 618323752 100 Vermilion 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 311 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 316 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 316 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11175.52 0 0 0 0 0 0 11175.52 0 0 0 1101363337 22 Physical Therapists 80 Peoria 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 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 13.8 13.8 0 0 0 1101363338 92 Waiver service provider--Disability (DHS/DRS) 53 Kane 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 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 5422.44 0 0 0 0 0 0 0 0 0 0 0 0 0 5422.44 0 0 0 1101363343 1902969413 22 Physical Therapists BOYLAND ANA 606234458 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1237 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1237 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42800.2 42800.2 0 0 0 1101363346 1174572929 10 Physicians ABDEL JALIL SUHAIR 602023452 200 Cook 0 1 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 701 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 701 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7601.87 0 0 0 0 0 0 7601.87 0 0 0 1101363351 1558506204 63 Other Providers of Medical Equipment/Supplies (Non-registered) MERCY CRYSTAL LAKE MEDICAL CTR 600146207 71 McHenry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90.91 0 338.64 0 0 0 0 429.55 0 0 0 1101363354 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13020.82 0 0 0 0 0 0 0 0 0 0 0 0 0 13020.82 0 0 0 1101363355 1649479650 10 Physicians CHAPA NAVEEN 623014038 10 Adams 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 2180 0 196 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3050 0 340 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3050 0 340 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38219.33 0 7291.57 0 0 0 0 0 0 45510.9 0 0 0 1101363356 1528263373 10 Physicians PUPPALA ANUJ 605213186 107 Will 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 34 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 378.66 0 2770.14 0 0 0 0 0 0 3148.8 0 0 0 1101363375 1548217466 10 Physicians BOLL ROBERT 604624509 200 Cook 0 1 Family Practice 0 11 0 0 11 0 0 0 0 0 0 4 0 46 0 0 0 0 0 0 13 0 0 11 0 0 0 0 0 0 6 0 79 0 0 0 0 0 0 13 0 0 11 0 0 0 0 0 0 6 0 79 0 0 0 0 0 0 32 0 0 687.1 0 0 0 0 0 0 53.94 0 1451.49 0 0 0 0 0 0 2224.53 0 0 0 1101363386 1245405497 10 Physicians ORTEL BERNHARD 600771049 200 Cook 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 0 1 0 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4.7 0 7402.35 0 0 0 0 0 0 7407.05 0 0 0 1101363391 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 2232.81 0 0 0 0 0 0 0 0 0 0 0 0 0 2232.81 0 0 0 1101363394 10 Physicians 852 Wisconsin 0 0 Otolaryngology 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 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 85.05 0 0 0 0 0 0 85.05 0 0 0 1101363399 1841284932 10 Physicians KARLIN KARYN 603022566 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 188 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 188 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4684.78 0 0 0 0 0 0 4684.78 0 0 0 1101363409 1265548010 50 Home Health Agencies - In Home MASON DIST HOSP H H SERVICE 626441243 68 Mason 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 0 263 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 263 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19043.1 0 0 0 0 0 0 19043.1 0 0 0 1101363431 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 13970.99 0 0 0 0 0 0 0 0 0 0 0 0 0 13970.99 0 0 0 1101363453 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5854.32 0 0 0 0 0 0 0 0 0 0 0 0 0 5854.32 0 0 0 1101363463 1073541447 38 Specialized Mental Health Rehabilitation Facilities (SMHRF) THORNTON HEIGHTS TERRACE LTD 604112002 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 774 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15038 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1324449.04 0 0 0 0 0 0 0 1324449.04 0 0 0 1101363482 1154347383 10 Physicians GOULD JENNIFER 631101016 826 Missouri 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 35 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 263.19 0 3565.38 0 0 0 0 0 0 3828.57 0 0 0 1101363494 1861513996 43 Encounter rate clinic THE CORE CENTER 606123741 200 Cook 0 1 Direct Access 0 103 1453 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 314 6262 0 247 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 314 6262 0 247 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 849 1198211.09 0 23909.75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1222969.84 0 0 0 1101363501 1376644385 30 General Hospitals ST ALEXIUS MEDICAL CENTER 601941018 200 Cook DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 0 0 0 0 0 2935 0 0 0 0 1760 0 0 0 2291 0 0 0 0 0 0 0 0 0 4252 0 0 0 0 1924 0 0 0 3773 0 0 0 0 0 0 0 0 0 4275 0 0 0 0 6724 0 0 0 3835 0 0 0 0 0 0 0 0 0 746940.84 0 0 0 0 3868926.55 0 0 0 608307.88 0 0 0 0 0 5224175.27 0 0 0 1101363504 1477618197 12 Optometrists MAY GAIL 605631269 30 DuPage 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 264 0 221 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 557 0 226 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 557 0 226 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14129.88 0 6352.68 0 0 0 0 20482.56 0 0 0 1101363506 1235297938 10 Physicians SETHI PAWAN 606313745 200 Cook 0 1 Family Practice 0 7 0 0 3 0 0 0 0 0 0 3 0 16 0 0 0 0 0 0 31 0 0 5 0 0 0 0 0 0 3 0 42 0 0 0 0 0 0 31 0 0 5 0 0 0 0 0 0 3 0 42 0 0 0 0 0 0 77 0 0 57.75 0 0 0 0 0 0 24.6 0 489.5 0 0 0 0 0 0 648.85 0 0 0 1101363507 1356378822 24 Speech Therapists DUCEY TRACY 620022415 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 661 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 661 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54120.19 54120.19 0 0 0 1101363513 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 19 0 0 0 0 0 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 5082.95 0 0 0 0 0 0 0 0 0 0 0 0 0 5082.95 0 0 0 1101363517 1437138120 16 Nurse Practitioners RAMSAY CINDY 612822904 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 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 0 208.01 0 0 0 0 0 0 208.01 0 0 0 1101363519 1376697466 16 Nurse Practitioners JOHNSON SUSAN 600891701 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 841.66 0 0 0 0 0 0 841.66 0 0 0 1101363526 1104066554 16 Nurse Practitioners BRIAN JASON 617014364 72 McLean 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2596.01 0 0 0 0 0 0 2596.01 0 0 0 1101363527 1588638811 10 Physicians DESTEFANI THOMAS 601376101 30 DuPage 0 1 Pediatrics 0 76 0 0 112 0 0 0 0 0 0 11 0 86 0 0 0 0 0 0 476 0 0 388 0 0 0 0 0 0 14 0 119 0 0 0 0 0 0 476 0 0 388 0 0 0 0 0 0 14 0 119 0 0 0 0 0 0 952 0 0 12091.32 0 0 0 0 0 0 98.12 0 5746.74 0 0 0 0 0 0 18888.18 0 0 0 1101363529 1154480630 10 Physicians TAN SIDHARTHA 602011718 200 Cook 0 0 Neonatology 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10490 0 0 0 0 0 0 10490 0 0 0 1101363530 92 Waiver service provider--Disability (DHS/DRS) 69 Massac 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 1527.96 0 0 0 0 0 0 0 0 0 0 0 0 0 1527.96 0 0 0 1101363545 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 216 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 216 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23937.35 0 0 0 0 0 0 0 0 0 0 0 0 0 23937.35 0 0 0 1101363548 98 Waiver service provider--TBI (DHS/DRS) 109 Winnebago 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 36249.83 0 0 0 0 0 0 0 0 0 0 0 0 0 36249.83 0 0 0 1101363552 92 Waiver service provider--Disability (DHS/DRS) 57 Lake 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 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 2023.19 0 0 0 0 0 0 0 0 0 0 0 0 0 2023.19 0 0 0 1101363553 1255561510 10 Physicians TYMOUCH JAROSLAV 606121101 200 Cook 0 0 Anesthesiology 0 0 0 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Cook 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 31015.11 0 0 0 0 0 0 0 0 0 0 0 0 0 31015.11 0 0 0 1101365309 1992711360 60 Pharmacies WALGREEN CO STORE 1173 606142023 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 292 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1233 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29619 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66200.8 0 0 0 66200.8 0 0 0 1101365310 1881720944 23 Occupational Therapists SHANKER SHARMA SHILPA 604677112 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1020 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1020 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87154.43 87154.43 0 0 0 1101365321 1699983007 23 Occupational Therapists GEMBARA JILL 606295560 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1556 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1556 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70890.24 70890.24 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 346 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6637.52 0 0 0 0 0 0 6637.52 0 0 0 1101365372 1689672750 63 Other Providers of Medical Equipment/Supplies (Non-registered) PROSTHETIC DESIGN INC 631101313 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9549.45 0 0 0 0 9549.45 0 0 0 1101365383 1417978990 10 Physicians POHL DAVID 633014405 826 Missouri 0 0 Radiology Diagnosis 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 19 0 0 0 0 0 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 0 284.43 0 0 0 0 0 0 0 0 284.43 0 0 0 1101365385 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 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 4068.9 0 0 0 0 0 0 0 0 0 0 0 0 0 4068.9 0 0 0 1101365395 1346338605 25 Audiologists MCKEE NATALIE 617017904 72 McLean 0 0 0 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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 12546.67 0 0 0 0 0 0 0 0 0 0 0 0 0 12546.67 0 0 0 1101365453 1013086990 12 Optometrists DEWAARD DAVID D 606405622 200 Cook 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 2368 0 2640 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3902 0 2650 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3902 0 2650 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105827.32 0 75539.35 0 0 0 0 181366.67 0 0 0 1101365461 1497890990 10 Physicians THOMPSON NICOLE 606127232 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68809.56 0 0 0 0 0 0 68809.56 0 0 0 1101365468 92 Waiver service provider--Disability (DHS/DRS) 107 Will 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 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 17800.99 0 0 0 0 0 0 0 0 0 0 0 0 0 17800.99 0 0 0 1101365471 1629024294 10 Physicians BYSKOSH ARKADIUSH 601344205 53 Kane 0 0 Otorhinolaryngology 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120.79 0 0 0 0 0 0 120.79 0 0 0 1101365483 91 Waiver service provider--Adults (DHS/DDD) 89 Rock Island 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 29 0 0 0 0 0 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 0 957 0 0 0 0 0 0 0 0 0 0 0 0 0 957 0 0 0 1101365510 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19242.29 0 0 0 0 0 0 0 0 0 0 0 0 0 19242.29 0 0 0 1101365518 1265605117 63 Other Providers of Medical Equipment/Supplies (Non-registered) ARABELLA BOUTIQUE 618011645 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 223.78 0 25.79 0 0 0 0 249.57 0 0 0 1101365535 1447247572 10 Physicians LENGEMANN JAMES 605406508 30 DuPage 0 1 Internal Medicine 0 6 0 0 0 0 0 0 0 0 0 1 0 7 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 1 0 14 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 1 0 14 0 0 0 0 0 0 162 0 0 0 0 0 0 0 0 0 6.3 0 436.73 0 0 0 0 0 0 605.03 0 0 0 1101365545 98 Waiver service provider--TBI (DHS/DRS) 92 Schuyler 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 1184.2 0 0 0 0 0 0 0 0 0 0 0 0 0 1184.2 0 0 0 1101365556 92 Waiver service provider--Disability (DHS/DRS) 58 La Salle 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 18972.24 0 0 0 0 0 0 0 0 0 0 0 0 0 18972.24 0 0 0 1101365559 1477532364 10 Physicians TERRELL DARIA 606213114 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 251 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 494 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 494 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16730.56 0 0 0 0 0 0 16730.56 0 0 0 1101365564 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 15142.2 0 0 0 0 0 0 0 0 0 0 0 0 0 15142.2 0 0 0 1101365587 1497701684 10 Physicians WAGNER ALAN 610324864 97 Stephenson 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 501 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 679 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 679 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15056.92 0 875.66 0 0 0 0 0 0 15932.58 0 0 0 1101365590 92 Waiver service provider--Disability (DHS/DRS) 24 Coles 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 14570.52 0 0 0 0 0 0 0 0 0 0 0 0 0 14570.52 0 0 0 1101365591 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20724.51 0 0 0 0 0 0 0 0 0 0 0 0 0 20724.51 0 0 0 1101365620 1841386729 10 Physicians BROWN MARIE 603042313 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101.1 0 0 0 0 0 0 101.1 0 0 0 1101365633 10 Physicians 852 Wisconsin 0 0 Internal Medicine 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 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 944.64 0 0 0 0 0 0 944.64 0 0 0 1101365635 1710935242 10 Physicians ANDERSON EDWIN 604405125 200 Cook 0 0 Family Practice 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 47 0 0 0 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 0 162.56 0 0 0 0 0 0 162.56 0 0 0 1101365648 1770664856 10 Physicians BUCHER GARY 606147734 200 Cook 0 0 Emergency Medicine 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 0 214 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 214 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 506.6 0 0 0 0 0 0 506.6 0 0 0 1101365650 1407801293 33 Nursing Facilities APOSTOLIC CHRISTIAN RESTMOR 615502301 98 Tazewell 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 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3257 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 291910.76 0 0 0 0 0 0 0 291910.76 0 0 0 1101365651 30 General Hospitals 803 Arizona ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 320.94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 320.94 0 0 0 1101365657 1720087398 16 Nurse Practitioners GALLAGHER KATRINA 605155641 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 184 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 520 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 520 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6292.32 0 0 0 0 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JAMAICA UNIT 12 618769518 100 Vermilion 0 0 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 0 597 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 597 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12819.81 0 12819.81 0 0 0 1101366935 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 30735.52 0 0 0 0 0 0 0 0 0 0 0 0 0 30735.52 0 0 0 1101366941 1609030428 10 Physicians BECCUE ALEXIA 618012530 19 Champaign 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 210 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34129.14 0 0 0 0 0 0 34129.14 0 0 0 1101366958 1972596419 12 Optometrists JURKUS JANICE 606163816 200 Cook 0 0 Therapeutic Pharmaceutical Agents 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 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 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Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 463 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2516 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63857 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 113968.78 0 0 0 113968.78 0 0 0 1101367144 91 Waiver service provider--Adults (DHS/DDD) 30 DuPage 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 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6396.4 0 0 0 0 0 0 0 0 0 0 0 0 0 6396.4 0 0 0 1101367149 1871773291 10 Physicians KHANDELWAL SONALI 606751611 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 349 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 349 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4653.31 0 0 0 0 0 0 4653.31 0 0 0 1101367179 1538452602 16 Nurse Practitioners WELSH SARAH 999999999 72 McLean 0 0 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 19 0 0 0 0 0 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 0 483.56 0 0 0 0 0 0 483.56 0 0 0 1101367187 92 Waiver 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 165403.03 0 0 0 0 0 0 0 0 0 0 0 0 0 165403.03 0 0 0 1101367221 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18218.19 0 0 0 0 0 0 0 0 0 0 0 0 0 18218.19 0 0 0 1101367228 1396737821 10 Physicians GARBOLSKI JEAN 604399393 30 DuPage 0 1 Family Practice 0 25 0 0 1 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 53 0 0 1 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 53 0 0 1 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 131 0 0 84.62 0 0 0 0 0 0 0 0 731.19 0 0 0 0 0 0 946.81 0 0 0 1101367231 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 26034.27 0 0 0 0 0 0 0 0 0 0 0 0 0 26034.27 0 0 0 1101367245 1891761466 60 Pharmacies PRI MED INFUSION SERVICES 606564740 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135 0 0 285 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135 0 0 1460 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13858.57 0 0 23611.87 0 0 0 37470.44 0 0 0 1101367246 1568479939 10 Physicians GREEN CHRISTOPHER 620026723 65 Madison 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 6 0 479 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 684 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 684 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98.55 0 4125.3 0 0 0 0 0 0 4223.85 0 0 0 1101367249 92 Waiver service provider--Disability (DHS/DRS) 106 Whiteside 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 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 0 169.05 0 0 0 0 0 0 0 0 0 0 0 0 0 169.05 0 0 0 1101367256 1962632190 40 Federally Qualified Health Centers CARMI COMMUNITY HEALTH CENTER 628211387 105 White 0 1 0 369 1027 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2631 4947 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2631 4947 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7095 198839.95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 205934.95 0 0 0 1101367267 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3520 0 0 0 0 0 0 0 0 0 0 0 0 0 3520 0 0 0 1101367268 92 Waiver service provider--Disability (DHS/DRS) 63 Macon 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 9756.27 0 0 0 0 0 0 0 0 0 0 0 0 0 9756.27 0 0 0 1101367282 1427144310 10 Physicians DAUBE STEVEN 605213535 30 DuPage 0 0 Obstetric-Gynecology 0 0 0 0 1 0 0 0 0 0 0 29 0 84 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 32 0 275 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 32 0 275 0 0 0 0 0 0 0 0 0 18.27 0 0 0 0 0 0 2072.72 0 20343.42 0 0 0 0 0 0 22434.41 0 0 0 1101367283 1750519427 11 Dentists PATEL SHWETA 463221065 815 Indiana 0 0 General Dentistry 0 0 0 1185 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5288 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5288 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 153151.03 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 153151.03 0 0 0 1101367287 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6439.46 0 0 0 0 0 0 0 0 0 0 0 0 0 6439.46 0 0 0 1101367288 1972572675 10 Physicians MUKUNDA RAMALINGAPPA 604363168 107 Will 0 1 Internal Medicine 0 38 0 0 0 0 0 0 0 0 0 0 0 338 0 0 0 0 0 0 258 0 0 0 0 0 0 0 0 0 0 0 1214 0 0 0 0 0 0 258 0 0 0 0 0 0 0 0 0 0 0 1214 0 0 0 0 0 0 701 0 0 0 0 0 0 0 0 0 0 0 12686.77 0 0 0 0 0 0 13387.77 0 0 0 1101367302 1831184431 10 Physicians STEPHENS ANTHONY 605212480 30 DuPage 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1744.11 0 0 0 0 0 0 1744.11 0 0 0 1101367304 1821049487 10 Physicians BEIGLER DAVID 600257645 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 26 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 840.74 0 2169.57 0 0 0 0 0 0 3010.31 0 0 0 1101367306 1568423184 61 Independent Laboratories UNIVERSITY PATHOLOGISTS CONSUL 606123825 200 Cook 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101367307 16 Nurse Practitioners 71 McHenry 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24.9 0 0 0 0 0 0 24.9 0 0 0 1101367308 1770648511 10 Physicians SULLIVAN CHRISTOPHER 605276686 30 DuPage 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 28 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 226 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 226 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 634.19 0 70915.92 0 0 0 0 0 0 71550.11 0 0 0 1101367326 1356563563 36 Community mental health provider HUMAN SERVICE CENTER 622331457 87 Randolph 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 233 0 0 163 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1434 0 0 163 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1434 0 0 3649.01 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77708.12 0 0 81357.13 0 0 0 1101367329 1710159165 29 ICF/MR STOUFFER TERRACE 610612308 79 Ogle 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 0 546 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9287 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 625902.86 0 0 0 0 0 0 0 0 0 0 625902.86 0 0 0 1101367349 1205965522 10 Physicians SANCHEZ VARGAS GUSTAVO 605063847 53 Kane 0 1 Family Practice 0 38 0 0 44 0 0 0 0 0 0 49 0 95 0 0 0 0 0 0 290 0 0 149 0 0 0 0 0 0 223 0 410 0 0 0 0 0 0 290 0 0 149 0 0 0 0 0 0 223 0 410 0 0 0 0 0 0 626 0 0 5423.34 0 0 0 0 0 0 476.34 0 26245.14 0 0 0 0 0 0 32770.82 0 0 0 1101367366 63 Other Providers of Medical Equipment/Supplies (Non-registered) 848 Virginia 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 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2135.42 0 0 0 0 0 0 2135.42 0 0 0 1101367367 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 9277.78 0 0 0 0 0 0 0 0 0 0 0 0 0 9277.78 0 0 0 1101367380 91 Waiver service provider--Adults (DHS/DDD) 57 Lake 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 0 315 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 315 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22354.73 0 0 0 0 0 0 0 0 0 0 0 0 0 22354.73 0 0 0 1101367394 1801817473 10 Physicians RAY DANIEL 602011718 200 Cook 0 0 Pulmonary Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 382 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 382 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8903.88 0 0 0 0 0 0 8903.88 0 0 0 1101367402 1811970486 10 Physicians BANSAL PRIYA 601082169 30 DuPage 0 0 Allergy-Immunization 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 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 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55.14 0 0 0 0 0 0 55.14 0 0 0 1101367404 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18253.33 0 0 0 0 0 0 0 0 0 0 0 0 0 18253.33 0 0 0 1101367413 2100357831 90 Waiver service provider--Elderly (DOA) UNIVERSAL INDUSTRIES 606451510 200 Cook 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11656 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11656 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 377175.93 0 0 0 0 0 0 0 0 0 0 0 0 0 377175.93 0 0 0 1101367416 1588818777 10 Physicians HUSSAIN SYED 999999999 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 250 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 250 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1229.19 0 0 0 0 0 0 1229.19 0 0 0 1101367417 1770802589 55 Early Intervention Services JACOBS KATIE 625689340 20 Christian 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5757.25 0 0 0 0 0 0 5757.25 0 0 0 1101367433 1356633911 36 Community mental health provider ADAPT OF ILLINOIS INC 605421260 53 Kane 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7108 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7108 0 0 3026.95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 217200.48 0 0 220227.43 0 0 0 1101367437 1467557686 10 Physicians CAMARDA VOIGHT MARIA L 601933553 65 Madison 0 1 Pediatrics 0 315 0 0 225 0 0 0 0 0 0 144 0 312 0 0 0 0 0 0 2656 0 0 937 0 0 0 0 0 0 200 0 603 0 0 0 0 0 0 2656 0 0 937 0 0 0 0 0 0 200 0 603 0 0 0 0 0 0 5312 0 0 23628.6 0 0 0 0 0 0 1088.5 0 27232.36 0 0 0 0 0 0 57261.46 0 0 0 1101367440 91 Waiver service provider--Adults (DHS/DDD) 57 Lake 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 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11605 0 0 0 0 0 0 0 0 0 0 0 0 0 11605 0 0 0 1101367441 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 12839.83 0 0 0 0 0 0 0 0 0 0 0 0 0 12839.83 0 0 0 1101367449 1023337672 16 Nurse Practitioners PATEL MANSI 600684218 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49.04 0 0 0 0 0 0 49.04 0 0 0 1101367466 92 Waiver service provider--Disability (DHS/DRS) 53 Kane 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 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 4427.02 0 0 0 0 0 0 0 0 0 0 0 0 0 4427.02 0 0 0 1101367470 1083685986 30 General Hospitals GATEWAY REGIONAL MEDICAL CTR 620404701 65 Madison DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 519 0 0 348 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1679 0 0 545 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1679 0 0 545 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17177.54 0 0 25597.58 0 0 0 0 0 42775.12 0 0 0 1101367473 1295841641 16 Nurse Practitioners SOSMAN LINDA 606225646 200 Cook 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 0 0 0 0 0 0 0 0 23 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 0 0 0 0 0 0 0 0 5205.26 0 0 0 0 0 0 5205.26 0 0 0 1101367489 1669499968 60 Pharmacies WALMART STORES INC 10 5403 618027804 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 679 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3706 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 96085 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 173997.49 0 0 0 173997.49 0 0 0 1101367506 98 Waiver service provider--TBI (DHS/DRS) 27 Dekalb 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 1364.46 0 0 0 0 0 0 0 0 0 0 0 0 0 1364.46 0 0 0 1101367510 1316036460 10 Physicians DUNCAN HOWARD 601901295 30 DuPage 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3488.36 0 0 0 0 0 0 3488.36 0 0 0 1101367522 91 Waiver service provider--Adults (DHS/DDD) 91 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 0 332 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 332 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21945 0 0 0 0 0 0 0 0 0 0 0 0 0 21945 0 0 0 1101367528 92 Waiver service provider--Disability (DHS/DRS) 96 St Clair 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 12063.25 0 0 0 0 0 0 0 0 0 0 0 0 0 12063.25 0 0 0 1101367532 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12861.3 0 0 0 0 0 0 0 0 0 0 0 0 0 12861.3 0 0 0 1101367535 94 Waiver service provider--Children's support (DHS/DDD) 65 Madison 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 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8269.8 0 0 0 0 0 0 0 0 0 0 0 0 0 8269.8 0 0 0 1101367541 1306910542 10 Physicians GARBER JOSEPH 606576163 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 9 0 235 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 484 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 484 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39.25 0 7387.78 0 0 0 0 0 0 7427.03 0 0 0 1101367548 1770515181 10 Physicians JAKOBY MICHAEL 627949636 91 Sangamon 0 0 Endocrinology 0 0 0 0 0 0 0 0 0 0 0 16 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 489 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 489 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 447.05 0 35903.81 0 0 0 0 0 0 36350.86 0 0 0 1101367559 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15793.21 0 0 0 0 0 0 0 0 0 0 0 0 0 15793.21 0 0 0 1101367563 1568618296 10 Physicians GERBER ROBERT 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1189.65 0 0 0 0 0 0 1189.65 0 0 0 1101367576 92 Waiver service provider--Disability (DHS/DRS) 106 Whiteside 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 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22705.39 0 0 0 0 0 0 0 0 0 0 0 0 0 22705.39 0 0 0 1101367577 92 Waiver service provider--Disability (DHS/DRS) 106 Whiteside 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 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 14474.65 0 0 0 0 0 0 0 0 0 0 0 0 0 14474.65 0 0 0 1101367587 10 Physicians 200 Cook 0 0 Family Practice 0 0 0 0 2 0 0 0 0 0 0 2 0 1 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 2 0 2 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 2 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3.33 0 0 0 0 0 0 0 0 3.33 0 0 0 1101367589 1740517408 10 Physicians MANZAR ASMA 608052701 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 401 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 401 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5346.82 0 0 0 0 0 0 5346.82 0 0 0 1101367594 1568664555 10 Physicians TZVETANOV IVO 606162315 200 Cook 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11580.2 0 0 0 0 0 0 11580.2 0 0 0 1101367608 92 Waiver service provider--Disability (DHS/DRS) 96 St Clair 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 12077.82 0 0 0 0 0 0 0 0 0 0 0 0 0 12077.82 0 0 0 1101367614 10 Physicians 852 Wisconsin 0 0 Pediatrics 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 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8230.14 0 0 0 0 0 0 8230.14 0 0 0 1101367634 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11480.56 0 0 0 0 0 0 0 0 0 0 0 0 0 11480.56 0 0 0 1101367649 10 Physicians 100 Vermilion 0 0 Emergency Medicine 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 0 104.8 0 0 0 0 0 0 104.8 0 0 0 1101367659 92 Waiver service provider--Disability (DHS/DRS) 99 Union 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 8717.4 0 0 0 0 0 0 0 0 0 0 0 0 0 8717.4 0 0 0 1101367660 10 Physicians 826 Missouri 0 0 Pediatrics 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 14 0 0 0 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 3694.76 0 0 0 0 0 0 3694.76 0 0 0 1101367662 1255380762 10 Physicians MOCK KRISTIN 601781335 27 Dekalb 0 1 Family Practice 0 99 0 0 25 0 0 0 0 0 0 86 0 237 0 0 0 0 0 0 997 0 0 37 0 0 0 0 0 0 128 0 498 0 0 0 0 0 0 997 0 0 37 0 0 0 0 0 0 128 0 498 0 0 0 0 0 0 2519 0 0 2211.59 0 0 0 0 0 0 1318.66 0 26925.57 0 0 0 0 0 0 32974.82 0 0 0 1101367668 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 41425.25 0 0 0 0 0 0 0 0 0 0 0 0 0 41425.25 0 0 0 1101367679 1598708331 64 Imaging Services CAPE RADIOLOGY GROUP I LLC 637034928 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 221.26 0 5296.67 0 0 0 0 0 0 5517.93 0 0 0 1101367700 1568631133 36 Community mental health provider TAZWOOD MENTAL HEALTH CTR 615546223 98 Tazewell 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 1495 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 146 0 0 1495 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9882.9 0 0 9882.9 0 0 0 1101367708 1376643007 10 Physicians LOPEZ LEONARDO 613429011 58 La Salle 0 1 Family Practice 0 409 0 0 172 0 0 0 0 0 0 50 0 457 0 0 0 0 0 0 4047 0 0 489 0 0 0 0 0 0 67 0 1593 0 0 0 0 0 0 4047 0 0 489 0 0 0 0 0 0 67 0 1593 0 0 0 0 0 0 9162 0 0 13986.55 0 0 0 0 0 0 441.93 0 37532.9 0 0 0 0 0 0 61123.38 0 0 0 1101367714 1447537881 56 School Based / Linked Health Clinics MMG IN SCHOOL HEALTH TREWYN 999999999 80 Peoria 0 0 0 0 147 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 388 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 388 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9432.63 0 1759.68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11192.31 0 0 0 1101367719 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 17665.12 0 0 0 0 0 0 0 0 0 0 0 0 0 17665.12 0 0 0 1101367722 1912153966 10 Physicians HERRON SARAH 604321439 107 Will 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 447 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 458 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 458 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17335.81 0 0 0 0 0 0 17335.81 0 0 0 1101367723 1427043769 10 Physicians CRUZ CHRISTOPHER 620343508 65 Madison 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 1008 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38426.79 0 0 0 0 0 0 38426.79 0 0 0 1101367730 1457435463 75 Department of Alcohol and Substance Abuse Provider BOND COUNTY HEALTH DEPARTMENT 622461847 12 Bond 0 0 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 0 793 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 793 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47164.82 0 0 47164.82 0 0 0 1101367736 10 Physicians 815 Indiana 0 0 Family Practice 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57.91 0 0 0 0 0 0 57.91 0 0 0 1101367753 1679661342 30 General Hospitals FMC OF OSWEGO 605435008 55 Kendall NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 173 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1976 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47394.59 0 0 0 0 0 47394.59 0 0 0 1101367773 1295864403 47 Local Education Agencies OPDYKE BELLE RIVE CCSD 628721014 49 Jefferson 0 0 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 1418 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1418 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33013.99 0 33013.99 0 0 0 1101367794 1104814490 33 Nursing Facilities AVISTON COUNTRYSIDE MANOR 622160487 23 Clinton 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 630 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16672 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1268814.04 0 0 0 0 0 0 0 1268814.04 0 0 0 1101367814 10 Physicians 826 Missouri 0 0 Cardiology 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11.05 0 0 0 0 0 0 11.05 0 0 0 1101367827 1215937867 33 Nursing Facilities SUNSET HOME 623014862 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1271 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29462 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2683033.23 0 0 0 0 0 0 0 2683033.23 0 0 0 1101367833 1043213820 10 Physicians MABRY ROBERT 420033813 818 Kentucky 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 87 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 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4565.91 0 0 0 0 0 0 4565.91 0 0 0 1101367843 1831144484 22 Physical Therapists HIGHLAND TIMOTHY 617641067 61 Livingston 0 0 0 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 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4536.32 4536.32 0 0 0 1101367844 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 22269.04 0 0 0 0 0 0 0 0 0 0 0 0 0 22269.04 0 0 0 1101367850 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12760 0 0 0 0 0 0 0 0 0 0 0 0 0 12760 0 0 0 1101367853 1417177627 16 Nurse Practitioners SALVATOR CHRISTINE A. 606118709 62 Logan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 223 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 223 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 920.58 0 0 0 0 0 0 920.58 0 0 0 1101367854 2100358272 90 Waiver service provider--Elderly (DOA) ASHLEYS QUALITY CARE 606161390 200 Cook 0 0 0 0 0 0 0 0 183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15989 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15989 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1058380.78 0 0 0 0 0 0 0 0 0 0 0 0 0 1058380.78 0 0 0 1101367872 1750394805 10 Physicians RAHEEM MOHAMMED 605064356 30 DuPage 0 0 Hematology 0 0 0 0 0 0 0 0 0 0 0 4 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 414 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 414 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31.49 0 20089.19 0 0 0 0 0 0 20120.68 0 0 0 1101367880 92 Waiver service provider--Disability (DHS/DRS) 20 Christian 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 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 14359.62 0 0 0 0 0 0 0 0 0 0 0 0 0 14359.62 0 0 0 1101367882 92 Waiver service provider--Disability (DHS/DRS) 91 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 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5177.68 0 0 0 0 0 0 0 0 0 0 0 0 0 5177.68 0 0 0 1101367894 91 Waiver service provider--Adults (DHS/DDD) 57 Lake 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 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22840.48 0 0 0 0 0 0 0 0 0 0 0 0 0 22840.48 0 0 0 1101367903 1598781817 10 Physicians QUAYLE KIMBERLY 631101002 826 Missouri 0 0 Pediatrics 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 61 0 0 0 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 2848.29 0 0 0 0 0 0 2848.29 0 0 0 1101367909 1285851329 23 Occupational Therapists LESTAR MALLINGER RENEE 600681110 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1220.52 1220.52 0 0 0 1101367940 1942578802 24 Speech Therapists RIBAUDO VANESSA 607141224 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 671 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 671 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48052.22 48052.22 0 0 0 1101367943 1922096973 10 Physicians SARTORE DANNY 626501136 77 Morgan 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 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0 0 0 0 0 4948.63 0 0 0 1101368056 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 21268.3 0 0 0 0 0 0 0 0 0 0 0 0 0 21268.3 0 0 0 1101368059 1366457897 70 Ambulance Service Providers GLENSIDE FIRE DIST 601392657 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 342 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 342 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12139.88 0 0 0 0 0 0 12139.88 0 0 0 1101368072 30 General Hospitals 72 McLean DIALYSIS Outpatient dialysis centers. 0 0 General Hospital - Adult and Child 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 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 233 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 813.31 0 0 0 0 0 813.31 0 0 0 1101368081 2100358499 90 Waiver service provider--Elderly (DOA) ADDUS HEALTHCARE INC 600677486 200 Cook 0 0 0 0 0 0 0 0 670 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50568 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50568 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2653467.95 0 0 0 0 0 0 0 0 0 0 0 0 0 2653467.95 0 0 0 1101368084 1043434665 10 Physicians HARRINGTON SILAS 606171124 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2890.59 0 0 0 0 0 0 2890.59 0 0 0 1101368085 1003064833 10 Physicians KAPUR SACHIN 604631055 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 215 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 336 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 336 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7390.58 0 0 0 0 0 0 7390.58 0 0 0 1101368097 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 0 251 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 251 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14349.93 0 0 0 0 0 0 0 0 0 0 0 0 0 14349.93 0 0 0 1101368102 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 4131.6 0 0 0 0 0 0 0 0 0 0 0 0 0 4131.6 0 0 0 1101368115 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13795.08 0 0 0 0 0 0 0 0 0 0 0 0 0 13795.08 0 0 0 1101368136 1396878682 16 Nurse Practitioners MCCORMACK DONNA 601533328 200 Cook 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 277 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 603 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 603 0 0 0 0 0 0 0 0 0 407.19 0 0 0 0 0 0 0 0 24206.74 0 0 0 0 0 0 24613.93 0 0 0 1101368139 1891724241 10 Physicians IYENGAR SHOBHA 611042315 109 Winnebago 0 1 Internal Medicine 0 24 0 0 1 0 0 0 0 0 0 4 0 84 0 0 0 0 0 0 129 0 0 1 0 0 0 0 0 0 4 0 323 0 0 0 0 0 0 129 0 0 1 0 0 0 0 0 0 4 0 323 0 0 0 0 0 0 391 0 0 87.38 0 0 0 0 0 0 49.6 0 5125.9 0 0 0 0 0 0 5653.88 0 0 0 1101368142 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4492.2 0 0 0 0 0 0 0 0 0 0 0 0 0 4492.2 0 0 0 1101368148 92 Waiver service provider--Disability (DHS/DRS) 53 Kane 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 14 0 0 0 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 19670.95 0 0 0 0 0 0 0 0 0 0 0 0 0 19670.95 0 0 0 1101368152 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 850.31 0 0 0 0 0 0 0 0 0 0 0 0 0 850.31 0 0 0 1101368155 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 1609.93 0 0 0 0 0 0 0 0 0 0 0 0 0 1609.93 0 0 0 1101368159 98 Waiver service provider--TBI (DHS/DRS) 76 Montgomery 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 25852.45 0 0 0 0 0 0 0 0 0 0 0 0 0 25852.45 0 0 0 1101368172 10 Physicians 65 Madison 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132.68 0 0 0 0 0 0 132.68 0 0 0 1101368176 1023204955 12 Optometrists FRAME CHRISTOPHER 607074212 200 Cook 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 113 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 252 0 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 252 0 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6979.71 0 2732.6 0 0 0 0 9712.31 0 0 0 1101368201 1063688752 10 Physicians PANJWANI ANJALI 606118709 200 Cook 0 0 Anesthesiology 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 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 1523.74 0 0 0 0 0 0 1523.74 0 0 0 1101368204 1003941139 70 Ambulance Service Providers NORTHERN EDGAR COUNTY AMB SER 619241023 31 Edgar 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 186 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 186 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7412.72 0 0 0 0 0 0 7412.72 0 0 0 1101368214 1285745976 10 Physicians TRAUGOTT ARTHUR 618012529 19 Champaign 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1828.47 0 0 0 0 0 0 1828.47 0 0 0 1101368225 1740234848 10 Physicians HILL JAMES 600052857 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 10 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48.33 0 1394.3 0 0 0 0 0 0 1442.63 0 0 0 1101368229 1174790745 10 Physicians BAUER SARAH 606143363 200 Cook 0 0 Pediatrics 0 0 0 0 47 0 0 0 0 0 0 0 0 143 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 173 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 173 0 0 0 0 0 0 0 0 0 725.77 0 0 0 0 0 0 0 0 19084.42 0 0 0 0 0 0 19810.19 0 0 0 1101368256 1518039692 60 Pharmacies MCKNIGHT PHARMACY 612311630 74 Mercer 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 804 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20435 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30280.96 0 0 0 30280.96 0 0 0 1101368257 1134334659 55 Early Intervention Services BROOKSHIRE HOLLIE 629602533 69 Massac 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 945 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 945 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58611.11 0 0 0 0 0 0 58611.11 0 0 0 1101368258 1588642136 10 Physicians MARTINI FRANK 60611 200 Cook 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 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 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2695.13 0 0 0 0 0 0 2695.13 0 0 0 1101368262 10 Physicians 57 Lake 0 0 Radiology 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 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 0 162.05 0 0 0 0 0 0 0 0 162.05 0 0 0 1101368263 1467487884 10 Physicians CHAUDHRY SAMINA 604652302 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 3 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14.35 0 3019.85 0 0 0 0 0 0 3034.2 0 0 0 1101368271 24 Speech Therapists 80 Peoria 0 0 0 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 508.46 508.46 0 0 0 1101368275 1710951520 10 Physicians SNITOVSKY PETER 606465727 200 Cook 0 0 Surgery Hand 0 0 0 0 0 0 0 0 0 0 0 79 0 245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 162 0 499 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 162 0 499 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3870.18 0 29388.57 0 0 0 0 0 0 33258.75 0 0 0 1101368284 92 Waiver service provider--Disability (DHS/DRS) 49 Jefferson 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 9670.16 0 0 0 0 0 0 0 0 0 0 0 0 0 9670.16 0 0 0 1101368300 1407011588 10 Physicians BEHAJ VALBONA 611042315 109 Winnebago 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 286 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 813 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 813 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9506.75 0 0 0 0 0 0 9506.75 0 0 0 1101368302 1255663381 10 Physicians TROTTER DAVID 608052701 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 958 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1049 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1049 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35227.42 0 0 0 0 0 0 35227.42 0 0 0 1101368303 1801103528 24 Speech Therapists FABISH ERIN 617043630 72 McLean 0 0 0 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 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5000.23 5000.23 0 0 0 1101368304 92 Waiver service provider--Disability (DHS/DRS) 54 Kankakee 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 0 765.64 0 0 0 0 0 0 0 0 0 0 0 0 0 765.64 0 0 0 1101368309 92 Waiver service provider--Disability (DHS/DRS) 30 DuPage 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 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 11569.82 0 0 0 0 0 0 0 0 0 0 0 0 0 11569.82 0 0 0 1101368322 1164508263 10 Physicians MALONE MICHAEL 606095322 200 Cook 0 0 Family Practice 0 108 0 0 70 0 0 0 0 0 0 44 0 247 0 0 0 0 0 0 278 0 0 173 0 0 0 0 0 0 56 0 586 0 0 0 0 0 0 278 0 0 173 0 0 0 0 0 0 56 0 586 0 0 0 0 0 0 648 0 0 6726.3 0 0 0 0 0 0 245.81 0 18677.15 0 0 0 0 0 0 26297.26 0 0 0 1101368323 24 Speech Therapists 107 Will 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 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3337.76 3337.76 0 0 0 1101368330 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 8820.76 0 0 0 0 0 0 0 0 0 0 0 0 0 8820.76 0 0 0 1101368361 1184620916 10 Physicians LIEBLICH JEFFREY 600353134 57 Lake 0 0 Endocrinology 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 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 0 216.71 0 0 0 0 0 0 216.71 0 0 0 1101368365 1720036882 16 Nurse Practitioners PHIPPS DARRYL 611112754 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2058.37 0 0 0 0 0 0 2058.37 0 0 0 1101368401 92 Waiver service provider--Disability (DHS/DRS) 37 Fulton 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 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13115.36 0 0 0 0 0 0 0 0 0 0 0 0 0 13115.36 0 0 0 1101368408 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 19 0 0 0 0 0 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 21639.98 0 0 0 0 0 0 0 0 0 0 0 0 0 21639.98 0 0 0 1101368413 1871615096 10 Physicians DHILLON RAJBIR 616151941 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 334 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 334 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230.61 0 0 0 0 0 0 230.61 0 0 0 1101368415 1164539730 30 General Hospitals LUTHERAN GENERAL HOSPITAL 600681174 200 Cook DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 0 0 0 0 147 0 0 0 0 0 0 2250 0 0 2185 0 0 0 0 0 0 0 0 237 0 0 0 0 0 0 6560 0 0 9475 0 0 0 0 0 0 0 0 237 0 0 0 0 0 0 6560 0 0 9475 0 0 0 0 0 0 0 0 1766.5 0 0 0 0 0 0 40004.51 0 0 927322.52 0 0 0 0 0 969093.53 0 0 0 1101368421 92 Waiver service 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 500 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 500 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12382.55 0 0 0 0 0 0 12382.55 0 0 0 1101369020 24 Speech Therapists 200 Cook 0 0 0 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 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1710.4 1710.4 0 0 0 1101369026 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7994.25 0 0 0 0 0 0 0 0 0 0 0 0 0 7994.25 0 0 0 1101369029 1477751428 11 Dentists BASHA FARHAT JOUMANA 600044314 200 Cook 0 0 General Dentistry 0 0 0 728 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3628 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3628 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94481.5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94481.5 0 0 0 1101369048 1386733681 30 General Hospitals SINAI CHILDRENS HOSPITAL 606081704 200 Cook CHILDRENS Hospital designated as childrens hospitals and paid a Per Diem rate. 0 0 General Hospital - Children Section 0 0 0 0 0 1731 0 0 0 0 407 0 0 0 587 0 0 0 0 0 0 0 0 0 2012 0 0 0 0 426 0 0 0 653 0 0 0 0 0 0 0 0 0 2012 0 0 0 0 3236 0 0 0 653 0 0 0 0 0 0 0 0 0 375070.41 0 0 0 0 6188675.02 0 0 0 327287.85 0 0 0 0 0 6891033.28 0 0 0 1101369064 1316963630 10 Physicians ISHAG SELMA 631101093 826 Missouri 0 0 Anesthesiology 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 29 0 0 0 0 0 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 3593.3 0 0 0 0 0 0 3593.3 0 0 0 1101369069 1023175338 60 Pharmacies HY VEE PHARMACY 1047 615201272 37 Fulton 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 510 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7898 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 212550 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 331834.02 0 0 0 331834.02 0 0 0 1101369072 92 Waiver service provider--Disability (DHS/DRS) 37 Fulton 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 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12647.25 0 0 0 0 0 0 0 0 0 0 0 0 0 12647.25 0 0 0 1101369073 1831383934 10 Physicians GALVAN CYNTHIA 482780769 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2691.03 0 0 0 0 0 0 2691.03 0 0 0 1101369077 91 Waiver service provider--Adults (DHS/DDD) 19 Champaign 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 0 208 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 208 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18833.1 0 0 0 0 0 0 0 0 0 0 0 0 0 18833.1 0 0 0 1101369091 1891754362 10 Physicians MUNEER RUKHSANA 601262748 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2082.89 0 0 0 0 0 0 2082.89 0 0 0 1101369098 92 Waiver service provider--Disability (DHS/DRS) 49 Jefferson 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 13442.55 0 0 0 0 0 0 0 0 0 0 0 0 0 13442.55 0 0 0 1101369101 92 Waiver service provider--Disability (DHS/DRS) 99 Union 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 22165.92 0 0 0 0 0 0 0 0 0 0 0 0 0 22165.92 0 0 0 1101369106 1134330426 10 Physicians BLONIGEN BRIAN 604356433 107 Will 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 219 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 219 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1712.12 0 0 0 0 0 0 1712.12 0 0 0 1101369114 92 Waiver service provider--Disability (DHS/DRS) 53 Kane 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12748.38 0 0 0 0 0 0 0 0 0 0 0 0 0 12748.38 0 0 0 1101369116 2100359534 91 Waiver service provider--Adults (DHS/DDD) RAY LYNN 618223506 19 Champaign 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 246 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 246 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6210 0 0 0 0 0 0 0 0 0 0 0 0 0 6210 0 0 0 1101369124 2100359542 90 Waiver service provider--Elderly (DOA) EUROPEAN SERVICE AT HOME INC 600670415 200 Cook 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1629 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1629 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103135.09 0 0 0 0 0 0 0 0 0 0 0 0 0 103135.09 0 0 0 1101369128 1013982578 10 Physicians CHERUKUPALLY SHILPA 601374418 30 DuPage 0 0 Otorhinolaryngology 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 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3465.11 0 0 0 0 0 0 3465.11 0 0 0 1101369149 1386860849 11 Dentists WEATHERFORD ALVIN 609144410 54 Kankakee 0 0 General Dentistry 0 0 0 122 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 472 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 472 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 14365.46 0 0 0 0 0 0 0 0 0 0 0 6021.6 0 0 0 0 20387.06 0 0 0 1101369151 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 14471.46 0 0 0 0 0 0 0 0 0 0 0 0 0 14471.46 0 0 0 1101369155 30 General Hospitals 852 Wisconsin NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31.36 0 0 0 0 0 31.36 0 0 0 1101369180 1619962941 10 Physicians GOLDFAIN VALERIE 609013485 54 Kankakee 0 0 Obstetric-Gynecology 0 0 0 0 2 0 0 0 0 0 0 69 0 168 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 315 0 374 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 315 0 374 0 0 0 0 0 0 0 0 0 171.3 0 0 0 0 0 0 7402.91 0 31350.43 0 0 0 0 0 0 38924.64 0 0 0 1101369184 1801870498 10 Physicians GINSBERG HARRY L 600856165 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 988.35 0 0 0 0 0 0 988.35 0 0 0 1101369198 1164492062 10 Physicians MCINERNEY PATRICK 601232300 53 Kane 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 1038 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1231 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1231 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30341.57 0 0 0 0 0 0 30341.57 0 0 0 1101369199 1265516058 70 Ambulance Service Providers CARPENTERSVILLE FIRE DEPT 601101913 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 209 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 538 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 538 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33193.11 0 0 0 0 0 0 33193.11 0 0 0 1101369203 92 Waiver service provider--Disability (DHS/DRS) 47 Jackson 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 24412.42 0 0 0 0 0 0 0 0 0 0 0 0 0 24412.42 0 0 0 1101369209 92 Waiver service provider--Disability (DHS/DRS) 57 Lake 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 30615.64 0 0 0 0 0 0 0 0 0 0 0 0 0 30615.64 0 0 0 1101369222 1265485007 70 Ambulance Service Providers CITY OF COUNTRY CLUB HILLS 604785311 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 193 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 550 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 550 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21661.92 0 0 0 0 0 0 21661.92 0 0 0 1101369236 1346236585 10 Physicians SIMMONS STEPHANIE 605655441 30 DuPage 0 0 Obstetric-Gynecology 0 0 0 0 1 0 0 0 0 0 0 2 0 19 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 3 0 55 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 3 0 55 0 0 0 0 0 0 0 0 0 32.15 0 0 0 0 0 0 65.02 0 4295.09 0 0 0 0 0 0 4392.26 0 0 0 1101369241 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13476.12 0 0 0 0 0 0 0 0 0 0 0 0 0 13476.12 0 0 0 1101369246 1356326482 16 Nurse Practitioners WILSON CARRIE 631101010 826 Missouri 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 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 0 391.16 0 0 0 0 0 0 391.16 0 0 0 1101369255 1760414221 61 Independent Laboratories MEDASSAY 605592780 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 507 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5743 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5743 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47949 0 0 0 0 0 0 0 0 47949 0 0 0 1101369275 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 579.93 0 0 0 0 0 0 0 0 0 0 0 0 0 579.93 0 0 0 1101369286 1396763876 16 Nurse Practitioners DAVIS SUSAN G. 631101002 826 Missouri 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 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1132.65 0 0 0 0 0 0 1132.65 0 0 0 1101369298 1528164118 10 Physicians MAJMUDAR SONALI 601691063 200 Cook 0 0 Internal Medicine 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 0 787 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 787 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14281.76 0 0 0 0 0 0 14281.76 0 0 0 1101369326 92 Waiver service provider--Disability (DHS/DRS) 107 Will 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 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 1956.15 0 0 0 0 0 0 0 0 0 0 0 0 0 1956.15 0 0 0 1101369330 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 259 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 259 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11965.25 0 0 0 0 0 0 0 0 0 0 0 0 0 11965.25 0 0 0 1101369336 92 Waiver service provider--Disability (DHS/DRS) 17 Carroll 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 4392.03 0 0 0 0 0 0 0 0 0 0 0 0 0 4392.03 0 0 0 1101369337 1710017124 63 Other Providers of Medical Equipment/Supplies (Non-registered) MACKMALTER ENTERPRISES INC 629483749 108 Williamson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 912 0 299 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5797 0 385 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5797 0 385 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 255821.72 0 29550.89 0 0 0 0 285372.61 0 0 0 1101369345 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18891.06 0 0 0 0 0 0 0 0 0 0 0 0 0 18891.06 0 0 0 1101369356 1568455293 10 Physicians PATEL JAIMINI 478042780 815 Indiana 0 0 Anesthesiology 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 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3346.59 0 0 0 0 0 0 3346.59 0 0 0 1101369367 1316242423 16 Nurse Practitioners MANKO ALLISON 606472319 200 Cook 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 167 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 167 0 0 0 0 0 0 0 0 0 104.96 0 0 0 0 0 0 0 0 27857.61 0 0 0 0 0 0 27962.57 0 0 0 1101369380 1275577983 10 Physicians HANSEN WARREN 462786013 815 Indiana 0 0 Radiology Diagnosis 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 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 223.48 0 0 0 0 0 0 0 0 223.48 0 0 0 1101369388 1417980988 10 Physicians AIRAN MOHAN 601485396 30 DuPage 0 0 Surgery General 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 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1523.2 0 0 0 0 0 0 1523.2 0 0 0 1101369392 10 Physicians 815 Indiana 0 0 Ophthalmology 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 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 0 260.35 0 0 0 0 0 0 260.35 0 0 0 1101369406 1811074651 30 General Hospitals SSM HEALTH CARDINAL GLENNON CH 631041003 826 Missouri CHILDRENS Hospital designated as childrens hospitals and paid a Per Diem rate. 0 0 Children's Hospital 0 0 0 0 0 1952 0 0 0 0 899 0 0 0 2113 0 0 0 0 0 0 0 0 0 2565 0 0 0 0 1118 0 0 0 3136 0 0 0 0 0 0 0 0 0 2565 0 0 0 0 7089 0 0 0 3148 0 0 0 0 0 0 0 0 0 324117.85 0 0 0 0 17331853.25 0 0 0 1701075.97 0 0 0 0 0 19357047.07 0 0 0 1101369435 1821084856 10 Physicians SCHWARTZ BRADLEY 627949639 91 Sangamon 0 0 Urology 0 0 0 0 0 0 0 0 0 0 0 33 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 266 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 266 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 770.65 0 89267.3 0 0 0 0 0 0 90037.95 0 0 0 1101369438 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27555.45 0 0 0 0 0 0 0 0 0 0 0 0 0 27555.45 0 0 0 1101369451 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 10551.84 0 0 0 0 0 0 0 0 0 0 0 0 0 10551.84 0 0 0 1101369456 1952377723 10 Physicians AKINBILE MUFUTAU 606127324 200 Cook 0 0 Pediatrics 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 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14471.59 0 0 0 0 0 0 14471.59 0 0 0 1101369463 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7606.5 0 0 0 0 0 0 0 0 0 0 0 0 0 7606.5 0 0 0 1101369466 92 Waiver service provider--Disability (DHS/DRS) 54 Kankakee 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 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 10396.79 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8250 0 0 0 0 0 0 0 0 0 0 0 0 0 8250 0 0 0 1101370600 1548447865 10 Physicians HARIHARAN RADHIKA 600614304 57 Lake 0 0 Endocrinology 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 606 0 0 0 0 0 0 606 0 0 0 1101370616 1275762007 11 Dentists SHAH COX MARY 616152176 80 Peoria 0 0 General Dentistry 0 0 0 1736 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8306 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8306 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 213743.45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 213743.45 0 0 0 1101370620 1386831030 10 Physicians SPIOTTO MICHAEL 606124795 200 Cook 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 697 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 697 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33586.34 0 0 0 0 0 0 33586.34 0 0 0 1101370623 1699884106 10 Physicians NEUWIRTH MICHAEL 618012530 19 Champaign 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 44 0 218 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 331 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 331 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 336.3 0 11306 0 0 0 0 0 0 11642.3 0 0 0 1101370633 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 14822.64 0 0 0 0 0 0 0 0 0 0 0 0 0 14822.64 0 0 0 1101370634 1548261910 10 Physicians SILIUNAS DONATAS 600073311 200 Cook 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 755 0 171 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1093 0 263 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1093 0 263 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18143.13 0 3965.87 0 0 0 0 0 0 22109 0 0 0 1101370637 1508049453 16 Nurse Practitioners KURTZ MONIKA 999999999 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 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 32.8 0 0 0 0 0 0 32.8 0 0 0 1101370656 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 19927.62 0 0 0 0 0 0 0 0 0 0 0 0 0 19927.62 0 0 0 1101370657 10 Physicians 816 Iowa 0 0 Internal Medicine 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 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 0 122.15 0 0 0 0 0 0 122.15 0 0 0 1101370663 1376530766 63 Other Providers of Medical Equipment/Supplies (Non-registered) ALDEN PARK STRATHMOOR INC 611075199 109 Winnebago 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 0 238 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 238 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38335.14 0 0 0 0 0 0 38335.14 0 0 0 1101370666 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50716.14 0 0 0 0 0 0 0 0 0 0 0 0 0 50716.14 0 0 0 1101370677 23 Occupational Therapists 200 Cook 0 0 0 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 406.84 406.84 0 0 0 1101370678 1932182748 10 Physicians THOMPSON JAMES A 604221452 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 34 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 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1990.9 0 0 0 0 0 0 1990.9 0 0 0 1101370680 1306036611 11 Dentists BAREKET SIMONA 600604433 57 Lake 0 0 General Dentistry 0 0 0 313 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1944 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1944 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75522.87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75522.87 0 0 0 1101370703 1205039955 10 Physicians LOETHEN JENNIFER 620405012 65 Madison 0 1 Pediatrics 0 23 0 0 41 0 0 0 0 0 0 20 0 59 0 0 0 0 0 0 169 0 0 104 0 0 0 0 0 0 26 0 67 0 0 0 0 0 0 169 0 0 104 0 0 0 0 0 0 26 0 67 0 0 0 0 0 0 351 0 0 3079.43 0 0 0 0 0 0 260.41 0 2733.58 0 0 0 0 0 0 6424.42 0 0 0 1101370710 1861528515 10 Physicians LEGRAND SCOTT 611033655 109 Winnebago 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19950.18 0 0 0 0 0 0 19950.18 0 0 0 1101370719 10 Physicians 53 Kane 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 1 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50.91 0 178.73 0 0 0 0 0 0 229.64 0 0 0 1101370728 30 General Hospitals 200 Cook DIALYSIS Outpatient dialysis centers. 0 0 General Hospital - Adult and Child 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 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 400 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101370734 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 14 0 0 0 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 1026.89 0 0 0 0 0 0 0 0 0 0 0 0 0 1026.89 0 0 0 1101370741 1427235530 63 Other Providers of Medical Equipment/Supplies (Non-registered) OHLEY HOME MEDICAL 628646724 49 Jefferson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 833 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 833 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36398.37 0 2500.6 0 0 0 0 38898.97 0 0 0 1101370757 1932148608 10 Physicians MAJOR SHEILA M 600912964 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 1449 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2369 0 259 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2369 0 259 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40551.1 0 3369.1 0 0 0 0 0 0 43920.2 0 0 0 1101370769 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 7624.61 0 0 0 0 0 0 0 0 0 0 0 0 0 7624.61 0 0 0 1101370774 1154551208 22 Physical Therapists KENNEDY CLARE 606381643 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 237 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 237 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 921.36 921.36 0 0 0 1101370776 92 Waiver service provider--Disability (DHS/DRS) 85 Pulaski 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 12583.02 0 0 0 0 0 0 0 0 0 0 0 0 0 12583.02 0 0 0 1101370779 1487629820 10 Physicians GARG RACHNA 604480688 107 Will 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2764.97 0 0 0 0 0 0 2764.97 0 0 0 1101370782 1083642672 10 Physicians CHIGURUPATI SRIDHAR 603022599 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13587.25 0 0 0 0 0 0 13587.25 0 0 0 1101370783 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 10233.2 0 0 0 0 0 0 0 0 0 0 0 0 0 10233.2 0 0 0 1101370792 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3669.68 0 0 0 0 0 0 0 0 0 0 0 0 0 3669.68 0 0 0 1101370817 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 12226.02 0 0 0 0 0 0 0 0 0 0 0 0 0 12226.02 0 0 0 1101370835 1164713129 40 Federally Qualified Health Centers ERIE AMUNDSEN SCHOOL BASED 606251317 200 Cook 0 1 0 6 235 0 205 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 1473 0 705 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 1473 0 705 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 94532.08 0 28787.57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123370.65 0 0 0 1101370836 91 Waiver service provider--Adults (DHS/DDD) 65 Madison 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 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21527 0 0 0 0 0 0 0 0 0 0 0 0 0 21527 0 0 0 1101370843 92 Waiver service provider--Disability (DHS/DRS) 40 Grundy 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15995.98 0 0 0 0 0 0 0 0 0 0 0 0 0 15995.98 0 0 0 1101370844 10 Physicians 852 Wisconsin 0 0 Internal Medicine 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 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 0 0 0 0 0 0 0 0 0 0 0 1101370874 92 Waiver service provider--Disability (DHS/DRS) 34 Fayette 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 16536.34 0 0 0 0 0 0 0 0 0 0 0 0 0 16536.34 0 0 0 1101370879 1588856405 10 Physicians HARRIS KEVIN 606114264 200 Cook 0 0 Physical Medicine/Rehabilitation 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 0 0 0 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 298.48 0 0 0 0 0 0 298.48 0 0 0 1101370883 1740221126 10 Physicians HISER CHRISTY 604355662 107 Will 0 0 Surgery General 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 29 0 0 0 0 0 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 95.06 0 0 0 0 0 0 95.06 0 0 0 1101370905 1124045406 60 Pharmacies WAL MART PHARMACY 10 0481 619389044 24 Coles 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2276 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24297 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 629716 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1066334.33 0 0 0 1066334.33 0 0 0 1101370913 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 18061.32 0 0 0 0 0 0 0 0 0 0 0 0 0 18061.32 0 0 0 1101370915 1477579712 10 Physicians DANIELE ALICE 605064356 53 Kane 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 178 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 178 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 867.86 0 0 0 0 0 0 867.86 0 0 0 1101370917 1306067657 24 Speech Therapists KNIGHT IRENE 629181988 108 Williamson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 549 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 549 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41231.01 41231.01 0 0 0 1101370919 1518972769 60 Pharmacies BOND DRUG COMPANY OF IL 02840 606405416 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 811 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3623 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90438 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 189766.52 0 0 0 189766.52 0 0 0 1101370925 1043374168 70 Ambulance Service Providers WEST FRANKFORT FIRE DEPT 628962442 36 Franklin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 425 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1332 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1332 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76504.02 0 0 0 0 0 0 76504.02 0 0 0 1101370926 1164464350 60 Pharmacies CVS PHARMACY 08530 611114353 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 328 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1652 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41946 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63949.64 0 0 0 63949.64 0 0 0 1101370929 1891734257 10 Physicians ALNATOUR MOURAD 625264163 63 Macon 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8735.45 0 0 0 0 0 0 8735.45 0 0 0 1101370936 1508845512 10 Physicians CARPENTER GARY B 623014038 10 Adams 0 0 Allergy-Immunization 0 0 0 0 2 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 554 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 554 0 0 0 0 0 0 0 0 0 12.8 0 0 0 0 0 0 0 0 8538.18 0 0 0 0 0 0 8550.98 0 0 0 1101370939 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 234 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 234 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20204.5 0 0 0 0 0 0 0 0 0 0 0 0 0 20204.5 0 0 0 1101370942 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 24744.71 0 0 0 0 0 0 0 0 0 0 0 0 0 24744.71 0 0 0 1101370960 10 Physicians 30 DuPage 0 0 Dermatology 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 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 0 0 0 0 0 0 0 0 0 0 0 1101370966 1316965569 10 Physicians CIEMINS JOHN 606313717 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 481 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 635 0 247 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 635 0 247 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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18456602.43 0 0 0 1101372987 1760524441 14 Chiropractors RUBRIGHT CHARLES 629484112 108 Williamson 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 0 251 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 251 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1191.14 0 0 0 0 0 0 1191.14 0 0 0 1101373002 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 31604.15 0 0 0 0 0 0 0 0 0 0 0 0 0 31604.15 0 0 0 1101373012 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3289 0 0 0 0 0 0 0 0 0 0 0 0 0 3289 0 0 0 1101373013 30 General Hospitals 844 Tennessee NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 84.12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84.12 0 0 0 1101373018 1912900192 30 General Hospitals FOX VALLEY DIALYSIS LTD 605045502 30 DuPage DIALYSIS Outpatient dialysis centers. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3829 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 206849.75 0 0 0 0 0 206849.75 0 0 0 1101373024 1164686812 10 Physicians KENT TIFFANY 601783103 27 Dekalb 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 0 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10580.73 0 0 0 0 0 0 10580.73 0 0 0 1101373028 1679692933 10 Physicians PINTO NEETHI 605276686 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 85 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 0 0 0 0 0 0 0 0 0 0 0 0 295 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30523.87 0 0 0 0 0 0 30523.87 0 0 0 1101373030 1780695239 10 Physicians VETTIANKAL GIJO 606123723 200 Cook 0 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0 0 0 0 0 0 251 0 0 0 0 0 0 0 0 0 0 0 25723.65 0 0 0 0 0 0 25974.65 0 0 0 1101373067 1083621544 10 Physicians BULL DOUGLAS 618203909 19 Champaign 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1094.28 0 0 0 0 0 0 1094.28 0 0 0 1101373073 1326212085 10 Physicians RICE SARAH 553722850 824 Minnesota 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 1 0 605 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 687 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 687 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22552.05 0 0 0 0 0 0 22552.05 0 0 0 1101373075 1306086673 16 Nurse Practitioners MALONEY REBEKAH 606143363 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 186.63 0 0 0 0 0 0 186.63 0 0 0 1101373096 1265525729 10 Physicians OTTOLIN MARK 605407430 30 DuPage 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 42 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 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 867.34 0 0 0 0 0 0 867.34 0 0 0 1101373101 1063430783 10 Physicians WIEDMANN MARGARET A 606313222 200 Cook 0 1 Family Practice 0 87 0 0 70 0 0 0 0 0 0 0 0 124 0 0 0 0 0 0 620 0 0 172 0 0 0 0 0 0 0 0 181 0 0 0 0 0 0 620 0 0 172 0 0 0 0 0 0 0 0 181 0 0 0 0 0 0 1436 0 0 6298.03 0 0 0 0 0 0 0 0 8896.01 0 0 0 0 0 0 16630.04 0 0 0 1101373102 1023065984 10 Physicians INDYK ANDRZEJ 606303151 200 Cook 0 1 Family Practice 0 92 0 0 25 0 0 0 0 0 0 1 0 84 0 0 0 0 0 0 382 0 0 72 0 0 0 0 0 0 1 0 366 0 0 0 0 0 0 382 0 0 72 0 0 0 0 0 0 1 0 366 0 0 0 0 0 0 919 0 0 2772.4 0 0 0 0 0 0 1.68 0 5116.47 0 0 0 0 0 0 8809.55 0 0 0 1101373107 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 19 0 0 0 0 0 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 17196.72 0 0 0 0 0 0 0 0 0 0 0 0 0 17196.72 0 0 0 1101373122 1184715062 10 Physicians KHALID MUHIYUDDIN 622691953 96 St Clair 0 1 Internal Medicine 0 10 0 0 0 0 0 0 0 0 0 7 0 67 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 11 0 463 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 11 0 463 0 0 0 0 0 0 279 0 0 0 0 0 0 0 0 0 112.51 0 3495.23 0 0 0 0 0 0 3886.74 0 0 0 1101373124 1104819697 10 Physicians KAVANAUGH KENNETH 605482178 27 Dekalb 0 1 Family Practice 0 142 0 0 25 0 0 0 0 0 0 28 0 207 0 0 0 0 0 0 1233 0 0 32 0 0 0 0 0 0 63 0 468 0 0 0 0 0 0 1233 0 0 32 0 0 0 0 0 0 63 0 468 0 0 0 0 0 0 3101 0 0 2435.78 0 0 0 0 0 0 218.21 0 21090.59 0 0 0 0 0 0 26845.58 0 0 0 1101373126 1356320238 10 Physicians BOBBA KUMAR 612541091 45 Henry 0 0 Internal Medicine 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 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165.86 0 0 0 0 0 0 165.86 0 0 0 1101373129 92 Waiver service provider--Disability (DHS/DRS) 106 Whiteside 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 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10252.35 0 0 0 0 0 0 0 0 0 0 0 0 0 10252.35 0 0 0 1101373144 1326266107 10 Physicians WOOD CATHERINE 600084506 200 Cook 0 1 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 3 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2.18 0 495.3 0 0 0 0 0 0 497.48 0 0 0 1101373147 1770596124 10 Physicians LUAN EDWARD 616148300 80 Peoria 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 1 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35.95 0 2170.14 0 0 0 0 0 0 2206.09 0 0 0 1101373152 91 Waiver service provider--Adults (DHS/DDD) 19 Champaign 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 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9780.08 0 0 0 0 0 0 0 0 0 0 0 0 0 9780.08 0 0 0 1101373156 92 Waiver service provider--Disability (DHS/DRS) 53 Kane 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 15573.92 0 0 0 0 0 0 0 0 0 0 0 0 0 15573.92 0 0 0 1101373165 1184641441 60 Pharmacies WAL MART 10 0792 612319400 74 Mercer 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 569 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3932 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 92516 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 142757.07 0 0 0 142757.07 0 0 0 1101373169 1912052804 70 Ambulance Service Providers OAKWOOD EMERGENCY RESCUE SERV 618580031 100 Vermilion 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9205.09 0 0 0 0 0 0 9205.09 0 0 0 1101373178 1154331965 63 Other Providers of Medical Equipment/Supplies (Non-registered) APRIA HEALTHCARE 528061344 816 Iowa 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 415 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 415 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31943.05 0 0 0 0 0 0 31943.05 0 0 0 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1093928483 10 Physicians DHARMARAJAN SEKHAR 631101010 826 Missouri 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3693.53 0 0 0 0 0 0 3693.53 0 0 0 1101373260 1972672715 10 Physicians SHAH ASHOK C 606131214 33 Effingham 0 1 Family Practice 0 628 0 0 108 0 0 0 0 0 0 84 0 659 0 0 0 0 0 0 4935 0 0 255 0 0 0 0 0 0 168 0 2800 0 0 0 0 0 0 4935 0 0 255 0 0 0 0 0 0 168 0 2800 0 0 0 0 0 0 11856 0 0 6276.81 0 0 0 0 0 0 329.12 0 41429.4 0 0 0 0 0 0 59891.33 0 0 0 1101373264 1235395930 10 Physicians RECHITSKY MICHAEL 600503151 71 McHenry 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 598 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 880 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 880 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13145.15 0 857.91 0 0 0 0 0 0 14003.06 0 0 0 1101373272 2100363690 91 Waiver service provider--Adults (DHS/DDD) "DEVELOPMENTAL FOUNDATIONS, INC" 619207471 24 Coles 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 24347 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24347 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2585766.18 0 0 0 0 0 0 0 0 0 0 0 0 0 2585766.18 0 0 0 1101373277 1932180981 10 Physicians HILD MOSLEY KATHERINE 627949639 91 Sangamon 0 0 Obstetric-Gynecology 0 0 0 0 3 0 0 0 0 0 0 52 0 208 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 104 0 299 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 104 0 299 0 0 0 0 0 0 0 0 0 38.16 0 0 0 0 0 0 2843.37 0 45827.6 0 0 0 0 0 0 48709.13 0 0 0 1101373284 1821077918 16 Nurse Practitioners GASTIGER JEAN 611092206 109 Winnebago 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 110 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 161 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3534.48 0 0 0 0 0 0 3534.48 0 0 0 1101373313 1114062353 10 Physicians QUARTETTI MARIA 606781345 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3853.99 0 0 0 0 0 0 3853.99 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15216.7 0 0 0 0 0 0 0 0 0 0 0 0 0 15216.7 0 0 0 1101373634 92 Waiver service provider--Disability (DHS/DRS) 24 Coles 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 21551.68 0 0 0 0 0 0 0 0 0 0 0 0 0 21551.68 0 0 0 1101373652 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13369.2 0 0 0 0 0 0 0 0 0 0 0 0 0 13369.2 0 0 0 1101373666 1962558593 10 Physicians ROOS KIMBERLY 637034911 826 Missouri 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 24 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2835.06 0 17845.97 0 0 0 0 0 0 20681.03 0 0 0 1101373675 1265651467 10 Physicians CHILES JONATHAN C 631600352 89 Rock Island 0 0 Pediatrics 0 0 0 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service provider--Disability (DHS/DRS) 37 Fulton 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 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 2526.14 0 0 0 0 0 0 0 0 0 0 0 0 0 2526.14 0 0 0 1101373746 1376781880 63 Other Providers of Medical Equipment/Supplies (Non-registered) ALFA MEDICAL SUPPLY INC 601812480 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1012 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1012 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87349.1 0 1415.25 0 0 0 0 88764.35 0 0 0 1101373751 16 Nurse Practitioners 100 Vermilion 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 184.2 0 0 0 0 0 0 184.2 0 0 0 1101373754 92 Waiver service provider--Disability (DHS/DRS) 56 Knox 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 433.87 0 0 0 0 0 0 0 0 0 0 0 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0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3934.18 0 1610.04 0 0 0 0 5544.22 0 0 0 1101373788 1083772248 10 Physicians TUMMALA REKHA 477470001 815 Indiana 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1728.5 0 0 0 0 0 0 1728.5 0 0 0 1101373795 1013959352 16 Nurse Practitioners BENAK KARYN 601181416 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 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 0 330.35 0 0 0 0 0 0 330.35 0 0 0 1101373810 91 Waiver service provider--Adults (DHS/DDD) 97 Stephenson 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 0 343 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 343 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9815.74 0 0 0 0 0 0 0 0 0 0 0 0 0 9815.74 0 0 0 1101373816 1548286859 10 Physicians LUHMANN SCOTT 631101002 826 Missouri 0 0 Orthopedic Surgery 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 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Adult and Child 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 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1650.14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1650.14 0 0 0 1101375370 1023072527 16 Nurse Practitioners WALL LINDA 606033206 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 454 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1903 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1903 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81922.96 0 0 0 0 0 0 81922.96 0 0 0 1101375371 10 Physicians 815 Indiana 0 0 Colon - Rectal Surgery 0 0 0 0 0 0 0 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1377.61 0 0 0 0 0 0 1377.61 0 0 0 1101375373 1639291297 10 Physicians GUERRA MARCO 601233243 53 Kane 0 1 Pediatrics 0 56 0 0 191 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 395 0 0 565 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 395 0 0 565 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 790 0 0 24193.95 0 0 0 0 0 0 0 0 114.68 0 0 0 0 0 0 25098.63 0 0 0 1101375377 92 Waiver service 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0 0 51.36 0 0 0 1101375420 1417942855 10 Physicians CHOON AUNG 476309225 815 Indiana 0 0 Pathology 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 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1629.33 0 0 0 0 0 0 0 0 1629.33 0 0 0 1101375432 2100365850 90 Waiver service provider--Elderly (DOA) VIETNAMESE ASSOCIATION OF ILL 606403004 200 Cook 0 0 0 0 0 0 0 0 236 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34209 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34209 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2349873.16 0 0 0 0 0 0 0 0 0 0 0 0 0 2349873.16 0 0 0 1101375443 1275570061 70 Ambulance Service Providers RIDGE AMBULANCE SERVICE 605381242 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1825 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19717 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19717 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 381131.24 0 0 0 0 0 0 381131.24 0 0 0 1101375444 1235148982 10 Physicians HAMMAD MOHAMMED 606454002 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 161 0 0 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0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 193.36 0 0 0 0 0 0 193.36 0 0 0 1101375978 1245308873 10 Physicians KURKA JENNIFER 605407415 30 DuPage 0 1 Family Practice 0 150 0 0 77 0 0 0 0 0 0 28 0 141 0 0 0 0 0 0 1246 0 0 225 0 0 0 0 0 0 33 0 284 0 0 0 0 0 0 1246 0 0 225 0 0 0 0 0 0 33 0 284 0 0 0 0 0 0 3065 0 0 6822.31 0 0 0 0 0 0 274.89 0 9558.66 0 0 0 0 0 0 19720.86 0 0 0 1101375998 91 Waiver service provider--Adults (DHS/DDD) 30 DuPage 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 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1224 0 0 0 0 0 0 0 0 0 0 0 0 0 1224 0 0 0 1101376004 1760669477 55 Early Intervention Services PUGAL DEMETRA 600562038 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 350 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 350 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35305.58 0 0 0 0 0 0 35305.58 0 0 0 1101376018 1962738021 36 Community mental health provider ONE HOPE UNITED 600468528 57 Lake 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 515 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3955 0 0 515 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3955 0 0 15826.16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156227.85 0 0 172054.01 0 0 0 1101376020 98 Waiver service provider--TBI (DHS/DRS) 17 Carroll 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 14549.23 0 0 0 0 0 0 0 0 0 0 0 0 0 14549.23 0 0 0 1101376026 1720029283 10 Physicians WILLEMSEN REID MARION 616142012 80 Peoria 0 1 Pediatrics 0 24 0 0 42 0 0 0 0 0 0 17 0 54 0 0 0 0 0 0 206 0 0 196 0 0 0 0 0 0 24 0 83 0 0 0 0 0 0 206 0 0 196 0 0 0 0 0 0 24 0 83 0 0 0 0 0 0 412 0 0 5800.98 0 0 0 0 0 0 243.85 0 3445.97 0 0 0 0 0 0 9902.8 0 0 0 1101376033 91 Waiver service provider--Adults (DHS/DDD) 24 Coles 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 0 240 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 240 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22826.65 0 0 0 0 0 0 0 0 0 0 0 0 0 22826.65 0 0 0 1101376037 92 Waiver service provider--Disability (DHS/DRS) 37 Fulton 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 9137.99 0 0 0 0 0 0 0 0 0 0 0 0 0 9137.99 0 0 0 1101376043 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 12591.01 0 0 0 0 0 0 0 0 0 0 0 0 0 12591.01 0 0 0 1101376053 1003996125 10 Physicians GODBOLE MUKUND 614621007 102 Warren 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 403 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 403 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40805.67 0 0 0 0 0 0 40805.67 0 0 0 1101376058 98 Waiver service provider--TBI (DHS/DRS) 109 Winnebago 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4216.64 0 0 0 0 0 0 0 0 0 0 0 0 0 4216.64 0 0 0 1101376067 1811928443 10 Physicians BOSH RONALD 605066222 57 Lake 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 1 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18.72 0 189.61 0 0 0 0 0 0 208.33 0 0 0 1101376077 94 Waiver service provider--Children's support (DHS/DDD) 109 Winnebago 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 0 159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8408.4 0 0 0 0 0 0 0 0 0 0 0 0 0 8408.4 0 0 0 1101376086 1194757831 10 Physicians ANDERS JEREMIAH 616033133 80 Peoria 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 241 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 241 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5600.71 0 0 0 0 0 0 5600.71 0 0 0 1101376089 1346297314 10 Physicians PAIK PETER 606403704 200 Cook 0 0 Internal Medicine 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 0 113 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 0 510.39 0 0 0 0 0 0 510.39 0 0 0 1101376093 1336128222 10 Physicians KOVACH MARK 612015351 89 Rock Island 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 1 0 391 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 926 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 926 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1.19 0 15492.89 0 0 0 0 0 0 15494.08 0 0 0 1101376094 1568649101 36 Community mental health provider NEW FOUND CTR INC SKOKIE APTS 600772387 200 Cook 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 2906 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1231 0 0 2906 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1231 0 0 38257.82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49570.14 0 0 87827.96 0 0 0 1101376110 1790993160 10 Physicians KARAM MATTHEW 522421009 816 Iowa 0 0 Orthopedic Surgery 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 23 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 0 0 0 0 0 0 0 0 5385.26 0 0 0 0 0 0 5385.26 0 0 0 1101376116 1649573460 60 Pharmacies MORRIS PHARMACY 604508854 40 Grundy 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 491 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12721 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49461.11 0 0 0 49461.11 0 0 0 1101376123 1497753875 70 Ambulance Service Providers CITY OF COLLINSVILLE EMERG SER 622342707 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 417 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 417 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11024.52 0 0 0 0 0 0 11024.52 0 0 0 1101376130 1700096781 23 Occupational Therapists BALLAK DONNA 604355271 107 Will 0 0 0 0 0 0 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 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 4342.04 4342.04 0 0 0 1101376149 1770617862 10 Physicians MARTINO ANTHONY 601603930 200 Cook 0 1 Internal Medicine 0 16 0 0 0 0 0 0 0 0 0 1 0 57 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 1 0 326 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 1 0 326 0 0 0 0 0 0 112 0 0 0 0 0 0 0 0 0 1.72 0 3054.85 0 0 0 0 0 0 3168.57 0 0 0 1101376159 1235254087 10 Physicians ROPER KEITH 606493954 200 Cook 0 0 Thoracic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4940.77 0 0 0 0 0 0 4940.77 0 0 0 1101376164 1497965131 11 Dentists ATTARI KATAYOUN 606301761 200 Cook 0 0 General Dentistry 0 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 625 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 625 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17637.19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17637.19 0 0 0 1101376167 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 8556.5 0 0 0 0 0 0 0 0 0 0 0 0 0 8556.5 0 0 0 1101376175 36 Community mental health provider 71 McHenry 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165 0 0 33.3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14131.66 0 0 14164.96 0 0 0 1101376176 1710002910 10 Physicians CIABURRI DANIEL 616151941 80 Peoria 0 0 Thoracic Surgery 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 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24483.32 0 0 0 0 0 0 24483.32 0 0 0 1101376181 1366644825 47 Local Education Agencies BATAVIA SCH DIST 101 605101948 53 Kane 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 256 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 11192 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 11192 0 0 0 0 579.53 0 0 0 0 0 0 0 0 0 0 0 0 0 256899.6 0 257479.13 0 0 0 1101376184 1811932254 10 Physicians PERLOW TAMAR 600681005 200 Cook 0 1 Family Practice 0 52 0 0 46 0 0 0 0 0 0 31 0 175 0 0 0 0 0 0 484 0 0 92 0 0 0 0 0 0 41 0 265 0 0 0 0 0 0 484 0 0 92 0 0 0 0 0 0 41 0 265 0 0 0 0 0 0 1199 0 0 3254.06 0 0 0 0 0 0 191.33 0 8319.22 0 0 0 0 0 0 12963.61 0 0 0 1101376195 1720114788 55 Early Intervention Services ARCHWAY INC CFC 24 629031180 47 Jackson 0 0 0 317 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1792 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1792 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 206107.33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 206107.33 0 0 0 1101376197 94 Waiver service provider--Children's support (DHS/DDD) 107 Will 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 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6735.65 0 0 0 0 0 0 0 0 0 0 0 0 0 6735.65 0 0 0 1101376198 1497882799 30 General Hospitals RICHLAND MEMORIAL HOSPITAL 624502598 88 Richland DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 0 0 0 0 48 0 0 0 0 0 0 2422 0 0 810 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 16401 0 0 3767 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 16401 0 0 3767 0 0 0 0 0 0 0 0 471.11 0 0 0 0 0 0 146764.79 0 0 305585.78 0 0 0 0 0 452821.68 0 0 0 1101376206 1366608770 10 Physicians FRANCIS SERENE 601892039 30 DuPage 0 0 Rheumatology 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4445.47 0 0 0 0 0 0 4445.47 0 0 0 1101376218 1669673869 10 Physicians BRIES ANDREW 527227565 816 Iowa 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 14 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 425.95 0 2165.16 0 0 0 0 0 0 2591.11 0 0 0 1101376228 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13864.63 0 0 0 0 0 0 0 0 0 0 0 0 0 13864.63 0 0 0 1101376230 1255586665 60 Pharmacies K AND K PHARMACY 606372366 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 482 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5055 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 126294 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 124762.43 0 0 0 124762.43 0 0 0 1101376236 1336366087 10 Physicians PURI VARUN 631101010 826 Missouri 0 0 Cardiovascular Diseases 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 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5268.94 0 0 0 0 0 0 5268.94 0 0 0 1101376238 1619944048 10 Physicians SCHRIER JAMES 612656812 89 Rock Island 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 178 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 178 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10289.29 0 0 0 0 0 0 10289.29 0 0 0 1101376246 1174627269 10 Physicians OBREGON JACINTO 611075076 109 Winnebago 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2025.48 0 0 0 0 0 0 2025.48 0 0 0 1101376249 91 Waiver service provider--Adults (DHS/DDD) 80 Peoria 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 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17120.5 0 0 0 0 0 0 0 0 0 0 0 0 0 17120.5 0 0 0 1101376255 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 2530.63 0 0 0 0 0 0 0 0 0 0 0 0 0 2530.63 0 0 0 1101376267 10 Physicians 200 Cook 0 0 Family Practice 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 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 241.25 0 0 0 0 0 0 241.25 0 0 0 1101376270 10 Physicians 818 Kentucky 0 0 Cardiovascular Diseases 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115.9 0 0 0 0 0 0 115.9 0 0 0 1101376275 92 Waiver service provider--Disability (DHS/DRS) 11 Alexander 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 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 7129.36 0 0 0 0 0 0 0 0 0 0 0 0 0 7129.36 0 0 0 1101376278 1457303943 10 Physicians EWELL KIMBALL 629461272 90 Saline 0 1 Family Practice 0 199 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 659 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 659 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 1732 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1732 0 0 0 1101376287 10 Physicians 852 Wisconsin 0 0 Ophthalmology 0 0 0 0 0 0 0 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104.55 0 0 0 0 0 0 104.55 0 0 0 1101376303 1174822266 33 Nursing Facilities PARKER NURSING AND REHAB CTR 613641216 58 La Salle 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 651 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17037 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1899826.19 0 0 0 0 0 0 0 1899826.19 0 0 0 1101376305 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 17985.43 0 0 0 0 0 0 0 0 0 0 0 0 0 17985.43 0 0 0 1101376314 1346253630 10 Physicians BERNAL ALEJANDRO 613541231 58 La Salle 0 1 Family Practice 0 268 0 0 83 0 0 0 0 0 0 262 0 929 0 0 0 0 0 0 2333 0 0 126 0 0 0 0 0 0 291 0 1577 0 0 0 0 0 0 2333 0 0 126 0 0 0 0 0 0 291 0 1577 0 0 0 0 0 0 6588 0 0 6011.94 0 0 0 0 0 0 2633.94 0 60572.48 0 0 0 0 0 0 75806.36 0 0 0 1101376322 1306015805 47 Local Education Agencies GALATIA CU SCHOOL DIST 1 629350097 90 Saline 0 0 0 0 0 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 150 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 819 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 819 0 0 0 0 999.46 0 0 0 0 0 0 0 0 0 0 0 0 0 8785.96 0 9785.42 0 0 0 1101376325 92 Waiver service provider--Disability (DHS/DRS) 49 Jefferson 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5539.8 0 0 0 0 0 0 0 0 0 0 0 0 0 5539.8 0 0 0 1101376333 10 Physicians 844 Tennessee 0 0 Pediatric Cardiology 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 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 0 281.61 0 0 0 0 0 0 281.61 0 0 0 1101376335 92 Waiver service provider--Disability (DHS/DRS) 91 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 4096.05 0 0 0 0 0 0 0 0 0 0 0 0 0 4096.05 0 0 0 1101376337 1750582714 47 Local Education Agencies RIVERSIDE SCHOOL DIST 96 605461974 200 Cook 0 0 0 0 0 0 163 0 0 0 0 0 0 0 0 0 0 0 0 0 167 0 0 0 0 291 0 0 0 0 0 0 0 0 0 0 0 0 0 5408 0 0 0 0 291 0 0 0 0 0 0 0 0 0 0 0 0 0 5408 0 0 0 0 1957.8 0 0 0 0 0 0 0 0 0 0 0 0 0 76602.38 0 78560.18 0 0 0 1101376341 1912931932 10 Physicians JACOBS EL JAMIL 605064356 53 Kane 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 1 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23.65 0 5278.95 0 0 0 0 0 0 5302.6 0 0 0 1101376346 1861418691 10 Physicians TAMURA RALPH 606113056 200 Cook 0 0 Obstetric-Gynecology 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0 0 0 312 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48787.2 0 0 0 0 0 0 0 0 0 0 0 0 0 48787.2 0 0 0 1101376429 1407893787 70 Ambulance Service Providers VILLAGE OF FARINA FAYETTE COUN 628381282 34 Fayette 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3393.79 0 0 0 0 0 0 3393.79 0 0 0 1101376437 1558666214 10 Physicians BISHOP MICHAEL 605277594 30 DuPage 0 0 Hematology 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 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2979.18 0 0 0 0 0 0 2979.18 0 0 0 1101376445 1811919954 10 Physicians BALFE DENNIS 631600352 826 Missouri 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 254 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 371 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 371 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5749.72 0 363.14 0 0 0 0 0 0 6112.86 0 0 0 1101376447 1164425062 10 Physicians HAMMING NANCY A 600313300 57 Lake 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 0 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 265 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 265 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7288.89 0 0 0 0 0 0 7288.89 0 0 0 1101376462 1962481861 63 Other Providers of Medical Equipment/Supplies (Non-registered) ORA ORTHOPEDICS PC 612656152 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73.69 0 2441.99 0 0 0 0 2515.68 0 0 0 1101376466 1952387987 10 Physicians CHANDLER BRUCE 617612281 72 McLean 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5562.96 0 0 0 0 0 0 5562.96 0 0 0 1101376486 1245439124 10 Physicians BROOKS CYNTHIA 601374464 30 DuPage 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 44 0 163 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 345 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 345 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 630.13 0 3656.69 0 0 0 0 0 0 4286.82 0 0 0 1101376496 1891805099 10 Physicians BYERS DOUGLAS M 620491912 76 Montgomery 0 0 Family Practice 0 0 0 0 3 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 406.43 0 0 0 0 0 0 0 0 4332.99 0 0 0 0 0 0 4739.42 0 0 0 1101376511 1154599884 75 Department of Alcohol and Substance Abuse Provider COMMUNITY RESOURCE CTR CARLYLE 622311803 23 Clinton 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8966.6 0 0 8966.6 0 0 0 1101376526 1255375887 10 Physicians BARAKAT ROUBA 605172665 30 DuPage 0 1 Pediatrics 0 739 0 0 539 0 0 0 0 0 0 0 0 578 0 0 0 0 0 0 6738 0 0 1707 0 0 0 0 0 0 0 0 2426 0 0 0 0 0 0 6738 0 0 1707 0 0 0 0 0 0 0 0 2426 0 0 0 0 0 0 13476 0 0 59374.36 0 0 0 0 0 0 0 0 89252.54 0 0 0 0 0 0 162102.9 0 0 0 1101376539 2100366957 92 Waiver service 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0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 448.36 0 0 0 0 0 0 448.36 0 0 0 1101376560 10 Physicians 815 Indiana 0 0 Neurology Surgery 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56.7 0 0 0 0 0 0 56.7 0 0 0 1101376565 1932259975 10 Physicians RUSCHHAUPT DAVID 604111748 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 368 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 442 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 442 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7487.52 0 0 0 0 0 0 7487.52 0 0 0 1101376575 1437175387 10 Physicians BLAUSTEIN NATE 627690002 91 Sangamon 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 1197 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1374 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1374 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47481.36 0 0 0 0 0 0 47481.36 0 0 0 1101376577 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 358 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 358 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11109.34 0 0 0 0 0 0 0 0 0 0 0 0 0 11109.34 0 0 0 1101376584 1821265554 10 Physicians RAGHAVAN AARTI 606127324 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 207 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 880 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 880 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 333528.52 0 0 0 0 0 0 333528.52 0 0 0 1101376611 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 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 6154.91 0 0 0 0 0 0 0 0 0 0 0 0 0 6154.91 0 0 0 1101376613 1568534147 10 Physicians SAMUELSON MATTHEW 600123711 71 McHenry 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 18 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 382.34 0 4475.74 0 0 0 0 0 0 4858.08 0 0 0 1101376633 1245420173 28 Waiver service provider--Supportive living facility (HFS) PLUM CREEK SUPPORTIVE LIVING 600083808 200 Cook 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 441 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11790 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 739129.69 0 0 0 0 0 0 0 0 0 0 0 0 0 739129.69 0 0 0 1101376645 1518914464 60 Pharmacies OPTION CARE 622862062 87 Randolph 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 858 0 0 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 858 0 0 2999 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36258.57 0 0 23594.43 0 0 0 59853 0 0 0 1101376650 92 Waiver service provider--Disability (DHS/DRS) 47 Jackson 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 3224.47 0 0 0 0 0 0 0 0 0 0 0 0 0 3224.47 0 0 0 1101376670 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14701.5 0 0 0 0 0 0 0 0 0 0 0 0 0 14701.5 0 0 0 1101376671 1114943610 60 Pharmacies STAR MEDICAL RX 641501512 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 1098 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 1098 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2.44 0 0 25843.69 0 0 0 25846.13 0 0 0 1101376696 1225121528 10 Physicians ALPERT JOSHUA 600106812 57 Lake 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 53 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 187 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 187 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1187.06 0 10461.87 0 0 0 0 0 0 11648.93 0 0 0 1101376698 1053348532 30 General Hospitals SHELBY MEMORIAL HOSPITAL 625651838 94 Shelby DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 0 0 0 0 0 1099 0 0 0 0 119 0 0 0 475 0 0 0 0 0 0 0 0 0 1888 0 0 0 0 134 0 0 0 840 0 0 0 0 0 0 0 0 0 1888 0 0 0 0 356 0 0 0 840 0 0 0 0 0 0 0 0 0 213064.28 0 0 0 0 125746.79 0 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0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18292.49 0 0 0 0 0 0 0 0 0 0 0 0 0 18292.49 0 0 0 1101377383 92 Waiver service provider--Disability (DHS/DRS) 19 Champaign 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1353.96 0 0 0 0 0 0 0 0 0 0 0 0 0 1353.96 0 0 0 1101377385 1972544526 10 Physicians GUPTA KANCHAN 627044183 91 Sangamon 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 743 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 914 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 914 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19184.67 0 1273.62 0 0 0 0 0 0 20458.29 0 0 0 1101377392 1720056302 10 Physicians SCHMITZ STEVEN 605151510 30 DuPage 0 1 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 176.4 0 0 0 0 0 0 176.4 0 0 0 1101377394 1497750749 10 Physicians RYAN PAUL 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LENUS 600182110 200 Cook 0 1 Family Practice 0 255 0 0 16 0 0 0 0 0 0 36 0 241 0 0 0 0 0 0 1557 0 0 28 0 0 0 0 0 0 42 0 363 0 0 0 0 0 0 1557 0 0 28 0 0 0 0 0 0 42 0 363 0 0 0 0 0 0 4091 0 0 1599.32 0 0 0 0 0 0 356.56 0 16332.77 0 0 0 0 0 0 22379.65 0 0 0 1101377453 1437123064 10 Physicians DAVIES JOHN J 612656896 89 Rock Island 0 1 Internal Medicine 0 95 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 894 0 0 0 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 894 0 0 0 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 3574 0 0 0 0 0 0 0 0 0 0 0 880.76 0 0 0 0 0 0 4454.76 0 0 0 1101377462 1043479405 10 Physicians ABBOTT SABRA 999999999 200 Cook 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 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1731.5 0 0 0 0 0 0 1731.5 0 0 0 1101377476 1669490132 10 Physicians CARLSON DOUGLAS 631101002 826 Missouri 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 210 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 210 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16413.9 0 0 0 0 0 0 16413.9 0 0 0 1101377485 92 Waiver service provider--Disability (DHS/DRS) 85 Pulaski 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 29112.1 0 0 0 0 0 0 0 0 0 0 0 0 0 29112.1 0 0 0 1101377486 1841460862 10 Physicians NELSON LATASHA 606118709 200 Cook 0 0 Maternal and Fetal Medicine 0 0 0 0 0 0 0 0 0 0 0 312 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 513 0 163 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 513 0 163 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12231.37 0 30110.49 0 0 0 0 0 0 42341.86 0 0 0 1101377495 92 Waiver service provider--Disability (DHS/DRS) 108 Williamson 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 16930.4 0 0 0 0 0 0 0 0 0 0 0 0 0 16930.4 0 0 0 1101377499 1356327514 10 Physicians ENGSTROM C DAVID 600993000 57 Lake 0 1 Family Practice 0 7 0 0 2 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 15 0 0 2 0 0 0 0 0 0 0 0 214 0 0 0 0 0 0 15 0 0 2 0 0 0 0 0 0 0 0 214 0 0 0 0 0 0 43 0 0 83.24 0 0 0 0 0 0 0 0 2595.04 0 0 0 0 0 0 2721.28 0 0 0 1101377526 1275617839 10 Physicians PRENTISS DONALD 605064356 53 Kane 0 0 Family Practice 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 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 1320.31 0 0 0 0 0 0 1320.31 0 0 0 1101377534 1407084759 10 Physicians PEREZ ROBERTO 616370001 80 Peoria 0 0 Pediatric Nephrology 0 0 0 0 0 0 0 0 0 0 0 72 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 480 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 480 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 212.96 0 42423.85 0 0 0 0 0 0 42636.81 0 0 0 1101377535 1982689964 10 Physicians SINGA MADHAVIAH 605611794 30 DuPage 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 284 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 284 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3104.08 0 0 0 0 0 0 3104.08 0 0 0 1101377538 1043228927 10 Physicians PRATHER CHARLENE 631102515 826 Missouri 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3346.87 0 0 0 0 0 0 3346.87 0 0 0 1101377542 1659485977 10 Physicians GALLO MARTIN 606740018 30 DuPage 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 4 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 287.6 0 3841.76 0 0 0 0 0 0 4129.36 0 0 0 1101377544 1689877136 10 Physicians STANCU MIHAELA 616145079 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 207 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 576 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 576 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57.74 0 10610.88 0 0 0 0 0 0 10668.62 0 0 0 1101377548 16 Nurse Practitioners 826 Missouri 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108.33 0 0 0 0 0 0 108.33 0 0 0 1101377549 1477595239 10 Physicians GOLDENBERG BRADLEY 601756354 53 Kane 0 0 Neonatal-Perinatal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4039.02 0 0 0 0 0 0 4039.02 0 0 0 1101377564 1861456022 10 Physicians CHAROUS STEVEN 601533328 200 Cook 0 0 Otorhinolaryngology 0 0 0 0 0 0 0 0 0 0 0 3 0 205 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 438 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 438 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9.44 0 25691.25 0 0 0 0 0 0 25700.69 0 0 0 1101377570 1063454379 70 Ambulance Service Providers MUNDELEIN FIRE DEPARTMENT 600602318 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 303 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 303 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16305.45 0 0 0 0 0 0 16305.45 0 0 0 1101377575 92 Waiver service provider--Disability (DHS/DRS) 55 Kendall 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 7283.4 0 0 0 0 0 0 0 0 0 0 0 0 0 7283.4 0 0 0 1101377576 92 Waiver service provider--Disability (DHS/DRS) 97 Stephenson 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 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 8971.04 0 0 0 0 0 0 0 0 0 0 0 0 0 8971.04 0 0 0 1101377586 1801811773 46 Ambulatory Surgical Treatment Centers DUPAGE EYE SURGERY CENTER LLC 601873152 30 DuPage ASTC Ambulatory Surgical Treatment Center. 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 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19606.25 0 0 0 0 0 19606.25 0 0 0 1101377599 1689875585 47 Local Education Agencies CALUMET CITY SCHOOL DIST 155 604093452 200 Cook 0 0 0 0 0 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 139 0 0 0 0 347 0 0 0 0 0 0 0 0 0 0 0 0 0 2748 0 0 0 0 347 0 0 0 0 0 0 0 0 0 0 0 0 0 2748 0 0 0 0 2024.05 0 0 0 0 0 0 0 0 0 0 0 0 0 48227.29 0 50251.34 0 0 0 1101377610 1124212022 60 Pharmacies UIC OUTPATIENT CARE CNTR PHARM 606124319 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 1258 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 6292 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 199665 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2262.18 0 0 525064.73 0 0 0 527326.91 0 0 0 1101377612 1326124355 16 Nurse Practitioners CHAPMAN MAUREEN 605231557 30 DuPage 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 61 0 0 0 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 1847.57 0 0 0 0 0 0 1847.57 0 0 0 1101377618 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14025 0 0 0 0 0 0 0 0 0 0 0 0 0 14025 0 0 0 1101377627 91 Waiver service provider--Adults (DHS/DDD) 18 Cass 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 0 566.5 0 0 0 0 0 0 0 0 0 0 0 0 0 566.5 0 0 0 1101377632 94 Waiver service provider--Children's support (DHS/DDD) 65 Madison 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 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9198.75 0 0 0 0 0 0 0 0 0 0 0 0 0 9198.75 0 0 0 1101377633 1407082001 11 Dentists DRAHOS PETER 606382312 200 Cook 0 0 General Dentistry 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 189 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 189 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6057.96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6057.96 0 0 0 1101377644 1952373557 30 General Hospitals HOLY CROSS HOSPITAL 606291813 200 Cook DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 0 0 0 0 6 0 0 0 0 0 0 415 0 0 315 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 1197 0 0 628 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 1197 0 0 628 0 0 0 0 0 0 0 0 49.1 0 0 0 0 0 0 14013.46 0 0 37543.15 0 0 0 0 0 51605.71 0 0 0 1101377657 92 Waiver service provider--Disability (DHS/DRS) 56 Knox 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 10873.85 0 0 0 0 0 0 0 0 0 0 0 0 0 10873.85 0 0 0 1101377662 92 Waiver service provider--Disability (DHS/DRS) 89 Rock Island 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 10921.34 0 0 0 0 0 0 0 0 0 0 0 0 0 10921.34 0 0 0 1101377684 92 Waiver service provider--Disability (DHS/DRS) 54 Kankakee 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 5241.42 0 0 0 0 0 0 0 0 0 0 0 0 0 5241.42 0 0 0 1101377687 1467613638 10 Physicians ANBERBER SISSAY ZELEKE 612821899 89 Rock Island 0 1 Pediatrics 0 566 0 0 403 0 0 0 0 0 0 48 0 470 0 0 0 0 0 0 5639 0 0 1771 0 0 0 0 0 0 54 0 1062 0 0 0 0 0 0 5639 0 0 1771 0 0 0 0 0 0 54 0 1062 0 0 0 0 0 0 11278 0 0 48695.78 0 0 0 0 0 0 700.69 0 54682.99 0 0 0 0 0 0 115357.46 0 0 0 1101377702 1972576510 10 Physicians BRYAN KATHRYN 477140508 815 Indiana 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 4 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 195.12 0 609.61 0 0 0 0 0 0 804.73 0 0 0 1101377704 1871615419 10 Physicians ROSSELSON MARIA 600355613 57 Lake 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 17 0 223 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 534 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 534 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103.54 0 18012.02 0 0 0 0 0 0 18115.56 0 0 0 1101377705 2100368123 91 Waiver service provider--Adults (DHS/DDD) REHABIL & VOC ED. 629061237 99 Union 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 14893 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14893 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1172684.53 0 0 0 0 0 0 0 0 0 0 0 0 0 1172684.53 0 0 0 1101377711 1386764884 10 Physicians KANG YONG 605401110 30 DuPage 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 631 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 737 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 737 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29511.05 0 0 0 0 0 0 29511.05 0 0 0 1101377717 1407872831 70 Ambulance Service Providers COUNTRYSIDE FIRE PROT DIST 600611804 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 453 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 453 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15622.57 0 0 0 0 0 0 15622.57 0 0 0 1101377722 1063630804 63 Other Providers of Medical Equipment/Supplies (Non-registered) HEARING AIDS SERVICES 600763117 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1584 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9210 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9210 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 565033.15 0 0 0 0 0 0 565033.15 0 0 0 1101377725 1033140553 10 Physicians GREEN JONATHAN 631082212 826 Missouri 0 0 Pulmonary Diseases 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 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1287.07 0 0 0 0 0 0 1287.07 0 0 0 1101377730 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HOSPITAL 480736769 823 Michigan NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 6 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 6 0 0 0 0 1 0 0 0 4 0 0 0 0 0 0 0 0 0 6 0 0 0 0 3 0 0 0 4 0 0 0 0 0 0 0 0 0 636.88 0 0 0 0 1934.43 0 0 0 4712.38 0 0 0 0 0 7283.69 0 0 0 1101378434 1154366706 10 Physicians HALEEM AZEEM 605481394 27 Dekalb 0 0 Urology 0 0 0 0 0 0 0 0 0 0 0 8 0 153 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 408 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 408 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 226.24 0 18692.16 0 0 0 0 0 0 18918.4 0 0 0 1101378436 1801823059 16 Nurse Practitioners PIPER ANNA 604501463 40 Grundy 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 592 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 959 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 959 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23548.87 0 0 0 0 0 0 23548.87 0 0 0 1101378454 1629321161 16 Nurse Practitioners COMOLA GILBERT 631101010 826 Missouri 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 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601812610 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 326 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 326 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16783 0 0 0 0 0 0 16783 0 0 0 1101379069 1881823839 16 Nurse Practitioners SCROGGINS VIRGINIA 620023931 65 Madison 0 0 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 23 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 0 0 0 0 0 0 0 0 487.35 0 0 0 0 0 0 487.35 0 0 0 1101379070 1467568345 10 Physicians JONES MONAHAN KELLIE 619389258 24 Coles 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 199 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 533 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 533 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42454.13 0 0 0 0 0 0 42454.13 0 0 0 1101379082 92 Waiver service provider--Disability (DHS/DRS) 103 Washington 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22854.38 0 0 0 0 0 0 0 0 0 0 0 0 0 22854.38 0 0 0 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Hospitals FRESENIUS MEDICAL CARE WEST WI 606421524 200 Cook DIALYSIS Outpatient dialysis centers. 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1606 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34013.67 0 0 0 0 0 34013.67 0 0 0 1101379444 1962659011 10 Physicians BROWN BEVERLY 606116649 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 390 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 713 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 713 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19136.02 0 0 0 0 0 0 19136.02 0 0 0 1101379445 16 Nurse Practitioners 826 Missouri 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 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 0 0 0 0 0 0 0 0 0 0 0 1101379449 92 Waiver service provider--Disability (DHS/DRS) 52 Johnson 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 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403 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 630 12503.31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13133.31 0 0 0 1101379469 1356451546 10 Physicians SOUFAN BASSAM 611033669 109 Winnebago 0 1 Family Practice 0 101 0 0 39 0 0 0 0 0 0 30 0 323 0 0 0 0 0 0 811 0 0 130 0 0 0 0 0 0 31 0 635 0 0 0 0 0 0 811 0 0 130 0 0 0 0 0 0 31 0 635 0 0 0 0 0 0 1876 0 0 4477.35 0 0 0 0 0 0 253.49 0 26234.13 0 0 0 0 0 0 32840.97 0 0 0 1101379471 1619186608 55 Early Intervention Services JAWORSKI KERI 605865006 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 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 2030.86 0 0 0 0 0 0 2030.86 0 0 0 1101379477 1609853985 10 Physicians CHANG SUNG 600992676 57 Lake 0 0 Radiology Therapeutic 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1309.67 0 0 0 0 0 0 1309.67 0 0 0 1101379483 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 236 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 236 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18672.5 0 0 0 0 0 0 0 0 0 0 0 0 0 18672.5 0 0 0 1101379488 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 0 257 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 257 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15543 0 0 0 0 0 0 0 0 0 0 0 0 0 15543 0 0 0 1101379498 1477636595 11 Dentists SONG DANIEL 600053401 200 Cook 0 0 General Dentistry 0 0 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 469 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 469 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26042.13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26042.13 0 0 0 1101379500 1922190024 50 Home Health Agencies - In Home LINCOLNLAND HOME CARE OF SBL 619389253 24 Coles 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2412 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2412 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 170767.08 0 0 0 0 0 0 170767.08 0 0 0 1101379502 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16553.61 0 0 0 0 0 0 0 0 0 0 0 0 0 16553.61 0 0 0 1101379525 1013235092 14 Chiropractors KATHALYNAS RYAN 628962037 36 Franklin 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 0 170 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 170 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1336.07 0 0 0 0 0 0 1336.07 0 0 0 1101379533 12 Optometrists 53 Kane 0 0 Therapeutic Pharmaceutical Agents 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 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 60.06 0 0 0 0 0 0 60.06 0 0 0 1101379568 92 Waiver service provider--Disability (DHS/DRS) 100 Vermilion 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 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 2240.38 0 0 0 0 0 0 0 0 0 0 0 0 0 2240.38 0 0 0 1101379569 92 Waiver service provider--Disability (DHS/DRS) 98 Tazewell 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 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 1005.93 0 0 0 0 0 0 0 0 0 0 0 0 0 1005.93 0 0 0 1101379579 1134381205 10 Physicians VASAIWALA SMIT 601533328 200 Cook 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 311 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 311 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10119.24 0 0 0 0 0 0 10119.24 0 0 0 1101379593 1457393985 63 Other Providers of Medical Equipment/Supplies (Non-registered) PREMIER MEDICAL PRODUCTS INC 605632948 30 DuPage 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 0 141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2209.99 0 0 0 0 0 0 2209.99 0 0 0 1101379616 1871581314 30 General Hospitals MT SINAI HOSP MED CTR CHICAGO 606081704 200 Cook DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 0 0 0 0 870 0 0 0 0 0 0 7190 0 0 1206 0 0 0 0 0 0 0 0 901 0 0 0 0 0 0 37011 0 0 2915 0 0 0 0 0 0 0 0 901 0 0 0 0 0 0 37011 0 0 2915 0 0 0 0 0 0 0 0 5501.02 0 0 0 0 0 0 456758.92 0 0 832887.26 0 0 0 0 0 1295147.2 0 0 0 1101379618 92 Waiver service provider--Disability (DHS/DRS) 107 Will 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6697.06 0 0 0 0 0 0 0 0 0 0 0 0 0 6697.06 0 0 0 1101379621 60 Pharmacies 852 Wisconsin 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14.61 0 0 0 14.61 0 0 0 1101379636 1649259201 10 Physicians MOORE JOHN 625264163 63 Macon 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 173 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17806.69 0 0 0 0 0 0 17806.69 0 0 0 1101379652 1235245358 10 Physicians PITTERMAN DANIEL 600267723 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 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 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3761.29 0 0 0 0 0 0 3761.29 0 0 0 1101379656 1316057557 10 Physicians BECKERT JOHN 634451701 826 Missouri 0 1 General Practice 0 10 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 238 0 0 0 0 0 0 0 0 0 0 0 151.89 0 0 0 0 0 0 389.89 0 0 0 1101379672 1609903111 34 State-operated facility (DHS) UNIT 3170 HOME 10 KILEY 600856263 57 Lake 0 0 0 0 0 0 0 0 0 0 0 8 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 0 720 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 536034.8 0 0 0 0 0 0 0 0 0 0 536034.8 0 0 0 1101379683 1093741340 60 Pharmacies SCHNUCKS PHARMACY 239 622052322 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 415 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9842 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 391 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 391 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10793.64 0 0 0 0 0 0 10793.64 0 0 0 1101380185 1366535528 12 Optometrists ALLES MARK 604353103 107 Will 0 0 Therapeutic Pharmaceutical Agents 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61.97 0 0 0 0 0 0 61.97 0 0 0 1101380188 1750410601 24 Speech Therapists PATNOUDES JESSICA 604679451 200 Cook 0 0 0 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 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5685.18 5685.18 0 0 0 1101380190 2100370608 94 Waiver service provider--Children's support (DHS/DDD) NEW HORIZON CENTER FOR THE DEV 606341470 200 Cook 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 0 301 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 301 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14563.64 0 0 0 0 0 0 0 0 0 0 0 0 0 14563.64 0 0 0 1101380211 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0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 900 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 571020 0 0 0 0 0 0 0 0 0 0 571020 0 0 0 1101380318 1700824679 22 Physical Therapists SCHMIDT PAUL 600352361 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 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 0 448.54 448.54 0 0 0 1101380321 1194993956 13 Podiatrists ROSS BRADLEY 607122234 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 278.8 0 0 0 0 0 0 278.8 0 0 0 1101380324 1093829566 10 Physicians DANZIGER ROBERT 606127232 200 Cook 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 756.04 0 0 0 0 0 0 756.04 0 0 0 1101380336 1306824511 10 Physicians DIXIT PARESH 601783192 27 Dekalb 0 0 Radiology Diagnosis 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103B SHAPIRO 609015018 54 Kankakee 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1980 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1325805.55 0 0 0 0 0 0 0 0 0 0 1325805.55 0 0 0 1101380456 1790724540 10 Physicians VIJAYAKUMAR ASHA NAIR 601734761 200 Cook 0 1 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 9 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49.27 0 1644.47 0 0 0 0 0 0 1693.74 0 0 0 1101380460 1548290349 10 Physicians PUPPALA BHAGYALAKSHMI 600681005 200 Cook 0 0 Neonatology 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 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 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7592.11 0 0 0 0 0 0 7592.11 0 0 0 1101380469 1437379435 10 Physicians LICHON FRANCIS 601882795 30 DuPage 0 0 Rheumatology 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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Salle 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88 0 0 2685 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88 0 0 68960 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3449.03 0 0 133808.78 0 0 0 137257.81 0 0 0 1101380625 1477545937 10 Physicians RICHARDS KEN 606173983 200 Cook 0 0 Endocrinology 0 0 0 0 0 0 0 0 0 0 0 0 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 235 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 235 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15694.79 0 0 0 0 0 0 15694.79 0 0 0 1101380634 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 15235.53 0 0 0 0 0 0 0 0 0 0 0 0 0 15235.53 0 0 0 1101380642 1548531403 33 Nursing Facilities WEST CHICAGO TERRACE NH 601853725 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 625 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11946 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1037148.87 0 0 0 0 0 0 0 1037148.87 0 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a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 389 0 0 0 0 41 0 0 0 17 0 0 0 0 0 0 0 0 0 576 0 0 0 0 44 0 0 0 21 0 0 0 0 0 0 0 0 0 577 0 0 0 0 201 0 0 0 21 0 0 0 0 0 0 0 0 0 142858.67 0 0 0 0 129088.87 0 0 0 8942.66 0 0 0 0 0 280890.2 0 0 0 1101381238 1073629531 13 Podiatrists OSTER MICHAEL 606342618 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 479 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 479 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6944.9 0 0 0 0 0 0 6944.9 0 0 0 1101381241 1194742650 10 Physicians TOBIN GARRY S 631101010 826 Missouri 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 11 0 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6.65 0 1879.13 0 0 0 0 0 0 1885.78 0 0 0 1101381246 92 Waiver service provider--Disability (DHS/DRS) 63 Macon 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 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0 0 0 1101382251 1982629382 10 Physicians SEGAL LEWIS 606118709 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 1411 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2325 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2325 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13054.33 0 0 0 0 0 0 0 0 13054.33 0 0 0 1101382254 91 Waiver service provider--Adults (DHS/DDD) 30 DuPage 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 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16256.24 0 0 0 0 0 0 0 0 0 0 0 0 0 16256.24 0 0 0 1101382263 1801058409 10 Physicians ILAHI SHAMS 616034309 80 Peoria 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 353 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 353 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5002.78 0 0 0 0 0 0 5002.78 0 0 0 1101382270 1861433039 10 Physicians HAMB AARON 606123723 200 Cook 0 0 Internal Medicine 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 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 198 0 0 0 0 0 0 198 0 0 0 1101382274 91 Waiver service provider--Adults (DHS/DDD) 107 Will 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 0 315 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 315 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11203.5 0 0 0 0 0 0 0 0 0 0 0 0 0 11203.5 0 0 0 1101382279 10 Physicians 852 Wisconsin 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 186.7 0 18.62 0 0 0 0 0 0 205.32 0 0 0 1101382283 1528018215 10 Physicians SAKS NOEL 600683277 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 238 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 238 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7889.28 0 0 0 0 0 0 7889.28 0 0 0 1101382289 1154495174 22 Physical Therapists DIAB MOHAMED ALAA 604537222 200 Cook 0 0 0 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 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4303.66 4303.66 0 0 0 1101382297 1558346007 30 General Hospitals GIBSON GENERAL HOSPITAL 476701043 815 Indiana NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 15 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 397.97 0 0 129.48 0 0 0 0 0 527.45 0 0 0 1101382309 1386846848 47 Local Education Agencies WEST PRAIRIE CUSD 103 623261129 70 McDonough 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2362 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2362 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40905.9 0 40905.9 0 0 0 1101382311 1457394520 10 Physicians TAYLOR DONALD 606740018 30 DuPage 0 0 Maternal and Fetal Medicine 0 0 0 0 0 0 0 0 0 0 0 33 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2380.39 0 2712.81 0 0 0 0 0 0 5093.2 0 0 0 1101382322 14 Chiropractors 10 Adams 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 14 0 0 0 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 68.9 0 0 0 0 0 0 68.9 0 0 0 1101382326 1013059724 11 Dentists NUNEZ SARA G 606321846 200 Cook 0 0 General Dentistry 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 731.95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 731.95 0 0 0 1101382329 1518062165 33 Nursing Facilities ANNA REHAB AND NURSING CENTER 629062306 99 Union 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 647 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14293 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1201259.33 0 0 0 0 0 0 0 1201259.33 0 0 0 1101382333 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 333 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 333 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24387 0 0 0 0 0 0 0 0 0 0 0 0 0 24387 0 0 0 1101382337 1407065154 10 Physicians EL TAG EIMAN 60508 30 DuPage 0 0 Obstetric-Gynecology 0 103 0 0 14 0 0 0 0 0 0 259 0 449 0 0 0 0 0 0 146 0 0 14 0 0 0 0 0 0 559 0 1493 0 0 0 0 0 0 146 0 0 14 0 0 0 0 0 0 559 0 1493 0 0 0 0 0 0 423 0 0 620.11 0 0 0 0 0 0 25350.71 0 123111.85 0 0 0 0 0 0 149505.67 0 0 0 1101382338 92 Waiver service provider--Disability (DHS/DRS) 77 Morgan 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 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2497.16 0 0 0 0 0 0 0 0 0 0 0 0 0 2497.16 0 0 0 1101382342 91 Waiver service provider--Adults (DHS/DDD) 97 Stephenson 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 0 529 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 529 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24310 0 0 0 0 0 0 0 0 0 0 0 0 0 24310 0 0 0 1101382343 1467560979 10 Physicians JUNGERS JEFFREY 478074209 815 Indiana 0 0 Ophthalmology 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 630.19 0 0 0 0 0 0 630.19 0 0 0 1101382350 1609038579 10 Physicians ARTEMYEVA GALINA 605407430 30 DuPage 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 86 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 0 0 0 0 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4347.41 0 0 0 0 0 0 4347.41 0 0 0 1101382351 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 120 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 0 0 0 0 0 0 0 0 0 0 0 0 21121.65 0 0 0 0 0 0 0 0 0 0 0 0 0 21121.65 0 0 0 1101382362 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17238.43 0 0 0 0 0 0 0 0 0 0 0 0 0 17238.43 0 0 0 1101382365 92 Waiver service provider--Disability (DHS/DRS) 10 Adams 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5042.08 0 0 0 0 0 0 0 0 0 0 0 0 0 5042.08 0 0 0 1101382366 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24345.75 0 0 0 0 0 0 0 0 0 0 0 0 0 24345.75 0 0 0 1101382371 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 40134.13 0 0 0 0 0 0 0 0 0 0 0 0 0 40134.13 0 0 0 1101382374 1467418137 64 Imaging Services EXCELL PORTABLE XRAY SVC INC 601856169 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 321 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 321 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 436.82 0 0 0 0 0 0 0 0 436.82 0 0 0 1101382387 1811982515 12 Optometrists HEDDINGHAUS SHAWNA 620253633 65 Madison 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 850 0 540 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2533 0 579 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2533 0 579 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64657.73 0 16531.72 0 0 0 0 81189.45 0 0 0 1101382390 1912018599 10 Physicians ODESSKY YEVGENY 600772953 200 Cook 0 1 Family Practice 0 762 0 0 37 0 0 0 0 0 0 2 0 219 0 0 0 0 0 0 4557 0 0 43 0 0 0 0 0 0 2 0 952 0 0 0 0 0 0 4557 0 0 43 0 0 0 0 0 0 2 0 952 0 0 0 0 0 0 11916 0 0 3993.06 0 0 0 0 0 0 8 0 16908.14 0 0 0 0 0 0 32825.2 0 0 0 1101382396 1972611234 10 Physicians COHRAN VALERIA 606143363 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 3 0 153 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 459 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 459 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7.03 0 32300.23 0 0 0 0 0 0 32307.26 0 0 0 1101382398 1225108988 63 Other Providers of Medical Equipment/Supplies (Non-registered) HANGER PROSTHETICS ORTHOTICS 420017448 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 420.25 0 14538.43 0 0 0 0 14958.68 0 0 0 1101382405 10 Physicians 826 Missouri 0 0 Cardiovascular Surgery 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 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 54.8 0 0 0 0 0 0 54.8 0 0 0 1101382411 92 Waiver service provider--Disability (DHS/DRS) 47 Jackson 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 14 0 0 0 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 7069.88 0 0 0 0 0 0 0 0 0 0 0 0 0 7069.88 0 0 0 1101382423 1427089119 10 Physicians ATTARIAN HRAYR 603023599 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 171 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 171 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3929.78 0 0 0 0 0 0 3929.78 0 0 0 1101382426 60 Pharmacies 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 126.23 0 0 0 126.23 0 0 0 1101382435 92 Waiver service provider--Disability (DHS/DRS) 72 McLean 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 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 0 476.65 0 0 0 0 0 0 0 0 0 0 0 0 0 476.65 0 0 0 1101382438 1316939994 10 Physicians PELLAR CHIMENE 602011779 200 Cook 0 0 Obstetric-Gynecology 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 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8173.79 0 0 0 0 0 0 8173.79 0 0 0 1101382459 91 Waiver service provider--Adults (DHS/DDD) 83 Pike 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 0 364 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 364 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19181.21 0 0 0 0 0 0 0 0 0 0 0 0 0 19181.21 0 0 0 1101382461 1780678441 10 Physicians PEARCE FRANCINE 604231272 107 Will 0 0 Pediatrics 0 0 0 0 6 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 579.09 0 0 0 0 0 0 0 0 932.69 0 0 0 0 0 0 1511.78 0 0 0 1101382462 92 Waiver service provider--Disability (DHS/DRS) 24 Coles 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 7829.15 0 0 0 0 0 0 0 0 0 0 0 0 0 7829.15 0 0 0 1101382470 1730289224 10 Physicians SCHULTZ MARY 616033103 80 Peoria 0 1 Pediatrics 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 11 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 0 0 0 0 0 0 0 0 23 0 0 0 1101382472 1932376746 10 Physicians ALGHOUL MOHAMMED 606118709 200 Cook 0 0 Plastic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10112.87 0 0 0 0 0 0 10112.87 0 0 0 1101382493 1023072378 10 Physicians WON MIYOUNG 606740018 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 2 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190.37 0 0 0 0 0 0 190.37 0 0 0 1101382494 1790790954 60 Pharmacies BOND DRUG COMPANY OF ILLINOIS 605172854 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 810 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4027 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 92097 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 141305.35 0 0 0 141305.35 0 0 0 1101382502 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 14856.57 0 0 0 0 0 0 0 0 0 0 0 0 0 14856.57 0 0 0 1101382508 1902899313 12 Optometrists MAINO DOMINICK 606164201 200 Cook 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 288 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 548 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 548 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11896.46 0 0 0 0 0 0 11896.46 0 0 0 1101382532 1326222563 16 Nurse Practitioners JOHNSON JOSHUA 629037647 47 Jackson 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1419 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106789.61 106789.61 0 0 0 1101383543 1972511731 10 Physicians KAVIC SUZANNE 601533328 200 Cook 0 0 Obstetric-Gynecology 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 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 0 762.77 0 0 0 0 0 0 762.77 0 0 0 1101383556 92 Waiver service provider--Disability (DHS/DRS) 10 Adams 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 11448.08 0 0 0 0 0 0 0 0 0 0 0 0 0 11448.08 0 0 0 1101383564 1124388624 30 General Hospitals FRESENIUS MEDICAL PLAINFIELD 604322560 107 Will DIALYSIS Outpatient dialysis centers. 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 215 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2568 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26863.21 0 0 0 0 0 26863.21 0 0 0 1101383570 1598917965 12 Optometrists BRAND JASON 611091737 109 Winnebago 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 186 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 351 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 351 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9709.11 0 0 0 0 0 0 9709.11 0 0 0 1101383571 92 Waiver service provider--Disability (DHS/DRS) 30 DuPage 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3071.08 0 0 0 0 0 0 0 0 0 0 0 0 0 3071.08 0 0 0 1101383580 1932107430 10 Physicians MEJICANO RODOLFO 604623165 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 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 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53.33 0 0 0 0 0 0 53.33 0 0 0 1101383589 98 Waiver service provider--TBI (DHS/DRS) 53 Kane 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 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 0 366.1 0 0 0 0 0 0 0 0 0 0 0 0 0 366.1 0 0 0 1101383602 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4887.85 0 0 0 0 0 0 0 0 0 0 0 0 0 4887.85 0 0 0 1101383617 1396707493 10 Physicians SOLARI MARIANA 606118709 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 35 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 538.51 0 1300 0 0 0 0 0 0 1838.51 0 0 0 1101383631 92 Waiver service provider--Disability (DHS/DRS) 54 Kankakee 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 24557.56 0 0 0 0 0 0 0 0 0 0 0 0 0 24557.56 0 0 0 1101383637 1609076835 28 Waiver service provider--Supportive living facility (HFS) HERITAGE WOODS OF WATSEKA 609702000 46 Iroquois 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 411 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10546 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 572572.37 0 0 0 0 0 0 0 0 0 0 0 0 0 572572.37 0 0 0 1101383649 91 Waiver service provider--Adults (DHS/DDD) 89 Rock Island 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 0 196 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 196 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9193.8 0 0 0 0 0 0 0 0 0 0 0 0 0 9193.8 0 0 0 1101383650 1063420248 63 Other Providers of Medical Equipment/Supplies (Non-registered) MCLEAN COUNTY ORTHOPEDICS 617043738 72 McLean 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88.03 0 1964.07 0 0 0 0 2052.1 0 0 0 1101383656 1598732398 10 Physicians RAO MURALIDHARA 601533304 30 DuPage 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 185 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 185 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6600.61 0 0 0 0 0 0 6600.61 0 0 0 1101383680 1396753489 63 Other Providers of Medical Equipment/Supplies (Non-registered) LINCARE INC 637035827 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 844 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 844 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32971.65 0 0 0 0 0 0 32971.65 0 0 0 1101383684 16 Nurse Practitioners 10 Adams 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 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 0 187.37 0 0 0 0 0 0 187.37 0 0 0 1101383686 94 Waiver service provider--Children's support (DHS/DDD) 30 DuPage 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 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 1549.35 0 0 0 0 0 0 0 0 0 0 0 0 0 1549.35 0 0 0 1101383695 1013993336 10 Physicians KARAS TIFFANY 601344205 53 Kane 0 0 Endocrinology 0 0 0 0 0 0 0 0 0 0 0 3 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17.85 0 1352.76 0 0 0 0 0 0 1370.61 0 0 0 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0 0 0 0 0 0 0 0 14.35 0 3583.24 0 0 0 0 0 0 3597.59 0 0 0 1101383764 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 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 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 14028.86 0 0 0 0 0 0 0 0 0 0 0 0 0 14028.86 0 0 0 1101383772 1447261847 10 Physicians MAGANA JOSE 605064356 53 Kane 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 4 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48.34 0 3194.27 0 0 0 0 0 0 3242.61 0 0 0 1101383777 1164609749 10 Physicians HANSON BRITT 600261301 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2190.45 0 0 0 0 0 0 2190.45 0 0 0 1101383794 1124181649 10 Physicians SWEISS NADERA 605276686 30 DuPage 0 0 Rheumatology 0 0 0 0 0 0 0 0 0 0 0 0 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 1101383828 1124041405 60 Pharmacies TARGET PHARMACY T 868 604451458 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 564 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14539 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55219.94 0 0 0 55219.94 0 0 0 1101383830 1285614347 10 Physicians EISENBERG RUSSELL 606344403 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 184 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 205 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 205 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6745.12 0 0 0 0 0 0 6745.12 0 0 0 1101383840 1184864399 10 Physicians HINA FATIMA 478024304 815 Indiana 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 24 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 321 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 321 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1809.2 0 22534.44 0 0 0 0 0 0 24343.64 0 0 0 1101383852 14 Chiropractors 53 Kane 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 52 0 0 0 0 0 0 240 0 0 0 0 0 0 0 0 0 0 0 1127.4 0 0 0 0 0 0 1367.4 0 0 0 1101383900 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9026.59 0 0 0 0 0 0 0 0 0 0 0 0 0 9026.59 0 0 0 1101383901 1346296415 10 Physicians LOPEZ OSVALDO I 606164201 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 15 0 428 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 888 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 888 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 143.14 0 19671.84 0 0 0 0 0 0 19814.98 0 0 0 1101383914 1144491085 10 Physicians BARTLETT ALLISON 606154906 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 178 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 178 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6928.85 0 0 0 0 0 0 6928.85 0 0 0 1101383915 92 Waiver service provider--Disability (DHS/DRS) 57 Lake 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 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 13573.47 0 0 0 0 0 0 0 0 0 0 0 0 0 13573.47 0 0 0 1101383922 1912190968 11 Dentists CUMMINS SHANNON 627041002 91 Sangamon 0 0 General Dentistry 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 994.8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 994.8 0 0 0 1101383943 1548415771 11 Dentists WILBORN HOOD SUSAN 606093013 200 Cook 0 0 Unspecified 0 0 0 727 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3723 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3723 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93820.01 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93820.01 0 0 0 1101383947 91 Waiver service provider--Adults (DHS/DDD) 53 Kane 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 0 312 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 312 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12355.2 0 0 0 0 0 0 0 0 0 0 0 0 0 12355.2 0 0 0 1101383953 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 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 1068.47 0 0 0 0 0 0 0 0 0 0 0 0 0 1068.47 0 0 0 1101383960 1023153525 10 Physicians SLOBODIAN MARIA 603022510 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 700.04 0 0 0 0 0 0 700.04 0 0 0 1101383964 1780640557 10 Physicians MATHEW ABRAHAM 601181454 53 Kane 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 84 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 6828.02 0 0 0 0 0 0 6828.02 0 0 0 1101383973 10 Physicians 200 Cook 0 0 Psychiatry 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38.6 0 0 0 0 0 0 38.6 0 0 0 1101383975 1306962618 10 Physicians ROBBINS CAMARYN 631101010 826 Missouri 0 0 Obstetric-Gynecology 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 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 1626.4 0 0 0 0 0 0 1626.4 0 0 0 1101383976 1376543629 10 Physicians HENDRIX ALAN 475911038 815 Indiana 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 23 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3302.37 0 0 0 0 0 0 3302.37 0 0 0 1101383985 1063417921 13 Podiatrists STORINO WILLIAM 600602304 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 405 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 405 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 683.23 0 0 0 0 0 0 683.23 0 0 0 1101383987 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 9858.99 0 0 0 0 0 0 0 0 0 0 0 0 0 9858.99 0 0 0 1101383992 1699874156 10 Physicians 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Jackson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 712.63 0 0 0 0 0 0 712.63 0 0 0 1101386073 1568572758 10 Physicians NASEER ALIYA 611033619 109 Winnebago 0 0 Endocrinology 0 0 0 0 0 0 0 0 0 0 0 0 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 417 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 417 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10363.21 0 0 0 0 0 0 10363.21 0 0 0 1101386074 1972577658 10 Physicians SANCHEZ MARIO 604532600 200 Cook 0 0 Neonatology 0 0 0 0 0 0 0 0 0 0 0 0 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 593 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 593 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74154.07 0 0 0 0 0 0 74154.07 0 0 0 1101386077 10 Physicians 852 Wisconsin 0 0 Physical Medicine/Rehabilitation 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156.48 0 0 0 0 0 0 156.48 0 0 0 1101386078 92 Waiver service provider--Disability (DHS/DRS) 107 Will 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 27629.21 0 0 0 0 0 0 0 0 0 0 0 0 0 27629.21 0 0 0 1101386083 92 Waiver service provider--Disability (DHS/DRS) 89 Rock Island 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 1498.39 0 0 0 0 0 0 0 0 0 0 0 0 0 1498.39 0 0 0 1101386089 1275719106 10 Physicians GORDON MELANIE 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 129.44 0 0 0 0 0 0 129.44 0 0 0 1101386093 1508807181 10 Physicians FLEMING MARK 629011472 47 Jackson 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 809 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1363 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1363 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 268024.5 0 0 0 0 0 0 268024.5 0 0 0 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(DHS/DDD) 200 Cook 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 0 230 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24171 0 0 0 0 0 0 0 0 0 0 0 0 0 24171 0 0 0 1101386319 93 Waiver service provider--HIV/AIDS (DHS/DRS) 24 Coles 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 13702.3 0 0 0 0 0 0 0 0 0 0 0 0 0 13702.3 0 0 0 1101386331 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 4508.74 0 0 0 0 0 0 0 0 0 0 0 0 0 4508.74 0 0 0 1101386338 91 Waiver service provider--Adults (DHS/DDD) 54 Kankakee 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 0 244 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 244 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5456.88 0 0 0 0 0 0 0 0 0 0 0 0 0 5456.88 0 0 0 1101386356 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 8887.48 0 0 0 0 0 0 0 0 0 0 0 0 0 8887.48 0 0 0 1101386368 1801951967 11 Dentists ORTEGA ROSA 606127210 200 Cook 0 0 General Dentistry 0 0 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 532 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 532 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22226.04 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22226.04 0 0 0 1101386369 92 Waiver service provider--Disability (DHS/DRS) 28 De Witt 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 23074.7 0 0 0 0 0 0 0 0 0 0 0 0 0 23074.7 0 0 0 1101386383 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 1660.3 0 0 0 0 0 0 0 0 0 0 0 0 0 1660.3 0 0 0 1101386385 1851318372 10 Physicians KLEIGER ROBERT E 631082212 826 Missouri 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 217 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 217 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2234.47 0 0 0 0 0 0 2234.47 0 0 0 1101386397 92 Waiver service provider--Disability (DHS/DRS) 107 Will 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 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 17013.96 0 0 0 0 0 0 0 0 0 0 0 0 0 17013.96 0 0 0 1101386416 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15225.75 0 0 0 0 0 0 0 0 0 0 0 0 0 15225.75 0 0 0 1101386421 1487929501 55 Early Intervention Services STEWART LOFTON JANET 604118549 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 330 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 330 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31323.19 0 0 0 0 0 0 31323.19 0 0 0 1101386429 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11813.94 0 0 0 0 0 0 0 0 0 0 0 0 0 11813.94 0 0 0 1101386447 10 Physicians 71 McHenry 0 0 Anesthesiology 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 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 0 112.07 0 0 0 0 0 0 112.07 0 0 0 1101386451 92 Waiver service provider--Disability (DHS/DRS) 64 Macoupin 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 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 2234.91 0 0 0 0 0 0 0 0 0 0 0 0 0 2234.91 0 0 0 1101386454 1083666432 10 Physicians DUDEK MARTA 606405120 200 Cook 0 0 Internal Medicine 0 0 0 0 1 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 341 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 341 0 0 0 0 0 0 0 0 0 57.66 0 0 0 0 0 0 0 0 3112.24 0 0 0 0 0 0 3169.9 0 0 0 1101386457 1033101688 10 Physicians AHLUWALIA YOGI 606081732 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 195 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 195 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7668.78 0 0 0 0 0 0 7668.78 0 0 0 1101386460 94 Waiver service provider--Children's support (DHS/DDD) 107 Will 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 2779.7 0 0 0 0 0 0 0 0 0 0 0 0 0 2779.7 0 0 0 1101386464 1235123308 10 Physicians UPADHYAY NANDINI 600313376 57 Lake 0 1 Pediatrics 0 246 0 0 522 0 0 0 0 0 0 423 0 656 0 0 0 0 0 0 2167 0 0 1307 0 0 0 0 0 0 542 0 1098 0 0 0 0 0 0 2167 0 0 1307 0 0 0 0 0 0 542 0 1098 0 0 0 0 0 0 4334 0 0 50764.63 0 0 0 0 0 0 2540.3 0 43589.75 0 0 0 0 0 0 101228.68 0 0 0 1101386471 92 Waiver service provider--Disability (DHS/DRS) 33 Effingham 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 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 4468.45 0 0 0 0 0 0 0 0 0 0 0 0 0 4468.45 0 0 0 1101386495 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6534 0 0 0 0 0 0 0 0 0 0 0 0 0 6534 0 0 0 1101386497 1013034644 34 State-operated facility (DHS) UNIT 4190 BLDG 100A SHAPIRO 609015018 54 Kankakee 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 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1710 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1153745.11 0 0 0 0 0 0 0 0 0 0 1153745.11 0 0 0 1101386500 1710980396 10 Physicians FORAN RONALD 611075182 109 Winnebago 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 388 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 956 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 956 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26842.14 0 0 0 0 0 0 26842.14 0 0 0 1101386509 10 Physicians 816 Iowa 0 0 Family Practice 0 0 0 0 2 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 12.8 0 0 0 0 0 0 4.7 0 0 0 0 0 0 0 0 17.5 0 0 0 1101386512 1225078413 10 Physicians RYDEL JAMES 604532627 200 Cook 0 0 Nephrology 0 0 0 0 0 0 0 0 0 0 0 0 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 926 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 926 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13183.77 0 0 0 0 0 0 13183.77 0 0 0 1101386525 1780618074 10 Physicians MIRANDA ARMAND 628121969 36 Franklin 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 345 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 393 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 393 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13298.26 0 0 0 0 0 0 13298.26 0 0 0 1101386549 1922167741 11 Dentists MUZYKANSKY VICTORIA 604038742 200 Cook 0 0 General Dentistry 0 0 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 844 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 844 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27594.41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27594.41 0 0 0 1101386557 1013075092 16 Nurse Practitioners PRINCE CHRISTINE 618012529 50 Jersey 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 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 203.19 0 0 0 0 0 0 203.19 0 0 0 1101386588 2100377006 91 Waiver service provider--Adults (DHS/DDD) OAK-LEYDEN DEVELOPMENTAL SERVI 603022233 200 Cook 0 0 0 0 0 0 0 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38710 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38710 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3398375.77 0 0 0 0 0 0 0 0 0 0 0 0 0 3398375.77 0 0 0 1101386595 1831112234 10 Physicians SABRI MOUSTAFA 600681188 200 Cook 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 8 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 293 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 293 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89.33 0 4756.58 0 0 0 0 0 0 4845.91 0 0 0 1101386600 1346281888 10 Physicians ROSANIA DAVID 606576183 200 Cook 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 0 0 0 157 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 561 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 561 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5945.79 0 0 0 0 0 0 5945.79 0 0 0 1101386603 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 23738.47 0 0 0 0 0 0 0 0 0 0 0 0 0 23738.47 0 0 0 1101386641 1225038532 10 Physicians MAURER BRIAN 616151941 80 Peoria 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 33 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 513.76 0 9259.79 0 0 0 0 0 0 9773.55 0 0 0 1101386642 1982733176 47 Local Education Agencies COMMUNITY HIGH SCHOOL DIST 155 600147901 71 McHenry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4422 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4422 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 109156.37 0 109156.37 0 0 0 1101386645 1689690463 10 Physicians SMALL ROBERT A 601691098 200 Cook 0 1 Internal Medicine 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 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 269.3 0 0 0 0 0 0 269.3 0 0 0 1101386649 73 Other Transportation Providers ( Non-Registered) 41 Hamilton 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 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 57.5 0 0 0 0 0 0 57.5 0 0 0 1101386652 1992767602 36 Community mental health provider HEPHZIBAH CHILDRENS ASSOC 603011205 200 Cook 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 2727 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7067 0 0 2727 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7067 0 0 89232.24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 244285.6 0 0 333517.84 0 0 0 1101386665 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 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 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 7372.85 0 0 0 0 0 0 0 0 0 0 0 0 0 7372.85 0 0 0 1101386668 1003955618 10 Physicians SHANLEY JOHN 606233596 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 2 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1.18 0 3774.63 0 0 0 0 0 0 3775.81 0 0 0 1101386680 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10195.35 0 0 0 0 0 0 0 0 0 0 0 0 0 10195.35 0 0 0 1101386686 91 Waiver service provider--Adults (DHS/DDD) 50 Jersey 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 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18186.3 0 0 0 0 0 0 0 0 0 0 0 0 0 18186.3 0 0 0 1101386687 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 16290.88 0 0 0 0 0 0 0 0 0 0 0 0 0 16290.88 0 0 0 1101386689 10 Physicians 200 Cook 0 0 Anesthesiology 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44.4 0 0 0 0 0 0 44.4 0 0 0 1101386701 1659380772 60 Pharmacies CAREMED PHARMACEUTICAL SERVICE 110421048 833 New York 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 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 0 0 0 0 0 0 0 0 0 0 0 7378 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1381999.27 0 0 0 1381999.27 0 0 0 1101386722 1720033160 10 Physicians MAKS JONATHAN 600911824 200 Cook 0 0 Internal Medicine 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 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 418.6 0 0 0 0 0 0 418.6 0 0 0 1101386724 1710902176 16 Nurse Practitioners CARLL VICKIE 620024568 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 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 0 129.57 0 0 0 0 0 0 129.57 0 0 0 1101386725 1841262540 12 Optometrists CHIARAMONTI NICHOLAS 604022317 200 Cook 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 168 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 257 0 224 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 257 0 224 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7204.15 0 6362.72 0 0 0 0 13566.87 0 0 0 1101386754 1992824924 70 Ambulance Service Providers FORRESTON FIRE PROT DIST 610307702 79 Ogle 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1279.33 0 0 0 0 0 0 1279.33 0 0 0 1101386759 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7493.09 0 0 0 0 0 0 0 0 0 0 0 0 0 7493.09 0 0 0 1101386763 10 Physicians 852 Wisconsin 0 0 Anesthesiology 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 153.5 0 0 0 0 0 0 153.5 0 0 0 1101386767 1750317061 10 Physicians RUEDA AMADO 608044222 200 Cook 0 1 Family Practice 0 515 0 0 92 0 0 0 0 0 0 15 0 371 0 0 0 0 0 0 843 0 0 170 0 0 0 0 0 0 15 0 629 0 0 0 0 0 0 843 0 0 170 0 0 0 0 0 0 15 0 629 0 0 0 0 0 0 1905 0 0 8310.75 0 0 0 0 0 0 50.69 0 16451.13 0 0 0 0 0 0 26717.57 0 0 0 1101386769 1194985564 10 Physicians NIERZWICKI ROBERT 601901295 30 DuPage 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 228 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 228 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3784.09 0 0 0 0 0 0 3784.09 0 0 0 1101386778 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 7938.78 0 0 0 0 0 0 0 0 0 0 0 0 0 7938.78 0 0 0 1101386782 1952652349 91 Waiver service provider--Adults (DHS/DDD) HEALTHCARE MANAGEMENT CORP 999999999 92 Schuyler 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18424 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18424 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2124753.64 0 0 0 0 0 0 0 0 0 0 0 0 0 2124753.64 0 0 0 1101386784 1154590214 16 Nurse Practitioners LUMB PATRICIA 606143363 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 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 0 876.32 0 0 0 0 0 0 876.32 0 0 0 1101386793 1699852491 33 Nursing Facilities FRIENDSHIP MANOR 612012758 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 335 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9859 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 702987.98 0 0 0 0 0 0 0 702987.98 0 0 0 1101386804 1447565072 30 General Hospitals WOODLAWN DIALYSIS 606095328 200 Cook DIALYSIS Outpatient dialysis centers. 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 566 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4633 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 96847.6 0 0 0 0 0 96847.6 0 0 0 1101386809 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 14744.54 0 0 0 0 0 0 0 0 0 0 0 0 0 14744.54 0 0 0 1101386811 10 Physicians 0 0 Otolaryngology 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21.4 0 0 0 0 0 0 21.4 0 0 0 1101386814 1467491092 10 Physicians MITCHELL ROBERT 613542769 58 La Salle 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 139 0 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 241 0 594 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 241 0 594 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3675.81 0 38477.92 0 0 0 0 0 0 42153.73 0 0 0 1101386818 30 General Hospitals 823 Michigan NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 218.11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 218.11 0 0 0 1101386822 1245215060 10 Physicians PALMER DAVID 606118709 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 6 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 361 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 361 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48.04 0 3547.86 0 0 0 0 0 0 3595.9 0 0 0 1101386826 91 Waiver service provider--Adults (DHS/DDD) 30 DuPage 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 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5782.01 0 0 0 0 0 0 0 0 0 0 0 0 0 5782.01 0 0 0 1101386834 92 Waiver service provider--Disability (DHS/DRS) 107 Will 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 21594.48 0 0 0 0 0 0 0 0 0 0 0 0 0 21594.48 0 0 0 1101386854 1427081272 10 Physicians BEHNKE STEPHEN 601943548 200 Cook 0 1 Family Practice 0 6 0 0 10 0 0 0 0 0 0 8 0 72 0 0 0 0 0 0 20 0 0 16 0 0 0 0 0 0 8 0 228 0 0 0 0 0 0 20 0 0 16 0 0 0 0 0 0 8 0 228 0 0 0 0 0 0 43 0 0 862.24 0 0 0 0 0 0 15.68 0 3425.24 0 0 0 0 0 0 4346.16 0 0 0 1101386866 1245433432 47 Local Education Agencies MALDEN COMM CONS SCH DIST 84 613370216 15 Bureau 0 0 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 0 546 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 546 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9885.05 0 9885.05 0 0 0 1101386867 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1548.25 0 0 0 0 0 0 0 0 0 0 0 0 0 1548.25 0 0 0 1101386872 92 Waiver service provider--Disability (DHS/DRS) 69 Massac 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 6715.84 0 0 0 0 0 0 0 0 0 0 0 0 0 6715.84 0 0 0 1101386879 1780764530 10 Physicians HAJJAR GAIL 611081454 109 Winnebago 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4554.48 0 0 0 0 0 0 4554.48 0 0 0 1101386888 1518284587 63 Other Providers of Medical Equipment/Supplies (Non-registered) COMPLETE HOME RESPIRATORY CARE 616151547 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1487 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1487 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46483.17 0 0 0 0 0 0 46483.17 0 0 0 1101386895 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22087.79 0 0 0 0 0 0 0 0 0 0 0 0 0 22087.79 0 0 0 1101386903 1497796957 10 Physicians JOHNSON MARK 628643649 49 Jefferson 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 464 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 464 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15329.06 0 0 0 0 0 0 15329.06 0 0 0 1101386912 1568533396 33 Nursing Facilities CLAREMONT REHAB AND LIVING CTR 600897047 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 157 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1081 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27351 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2903343.83 0 0 0 0 0 0 0 2903343.83 0 0 0 1101386913 24 Speech Therapists 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 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 21910 21910 0 0 0 1101386922 1730152273 10 Physicians EVANS D 623014040 10 Adams 0 0 Nephrology 0 0 0 0 0 0 0 0 0 0 0 0 0 383 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1721 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1721 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23393.35 0 0 0 0 0 0 23393.35 0 0 0 1101386931 1881955995 16 Nurse Practitioners LESLIE JESSA 606112615 58 La Salle 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 255 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 273 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 273 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9385.62 0 0 0 0 0 0 9385.62 0 0 0 1101386932 1205056389 34 State-operated facility (DHS) UNIT 0226 HOME 26 LUDEMAN 604661200 200 Cook 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 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 900 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 568746.24 0 0 0 0 0 0 0 0 0 0 568746.24 0 0 0 1101386941 1053383737 10 Physicians JAFRY SHAHINA 611011214 109 Winnebago 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 215 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 215 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9736.13 0 0 0 0 0 0 9736.13 0 0 0 1101386953 94 Waiver service provider--Children's support (DHS/DDD) 52 Johnson 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4884 0 0 0 0 0 0 0 0 0 0 0 0 0 4884 0 0 0 1101386965 2100377383 91 Waiver service 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0 0 0 0 0 0 674 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22142.12 0 0 0 0 0 0 22142.12 0 0 0 1101388036 1215223672 36 Community mental health provider WILL COUNTY HEALTH DEPT 604403409 107 Will 0 0 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166 0 0 503 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 553 0 0 503 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 553 0 0 10657.84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31605.04 0 0 42262.88 0 0 0 1101388037 1659511988 32 Rehabilitation Hospitals SSM SELECT REHAB ST LOUIS LLC 63044 826 Missouri NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 167800.42 0 0 0 0 0 0 0 0 0 167800.42 0 0 0 1101388045 1518071760 10 Physicians CHEEMA USMAN 614012852 56 Knox 0 0 Pulmonary Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 905 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 905 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1751 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72164.63 0 0 0 0 0 0 72164.63 0 0 0 1101388277 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 5370.39 0 0 0 0 0 0 0 0 0 0 0 0 0 5370.39 0 0 0 1101388281 1558476374 22 Physical Therapists REISINGER AMANDA 611121019 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 173 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 173 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 946.34 946.34 0 0 0 1101388282 92 Waiver service provider--Disability (DHS/DRS) 68 Mason 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10592.71 0 0 0 0 0 0 0 0 0 0 0 0 0 10592.71 0 0 0 1101388289 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 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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 8543.38 0 0 0 0 0 0 0 0 0 0 0 0 0 8543.38 0 0 0 1101389953 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13981 0 0 0 0 0 0 0 0 0 0 0 0 0 13981 0 0 0 1101389961 1447382635 47 Local Education Agencies KANKAKEE SCH DIST 111 609014319 54 Kankakee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 519 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14754 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14754 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 274537.55 0 274537.55 0 0 0 1101389962 91 Waiver service provider--Adults (DHS/DDD) 107 Will 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 0 113 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 18005.57 0 0 0 0 0 0 0 0 0 0 0 0 0 18005.57 0 0 0 1101389963 1639159221 11 Dentists SUASTEGUI MURSULI ISABEL 606233910 200 Cook 0 0 General Dentistry 0 0 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 367 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 367 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11407.74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11407.74 0 0 0 1101389978 91 Waiver service provider--Adults (DHS/DDD) 54 Kankakee 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 515 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 515 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32920.33 0 0 0 0 0 0 0 0 0 0 0 0 0 32920.33 0 0 0 1101389984 92 Waiver service provider--Disability (DHS/DRS) 56 Knox 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 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 2987.54 0 0 0 0 0 0 0 0 0 0 0 0 0 2987.54 0 0 0 1101389986 1467669259 10 Physicians GAO ZHENQIANG 627810001 91 Sangamon 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 335 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 547 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 547 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8498.19 0 0 0 0 0 0 0 0 8498.19 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 171 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86.22 0 22847.26 0 0 0 0 0 0 22933.48 0 0 0 1101390069 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 6536.67 0 0 0 0 0 0 0 0 0 0 0 0 0 6536.67 0 0 0 1101390099 92 Waiver service provider--Disability (DHS/DRS) 86 Putnam 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 6892.06 0 0 0 0 0 0 0 0 0 0 0 0 0 6892.06 0 0 0 1101390106 92 Waiver service provider--Disability (DHS/DRS) 107 Will 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 28720.84 0 0 0 0 0 0 0 0 0 0 0 0 0 28720.84 0 0 0 1101390113 1598759292 40 Federally Qualified Health Centers COMMUNITY HEALTH CARE INC 612015216 89 Rock Island 0 1 0 332 3340 0 1046 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2515 17736 0 3437 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2515 17736 0 3437 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9000 830852.78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 839852.78 0 0 0 1101390127 94 Waiver service provider--Children's support (DHS/DDD) 30 DuPage 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 14 0 0 0 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 2556.1 0 0 0 0 0 0 0 0 0 0 0 0 0 2556.1 0 0 0 1101390129 24 Speech Therapists 21 Clark 0 0 0 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 92 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 7081.91 7081.91 0 0 0 1101390139 1609855857 10 Physicians HARDIN JOEL 60611 200 Cook 0 0 Pediatric Cardiology 0 0 0 0 0 0 0 0 0 0 0 0 0 332 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 524 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 524 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14075.68 0 0 0 0 0 0 14075.68 0 0 0 1101390141 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 41382.03 0 0 0 0 0 0 0 0 0 0 0 0 0 41382.03 0 0 0 1101390142 1306805551 30 General Hospitals SKYLINE HOME DIALYSIS 606344533 200 Cook DIALYSIS Outpatient dialysis centers. 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 989 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8930.32 0 0 0 0 0 8930.32 0 0 0 1101390145 91 Waiver service provider--Adults (DHS/DDD) 109 Winnebago 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 0 312 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 312 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13384.25 0 0 0 0 0 0 0 0 0 0 0 0 0 13384.25 0 0 0 1101390150 1164498614 10 Physicians BERNSTEIN RICHARD 606118709 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 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631600352 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9474.56 0 0 0 0 0 0 9474.56 0 0 0 1101390202 92 Waiver service provider--Disability (DHS/DRS) 98 Tazewell 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 0 111.96 0 0 0 0 0 0 0 0 0 0 0 0 0 111.96 0 0 0 1101390208 1942250030 10 Physicians KIM PETER 622491285 65 Madison 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 138 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 361 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 361 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26614.88 0 0 0 0 0 0 26614.88 0 0 0 1101390225 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23533.4 0 0 0 0 0 0 0 0 0 0 0 0 0 23533.4 0 0 0 1101390238 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0 0 0 0 0 0 0 8363.01 0 0 0 0 0 0 8363.01 0 0 0 1101390262 1215139001 10 Physicians BARRICK KEN 611082425 109 Winnebago 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 187 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 201 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 201 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6301.02 0 0 0 0 0 0 6301.02 0 0 0 1101390278 1285800391 10 Physicians BEATO DAVID 554860362 12 Bond 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 323 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 348 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 348 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11387.96 0 0 0 0 0 0 11387.96 0 0 0 1101390287 1003889957 10 Physicians SCHROEDER JENNIFER 623531378 14 Brown 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 39 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 223.6 0 74.09 0 0 0 0 0 0 297.69 0 0 0 1101390289 1063478253 10 Physicians DEMKO MERRY 610213083 60 Lee 0 1 Family Practice 0 0 0 0 2 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 119.54 0 0 0 0 0 0 0 0 2008.11 0 0 0 0 0 0 2127.65 0 0 0 1101390290 1669407912 10 Physicians GAGERMEIER JAMES 601533328 200 Cook 0 0 Pulmonary Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 558 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 558 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9975.28 0 0 0 0 0 0 9975.28 0 0 0 1101390292 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 14631.71 0 0 0 0 0 0 0 0 0 0 0 0 0 14631.71 0 0 0 1101390295 1194815290 10 Physicians SRIVASTAVA UMA 611011214 109 Winnebago 0 0 General Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 296 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 296 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7084.36 0 0 0 0 0 0 7084.36 0 0 0 1101390298 1598717290 16 Nurse Practitioners ARQUILLA ROGER 610813510 106 Whiteside 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180.34 0 0 0 0 0 0 180.34 0 0 0 1101390308 1689776973 10 Physicians HELGASON CATHY 606127325 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 205 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 205 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8105.98 0 0 0 0 0 0 8105.98 0 0 0 1101390314 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24975.5 0 0 0 0 0 0 0 0 0 0 0 0 0 24975.5 0 0 0 1101390326 92 Waiver service provider--Disability (DHS/DRS) 98 Tazewell 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 19274.3 0 0 0 0 0 0 0 0 0 0 0 0 0 19274.3 0 0 0 1101390355 1164772778 22 Physical Therapists 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0 0 0 0 0 124.81 0 0 0 0 0 0 2391.42 0 8748.73 0 0 0 0 0 0 11264.96 0 0 0 1101390417 14 Chiropractors 23 Clinton 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 28.28 0 0 0 0 0 0 28.28 0 0 0 1101390432 1881700722 30 General Hospitals PASSAVANT AREA HOSPITAL 626501136 77 Morgan DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 0 0 0 0 10 0 0 0 0 0 0 2288 0 0 1341 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 11544 0 0 6940 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 11544 0 0 6940 0 0 0 0 0 0 0 0 57.7 0 0 0 0 0 0 89610.44 0 0 510307.35 0 0 0 0 0 599975.49 0 0 0 1101390444 1407877160 10 Physicians AKHTAR RIAZ 606295148 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 33 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 1318 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 1318 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72.75 0 5115.03 0 0 0 0 0 0 5187.78 0 0 0 1101390452 1003089707 10 Physicians STEGEMANN ANNA 600442203 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LARRY D 627078549 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 696.69 0 0 0 0 0 0 696.69 0 0 0 1101391155 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 267 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 267 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13101 0 0 0 0 0 0 0 0 0 0 0 0 0 13101 0 0 0 1101391184 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 44111.87 0 0 0 0 0 0 0 0 0 0 0 0 0 44111.87 0 0 0 1101391188 1255424826 60 Pharmacies THE MEDICINE SHOPPE 628321424 81 Perry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97 0 0 2025 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 0 26947 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 0 691795 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9075.25 0 0 1380677.14 0 0 0 1389752.39 0 0 0 1101391189 1194741496 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10838.05 0 0 0 0 0 0 13928.57 0 0 0 1101391215 11 Dentists 200 Cook 0 0 General Dentistry 0 0 0 4 0 0 0 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 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 407.25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 407.25 0 0 0 1101391225 91 Waiver service provider--Adults (DHS/DDD) 13 Boone 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 0 228 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 228 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24453 0 0 0 0 0 0 0 0 0 0 0 0 0 24453 0 0 0 1101391231 1437165578 10 Physicians HUANG MARK 606112654 200 Cook 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 0 0 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 351 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 351 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 311.32 0 0 0 0 0 0 311.32 0 0 0 1101391244 1922050707 12 Optometrists GIANNONE JOHN 604508920 40 Grundy 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 692 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1787 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1787 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54137.76 0 0 0 0 0 0 54137.76 0 0 0 1101391274 1548363310 60 Pharmacies CVS PHARMACY 6371 624501131 841 Rhode Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2543 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21310 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 481045 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 852163.01 0 0 0 852163.01 0 0 0 1101391299 1588683593 10 Physicians HE THERESA 605151500 30 DuPage 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5914.88 0 0 0 0 0 0 5914.88 0 0 0 1101391302 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 1790.88 0 0 0 0 0 0 0 0 0 0 0 0 0 1790.88 0 0 0 1101391307 1962508382 63 Other Providers of Medical Equipment/Supplies (Non-registered) WALGREENS SLEEP AND RESPIRATOR 999999999 30 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266740.58 0 0 0 266752.39 0 0 0 1101391857 1366776163 47 Local Education Agencies MILLBURN CC SCH DIST 24 600839248 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 850 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 850 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11304.76 0 11304.76 0 0 0 1101391859 24 Speech Therapists 107 Will 0 0 0 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 290.24 290.24 0 0 0 1101391865 1376527523 10 Physicians KHOSLA PARAMJEET 606123841 200 Cook 0 0 Oncology 0 0 0 0 0 0 0 0 0 0 0 0 0 260 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 895 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 895 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20324.85 0 0 0 0 0 0 20324.85 0 0 0 1101391870 92 Waiver service provider--Disability (DHS/DRS) 33 Effingham 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 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0 0 0 0 0 1926 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7762 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7762 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 291999.96 0 0 0 0 0 0 291999.96 0 0 0 1101391904 1811943053 10 Physicians FRIEDMAN ARIE 60069 57 Lake 0 0 Emergency Medicine 0 32 0 0 13 0 0 0 0 0 0 5 0 13 0 0 0 0 0 0 186 0 0 34 0 0 0 0 0 0 6 0 25 0 0 0 0 0 0 186 0 0 34 0 0 0 0 0 0 6 0 25 0 0 0 0 0 0 372 0 0 1654.07 0 0 0 0 0 0 41.14 0 1472.85 0 0 0 0 0 0 3540.06 0 0 0 1101391905 1629132741 70 Ambulance Service Providers HARRE HAMILTON CO AMB INC 628591278 41 Hamilton 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 184 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1038 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1038 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38462.67 0 0 0 0 0 0 38462.67 0 0 0 1101391914 55 Early Intervention Services 200 Cook 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 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5953.32 0 0 0 0 0 0 5953.32 0 0 0 1101391923 1992739221 10 Physicians HENNON NELL ANN 622691953 96 St Clair 0 1 Family Practice 0 1 0 0 4 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 1 0 0 11 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 1 0 0 11 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 3 0 0 772.04 0 0 0 0 0 0 0 0 975.5 0 0 0 0 0 0 1750.54 0 0 0 1101391929 1699883595 10 Physicians BAJAJ MADHURI 616157822 80 Peoria 0 0 Oncology 0 0 0 0 0 0 0 0 0 0 0 31 0 234 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 277 0 2115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 277 0 2115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2303.14 0 237350.44 0 0 0 0 0 0 239653.58 0 0 0 1101391951 1992722250 60 Pharmacies WAL MART 10 0197 614552531 70 McDonough 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1283 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12204 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 322676 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 452826.99 0 0 0 452826.99 0 0 0 1101391961 1467451294 10 Physicians SAKKA NIDAL 601692045 200 Cook 0 0 Pulmonary Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 254 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1607 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1607 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23421.81 0 0 0 0 0 0 23421.81 0 0 0 1101391967 1669469706 10 Physicians VALLEJO RICARDO 600441421 57 Lake 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 1 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 281 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 281 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5.6 0 3050.87 0 0 0 0 0 0 3056.47 0 0 0 1101391969 1942519368 50 Home Health Agencies - In Home VISTA HOME HEALTH 600319176 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 224 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 224 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15332.04 0 0 0 0 0 0 15332.04 0 0 0 1101391970 1174657605 55 Early Intervention Services SCHWERMAN KATHRYN 601026725 71 McHenry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6554.09 0 0 0 0 0 0 6554.09 0 0 0 1101391978 1184821977 10 Physicians BEFFA DAVID 631282106 826 Missouri 0 0 Emergency Medicine 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 501.7 0 0 0 0 0 0 501.7 0 0 0 1101391979 1790737781 10 Physicians BUDDHARAJU VENKATA 600681538 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 502 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3883 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3883 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37675.6 0 0 0 0 0 0 37675.6 0 0 0 1101391985 1528110566 11 Dentists HAYES MARY 606112615 200 Cook 0 0 Pedodontics 0 0 0 26 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 3457.69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3457.69 0 0 0 1101391993 98 Waiver service provider--TBI (DHS/DRS) 57 Lake 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 8561.54 0 0 0 0 0 0 0 0 0 0 0 0 0 8561.54 0 0 0 1101391998 1013035237 24 Speech Therapists FAULKNER KRISTIN 615179588 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14929.58 14929.58 0 0 0 1101392017 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33478.03 0 0 0 0 0 0 0 0 0 0 0 0 0 33478.03 0 0 0 1101392026 1629287776 10 Physicians RATHINAM ALFRED 60605 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 229 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 229 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4576.03 0 0 0 0 0 0 4576.03 0 0 0 1101392030 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10399.6 0 0 0 0 0 0 0 0 0 0 0 0 0 10399.6 0 0 0 1101392045 1992903645 91 Waiver service provider--Adults (DHS/DDD) BROOKE HILL MANAGEMENT INC 628630001 101 Wabash 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 6980 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6980 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 790363.1 0 0 0 0 0 0 0 0 0 0 0 0 0 790363.1 0 0 0 1101392063 1376595371 47 Local Education Agencies BUNKER HILL CUSD 8 620141102 64 Macoupin 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 1725 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 1725 0 0 0 0 107.08 0 0 0 0 0 0 0 0 0 0 0 0 0 9522.14 0 9629.22 0 0 0 1101392068 1902191208 11 Dentists ANWAR SARA 604356451 107 Will 0 0 General Dentistry 0 0 0 317 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1515 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1515 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41291.26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41291.26 0 0 0 1101392070 1437164654 60 Pharmacies WALGREENS #01515 611114647 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117 0 0 1119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117 0 0 5587 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117 0 0 140737 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12884.23 0 0 263077.75 0 0 0 275961.98 0 0 0 1101392077 1053456186 34 State-operated facility (DHS) UNIT 4067 GRAPE MURRAY 628015805 66 Marion 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3458 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2661572.28 0 0 0 0 0 0 0 0 0 0 2661572.28 0 0 0 1101392078 92 Waiver service provider--Disability (DHS/DRS) 97 Stephenson 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20103.43 0 0 0 0 0 0 0 0 0 0 0 0 0 20103.43 0 0 0 1101392083 1831399518 10 Physicians KAPUR KULJIT 605064356 53 Kane 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 254 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 254 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159.83 0 0 0 0 0 0 159.83 0 0 0 1101392090 10 Physicians 823 Michigan 0 0 Radiology Diagnosis 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 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 10.54 0 0 0 0 0 0 0 0 10.54 0 0 0 1101392096 1053459412 10 Physicians ERSAHIN CAGATAY 601533328 200 Cook 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 157 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 281 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 281 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3353.9 0 0 0 0 0 0 0 0 3353.9 0 0 0 1101392106 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 17941.8 0 0 0 0 0 0 0 0 0 0 0 0 0 17941.8 0 0 0 1101392127 92 Waiver service provider--Disability (DHS/DRS) 59 Lawrence 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 3595.19 0 0 0 0 0 0 0 0 0 0 0 0 0 3595.19 0 0 0 1101392129 1366476947 11 Dentists BAILEY JONATHAN 618012530 19 Champaign 0 0 Oral Surgery 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 185 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 185 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8593.02 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8593.02 0 0 0 1101392133 1043238306 10 Physicians BURKE JOHN 604536460 200 Cook 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 1 0 189 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 415 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 415 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11398.49 0 0 0 0 0 0 11398.49 0 0 0 1101392136 1134141948 60 Pharmacies TARGET PHARMACY T 957 601811244 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 404 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10342 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9135.04 0 0 0 9135.04 0 0 0 1101392143 2100382561 92 Waiver service provider--Disability (DHS/DRS) BLESSING HOSPITAL 999999999 10 Adams 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 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17752.16 0 0 0 0 0 0 0 0 0 0 0 0 0 17752.16 0 0 0 1101392158 91 Waiver service provider--Adults (DHS/DDD) 30 DuPage 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 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23347.5 0 0 0 0 0 0 0 0 0 0 0 0 0 23347.5 0 0 0 1101392175 1457323750 10 Physicians LEW GEORGE 601545716 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 395 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 420 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 420 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12747.09 0 0 0 0 0 0 12747.09 0 0 0 1101392181 1376519132 10 Physicians HEIMBURGER STUART 601082227 30 DuPage 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 6 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93.84 0 630.55 0 0 0 0 0 0 724.39 0 0 0 1101392189 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 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 2719.01 0 0 0 0 0 0 0 0 0 0 0 0 0 2719.01 0 0 0 1101392193 10 Physicians 826 Missouri 0 0 Neonatology 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 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 267.67 0 0 0 0 0 0 267.67 0 0 0 1101392196 1508133067 24 Speech Therapists TEAGUE KRISTEN 999999999 200 Cook 0 0 0 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 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12495.84 12495.84 0 0 0 1101392213 1548290901 10 Physicians GULLONE MATTHEW 610368118 51 Jo Daviess 0 0 Family Practice 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 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 538.43 0 0 0 0 0 0 538.43 0 0 0 1101392216 1548362841 10 Physicians WINKELER BRETT M 622581447 96 St Clair 0 1 Family Practice 0 9 0 0 3 0 0 0 0 0 0 1 0 24 0 0 0 0 0 0 82 0 0 4 0 0 0 0 0 0 1 0 47 0 0 0 0 0 0 82 0 0 4 0 0 0 0 0 0 1 0 47 0 0 0 0 0 0 181 0 0 260.26 0 0 0 0 0 0 2.58 0 708.22 0 0 0 0 0 0 1152.06 0 0 0 1101392217 1528254331 11 Dentists KRUPA THOMAS 604801084 200 Cook 0 0 General Dentistry 0 0 0 255 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 956 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 956 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32633.57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32633.57 0 0 0 1101392219 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 21206.98 0 0 0 0 0 0 0 0 0 0 0 0 0 21206.98 0 0 0 1101392220 1669420766 30 General Hospitals MCDONOUGH DISTRICT HOSP 614553313 70 McDonough ARS-PD Hospitals paid a Per Diem rate. 0 0 Government Owned 0 3 0 0 0 3423 0 0 0 0 483 0 0 2 1673 0 0 0 0 0 12 0 0 0 7618 0 0 0 0 557 0 0 2 3866 0 0 0 0 0 20 0 0 0 7618 0 0 0 0 1657 0 0 2 3875 0 0 0 0 0 360.93 0 0 0 966687.12 0 0 0 0 616593.82 0 0 3707.62 758660.68 0 0 0 0 0 2346010.17 0 0 0 1101392231 1205061124 60 Pharmacies MEXICARE INC 606234031 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 660 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3988 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105945 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 185412.7 0 0 0 185412.7 0 0 0 1101392235 1821075177 10 Physicians LITBARG NATALIA O 606123725 200 Cook 0 0 Nephrology 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5698.96 0 0 0 0 0 0 5698.96 0 0 0 1101392236 92 Waiver service provider--Disability (DHS/DRS) 46 Iroquois 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18445.57 0 0 0 0 0 0 0 0 0 0 0 0 0 18445.57 0 0 0 1101392242 92 Waiver service provider--Disability (DHS/DRS) 27 Dekalb 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 5304.89 0 0 0 0 0 0 0 0 0 0 0 0 0 5304.89 0 0 0 1101392243 1356505788 10 Physicians VALENTIN CARL 606081732 200 Cook 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 1341 0 383 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1971 0 784 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1971 0 784 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37415.11 0 13916.26 0 0 0 0 0 0 51331.37 0 0 0 1101392245 1225321771 16 Nurse Practitioners SCHWARTZ MAGAN 605553269 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 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 0 182.2 0 0 0 0 0 0 182.2 0 0 0 1101392250 1518944248 10 Physicians ARGUELLES CESAR 627949639 200 Cook 0 1 Family Practice 0 90 0 0 68 0 0 0 0 0 0 42 0 271 0 0 0 0 0 0 650 0 0 189 0 0 0 0 0 0 53 0 418 0 0 0 0 0 0 650 0 0 189 0 0 0 0 0 0 53 0 418 0 0 0 0 0 0 1720 0 0 5954.87 0 0 0 0 0 0 610.96 0 30262.04 0 0 0 0 0 0 38547.87 0 0 0 1101392254 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 47 0 0 0 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 35573.98 0 0 0 0 0 0 0 0 0 0 0 0 0 35573.98 0 0 0 1101392266 16 Nurse Practitioners 826 Missouri 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10.98 0 0 0 0 0 0 10.98 0 0 0 1101392267 1164445854 10 Physicians FLORES JAVIER 606475257 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 1 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.15 0 918.64 0 0 0 0 0 0 918.79 0 0 0 1101392271 1902810823 10 Physicians GALPERIN ALEKSANDR 600892813 57 Lake 0 1 Family Practice 0 205 0 0 49 0 0 0 0 0 0 25 0 152 0 0 0 0 0 0 455 0 0 142 0 0 0 0 0 0 34 0 429 0 0 0 0 0 0 455 0 0 142 0 0 0 0 0 0 34 0 429 0 0 0 0 0 0 1085 0 0 3637.2 0 0 0 0 0 0 113.68 0 20499.55 0 0 0 0 0 0 25335.43 0 0 0 1101392275 1770719171 10 Physicians PARSLEY AMANDA 620404700 826 Missouri 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3342.63 0 0 0 0 0 0 3342.63 0 0 0 1101392276 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 3533.94 0 0 0 0 0 0 0 0 0 0 0 0 0 3533.94 0 0 0 1101392285 1932362928 10 Physicians VELURU MURALI 999999999 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 438 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 438 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5035.41 0 0 0 0 0 0 5035.41 0 0 0 1101392290 1699848705 10 Physicians ANDERSEN REBECCA 600508409 71 McHenry 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 350 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 376 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 376 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9754.67 0 0 0 0 0 0 9754.67 0 0 0 1101392308 92 Waiver 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 834 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 248310.78 0 0 0 0 0 0 0 0 0 0 0 0 0 248310.78 0 0 0 1101394317 1053572818 29 ICF/MR BLACKHAWK GROUP HOME 610211615 60 Lee 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 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 465 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45059.02 0 0 0 0 0 0 0 0 0 0 45059.02 0 0 0 1101394328 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 11892.23 0 0 0 0 0 0 0 0 0 0 0 0 0 11892.23 0 0 0 1101394337 1811939234 10 Physicians WIECHERT RONALD 528041707 816 Iowa 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 401 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 467 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 467 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13991.45 0 0 0 0 0 0 13991.45 0 0 0 1101394340 1679648125 10 Physicians WASKOW SHOSHANA 600912604 200 Cook 0 1 Pediatrics 0 9 0 0 4 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 39 0 0 12 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 39 0 0 12 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 78 0 0 281.83 0 0 0 0 0 0 0 0 157.66 0 0 0 0 0 0 517.49 0 0 0 1101394344 1174723290 10 Physicians AGRAWAL PRANJAL 610211224 60 Lee 0 1 Internal Medicine 0 94 0 0 0 0 0 0 0 0 0 0 0 183 0 0 0 0 0 0 820 0 0 0 0 0 0 0 0 0 0 0 431 0 0 0 0 0 0 820 0 0 0 0 0 0 0 0 0 0 0 431 0 0 0 0 0 0 2575 0 0 0 0 0 0 0 0 0 0 0 14018.17 0 0 0 0 0 0 16593.17 0 0 0 1101394345 91 Waiver service provider--Adults (DHS/DDD) 57 Lake 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 0 358 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 358 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24301.2 0 0 0 0 0 0 0 0 0 0 0 0 0 24301.2 0 0 0 1101394356 10 Physicians 0 0 Otolaryngology 0 0 0 0 0 0 0 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72.51 0 0 0 0 0 0 72.51 0 0 0 1101394362 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 6120.38 0 0 0 0 0 0 0 0 0 0 0 0 0 6120.38 0 0 0 1101394364 1669484861 10 Physicians RYU MINA L 600267741 200 Cook 0 1 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1396.08 0 0 0 0 0 0 1396.08 0 0 0 1101394365 1588752877 10 Physicians LEMAY JEFFREY 610811252 106 Whiteside 0 0 Obstetric-Gynecology 0 0 0 0 21 0 0 0 0 0 0 258 0 1030 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 327 0 2988 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 327 0 2988 0 0 0 0 0 0 0 0 0 922.8 0 0 0 0 0 0 19055.32 0 257423.1 0 0 0 0 0 0 277401.22 0 0 0 1101394380 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 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 10521.06 0 0 0 0 0 0 0 0 0 0 0 0 0 10521.06 0 0 0 1101394396 1942488093 12 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29969.26 0 0 0 29969.26 0 0 0 1101394421 1124238688 10 Physicians BOBROWSKI AMY 606112991 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 669 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 669 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26178.97 0 0 0 0 0 0 26178.97 0 0 0 1101394427 1336100734 30 General Hospitals DECATUR EAST WOOD DIALYSIS 625231155 63 Macon DIALYSIS Outpatient dialysis centers. 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 280 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2303 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69746.17 0 0 0 0 0 69746.17 0 0 0 1101394455 1568498186 10 Physicians HALVERSON AMY 606118709 200 Cook 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 1 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7.98 0 9203.97 0 0 0 0 0 0 9211.95 0 0 0 1101394458 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 0 1 0 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WALGREENS #03539 606191601 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 337 0 0 6278 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 592 0 0 22685 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 592 0 0 489129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34249.19 0 0 1266418.75 0 0 0 1300667.94 0 0 0 1101394520 1194902551 47 Local Education Agencies WABASH C U SCH DIST 348 628631243 101 Wabash 0 0 0 0 0 0 284 0 0 0 0 0 0 0 0 0 0 0 0 0 392 0 0 0 0 563 0 0 0 0 0 0 0 0 0 0 0 0 0 9952 0 0 0 0 563 0 0 0 0 0 0 0 0 0 0 0 0 0 9952 0 0 0 0 3458.3 0 0 0 0 0 0 0 0 0 0 0 0 0 135726.36 0 139184.66 0 0 0 1101394526 91 Waiver service provider--Adults (DHS/DDD) 89 Rock Island 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 0 364 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 364 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7540.5 0 0 0 0 0 0 0 0 0 0 0 0 0 7540.5 0 0 0 1101394529 1952480196 10 Physicians ORANU CHINEDU 606081732 200 Cook 0 0 Pediatrics 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 0 233 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 233 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75510.89 0 0 0 0 0 0 75510.89 0 0 0 1101394543 1760505044 36 Community mental health provider BRIDGEWAY INC 614553317 70 McDonough 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1677 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1677 0 0 1528.25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43980.06 0 0 45508.31 0 0 0 1101394545 10 Physicians 852 Wisconsin 0 0 Pediatrics 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 0 154.86 0 0 0 0 0 0 154.86 0 0 0 1101394550 1629183470 30 General Hospitals DIALYSIS CTRS OF AMERICA ILL 604022100 200 Cook DIALYSIS Outpatient dialysis centers. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 463 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5595 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 148380.56 0 0 0 0 0 148380.56 0 0 0 1101394551 1073809364 24 Speech Therapists CASON BRIENNE 622262038 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 168 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 168 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12141.17 12141.17 0 0 0 1101394562 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 6044.79 0 0 0 0 0 0 0 0 0 0 0 0 0 6044.79 0 0 0 1101394587 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 19 0 0 0 0 0 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 11092.43 0 0 0 0 0 0 0 0 0 0 0 0 0 11092.43 0 0 0 1101394591 1871521872 23 Occupational Therapists BECKHAM MLIS 604318520 107 Will 0 0 0 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 0 0 0 344 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 344 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25459.17 25459.17 0 0 0 1101394594 1265431381 10 Physicians LEVY RICHARD 606123828 200 Cook 0 0 Endocrinology 0 0 0 0 0 0 0 0 0 0 0 5 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26.12 0 6719.24 0 0 0 0 0 0 6745.36 0 0 0 1101394607 1184662876 10 Physicians AVRAMOV VIOLETA 606313715 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 241 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 241 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1863.2 0 0 0 0 0 0 1863.2 0 0 0 1101394609 1033153663 10 Physicians HILL THOMAS 620628521 65 Madison 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 413 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 591 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 591 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5686.97 0 1405.11 0 0 0 0 0 0 7092.08 0 0 0 1101394645 10 Physicians 815 Indiana 0 0 Internal Medicine 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 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 93.9 0 0 0 0 0 0 93.9 0 0 0 1101394650 1932172848 63 Other Providers of Medical Equipment/Supplies (Non-registered) NATIONAL SEATING AND MOBILITY 616072812 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 333 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1533 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1533 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 372382.25 0 0 0 0 0 0 372382.25 0 0 0 1101394671 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 9210.48 0 0 0 0 0 0 0 0 0 0 0 0 0 9210.48 0 0 0 1101394687 1336122902 10 Physicians FOTSO CARMEN 601181648 53 Kane 0 1 Family Practice 0 536 0 0 169 0 0 0 0 0 0 137 0 367 0 0 0 0 0 0 4793 0 0 439 0 0 0 0 0 0 202 0 790 0 0 0 0 0 0 4793 0 0 439 0 0 0 0 0 0 202 0 790 0 0 0 0 0 0 11603 0 0 14390.41 0 0 0 0 0 0 1098.32 0 34304.58 0 0 0 0 0 0 61396.31 0 0 0 1101394699 98 Waiver service provider--TBI (DHS/DRS) 66 Marion 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 1247.73 0 0 0 0 0 0 0 0 0 0 0 0 0 1247.73 0 0 0 1101394701 1336256825 10 Physicians MUSSELMAN MARK 618012530 19 Champaign 0 1 Pediatrics 0 223 0 0 87 0 0 0 0 0 0 0 0 324 0 0 0 0 0 0 1534 0 0 125 0 0 0 0 0 0 0 0 508 0 0 0 0 0 0 1534 0 0 125 0 0 0 0 0 0 0 0 508 0 0 0 0 0 0 3068 0 0 1566.45 0 0 0 0 0 0 0 0 25960.73 0 0 0 0 0 0 30595.18 0 0 0 1101394714 1326292228 10 Physicians JAIN SACHIN 190442279 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 69 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 0 0 0 0 0 0 0 0 0 0 0 0 392 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2060.14 0 0 0 0 0 0 2060.14 0 0 0 1101394715 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 17078.6 0 0 0 0 0 0 0 0 0 0 0 0 0 17078.6 0 0 0 1101394718 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13447.88 0 0 0 0 0 0 0 0 0 0 0 0 0 13447.88 0 0 0 1101394726 92 Waiver service provider--Disability (DHS/DRS) 58 La Salle 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 35027.55 0 0 0 0 0 0 0 0 0 0 0 0 0 35027.55 0 0 0 1101394728 1235422130 33 Nursing Facilities HAMILTON MEM REHAB AND HCC 628591213 41 Hamilton 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 0 510 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12999 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1104153.59 0 0 0 0 0 0 0 1104153.59 0 0 0 1101394739 1568542975 10 Physicians MULCAHEY KATHRYN 616157829 80 Peoria 0 1 Internal Medicine 0 40 0 0 0 0 0 0 0 0 0 6 0 99 0 0 0 0 0 0 316 0 0 0 0 0 0 0 0 0 29 0 202 0 0 0 0 0 0 316 0 0 0 0 0 0 0 0 0 29 0 202 0 0 0 0 0 0 946 0 0 0 0 0 0 0 0 0 131.97 0 4286.98 0 0 0 0 0 0 5364.95 0 0 0 1101394744 1144320839 10 Physicians SIELAFF DON 626565059 62 Logan 0 0 Obstetric-Gynecology 0 0 0 0 13 0 0 0 0 0 0 75 0 151 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 146 0 730 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 146 0 730 0 0 0 0 0 0 0 0 0 354.34 0 0 0 0 0 0 9793.56 0 48399.6 0 0 0 0 0 0 58547.5 0 0 0 1101394753 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 31104.32 0 0 0 0 0 0 0 0 0 0 0 0 0 31104.32 0 0 0 1101394759 10 Physicians 826 Missouri 0 0 Neurology 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 197.31 0 0 0 0 0 0 197.31 0 0 0 1101394770 1467405472 10 Physicians BRANDIES JULIE 606031882 200 Cook 0 1 Internal Medicine 0 7 0 0 0 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 202 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 202 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 5768.35 0 0 0 0 0 0 5816.35 0 0 0 1101394786 1790923241 10 Physicians FINE LAUREN 606579268 200 Cook 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2034.49 0 0 0 0 0 0 2034.49 0 0 0 1101394794 1174631907 47 Local Education Agencies COMMUNITY UNIT SCHOOL DIST 76 618445195 100 Vermilion 0 0 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 1510 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1510 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18029.07 0 18029.07 0 0 0 1101394795 1154317899 10 Physicians OLYSAV DAVID 626565059 62 Logan 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 9 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 189.75 0 4961.06 0 0 0 0 0 0 5150.81 0 0 0 1101394806 1811012883 47 Local Education Agencies CARLINVILLE CUSD NO 1 626261261 64 Macoupin 0 0 0 0 0 0 314 0 0 0 0 0 0 0 0 0 0 0 0 0 82 0 0 0 0 647 0 0 0 0 0 0 0 0 0 0 0 0 0 4846 0 0 0 0 647 0 0 0 0 0 0 0 0 0 0 0 0 0 4846 0 0 0 0 4012.04 0 0 0 0 0 0 0 0 0 0 0 0 0 28989.86 0 33001.9 0 0 0 1101394818 1861478893 10 Physicians BONOMO STEVEN 60608 200 Cook 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 1 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23654.96 0 0 0 0 0 0 23654.96 0 0 0 1101394831 1689679995 63 Other Providers of Medical Equipment/Supplies (Non-registered) ORTHOTIC PROSTHETIC SPECIALIST 463211695 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 491.77 0 0 0 0 491.77 0 0 0 1101394834 1811978059 10 Physicians SABREE LATIFAH 606195664 200 Cook 0 1 Family Practice 0 556 0 0 58 0 0 0 0 0 0 3 0 113 0 0 0 0 0 0 3617 0 0 79 0 0 0 0 0 0 3 0 192 0 0 0 0 0 0 3617 0 0 79 0 0 0 0 0 0 3 0 192 0 0 0 0 0 0 8854 0 0 2060.27 0 0 0 0 0 0 12.7 0 4648.95 0 0 0 0 0 0 15575.92 0 0 0 1101394841 22 Physical Therapists 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 23 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 0 0 0 0 0 0 0 0 280.41 280.41 0 0 0 1101394846 2100385264 71 Medicar Provider DEPENDABLE AND RELIABLE TRANSP 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29881 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29881 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 187354.81 0 0 0 0 0 0 187354.81 0 0 0 1101394870 1790913903 48 Rural Health Clinics FAMILY HEALTH CLINIC FARMER 618429488 28 De Witt 0 0 0 0 58 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6546.39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6546.39 0 0 0 1101394874 1255420881 22 Physical Therapists ANDERSON JOSHUA 62896 36 Franklin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1250 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1250 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25195.92 25195.92 0 0 0 1101394878 1588844955 16 Nurse Practitioners GILHOOLY MICHELLE 606890001 200 Cook 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 742.17 0 0 0 0 0 0 742.17 0 0 0 1101394879 1598812414 10 Physicians MELONE PAULA 601533328 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 454 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 722 0 441 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 722 0 441 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19549.21 0 18130.62 0 0 0 0 0 0 37679.83 0 0 0 1101394887 10 Physicians 844 Tennessee 0 0 Pediatrics 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 0 115.69 0 0 0 0 0 0 115.69 0 0 0 1101394919 1225135940 10 Physicians ARYA JAI 606284247 200 Cook 0 1 Internal Medicine 0 269 0 0 13 0 0 0 0 0 0 2 0 106 0 0 0 0 0 0 1513 0 0 17 0 0 0 0 0 0 2 0 428 0 0 0 0 0 0 1513 0 0 17 0 0 0 0 0 0 2 0 428 0 0 0 0 0 0 3860 0 0 1323.68 0 0 0 0 0 0 8 0 7195.43 0 0 0 0 0 0 12387.11 0 0 0 1101394922 1417113366 10 Physicians CARABETTA JOSEPH 601262966 30 DuPage 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 127 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 148 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 148 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3777.77 0 45.71 0 0 0 0 0 0 3823.48 0 0 0 1101394925 1649248030 10 Physicians PERLMAN SCOTT 535625531 852 Wisconsin 0 0 Radiology 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 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 0 837.41 0 0 0 0 0 0 837.41 0 0 0 1101394929 1811913395 10 Physicians HA JUHYUN 606731210 200 Cook 0 1 Internal Medicine 0 24 0 0 0 0 0 0 0 0 0 6 0 56 0 0 0 0 0 0 124 0 0 0 0 0 0 0 0 0 7 0 96 0 0 0 0 0 0 124 0 0 0 0 0 0 0 0 0 7 0 96 0 0 0 0 0 0 364 0 0 0 0 0 0 0 0 0 64.87 0 2587.93 0 0 0 0 0 0 3016.8 0 0 0 1101394951 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 25201.09 0 0 0 0 0 0 0 0 0 0 0 0 0 25201.09 0 0 0 1101394954 1093896573 10 Physicians RAHMAN SAMEENA 606118700 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 1 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35.95 0 209.13 0 0 0 0 0 0 245.08 0 0 0 1101394956 16 Nurse Practitioners 30 DuPage 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42.5 0 0 0 0 0 0 42.5 0 0 0 1101394963 1831203801 60 Pharmacies SNS PHARMACY 606242354 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 628 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3303 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74053 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95029.23 0 0 0 95029.23 0 0 0 1101394966 1073604534 10 Physicians OLOFSSON BRIAN P 609142451 54 Kankakee 0 1 General Practice 0 23 0 0 5 0 0 0 0 0 0 20 0 70 0 0 0 0 0 0 218 0 0 5 0 0 0 0 0 0 33 0 274 0 0 0 0 0 0 218 0 0 5 0 0 0 0 0 0 33 0 274 0 0 0 0 0 0 554 0 0 395.07 0 0 0 0 0 0 129.27 0 8459.81 0 0 0 0 0 0 9538.15 0 0 0 1101394981 1528083193 10 Physicians TOBIN MARY 603021623 200 Cook 0 0 Allergy-Immunization 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2441.99 0 0 0 0 0 0 2441.99 0 0 0 1101394995 92 Waiver service provider--Disability (DHS/DRS) 30 DuPage 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 43185.49 0 0 0 0 0 0 0 0 0 0 0 0 0 43185.49 0 0 0 1101395005 1811985351 13 Podiatrists FINKELSTEIN DAVID 604534718 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 226 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 226 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4311.56 0 0 0 0 0 0 4311.56 0 0 0 1101395007 16 Nurse Practitioners 826 Missouri 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 451.85 0 0 0 0 0 0 451.85 0 0 0 1101395015 1518090448 61 Independent Laboratories ATHEROTECH INC 352114498 801 Alabama 0 0 0 0 0 0 0 0 0 0 0 0 0 491 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3677 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3677 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38834.51 0 0 0 0 0 0 0 0 38834.51 0 0 0 1101395020 10 Physicians 200 Cook 0 0 Obstetric-Gynecology 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 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 0 186.32 0 0 0 0 0 0 186.32 0 0 0 1101395029 1114002136 60 Pharmacies WALTS PHARMACY 604303119 200 Cook 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 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1281 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1233.67 0 0 0 1233.67 0 0 0 1101395040 1033156385 10 Physicians SHUKLA ARVIND 604358200 107 Will 0 0 Neonatology 0 0 0 0 0 0 0 0 0 0 0 0 0 199 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 644 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 644 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 188759.05 0 0 0 0 0 0 188759.05 0 0 0 1101395059 1467530493 10 Physicians TROE THEODORE 605667060 30 DuPage 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 153 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 153 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2160.88 0 0 0 0 0 0 0 0 2160.88 0 0 0 1101395060 1053557678 16 Nurse Practitioners BAKER REBECCA 601429545 71 McHenry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 289.78 0 0 0 0 0 0 289.78 0 0 0 1101395062 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18171.71 0 0 0 0 0 0 0 0 0 0 0 0 0 18171.71 0 0 0 1101395064 60 Pharmacies 824 Minnesota 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 3 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 0 387.24 0 0 0 387.24 0 0 0 1101395067 92 Waiver service provider--Disability (DHS/DRS) 19 Champaign 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2275 0 0 0 0 0 0 0 0 0 0 0 0 0 2275 0 0 0 1101395072 1902136914 10 Physicians PAPIREDDY MURALIDHAR 627949636 91 Sangamon 0 0 Internal Medicine 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 0 148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9436.99 0 0 0 0 0 0 9436.99 0 0 0 1101395075 1679584767 10 Physicians MOORE LISA 601181416 53 Kane 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 86 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 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10524.77 0 0 0 0 0 0 10524.77 0 0 0 1101395079 1063538353 10 Physicians JABRI MOHAMED 605232797 30 DuPage 0 1 Pediatrics 0 62 0 0 175 0 0 0 0 0 0 1 0 245 0 0 0 0 0 0 293 0 0 1201 0 0 0 0 0 0 1 0 840 0 0 0 0 0 0 293 0 0 1201 0 0 0 0 0 0 1 0 840 0 0 0 0 0 0 586 0 0 30406.57 0 0 0 0 0 0 4 0 32769.63 0 0 0 0 0 0 63766.2 0 0 0 1101395085 1245236363 10 Physicians SCHUBERT ROBERT 604352841 107 Will 0 0 Internal Medicine 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 0 219 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 219 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1267.11 0 0 0 0 0 0 1267.11 0 0 0 1101395093 1164537627 10 Physicians DICKSTEIN ROBERT 600854988 57 Lake 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 1141 0 288 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1678 0 522 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1678 0 522 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29600.35 0 13692.64 0 0 0 0 0 0 43292.99 0 0 0 1101395105 1063789071 16 Nurse Practitioners SILASIRI JENNY 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 977.01 0 0 0 0 0 0 977.01 0 0 0 1101395111 92 Waiver service provider--Disability (DHS/DRS) 60 Lee 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 0 437.47 0 0 0 0 0 0 0 0 0 0 0 0 0 437.47 0 0 0 1101395118 1124086475 10 Physicians ROSENBERG MARK 606575084 200 Cook 0 1 Pediatrics 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 0 0 0 1101395120 1053587964 10 Physicians CHEN HONG 600892082 57 Lake 0 1 Family Practice 0 164 0 0 11 0 0 0 0 0 0 0 0 112 0 0 0 0 0 0 824 0 0 11 0 0 0 0 0 0 0 0 201 0 0 0 0 0 0 824 0 0 11 0 0 0 0 0 0 0 0 201 0 0 0 0 0 0 2159 0 0 939.3 0 0 0 0 0 0 0 0 7366.49 0 0 0 0 0 0 10464.79 0 0 0 1101395126 1093738163 10 Physicians OBERLE JASON 637035049 826 Missouri 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 557 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 557 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10613.52 0 4623.56 0 0 0 0 15237.08 0 0 0 1101395269 1417111311 10 Physicians OLUTADE TOYOSI 999999999 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 265 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 265 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4433.48 0 0 0 0 0 0 4433.48 0 0 0 1101395277 98 Waiver service provider--TBI (DHS/DRS) 39 Greene 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 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 5993.49 0 0 0 0 0 0 0 0 0 0 0 0 0 5993.49 0 0 0 1101395285 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 27451.61 0 0 0 0 0 0 0 0 0 0 0 0 0 27451.61 0 0 0 1101395286 10 Physicians 57 Lake 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 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1101398359 1437367927 10 Physicians BERNS STEPHEN 610811279 106 Whiteside 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 244 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 244 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1067.6 0 0 0 0 0 0 0 0 1067.6 0 0 0 1101398374 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7261.04 0 0 0 0 0 0 0 0 0 0 0 0 0 7261.04 0 0 0 1101398376 1497898191 23 Occupational Therapists REYES GLADY 603052004 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 364 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 364 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32340.28 32340.28 0 0 0 1101398383 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24436.4 0 0 0 0 0 0 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Vermilion 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 18419.51 0 0 0 0 0 0 0 0 0 0 0 0 0 18419.51 0 0 0 1101398414 1104892215 10 Physicians CASTRO EILEEN 612444004 89 Rock Island 0 0 Internal Medicine 0 0 0 0 47 0 0 0 0 0 0 219 0 975 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 261 0 1314 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 261 0 1314 0 0 0 0 0 0 0 0 0 1472.17 0 0 0 0 0 0 2882.45 0 29690.26 0 0 0 0 0 0 34044.88 0 0 0 1101398419 1205986486 10 Physicians TAYLOR JULIE 606173905 54 Kankakee 0 1 Family Practice 0 1028 0 0 155 0 0 0 0 0 0 183 0 337 0 0 0 0 0 0 7880 0 0 373 0 0 0 0 0 0 263 0 813 0 0 0 0 0 0 7880 0 0 373 0 0 0 0 0 0 263 0 813 0 0 0 0 0 0 20766 0 0 15103.44 0 0 0 0 0 0 658.67 0 25706.84 0 0 0 0 0 0 62234.95 0 0 0 1101398432 1255408704 33 Nursing Facilities GLENLAKE TERRACE NURSING REHAB 600857708 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1645 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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"JH Stroger, Oak Forest and Provident Hospitals, paid under an alternate reimbursement system" 0 1 Direct Access 0 166 563 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 491 1728 0 185 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 491 1728 0 185 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1150 355677.86 0 34411.25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 391239.11 0 0 0 1101401361 1285743955 10 Physicians BRYAN DOUGLAS 600987401 71 McHenry 0 0 Vascular Surgery 0 0 0 0 0 0 0 0 0 0 0 4 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51.49 0 5819.53 0 0 0 0 0 0 5871.02 0 0 0 1101401364 1013080035 16 Nurse Practitioners LAWSON LAURA 617017905 72 McLean 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 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 4426.75 0 0 0 0 0 0 4426.75 0 0 0 1101401369 92 Waiver service provider--Disability (DHS/DRS) 47 Jackson 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21.69 0 0 0 0 0 0 0 0 0 0 0 0 0 21.69 0 0 0 1101401374 1245390285 60 Pharmacies SCHNUCKS PHARMACY 754 611081671 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 785 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21891 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25943.02 0 0 0 25943.02 0 0 0 1101401387 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 14681.49 0 0 0 0 0 0 0 0 0 0 0 0 0 14681.49 0 0 0 1101401411 1558389361 16 Nurse Practitioners WILLINGHAM DONNA 631101002 826 Missouri 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 19 0 0 0 0 0 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 0 463.85 0 0 0 0 0 0 463.85 0 0 0 1101401416 10 Physicians 200 Cook 0 0 Family Practice 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 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1780790717 10 Physicians POLA BHARATH 620881499 64 Macoupin 0 0 Internal Medicine 0 148 0 0 0 0 0 0 0 0 0 0 0 121 0 0 0 0 0 0 1091 0 0 0 0 0 0 0 0 0 0 0 501 0 0 0 0 0 0 1091 0 0 0 0 0 0 0 0 0 0 0 501 0 0 0 0 0 0 3196 0 0 0 0 0 0 0 0 0 0 0 18449.06 0 0 0 0 0 0 21645.06 0 0 0 1101401654 1114913845 10 Physicians POLYAK VALENTINA 600313376 57 Lake 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 3 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 416.33 0 0 0 0 0 0 416.33 0 0 0 1101401660 1942453022 10 Physicians ALBRECHT JOERG 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 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 0 342.69 0 0 0 0 0 0 342.69 0 0 0 1101401667 1457493082 16 Nurse Practitioners BAUDINO JARED 623012834 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 264 0 0 37 0 0 0 0 0 0 2 0 103 0 0 0 0 0 0 634 0 0 2774.2 0 0 0 0 0 0 8 0 3890.45 0 0 0 0 0 0 7306.65 0 0 0 1101401711 92 Waiver service provider--Disability (DHS/DRS) 63 Macon 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 10201.02 0 0 0 0 0 0 0 0 0 0 0 0 0 10201.02 0 0 0 1101401713 1962512152 10 Physicians EHTESHAM RUBINA 601220021 109 Winnebago 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 237 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 594 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 594 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7509.62 0 0 0 0 0 0 7509.62 0 0 0 1101401719 1225144462 10 Physicians SOLTES STEVEN 604532659 200 Cook 0 0 Otorhinolaryngology 0 0 0 0 0 0 0 0 0 0 0 0 0 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 216 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 216 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2313.8 0 0 0 0 0 0 2313.8 0 0 0 1101401726 98 Waiver service provider--TBI (DHS/DRS) 80 Peoria 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 5503.92 0 0 0 0 0 0 0 0 0 0 0 0 0 5503.92 0 0 0 1101401727 1316134281 55 Early Intervention Services HARDEN AMANDA 618347424 100 Vermilion 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 317 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 317 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21970.45 0 0 0 0 0 0 21970.45 0 0 0 1101401728 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 36544.83 0 0 0 0 0 0 0 0 0 0 0 0 0 36544.83 0 0 0 1101401729 1568547594 60 Pharmacies WALTS PHARMACY 604731237 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 311 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8050 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14852.08 0 0 0 14852.08 0 0 0 1101401738 1477685634 71 Medicar Provider RHONDAS 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Physicians NASR ISAM 601604039 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 369 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 380 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 380 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13993.81 0 0 0 0 0 0 13993.81 0 0 0 1101401755 1831310648 10 Physicians GILL POONAM 601082140 30 DuPage 0 1 Internal Medicine 0 20 0 0 1 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 65 0 0 1 0 0 0 0 0 0 0 0 410 0 0 0 0 0 0 65 0 0 1 0 0 0 0 0 0 0 0 410 0 0 0 0 0 0 188 0 0 85.65 0 0 0 0 0 0 0 0 2903.12 0 0 0 0 0 0 3176.77 0 0 0 1101401767 92 Waiver service provider--Disability (DHS/DRS) 71 McHenry 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 23391.41 0 0 0 0 0 0 0 0 0 0 0 0 0 23391.41 0 0 0 1101401769 1902943327 63 Other Providers of Medical Equipment/Supplies (Non-registered) WOODFIELD ORTHO SERVICES LLC 600109543 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 369.33 0 6125.27 0 0 0 0 6494.6 0 0 0 1101401780 1114201621 11 Dentists KAPOOR SHIKHA 999999999 200 Cook 0 0 0 0 0 752 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3290 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3290 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86893.03 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86893.03 0 0 0 1101401784 1891959144 10 Physicians SADHU JULIE 606143363 200 Cook 0 0 Child Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 769.56 0 0 0 0 0 0 769.56 0 0 0 1101401787 92 Waiver service provider--Disability (DHS/DRS) 33 Effingham 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9334.05 0 0 0 0 0 0 0 0 0 0 0 0 0 9334.05 0 0 0 1101401793 1144360777 11 Dentists VILLALOBOS FRANCISCO 606234313 200 Cook 0 0 Orthodontist 0 0 0 270 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 619 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 619 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159160.35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159160.35 0 0 0 1101401801 1598978454 10 Physicians MASSEY SUENA 606118709 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1967.96 0 0 0 0 0 0 1967.96 0 0 0 1101401810 1245238625 10 Physicians RIBBING WILLIAM G 629061668 99 Union 0 0 Emergency Medicine 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 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40.23 0 0 0 0 0 0 40.23 0 0 0 1101401811 1851505762 55 Early Intervention Services SERIO JOANNE 604919025 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10819.71 0 0 0 0 0 0 10819.71 0 0 0 1101401812 1851508337 10 Physicians ANDREWS SAMUEL 611042315 109 Winnebago 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 211 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 211 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2490.14 0 0 0 0 0 0 2490.14 0 0 0 1101401822 1003127648 55 Early Intervention Services TAYLOR MARIA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56357.61 0 0 0 0 0 0 56357.61 0 0 0 1101401827 1669615241 10 Physicians RODRIGUEZ MARCO 601975997 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 807 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 902 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 902 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32730.62 0 0 0 0 0 0 32730.62 0 0 0 1101401828 1306985627 10 Physicians STAMBOLIU LAETITIA 601691065 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13521.34 0 0 0 0 0 0 13521.34 0 0 0 1101401836 1558476309 30 General Hospitals GLENDALE HEIGHTS DIALYSIS CTR 601393119 30 DuPage DIALYSIS Outpatient dialysis centers. 0 0 General Hospital - Adult and Child 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 0 244 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2818 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43350.11 0 0 0 0 0 43350.11 0 0 0 1101401838 1760646574 10 Physicians HENRY ELIZABETH 601533328 200 Cook 0 0 Hematology 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 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1841.67 0 0 0 0 0 0 1841.67 0 0 0 1101401844 92 Waiver service provider--Disability (DHS/DRS) 59 Lawrence 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10394.41 0 0 0 0 0 0 0 0 0 0 0 0 0 10394.41 0 0 0 1101401845 1619962982 10 Physicians JOLLY CHRISTINE 531435031 852 Wisconsin 0 0 Pediatrics 0 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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 26247.45 0 0 0 0 0 0 0 0 0 0 0 0 0 26247.45 0 0 0 1101405428 1790813715 34 State-operated facility (DHS) UNIT 3563 HOME 43 KILEY 600856263 57 Lake 0 0 0 0 0 0 0 0 0 0 0 8 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 0 720 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 544576.6 0 0 0 0 0 0 0 0 0 0 544576.6 0 0 0 1101405435 1154578060 10 Physicians BOCK MARGRET 606112991 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 511 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 511 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18570.18 0 0 0 0 0 0 18570.18 0 0 0 1101405442 60 Pharmacies 816 Iowa 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 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 244 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55.01 0 0 0 55.01 0 0 0 1101405459 91 Waiver service provider--Adults (DHS/DDD) 30 DuPage 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 0 281 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 281 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22830.5 0 0 0 0 0 0 0 0 0 0 0 0 0 22830.5 0 0 0 1101405462 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27336.02 0 0 0 0 0 0 0 0 0 0 0 0 0 27336.02 0 0 0 1101405464 10 Physicians 96 St Clair 0 0 Internal Medicine 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 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67.55 0 0 0 0 0 0 67.55 0 0 0 1101405467 1356396311 10 Physicians WAXMAN BRYAN 600151836 57 Lake 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 24 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 310.34 0 1621.39 0 0 0 0 0 0 1931.73 0 0 0 1101405479 1811171143 40 Federally Qualified Health Centers AUNT MARTHAS YOUTH SERVICE INC 606177314 200 Cook 0 1 0 2135 1285 0 442 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13908 6558 0 1176 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13908 6558 0 1176 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33625 328957.14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 362582.14 0 0 0 1101405486 30 General Hospitals 852 Wisconsin NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 41.33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41.33 0 0 0 1101405498 91 Waiver service provider--Adults (DHS/DDD) 107 Will 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 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10248.96 0 0 0 0 0 0 0 0 0 0 0 0 0 10248.96 0 0 0 1101405500 92 Waiver service provider--Disability (DHS/DRS) 25 Crawford 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7378.49 0 0 0 0 0 0 0 0 0 0 0 0 0 7378.49 0 0 0 1101405505 92 Waiver service provider--Disability (DHS/DRS) 67 Marshall 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 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 0 741.85 0 0 0 0 0 0 0 0 0 0 0 0 0 741.85 0 0 0 1101405524 91 Waiver service provider--Adults (DHS/DDD) 10 Adams 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 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2194.5 0 0 0 0 0 0 0 0 0 0 0 0 0 2194.5 0 0 0 1101405526 1174640114 10 Physicians GOLDBERG SETH 631101010 826 Missouri 0 0 Nephrology 0 0 0 0 0 0 0 0 0 0 0 6 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10.9 0 2077.15 0 0 0 0 0 0 2088.05 0 0 0 1101405548 1245392349 48 Rural Health Clinics EAST ADAMS COUNTY RHC 623390086 10 Adams 0 1 0 750 660 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6360 4290 0 478 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6360 4290 0 478 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16489 178316.38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 194805.38 0 0 0 1101405554 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18274.33 0 0 0 0 0 0 0 0 0 0 0 0 0 18274.33 0 0 0 1101405577 1730373895 10 Physicians COLLINS KATHERINE 623014038 10 Adams 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 234 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 234 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9169.8 0 0 0 0 0 0 9169.8 0 0 0 1101405582 12 Optometrists 83 Pike 0 0 Therapeutic Pharmaceutical Agents 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29.28 0 0 0 0 29.28 0 0 0 1101405588 1225249907 10 Physicians TROST SHEA PHILIP 614553313 70 McDonough 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 2 0 698 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 890 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 890 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87116.92 0 0 0 0 0 0 87116.92 0 0 0 1101405592 1104160845 33 Nursing Facilities RIVERSHORES HLTH AND REHAB CTR 999999999 58 La Salle 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1049 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24039 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1964423 0 0 0 0 0 0 0 1964423 0 0 0 1101405593 1467568642 10 Physicians HOROWITZ KENNETH 600452672 57 Lake 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5979.3 0 0 0 0 0 0 5979.3 0 0 0 1101405611 10 Physicians 200 Cook 0 0 Pediatrics 0 0 0 0 2 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 67.72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67.72 0 0 0 1101405635 1962551028 12 Optometrists SPERLAKIS MICHAEL 605601877 55 Kendall 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 282 0 152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 633 0 168 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 633 0 168 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14809.58 0 5913.4 0 0 0 0 20722.98 0 0 0 1101405639 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7940.61 0 0 0 0 0 0 0 0 0 0 0 0 0 7940.61 0 0 0 1101405655 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14357.28 0 0 0 0 0 0 0 0 0 0 0 0 0 14357.28 0 0 0 1101405659 1033260468 10 Physicians DELBECCARO MARIA 627813757 91 Sangamon 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 250 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 283 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 283 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7712.18 0 0 0 0 0 0 7712.18 0 0 0 1101405664 1730310251 56 School Based / Linked Health Clinics MERCY PHILLIPS HEALTH CENTER 606532222 200 Cook 0 0 0 0 107 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 229 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 229 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5686.74 0 128.3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5815.04 0 0 0 1101405677 1740590231 10 Physicians PATEL BHAVESH 624711044 34 Fayette 0 0 Family Practice 0 0 0 0 2 0 0 0 0 0 0 0 0 612 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 1255 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 1255 0 0 0 0 0 0 0 0 0 13.78 0 0 0 0 0 0 0 0 43861.98 0 0 0 0 0 0 43875.76 0 0 0 1101405681 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5173.77 0 0 0 0 0 0 0 0 0 0 0 0 0 5173.77 0 0 0 1101405690 92 Waiver service provider--Disability (DHS/DRS) 10 Adams 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 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 10815.63 0 0 0 0 0 0 0 0 0 0 0 0 0 10815.63 0 0 0 1101405718 1487622411 10 Physicians REJDUKOWSKI CHRISTINE 601742463 53 Kane 0 1 Pediatrics 0 8 0 0 10 0 0 0 0 0 0 8 0 24 0 0 0 0 0 0 76 0 0 15 0 0 0 0 0 0 8 0 38 0 0 0 0 0 0 76 0 0 15 0 0 0 0 0 0 8 0 38 0 0 0 0 0 0 152 0 0 825.8 0 0 0 0 0 0 43.28 0 1117.36 0 0 0 0 0 0 2138.44 0 0 0 1101405720 1700079415 10 Physicians BANDEPALLI CHANDRAREKHA 606123723 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1215.62 0 0 0 0 0 0 1215.62 0 0 0 1101405727 1700876166 11 Dentists KIM HANNAH 600732247 57 Lake 0 0 General Dentistry 0 0 0 317 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59202.16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59202.16 0 0 0 1101405731 1548272545 10 Physicians SCHWARTZENBERG ROBERT 600211925 57 Lake 0 1 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 2 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5.93 0 2445.03 0 0 0 0 0 0 2450.96 0 0 0 1101405743 2100396161 71 Medicar Provider MATTS TRANSPORTATION SRVCS INC 606434317 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8621 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8621 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65840.07 0 0 0 0 0 0 65840.07 0 0 0 1101405761 1194748475 74 Hospital-Based Transportation Providers GREENVILLE REGIONAL HOSPITAL 622461154 12 Bond 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 374 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 374 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42729.59 0 0 0 0 0 0 42729.59 0 0 0 1101405765 1477594612 10 Physicians KAUFMAN MICHAEL 602011718 200 Cook 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 275 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 374 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 374 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5952.1 0 0 0 0 0 0 0 0 5952.1 0 0 0 1101405768 1649270711 10 Physicians BELOW STEVEN 616052507 80 Peoria 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 78 0 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 96 0 266 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 96 0 266 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1191.51 0 20946.32 0 0 0 0 0 0 22137.83 0 0 0 1101405778 1558460477 10 Physicians OTTNEY MICHAEL 325024910 30 DuPage 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 1218 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1571 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1571 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56968.76 0 0 0 0 0 0 56968.76 0 0 0 1101405794 1073675138 30 General Hospitals KANKAKEE COUNTY DIALYSIS 609142439 54 Kankakee DIALYSIS Outpatient dialysis centers. 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1577 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29028.56 0 0 0 0 0 29028.56 0 0 0 1101405795 1780636803 70 Ambulance Service Providers DUBUQUE FIRE AND EMS 520014839 816 Iowa 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 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 1361.72 0 0 0 0 0 0 1361.72 0 0 0 1101405797 92 Waiver service provider--Disability (DHS/DRS) 29 Douglas 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 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5242.61 0 0 0 0 0 0 0 0 0 0 0 0 0 5242.61 0 0 0 1101405799 1346254042 11 Dentists LUNKEN DINA 616152179 80 Peoria 0 0 General Dentistry 0 0 0 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 496 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 496 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16134.69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16134.69 0 0 0 1101405804 1437211463 10 Physicians COHEN RONALD 605275993 30 DuPage 0 0 Endocrinology 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1887.49 0 0 0 0 0 0 1887.49 0 0 0 1101405815 98 Waiver service provider--TBI (DHS/DRS) 91 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 25744.59 0 0 0 0 0 0 0 0 0 0 0 0 0 25744.59 0 0 0 1101405822 10 Physicians 816 Iowa 0 0 Anesthesiology 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 307 0 0 0 0 0 0 307 0 0 0 1101405840 1609057587 10 Physicians FRIEDMAN AARON D. 600352321 57 Lake 0 0 Otolaryngology 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 194 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 194 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15705.12 0 0 0 0 0 0 15705.12 0 0 0 1101405857 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 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 4037.06 0 0 0 0 0 0 0 0 0 0 0 0 0 4037.06 0 0 0 1101405859 1871547224 10 Physicians DSILVA JOSEPH 606465713 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 142 0 321 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 340 0 862 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 340 0 862 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1733.98 0 21802.63 0 0 0 0 0 0 23536.61 0 0 0 1101405871 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 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 15225.16 0 0 0 0 0 0 0 0 0 0 0 0 0 15225.16 0 0 0 1101405879 1164525275 10 Physicians DUARTE BERNARDO 606221777 200 Cook 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6909.71 0 0 0 0 0 0 6909.71 0 0 0 1101405885 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 204 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 204 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 741.21 0 0 0 0 0 0 816.21 0 0 0 1101407448 1164744215 22 Physical Therapists PULLEN WHITNEY 614011251 56 Knox 0 0 0 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 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8239.3 8239.3 0 0 0 1101407450 92 Waiver service provider--Disability (DHS/DRS) 58 La Salle 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 237.35 0 0 0 0 0 0 0 0 0 0 0 0 0 237.35 0 0 0 1101407454 1912914144 61 Independent Laboratories DERMATOPATHOLOGY LABORATORY 454594021 836 Ohio 0 0 0 0 0 0 0 0 0 0 0 0 0 1294 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1884 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1884 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73249.44 0 0 0 0 0 0 0 0 73249.44 0 0 0 1101407460 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 307 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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Physicians IGNACIO JEMINI 601182440 53 Kane 0 1 Internal Medicine 0 4 0 0 0 0 0 0 0 0 0 4 0 147 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 6 0 645 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 6 0 645 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 80.77 0 1725.12 0 0 0 0 0 0 1889.89 0 0 0 1101407524 16 Nurse Practitioners 30 DuPage 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 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 464.83 0 0 0 0 0 0 464.83 0 0 0 1101407532 1750308631 30 General Hospitals COMMUNITY MEMORIAL HOSPITAL 620881423 64 Macoupin DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 1 0 0 0 0 0 81 0 0 0 0 0 0 609 0 0 1124 0 0 0 0 0 0 0 0 110 0 0 0 0 0 0 3449 0 0 2877 0 0 0 0 0 0 0 0 110 0 0 0 0 0 0 3449 0 0 2877 0 0 0 0 0 0 0 0 438.9 0 0 0 0 0 0 18336.68 0 0 272214.71 0 0 0 0 0 290990.29 0 0 0 1101407540 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 4477.68 0 0 0 0 0 0 0 0 0 0 0 0 0 4477.68 0 0 0 1101407553 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 442.79 0 0 0 0 0 0 0 0 0 0 0 0 0 442.79 0 0 0 1101407562 1750378923 33 Nursing Facilities BETHESDA HOME AND RETIREMENT C 606344726 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3398 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 270189.76 0 0 0 0 0 0 0 270189.76 0 0 0 1101407565 1104853878 10 Physicians BURTON KAREN 600451688 57 Lake 0 1 Pediatrics 0 14 0 0 26 0 0 0 0 0 0 25 0 64 0 0 0 0 0 0 65 0 0 81 0 0 0 0 0 0 49 0 72 0 0 0 0 0 0 65 0 0 81 0 0 0 0 0 0 49 0 72 0 0 0 0 0 0 130 0 0 2204.96 0 0 0 0 0 0 289.41 0 2898.52 0 0 0 0 0 0 5522.89 0 0 0 1101407576 1326099474 10 Physicians CESPEDES CARLOS 601262816 30 DuPage 0 1 Family 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Education Agencies 79 Ogle 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 170 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 170 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2527.97 0 2527.97 0 0 0 1101408210 1790912699 13 Podiatrists CHURA JOANNA 605445546 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 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 0 186.32 0 0 0 0 0 0 186.32 0 0 0 1101408216 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23380.06 0 0 0 0 0 0 0 0 0 0 0 0 0 23380.06 0 0 0 1101408234 1437354115 10 Physicians KHAN WASEEM K 384741503 30 DuPage 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 263 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 344 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 344 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13660.81 0 59.74 0 0 0 0 0 0 13720.55 0 0 0 1101408254 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 13747.21 0 0 0 0 0 0 0 0 0 0 0 0 0 13747.21 0 0 0 1101408257 1518096049 24 Speech Therapists STEFELY MARY 606465726 200 Cook 0 0 0 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 0 236 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 236 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12718.46 12718.46 0 0 0 1101408261 1003849563 10 Physicians LEVENSTEIN JOSEPH 600987401 71 McHenry 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 32 0 146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 171 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 171 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 463.96 0 4689.55 0 0 0 0 0 0 5153.51 0 0 0 1101408263 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3319 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 282 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13954.62 0 0 0 0 0 0 13954.62 0 0 0 1101408277 92 Waiver service provider--Disability (DHS/DRS) 104 Wayne 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 11570.67 0 0 0 0 0 0 0 0 0 0 0 0 0 11570.67 0 0 0 1101408281 1962695924 63 Other Providers of Medical Equipment/Supplies (Non-registered) HOME BOUND HEALTHCARE MEDICAL 601603622 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 189 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 708 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 708 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37539.88 0 0 0 0 0 0 37539.88 0 0 0 1101408282 1760698534 10 Physicians CHHADIA ANKUR 601033007 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 100 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165 0 505 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165 0 505 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 703.66 0 11551.79 0 0 0 0 0 0 12255.45 0 0 0 1101408286 92 Waiver service provider--Disability (DHS/DRS) 27 Dekalb 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 15440.88 0 0 0 0 0 0 0 0 0 0 0 0 0 15440.88 0 0 0 1101408290 1700905981 10 Physicians PATTERSON LEE 604515501 107 Will 0 1 Pediatrics 0 127 0 0 605 0 0 0 0 0 0 127 0 415 0 0 0 0 0 0 811 0 0 1817 0 0 0 0 0 0 135 0 548 0 0 0 0 0 0 811 0 0 1817 0 0 0 0 0 0 135 0 548 0 0 0 0 0 0 1622 0 0 51989.29 0 0 0 0 0 0 217.83 0 26779.96 0 0 0 0 0 0 80609.08 0 0 0 1101408303 2100398721 71 Medicar Provider J O T TRANSPORTATION COMPANY 606493311 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12431 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12431 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89648.08 0 0 0 0 0 0 89648.08 0 0 0 1101408312 16 Nurse Practitioners 80 Peoria 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 82.13 0 0 0 0 0 0 82.13 0 0 0 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0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120.77 0 0 0 0 0 0 0 0 0 0 0 0 0 120.77 0 0 0 1101408340 91 Waiver service provider--Adults (DHS/DDD) 96 St Clair 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 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22823.57 0 0 0 0 0 0 0 0 0 0 0 0 0 22823.57 0 0 0 1101408360 1881645844 10 Physicians KAHN EVAN 605252600 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4072 0 0 0 0 0 0 4072 0 0 0 1101408367 1407918485 10 Physicians ACCARDI SUSAN 606022208 200 Cook 0 0 Psychiatry 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 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1948.47 0 0 0 0 0 0 1948.47 0 0 0 1101408368 1629064449 10 Physicians MASH STEVEN J 606740018 30 DuPage 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 3 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2.39 0 0 0 0 0 0 2.39 0 0 0 1101408382 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 23808.03 0 0 0 0 0 0 0 0 0 0 0 0 0 23808.03 0 0 0 1101408392 1477596567 10 Physicians STROPLE JENNIFER 606112991 200 Cook 0 0 Pediatrics 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 0 0 0 214 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 214 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10799.96 0 0 0 0 0 0 10799.96 0 0 0 1101408403 1417118852 55 Early Intervention Services KOENIG KAREN 60137 30 DuPage 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 0 0 0 0 0 0 0 0 369 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 369 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20362.86 0 0 0 0 0 0 20362.86 0 0 0 1101408422 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 20520.86 0 0 0 0 0 0 0 0 0 0 0 0 0 20520.86 0 0 0 1101408425 1972518116 60 Pharmacies BOND DRUG COMPANY OF ILLINOIS 622082026 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 897 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3316 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73510 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 162335.96 0 0 0 162335.96 0 0 0 1101408429 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 340 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 340 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13706 0 0 0 0 0 0 0 0 0 0 0 0 0 13706 0 0 0 1101408439 1932268893 10 Physicians CHANDER MANU 602011718 200 Cook 0 1 Internal Medicine 0 71 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 503 0 0 0 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 503 0 0 0 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 1463 0 0 0 0 0 0 0 0 0 0 0 4274.25 0 0 0 0 0 0 5737.25 0 0 0 1101408458 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 2568.12 0 0 0 0 0 0 0 0 0 0 0 0 0 2568.12 0 0 0 1101408463 1669617551 10 Physicians NAPIER LAURA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 1084 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 1179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 1179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 168.16 0 36440.84 0 0 0 0 0 0 36609 0 0 0 1101408479 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 17737.33 0 0 0 0 0 0 0 0 0 0 0 0 0 17737.33 0 0 0 1101408488 92 Waiver service provider--Disability (DHS/DRS) 37 Fulton 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 19136.06 0 0 0 0 0 0 0 0 0 0 0 0 0 19136.06 0 0 0 1101408491 1447230149 63 Other Providers of Medical Equipment/Supplies (Non-registered) HOOKS OXYGEN MEDICAL EQUIPMENT 478023993 815 Indiana 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 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2640.14 0 0 0 0 0 0 2640.14 0 0 0 1101408517 1043410392 10 Physicians CARSON DEBRA 622861048 87 Randolph 0 0 Obstetric-Gynecology 0 0 0 0 5 0 0 0 0 0 0 244 0 617 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 331 0 1062 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 331 0 1062 0 0 0 0 0 0 0 0 0 505.49 0 0 0 0 0 0 10196.75 0 181265.86 0 0 0 0 0 0 191968.1 0 0 0 1101408521 14 Chiropractors 57 Lake 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 23 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 0 0 0 0 0 0 0 0 29.24 0 0 0 0 0 0 29.24 0 0 0 1101408524 10 Physicians 815 Indiana 0 0 Cardiovascular Diseases 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 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 91.05 0 0 0 0 0 0 91.05 0 0 0 1101408528 1164451993 10 Physicians CRUZAT MERLITA 606101174 200 Cook 0 1 Internal Medicine 0 17 0 0 0 0 0 0 0 0 0 1 0 59 0 0 0 0 0 0 109 0 0 0 0 0 0 0 0 0 1 0 241 0 0 0 0 0 0 109 0 0 0 0 0 0 0 0 0 1 0 241 0 0 0 0 0 0 325 0 0 0 0 0 0 0 0 0 3.33 0 2490.96 0 0 0 0 0 0 2819.29 0 0 0 1101408531 92 Waiver service provider--Disability (DHS/DRS) 63 Macon 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26715.51 0 0 0 0 0 0 0 0 0 0 0 0 0 26715.51 0 0 0 1101408581 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 29748.82 0 0 0 0 0 0 0 0 0 0 0 0 0 29748.82 0 0 0 1101408584 1568769420 16 Nurse Practitioners YOUNG ABBY 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 278.7 0 0 0 0 0 0 278.7 0 0 0 1101408585 10 Physicians 852 Wisconsin 0 0 Urological Surgery 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1260.37 0 0 0 0 0 0 1260.37 0 0 0 1101408587 1689672289 10 Physicians BENNING LISA 627810001 91 Sangamon 0 1 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 345 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 345 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3706.25 0 0 0 0 0 0 3706.25 0 0 0 1101408592 92 Waiver service provider--Disability (DHS/DRS) 96 St Clair 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10168.83 0 0 0 0 0 0 0 0 0 0 0 0 0 10168.83 0 0 0 1101408594 1316139116 10 Physicians BOHNENKAMP DONALD 999999999 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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Kentucky 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 150.69 0 2800.32 0 0 0 0 2951.01 0 0 0 1101408703 1669762084 55 Early Intervention Services ANDERSON MOLLY B 615689703 98 Tazewell 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 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2997.94 0 0 0 0 0 0 2997.94 0 0 0 1101408705 1588781298 60 Pharmacies PROVIDENT HOSPITAL OF COOK CO 606152310 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4313 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19959 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 787668 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3638016.96 0 0 0 3638016.96 0 0 0 1101408721 1558460337 10 Physicians MORGAN OCONNOR MAUREEN 609144430 54 Kankakee 0 0 Endocrinology 0 0 0 0 0 0 0 0 0 0 0 1 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6.3 0 1463.96 0 0 0 0 0 0 1470.26 0 0 0 1101408727 98 Waiver service provider--TBI (DHS/DRS) 97 Stephenson 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 16379.91 0 0 0 0 0 0 0 0 0 0 0 0 0 16379.91 0 0 0 1101408734 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 363.86 0 0 0 0 0 0 0 0 0 0 0 0 0 363.86 0 0 0 1101408737 1316028657 10 Physicians JAIN NEERAJ 605212602 30 DuPage 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 311.12 0 0 0 0 0 0 311.12 0 0 0 1101408743 1205971900 11 Dentists SHETH NEHABEN 605054290 53 Kane 0 0 General Dentistry 0 0 0 186 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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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 3716 0 0 0 0 0 0 0 0 0 0 0 0 0 3716 0 0 0 1101409181 1164415600 12 Optometrists GABRIEL HELEN 606163816 200 Cook 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 367 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 367 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8442.43 0 0 0 0 0 0 8442.43 0 0 0 1101409191 1700921566 24 Speech Therapists CHIBUCOS THOMAS 606141869 200 Cook 0 0 0 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 0 0 0 0 0 0 0 0 0 0 0 0 1269 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1269 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97777.66 97777.66 0 0 0 1101409194 1801917653 47 Local Education Agencies TRICO UNIT SCH DIST 176 629160220 47 Jackson 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 4398 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 4398 0 0 0 0 166.6 0 0 0 0 0 0 0 0 0 0 0 0 0 77357.25 0 77523.85 0 0 0 1101409196 1679503692 46 Ambulatory Surgical Treatment Centers CENTER FOR ORTHOPEDIC MEDICINE 617043739 72 McLean NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 247 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 294 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 294 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 146254.78 0 0 0 0 0 146254.78 0 0 0 1101409197 1992814628 10 Physicians WEISKOPF JEROME 611083015 109 Winnebago 0 0 Pediatric Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 175 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 175 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12742.28 0 0 0 0 0 0 12742.28 0 0 0 1101409204 1699026922 16 Nurse Practitioners SPARKS ANN 601545709 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 237 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 237 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 816.58 0 0 0 0 0 0 816.58 0 0 0 1101409206 1154429710 10 Physicians KEENE MURRAY 604404906 107 Will 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 654 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 678 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 678 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25516.98 0 0 0 0 0 0 25516.98 0 0 0 1101409207 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 23335.69 0 0 0 0 0 0 0 0 0 0 0 0 0 23335.69 0 0 0 1101409215 16 Nurse Practitioners 90 Saline 0 0 0 0 0 0 0 0 0 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1.87 0 0 0 0 0 0 1.87 0 0 0 1101409223 1407924251 10 Physicians AHMED FIAZ 605638669 53 Kane 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 2 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3325.14 0 0 0 0 0 0 3325.14 0 0 0 1101409224 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 1 0 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THEODORE 606575147 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3179.39 0 0 0 0 0 0 3179.39 0 0 0 1101409300 1912169962 12 Optometrists CUNDIFF TIMOTHY 616144685 80 Peoria 0 0 Diagnostic Pharmaceutical Agents 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 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 965.74 0 0 0 0 0 0 965.74 0 0 0 1101409309 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22435.02 0 0 0 0 0 0 0 0 0 0 0 0 0 22435.02 0 0 0 1101409322 1558336057 10 Physicians DUNGAN DAVID 601484932 30 DuPage 0 1 Pediatrics 0 6 0 0 1 0 0 0 0 0 0 1 0 19 0 0 0 0 0 0 21 0 0 4 0 0 0 0 0 0 1 0 31 0 0 0 0 0 0 21 0 0 4 0 0 0 0 0 0 1 0 31 0 0 0 0 0 0 43 0 0 97.07 0 0 0 0 0 0 15.7 0 600.1 0 0 0 0 0 0 755.87 0 0 0 1101409324 1013122613 55 Early Intervention Services MORAN NANCY 600839276 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 153 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 242 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 242 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29162.1 0 0 0 0 0 0 29162.1 0 0 0 1101409328 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 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 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 1031.25 0 0 0 0 0 0 0 0 0 0 0 0 0 1031.25 0 0 0 1101409334 1558413294 10 Physicians RUBENSTEIN JONATHAN B 606123848 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 5 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 334 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 334 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7447.16 0 0 0 0 0 0 7447.16 0 0 0 1101409348 98 Waiver service provider--TBI (DHS/DRS) 98 Tazewell 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 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 3616.99 0 0 0 0 0 0 0 0 0 0 0 0 0 3616.99 0 0 0 1101409359 1861416786 16 Nurse Practitioners FERGUSON JANET 606225646 200 Cook 0 0 Delivery Privileged by referral 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1709.64 0 0 0 0 0 0 1709.64 0 0 0 1101409368 1013115955 16 Nurse Practitioners REYNOLDS MELANIE 627817401 91 Sangamon 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 138 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 199 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 199 0 0 0 0 0 0 0 0 0 1292.4 0 0 0 0 0 0 0 0 5221.52 0 0 0 0 0 0 6513.92 0 0 0 1101409370 1427227669 36 Community mental health provider LEYDEN FAMILY SERVICE AND MHC 601313139 200 Cook 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 230 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6477 0 0 230 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6477 0 0 16082.56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 311587.21 0 0 327669.77 0 0 0 1101409374 1710143565 10 Physicians THUMMALAKUNTA LAXMI 620404701 65 Madison 0 0 Internal Medicine 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 0 0 0 0 0 0 0 0 0 0 0 1101409393 1730193004 70 Ambulance Service Providers KURTZ AMBULANCE SERVICE 604511559 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6037 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37633 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37633 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 594988.67 0 0 0 0 0 0 594988.67 0 0 0 1101409399 1831130392 10 Physicians SHOEMAKER DENNIS 637035049 826 Missouri 0 0 Infectious Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1163.26 0 0 0 0 0 0 1163.26 0 0 0 1101409425 1598835167 10 Physicians JOHNSON MARGERY 606143363 200 Cook 0 0 Child Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 6 0 0 0 0 0 0 0 0 381 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 381 0 0 0 0 0 0 0 0 0 91.2 0 0 0 0 0 0 0 0 21198.35 0 0 0 0 0 0 21289.55 0 0 0 1101409475 1629125661 10 Physicians PADALIK SCOTT 605407430 30 DuPage 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166.06 0 0 0 0 0 0 166.06 0 0 0 1101409477 1972547990 10 Physicians SAXENA MADHULIKA 604591403 200 Cook 0 1 Internal Medicine 0 102 0 0 0 0 0 0 0 0 0 7 0 196 0 0 0 0 0 0 872 0 0 0 0 0 0 0 0 0 18 0 1241 0 0 0 0 0 0 872 0 0 0 0 0 0 0 0 0 18 0 1241 0 0 0 0 0 0 2604 0 0 0 0 0 0 0 0 0 63.68 0 15834.94 0 0 0 0 0 0 18502.62 0 0 0 1101409480 30 General Hospitals 803 Arizona NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 0 194.12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 194.12 0 0 0 1101409487 1194701144 10 Physicians COURTNEY JOHN 605631290 30 DuPage 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 197 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 251 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 251 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4093.18 0 558.08 0 0 0 0 0 0 4651.26 0 0 0 1101409488 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 51206.85 0 0 0 0 0 0 0 0 0 0 0 0 0 51206.85 0 0 0 1101409495 1043269210 10 Physicians KESANI AJIT K 602023445 200 Cook 0 0 Nephrology 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 366 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 366 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22712.5 0 0 0 0 0 0 22712.5 0 0 0 1101409497 10 Physicians 816 Iowa 0 0 Radiation Oncology 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 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 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0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3454.64 0 0 0 0 0 0 0 0 0 0 0 0 0 3454.64 0 0 0 1101409522 98 Waiver service provider--TBI (DHS/DRS) 53 Kane 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 13410.58 0 0 0 0 0 0 0 0 0 0 0 0 0 13410.58 0 0 0 1101409537 1942341409 10 Physicians OWAISI ANJUM 605638611 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 176 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 732 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 732 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50082.36 0 0 0 0 0 0 50082.36 0 0 0 1101409551 1174756837 10 Physicians MUKKERA SATYANARAYANA 627810001 91 Sangamon 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 175 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 175 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132.17 0 0 0 0 0 0 132.17 0 0 0 1101409569 1396786844 10 Physicians FELDMAN RICHARD 606575147 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 240 0 0 0 0 0 0 240 0 0 0 1101409579 1932161056 10 Physicians FRIEDMAN MICHAEL 606023747 200 Cook 0 0 Otorhinolaryngology 0 0 0 0 0 0 0 0 0 0 0 38 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 486 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 486 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 364.04 0 14596.61 0 0 0 0 0 0 14960.65 0 0 0 1101409592 92 Waiver service provider--Disability (DHS/DRS) 72 McLean 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 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 2772.03 0 0 0 0 0 0 0 0 0 0 0 0 0 2772.03 0 0 0 1101409599 1154518454 48 Rural Health Clinics GRAHAM MEDICAL GROUP 614275062 37 Fulton 0 1 0 145 134 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1165 291 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1165 291 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3139 13021.56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16160.56 0 0 0 1101409616 1891828976 36 Community mental health provider PIONEER CENTER OF MCHENRY CO 600508377 71 McHenry 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78 0 0 183.15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5253.82 0 0 5436.97 0 0 0 1101409617 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 14084.41 0 0 0 0 0 0 0 0 0 0 0 0 0 14084.41 0 0 0 1101409620 1902987217 22 Physical Therapists HERTZ KACY 606466153 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 255 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 255 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12311.08 12311.08 0 0 0 1101409622 1043396419 10 Physicians BRULL ELLEN 607143240 200 Cook 0 1 Admitting Privileges 0 17 0 0 2 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 116 0 0 2 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 116 0 0 2 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 324 0 0 169.24 0 0 0 0 0 0 0 0 565.82 0 0 0 0 0 0 1059.06 0 0 0 1101409626 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11385 0 0 0 0 0 0 0 0 0 0 0 0 0 11385 0 0 0 1101409627 92 Waiver service provider--Disability (DHS/DRS) 54 Kankakee 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 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 0 296.68 0 0 0 0 0 0 0 0 0 0 0 0 0 296.68 0 0 0 1101409629 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13543.72 0 0 0 0 0 0 0 0 0 0 0 0 0 13543.72 0 0 0 1101409638 1417289067 16 Nurse Practitioners WILLIAMS LINDSEY 620404701 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1865.72 0 0 0 0 0 0 1865.72 0 0 0 1101409646 1467420620 16 Nurse Practitioners SQUIRES KIMBERLY 535625531 852 Wisconsin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 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 0 325.9 0 0 0 0 0 0 325.9 0 0 0 1101409651 1831140292 10 Physicians MITCHELL MICHAEL 605407430 30 DuPage 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 782 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1083 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1083 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19416.82 0 948.88 0 0 0 0 0 0 20365.7 0 0 0 1101409665 94 Waiver service provider--Children's support (DHS/DDD) 54 Kankakee 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 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4757.5 0 0 0 0 0 0 0 0 0 0 0 0 0 4757.5 0 0 0 1101409674 92 Waiver service provider--Disability (DHS/DRS) 58 La Salle 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 12324.82 0 0 0 0 0 0 0 0 0 0 0 0 0 12324.82 0 0 0 1101409686 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 9090.7 0 0 0 0 0 0 0 0 0 0 0 0 0 9090.7 0 0 0 1101409688 1265427033 63 Other Providers of Medical Equipment/Supplies (Non-registered) NORTHERN IL HOME MED SUPPLY 610814602 106 Whiteside 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 552 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3025 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3025 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106718.21 0 1823.2 0 0 0 0 108541.41 0 0 0 1101409722 1518967850 10 Physicians GARST JEFFREY 616052507 80 Peoria 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 53 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 241 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 241 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1082.07 0 11563.68 0 0 0 0 0 0 12645.75 0 0 0 1101409727 1164448478 10 Physicians ORY DANIEL S 631082212 826 Missouri 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 958.21 0 0 0 0 0 0 958.21 0 0 0 1101409746 1750315354 16 Nurse Practitioners BUERGER CARRI 606143363 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 274 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 305 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 305 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9528.83 0 0 0 0 0 0 9528.83 0 0 0 1101409750 1699752659 10 Physicians ARAND WALTER 605213625 30 DuPage 0 1 Internal Medicine 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 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51.14 0 0 0 0 0 0 51.14 0 0 0 1101409752 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13663.82 0 0 0 0 0 0 0 0 0 0 0 0 0 13663.82 0 0 0 1101409762 1851387443 10 Physicians BATTENBURG JAMES 614620590 102 Warren 0 0 General 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 78 0 0 0 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 1479.27 0 0 0 0 0 0 1479.27 0 0 0 1101409771 1528162898 10 Physicians BAYER WILLIAM 601882793 30 DuPage 0 0 Endocrinology 0 0 0 0 0 0 0 0 0 0 0 2 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12.6 0 1325.88 0 0 0 0 0 0 1338.48 0 0 0 1101409774 1447353925 60 Pharmacies CVS PHARMACY 6937 618323920 100 Vermilion 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1450 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7404 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 162491 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 323241.38 0 0 0 323241.38 0 0 0 1101409790 1376509380 33 Nursing Facilities BATAVIA REHAB HEALTH CARE CTR 605101323 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 448 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10912 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1024071.87 0 0 0 0 0 0 0 1024071.87 0 0 0 1101409797 1942289459 10 Physicians FLEISSNER MICHAEL 631312331 826 Missouri 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 0 0 128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2662.37 0 0 0 0 0 0 2662.37 0 0 0 1101409804 92 Waiver service provider--Disability (DHS/DRS) 54 Kankakee 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 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 2841.58 0 0 0 0 0 0 0 0 0 0 0 0 0 2841.58 0 0 0 1101409818 1609870260 10 Physicians MONAHAN JOSEPH 527322940 816 Iowa 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 185 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 185 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6925.51 0 0 0 0 0 0 6925.51 0 0 0 1101409819 1811997638 63 Other Providers of Medical Equipment/Supplies (Non-registered) MEDLINE INDUSTRIES INC 600604486 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 574 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4363 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4363 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 178144.06 0 0 0 0 0 0 178144.06 0 0 0 1101409827 92 Waiver service provider--Disability (DHS/DRS) 53 Kane 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 19019.36 0 0 0 0 0 0 0 0 0 0 0 0 0 19019.36 0 0 0 1101409828 1093720856 10 Physicians SEMENOV IRENE 600261361 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 264 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 264 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4469.93 0 0 0 0 0 0 4469.93 0 0 0 1101409829 1710104328 16 Nurse Practitioners TUCCO LAURA 604518537 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 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 0 273.85 0 0 0 0 0 0 273.85 0 0 0 1101409843 1851512776 34 State-operated facility (DHS) UNIT 0332 HOME 32 LUDEMAN 604661200 200 Cook 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 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 978 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 606869.72 0 0 0 0 0 0 0 0 0 0 606869.72 0 0 0 1101409865 92 Waiver service provider--Disability (DHS/DRS) 53 Kane 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 30374.19 0 0 0 0 0 0 0 0 0 0 0 0 0 30374.19 0 0 0 1101409881 1477758555 10 Physicians ASHER YOGEN 606118709 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7079.06 0 0 0 0 0 0 7079.06 0 0 0 1101409899 1902881428 10 Physicians PLICHTA STEPHEN 532024809 852 Wisconsin 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 51 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1494.53 0 47.83 0 0 0 0 0 0 1542.36 0 0 0 1101409900 1235122466 12 Optometrists SNOWDEN CLAUD R 62095 65 Madison 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 231 0 175 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 637 0 178 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 637 0 178 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19654.45 0 5094.24 0 0 0 0 24748.69 0 0 0 1101409902 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 328.87 0 0 0 0 0 0 0 0 0 0 0 0 0 328.87 0 0 0 1101409911 1710941588 70 Ambulance Service Providers BUDS AMBULANCE SERVICE 604190659 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3566 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25852 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25852 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 620226.2 0 0 0 0 0 0 620226.2 0 0 0 1101409915 1467435834 10 Physicians MEYER JOHN 527322940 816 Iowa 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4436.85 0 0 0 0 0 0 4436.85 0 0 0 1101409924 1518035385 10 Physicians GOLDBERG STEVEN B. 600761838 200 Cook 0 1 Pediatrics 0 0 0 0 33 0 0 0 0 0 0 5 0 46 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 6 0 61 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 6 0 61 0 0 0 0 0 0 0 0 0 2810.4 0 0 0 0 0 0 78.5 0 2687.65 0 0 0 0 0 0 5576.55 0 0 0 1101409926 92 Waiver service provider--Disability (DHS/DRS) 48 Jasper 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2972.82 0 0 0 0 0 0 0 0 0 0 0 0 0 2972.82 0 0 0 1101409928 1235133935 10 Physicians JOHNSON DAVID 616152602 80 Peoria 0 1 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 1 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15.7 0 316.6 0 0 0 0 0 0 332.3 0 0 0 1101409947 1275621195 63 Other Providers of Medical Equipment/Supplies (Non-registered) WALGREENS HOME CARE INC 604451404 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 233 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 233 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15320.5 0 0 0 0 0 0 15320.5 0 0 0 1101409949 1326147935 10 Physicians AGNE MARY 622235000 96 St Clair 0 1 Family Practice 0 8 0 0 11 0 0 0 0 0 0 13 0 66 0 0 0 0 0 0 71 0 0 15 0 0 0 0 0 0 16 0 326 0 0 0 0 0 0 71 0 0 15 0 0 0 0 0 0 16 0 326 0 0 0 0 0 0 185 0 0 616.91 0 0 0 0 0 0 96.74 0 4102.51 0 0 0 0 0 0 5001.16 0 0 0 1101409950 1013968262 39 Hospice GENESIS HOSPICE 527223406 200 Cook 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 109533.47 0 0 0 0 0 0 0 0 0 0 0 109533.47 0 0 0 1101409974 1952570509 47 Local Education Agencies CARY C C SCHOOL DIST 26 600131426 71 McHenry 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 87 0 0 0 0 185 0 0 0 0 0 0 0 0 0 0 0 0 0 5023 0 0 0 0 185 0 0 0 0 0 0 0 0 0 0 0 0 0 5023 0 0 0 0 1002.25 0 0 0 0 0 0 0 0 0 0 0 0 0 59170.48 0 60172.73 0 0 0 1101409977 1700972999 10 Physicians SPIRTOVIC SUADA 604355765 107 Will 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 204 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 204 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14248.86 0 0 0 0 0 0 14248.86 0 0 0 1101409998 1790915700 25 Audiologists PURDY JAMIE 627025222 91 Sangamon 0 0 0 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 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1203.89 1203.89 0 0 0 1101410010 1194986240 11 Dentists OSAN MARIA 604382711 200 Cook 0 0 Prosthodontist 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 278 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 278 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9648.25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9648.25 0 0 0 1101410011 1235260357 24 Speech Therapists MOSEY GAIL 604501120 40 Grundy 0 0 0 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 0 261 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 261 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19428.84 19428.84 0 0 0 1101410014 2100400432 91 Waiver service provider--Adults (DHS/DDD) SPRINGFIELD DEVELOPMENTAL CENT 627079732 91 Sangamon 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 1470 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1470 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80772.99 0 0 0 0 0 0 0 0 0 0 0 0 0 80772.99 0 0 0 1101410025 1003843517 10 Physicians TAM MARIA 606472607 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 3 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2.58 0 3004.2 0 0 0 0 0 0 3006.78 0 0 0 1101410027 1972533990 36 Community mental health provider JEFFERSON CO COMPREHENSIVE SVC 628640054 49 Jefferson 0 0 0 509 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 743 0 0 4258 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6967 0 0 4258 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6967 0 0 103231.59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 460042.82 0 0 563274.41 0 0 0 1101410036 1437279130 74 Hospital-Based Transportation Providers MORRISON COMMUNITY HOSPITAL 612703042 106 Whiteside 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 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9594.99 0 0 0 0 0 0 9594.99 0 0 0 1101410059 1295819688 16 Nurse Practitioners SHALLOW CHARLENE 627026700 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3002.36 0 0 0 0 0 0 3002.36 0 0 0 1101410074 92 Waiver service provider--Disability (DHS/DRS) 63 Macon 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 22454.59 0 0 0 0 0 0 0 0 0 0 0 0 0 22454.59 0 0 0 1101410080 1710182670 10 Physicians BAILEY MICHELE 606123849 200 Cook 0 0 Internal Medicine 0 0 0 0 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BOYD MEMORIAL HOSPIT 620161436 39 Greene 0 1 Direct Access 0 326 1576 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2519 6117 0 175 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2519 6117 0 175 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6878 233916.09 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 240794.09 0 0 0 1101410092 1841295342 13 Podiatrists KULEKOWSKIS ANNMARIE 606184715 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 247 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1376 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1376 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16097.07 0 0 0 0 0 0 16097.07 0 0 0 1101410098 63 Other Providers of Medical Equipment/Supplies (Non-registered) 815 Indiana 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 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 0 327.98 0 0 0 0 0 0 327.98 0 0 0 1101410110 1982768883 60 Pharmacies CURRYS FAMILY PHARMACY INC 625619739 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 1345 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 33474 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 473.89 0 0 72457.58 0 0 0 72931.47 0 0 0 1101410117 1275710477 10 Physicians BAUM TARA 614010500 56 Knox 0 0 Obstetric-Gynecology 0 0 0 0 8 0 0 0 0 0 0 154 0 273 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 247 0 844 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 247 0 844 0 0 0 0 0 0 0 0 0 193.07 0 0 0 0 0 0 14066.91 0 79421.37 0 0 0 0 0 0 93681.35 0 0 0 1101410122 1649365917 10 Physicians GARDNER ROBERT 637038399 826 Missouri 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 9 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 340.66 0 2974.56 0 0 0 0 0 0 3315.22 0 0 0 1101410139 1164475018 75 Department of Alcohol and Substance Abuse Provider BOBBY E WRIGHT CCMHC 606122705 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1836 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1836 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125084.81 0 0 125084.81 0 0 0 1101410141 1780698050 70 Ambulance Service 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0 0 0 0 0 0 178.92 0 0 0 1101410228 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21766.47 0 0 0 0 0 0 0 0 0 0 0 0 0 21766.47 0 0 0 1101410231 1760631683 16 Nurse Practitioners ALLEN SUSAN 627011034 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 692 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 744 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 744 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27682.86 0 0 0 0 0 0 27682.86 0 0 0 1101410232 1841240322 10 Physicians AHMED MOHAMMED 618012530 19 Champaign 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 305 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 577 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 577 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36841.32 0 0 0 0 0 0 36841.32 0 0 0 1101410256 2100400674 90 Waiver service provider--Elderly (DOA) WESLEY VLG UNITED METHODIST 614553428 70 McDonough 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 963 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 963 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48979.92 0 0 0 0 0 0 0 0 0 0 0 0 0 48979.92 0 0 0 1101410257 1508863531 10 Physicians MINGOLELLI GERALD 604292078 200 Cook 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 1 0 295 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 730 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 730 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2.58 0 65089.73 0 0 0 0 0 0 65092.31 0 0 0 1101410259 1225047921 10 Physicians ALSHAHROUR ADEEB 606392057 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 7 0 0 0 0 0 0 77 0 249 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 139 0 590 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 139 0 590 0 0 0 0 0 0 0 0 0 534.69 0 0 0 0 0 0 6539.3 0 66207.28 0 0 0 0 0 0 73281.27 0 0 0 1101410265 1851409825 10 Physicians CORDES TIMOTHY 462025109 815 Indiana 0 0 Pediatric Cardiology 0 0 0 0 0 0 0 0 0 0 0 2 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107.84 0 408.13 0 0 0 0 0 0 515.97 0 0 0 1101410274 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 11329.67 0 0 0 0 0 0 0 0 0 0 0 0 0 11329.67 0 0 0 1101410276 1942267604 10 Physicians SAHAJPAL TRIPAT 604532521 200 Cook 0 1 Pediatrics 0 226 0 0 127 0 0 0 0 0 0 36 0 126 0 0 0 0 0 0 1308 0 0 341 0 0 0 0 0 0 59 0 265 0 0 0 0 0 0 1308 0 0 341 0 0 0 0 0 0 59 0 265 0 0 0 0 0 0 2618 0 0 12624.87 0 0 0 0 0 0 663.65 0 11100.92 0 0 0 0 0 0 27007.44 0 0 0 1101410284 1922231901 16 Nurse Practitioners SMITH TRICIA 535625531 852 Wisconsin 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 14 0 0 0 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 0 611.79 0 0 0 0 0 0 611.79 0 0 0 1101410289 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12262 0 0 0 0 0 0 0 0 0 0 0 0 0 12262 0 0 0 1101410290 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 15184.81 0 0 0 0 0 0 0 0 0 0 0 0 0 15184.81 0 0 0 1101410295 1235195702 10 Physicians GERINGER CHARLES 604111748 200 Cook 0 0 Rheumatology 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1575.25 0 0 0 0 0 0 1575.25 0 0 0 1101410311 92 Waiver service provider--Disability (DHS/DRS) 58 La Salle 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 1352.43 0 0 0 0 0 0 0 0 0 0 0 0 0 1352.43 0 0 0 1101410318 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 244 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 244 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11924.55 0 0 0 0 0 0 0 0 0 0 0 0 0 11924.55 0 0 0 1101410319 1700832292 10 Physicians MOTIANI SUNITA 605407430 30 DuPage 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 19 0 0 0 0 0 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 2093.55 0 0 0 0 0 0 2093.55 0 0 0 1101410321 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 37823.05 0 0 0 0 0 0 0 0 0 0 0 0 0 37823.05 0 0 0 1101410329 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 14917.32 0 0 0 0 0 0 0 0 0 0 0 0 0 14917.32 0 0 0 1101410330 10 Physicians 852 Wisconsin 0 0 Pediatrics 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 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 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0 0 0 0 0 0 0 0 0 0 5184.61 5184.61 0 0 0 1101410412 1750581328 12 Optometrists TSENG PARK SUSAN 606431831 200 Cook 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 436 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 224 0 464 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 224 0 464 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6595.07 0 13247.68 0 0 0 0 19842.75 0 0 0 1101410439 1316000821 10 Physicians SINGH DEEPTI 606576708 200 Cook 0 0 Hematology 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1774.93 0 0 0 0 0 0 1774.93 0 0 0 1101410447 1013909068 10 Physicians MATTERA ANTHONY 604733210 200 Cook 0 0 General Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 518 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 518 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 810.98 0 0 0 0 0 0 810.98 0 0 0 1101410455 92 Waiver service provider--Disability (DHS/DRS) 28 De Witt 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 13426.36 0 0 0 0 0 0 0 0 0 0 0 0 0 13426.36 0 0 0 1101410456 98 Waiver service provider--TBI (DHS/DRS) 97 Stephenson 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 503.1 0 0 0 0 0 0 0 0 0 0 0 0 0 503.1 0 0 0 1101410459 1184631087 10 Physicians THOMAS KURIAN 606127330 200 Cook 0 0 Neurology 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 19 0 0 0 0 0 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 1333.53 0 0 0 0 0 0 1333.53 0 0 0 1101410464 1578569505 10 Physicians CAHILL TIMOTHY 600161209 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 497 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 497 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2591.34 0 0 0 0 0 0 2591.34 0 0 0 1101410484 1245277581 10 Physicians RAVIKUMAR SHOBHANA 604358200 107 Will 0 0 Neonatal-Perinatal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 215 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 510 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 510 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49873.68 0 0 0 0 0 0 49873.68 0 0 0 1101410490 1508881871 10 Physicians MANADAN AUGUSTINE 606124861 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 383.16 0 0 0 0 0 0 383.16 0 0 0 1101410491 1821080078 10 Physicians PATEL GAVISH 616142017 80 Peoria 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 199 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 381 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 381 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36203.95 0 0 0 0 0 0 36203.95 0 0 0 1101410517 1992750020 10 Physicians PARK JOHN 607141406 57 Lake 0 0 Colon - Rectal Surgery 0 0 0 0 0 0 0 0 0 0 0 1 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 215 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 215 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35.95 0 10348.79 0 0 0 0 0 0 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0 0 0 722 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1953 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1953 0 0 0 1101410536 92 Waiver service provider--Disability (DHS/DRS) 108 Williamson 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 14066.18 0 0 0 0 0 0 0 0 0 0 0 0 0 14066.18 0 0 0 1101410543 1245287127 22 Physical Therapists EGEL ANNETTE 600532127 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 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 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 658.82 658.82 0 0 0 1101410546 1871695684 10 Physicians DILLARD TIFFANI 618012500 19 Champaign 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32035.7 0 0 0 0 0 0 32035.7 0 0 0 1101410548 91 Waiver service provider--Adults (DHS/DDD) 53 Kane 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 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3323.1 0 0 0 0 0 0 0 0 0 0 0 0 0 3323.1 0 0 0 1101410573 92 Waiver service provider--Disability (DHS/DRS) 66 Marion 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5162.9 0 0 0 0 0 0 0 0 0 0 0 0 0 5162.9 0 0 0 1101410575 55 Early Intervention Services 107 Will 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 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 0 776.52 0 0 0 0 0 0 776.52 0 0 0 1101410589 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 461.82 0 0 0 0 0 0 0 0 0 0 0 0 0 461.82 0 0 0 1101410620 1699733006 36 Community mental health provider CATHOLIC CHARITIES OF SPFLD 620023410 65 Madison 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 6.54 0 2261.96 0 0 0 0 0 0 2268.5 0 0 0 1101410995 92 Waiver service provider--Disability (DHS/DRS) 53 Kane 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 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4652.06 0 0 0 0 0 0 0 0 0 0 0 0 0 4652.06 0 0 0 1101410996 92 Waiver service provider--Disability (DHS/DRS) 77 Morgan 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 1161.12 0 0 0 0 0 0 0 0 0 0 0 0 0 1161.12 0 0 0 1101411005 1992961643 10 Physicians GORDON CYNTHIA 600164550 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 393 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 393 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12056.15 0 0 0 0 0 0 12056.15 0 0 0 1101411006 1912014564 30 General Hospitals ADVOCATE ILLINOIS MASONIC MEDI 606575147 200 Cook DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General 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0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3159.77 0 0 0 0 0 0 0 0 0 0 0 0 0 3159.77 0 0 0 1101411266 10 Physicians 852 Wisconsin 0 0 Rheumatology 0 0 0 0 0 0 0 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 255.9 0 0 0 0 0 0 255.9 0 0 0 1101411272 1922019926 30 General Hospitals TOUCHETTE REGIONAL HOSPITAL 622072397 96 St Clair DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 0 0 0 0 91 0 0 0 0 0 0 1530 0 0 439 0 0 0 0 0 0 0 0 92 0 0 0 0 0 0 9945 0 0 646 0 0 0 0 0 0 0 0 92 0 0 0 0 0 0 9945 0 0 646 0 0 0 0 0 0 0 0 1061.68 0 0 0 0 0 0 154169.75 0 0 26421.4 0 0 0 0 0 181652.83 0 0 0 1101411273 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12432.55 0 0 0 0 0 0 0 0 0 0 0 0 0 12432.55 0 0 0 1101411283 1134159825 10 Physicians 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8968.15 0 0 0 0 0 0 0 0 0 0 0 0 0 8968.15 0 0 0 1101411341 1417936907 10 Physicians SAKSENA FRANKLIN 606123714 200 Cook 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 703 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 937 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 937 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6138.25 0 0 0 0 0 0 6138.25 0 0 0 1101411344 1538208004 10 Physicians LERTSBURAPA KIRKEITH 606740018 53 Kane 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 457 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1086 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1086 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16592.47 0 0 0 0 0 0 16592.47 0 0 0 1101411351 1922326271 11 Dentists PATEL MITALKUMAR 611151621 109 Winnebago 0 0 General Dentistry 0 0 0 644 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107933.56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107933.56 0 0 0 1101411353 1578667416 60 Pharmacies 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CHAMPAIGN URBANA DIALYSIS 618012356 19 Champaign DIALYSIS Outpatient dialysis centers. 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 407 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4858 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130125.94 0 0 0 0 0 130125.94 0 0 0 1101411548 1780840488 10 Physicians NESSIM MARK 605026969 30 DuPage 0 0 Anesthesiology 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 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12157.33 0 0 0 0 0 0 12157.33 0 0 0 1101411551 1023053691 61 Independent Laboratories OCL LABS 604351940 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 744.86 0 0 0 0 0 0 0 0 744.86 0 0 0 1101411572 1467568279 47 Local Education Agencies PARIS UNION SCHOOL DIST 95 619441938 31 Edgar 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5282 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5282 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31109.9 0 31109.9 0 0 0 1101411581 1013934579 10 Physicians MANN CAROLINE 631101010 826 Missouri 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 0 1 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2.58 0 563.9 0 0 0 0 0 0 566.48 0 0 0 1101411593 2100402011 90 Waiver service provider--Elderly (DOA) BEST IN HOME SERVICE INC 600624032 200 Cook 0 0 0 0 0 0 0 0 218 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28352 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28352 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1900461.54 0 0 0 0 0 0 0 0 0 0 0 0 0 1900461.54 0 0 0 1101411596 94 Waiver service provider--Children's support (DHS/DDD) 64 Macoupin 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 286 0 0 0 0 0 0 0 0 0 0 0 0 0 286 0 0 0 1101411597 94 Waiver service provider--Children's support (DHS/DDD) 30 DuPage 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 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16038 0 0 0 0 0 0 0 0 0 0 0 0 0 16038 0 0 0 1101411600 1760595938 10 Physicians POTTER MARK 606371606 200 Cook 0 1 Family Practice 0 76 0 0 19 0 0 0 0 0 0 5 0 111 0 0 0 0 0 0 313 0 0 22 0 0 0 0 0 0 5 0 199 0 0 0 0 0 0 313 0 0 22 0 0 0 0 0 0 5 0 199 0 0 0 0 0 0 857 0 0 1544.68 0 0 0 0 0 0 13.96 0 20897.29 0 0 0 0 0 0 23312.93 0 0 0 1101411603 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 1184.64 0 0 0 0 0 0 0 0 0 0 0 0 0 1184.64 0 0 0 1101411605 1932224243 38 Specialized Mental Health Rehabilitation Facilities (SMHRF) GRASMERE PLACE 606405019 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 754 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15437 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1160234.31 0 0 0 0 0 0 0 1160234.31 0 0 0 1101411643 1417973116 10 Physicians WAYNE JEFFREY 606118702 200 Cook 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2202 0 0 0 0 0 0 2202 0 0 0 1101411653 1134135676 60 Pharmacies WALGREEN CO 631365144 826 Missouri 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 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1335 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6570.01 0 0 0 6570.01 0 0 0 1101411654 91 Waiver service provider--Adults (DHS/DDD) 57 Lake 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 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22644.84 0 0 0 0 0 0 0 0 0 0 0 0 0 22644.84 0 0 0 1101411668 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28735.49 0 0 0 28735.49 0 0 0 1101411705 1891800645 30 General Hospitals RCGCI CANTON 615202444 37 Fulton NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1755 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54270.66 0 0 0 0 0 54270.66 0 0 0 1101411723 1558350967 12 Optometrists VOGEL GARY 622011129 96 St Clair 0 0 Therapeutic Pharmaceutical Agents 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 77 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 0 0 0 1429.72 0 0 0 0 0 0 1429.72 0 0 0 1101411739 1225003411 10 Physicians DRAGUESKU JAMES 604631435 200 Cook 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3998.26 0 0 0 0 0 0 3998.26 0 0 0 1101411746 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 4554.51 0 0 0 0 0 0 0 0 0 0 0 0 0 4554.51 0 0 0 1101411749 1902968928 10 Physicians GOSIENGFIAO YASMIN 606143363 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15198.08 0 0 0 0 0 0 15198.08 0 0 0 1101411751 1851322903 60 Pharmacies KMART STORES OF IL LLC 3233 611092120 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 238 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1892 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49027 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64981.21 0 0 0 64981.21 0 0 0 1101411770 1881885044 10 Physicians ABATE GETAHUN 631102515 826 Missouri 0 0 Internal Medicine 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 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1037.45 0 0 0 0 0 0 1037.45 0 0 0 1101411777 1740267707 13 Podiatrists ANDREAS JULIE 601484932 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 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 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 454.67 0 0 0 0 0 0 454.67 0 0 0 1101411781 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 18812.82 0 0 0 0 0 0 0 0 0 0 0 0 0 18812.82 0 0 0 1101411784 1871646133 63 Other Providers of Medical Equipment/Supplies (Non-registered) PARIS HEALTHCARE CENTER 619441145 31 Edgar 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 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13237.4 0 0 0 0 0 0 13237.4 0 0 0 1101411790 1215030986 60 Pharmacies CVS PHARMACY 3674 606035711 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2988 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4609.65 0 0 0 4609.65 0 0 0 1101411794 98 Waiver service provider--TBI (DHS/DRS) 102 Warren 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2536.5 0 0 0 0 0 0 0 0 0 0 0 0 0 2536.5 0 0 0 1101411807 1750416467 16 Nurse Practitioners SARACCO MARY 601265626 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4186.48 0 0 0 0 0 0 4186.48 0 0 0 1101411846 1801821582 10 Physicians PAES MAURO M 606162333 200 Cook 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 1257 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1991 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1991 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12421.43 0 0 0 0 0 0 12421.43 0 0 0 1101411850 1235183351 10 Physicians KORNBLATT MICHAEL 600532111 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 14 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132.24 0 404.54 0 0 0 0 0 0 536.78 0 0 0 1101411855 10 Physicians 852 Wisconsin 0 0 Radiation Oncology 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 411.61 0 0 0 0 0 0 411.61 0 0 0 1101411861 1932109337 10 Physicians SHARE ROBERT 604771758 200 Cook 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 0 6 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 448 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 448 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48.01 0 7140.28 0 0 0 0 0 0 7188.29 0 0 0 1101411870 1558599100 10 Physicians TUREANU LUMINITA 606118709 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6148.52 0 0 0 0 0 0 6148.52 0 0 0 1101411876 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 25503.74 0 0 0 0 0 0 0 0 0 0 0 0 0 25503.74 0 0 0 1101411882 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11896.88 0 0 0 0 0 0 0 0 0 0 0 0 0 11896.88 0 0 0 1101411914 1619085180 16 Nurse Practitioners MARKS JULIE 601533328 200 Cook 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 221 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 520 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 520 0 0 0 0 0 0 0 0 0 260.89 0 0 0 0 0 0 0 0 23137.28 0 0 0 0 0 0 23398.17 0 0 0 1101411952 30 General Hospitals 839 Pennsylvania NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 0 182.06 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182.06 0 0 0 1101411989 1043237035 10 Physicians ALKHALAF ABDULHAMID 627949636 91 Sangamon 0 0 Infectious Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 318 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 318 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5501.79 0 0 0 0 0 0 5501.79 0 0 0 1101411999 1861579377 10 Physicians DAHODWALA MOHAMED 606295148 200 Cook 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 0 0 938 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2244 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2244 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21765.98 0 0 0 0 0 0 21765.98 0 0 0 1101412016 1811955560 10 Physicians KIRK TODD 604630020 200 Cook 0 0 Ophthalmology 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 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 700.1 0 0 0 0 0 0 700.1 0 0 0 1101412025 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3718 0 0 0 0 0 0 0 0 0 0 0 0 0 3718 0 0 0 1101412029 1285659516 10 Physicians STOCK M CHRISTINE 606118702 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 637.93 0 0 0 0 0 0 637.93 0 0 0 1101412031 10 Physicians 30 DuPage 0 0 Family Practice 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 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 35.39 0 0 0 0 0 0 35.39 0 0 0 1101412053 92 Waiver service provider--Disability (DHS/DRS) 53 Kane 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 1156.08 0 0 0 0 0 0 0 0 0 0 0 0 0 1156.08 0 0 0 1101412065 1255347720 60 Pharmacies BOND DRUG COMPANY OF IL 02986 601204315 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 1662 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 6564 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 144167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1213.3 0 0 304739.12 0 0 0 305952.42 0 0 0 1101412076 1083672950 30 General Hospitals UNITY HOSPITAL 554322718 824 Minnesota NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 5 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 589.5 0 0 0 0 648.71 0 0 0 0 0 0 0 0 0 1238.21 0 0 0 1101412078 1154311694 10 Physicians AQUINO SUZANNE 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 1651 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2190 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2190 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56032.06 0 380.94 0 0 0 0 0 0 56413 0 0 0 1101412086 91 Waiver service provider--Adults (DHS/DDD) 53 Kane 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 0 345 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 345 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18161 0 0 0 0 0 0 0 0 0 0 0 0 0 18161 0 0 0 1101412088 91 Waiver service provider--Adults (DHS/DDD) 53 Kane 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 0 128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17586.76 0 0 0 0 0 0 0 0 0 0 0 0 0 17586.76 0 0 0 1101412091 91 Waiver service provider--Adults (DHS/DDD) 24 Coles 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 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10969.02 0 0 0 0 0 0 0 0 0 0 0 0 0 10969.02 0 0 0 1101412093 91 Waiver service provider--Adults (DHS/DDD) 54 Kankakee 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 492.8 0 0 0 0 0 0 0 0 0 0 0 0 0 492.8 0 0 0 1101412097 1831161959 10 Physicians WANG CHANG YANG 604591554 200 Cook 0 0 Laryngology 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12.76 0 0 0 0 0 0 12.76 0 0 0 1101412105 1023283611 10 Physicians CHOH MARK 604023475 200 Cook 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 157 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 284 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 284 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15505.32 0 0 0 0 0 0 15505.32 0 0 0 1101412106 1063594554 10 Physicians RUMILLA ALFREDO 606472915 200 Cook 0 0 Family Practice 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 474.29 0 0 0 0 0 0 474.29 0 0 0 1101412108 1669429890 10 Physicians DIESFELD JAMES 606133011 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 161 0 308 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 426 0 1522 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 426 0 1522 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1934.7 0 30224.78 0 0 0 0 0 0 32159.48 0 0 0 1101412111 94 Waiver service provider--Children's support (DHS/DDD) 53 Kane 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 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1399.2 0 0 0 0 0 0 0 0 0 0 0 0 0 1399.2 0 0 0 1101412114 1194826115 10 Physicians FRASER KENNETH 616147300 80 Peoria 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 751 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1016 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1016 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43835.58 0 17564.77 0 0 0 0 0 0 61400.35 0 0 0 1101412130 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 10164.43 0 0 0 0 0 0 0 0 0 0 0 0 0 10164.43 0 0 0 1101412138 1912175985 47 Local Education Agencies PEARL CITY COMM UNIT DIST 200 610628816 97 Stephenson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 961 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 961 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23186.18 0 23186.18 0 0 0 1101412144 1316193543 10 Physicians JAFFER ASIM 616021076 80 Peoria 0 1 Family Practice 0 38 0 0 84 0 0 0 0 0 0 71 0 357 0 0 0 0 0 0 209 0 0 176 0 0 0 0 0 0 104 0 546 0 0 0 0 0 0 209 0 0 176 0 0 0 0 0 0 104 0 546 0 0 0 0 0 0 558 0 0 6110.4 0 0 0 0 0 0 507.59 0 14461.65 0 0 0 0 0 0 21637.64 0 0 0 1101412147 10 Physicians 107 Will 0 0 Family Practice 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 279.9 0 0 0 0 0 0 279.9 0 0 0 1101412148 22 Physical Therapists 30 DuPage 0 0 0 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 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 0 536.98 536.98 0 0 0 1101412153 1750583761 55 Early Intervention Services GRULKE LISA 601745771 53 Kane 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 0 0 0 0 0 0 0 0 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18199.95 0 0 0 0 0 0 18199.95 0 0 0 1101412154 13 Podiatrists 54 Kankakee 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 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 9.32 0 0 0 0 0 0 9.32 0 0 0 1101412159 1053643106 10 Physicians KHOUBAEVA ANASTASIA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 401 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 424 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 424 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13530.78 0 0 0 0 0 0 13530.78 0 0 0 1101412171 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22026.63 0 0 0 0 0 0 0 0 0 0 0 0 0 22026.63 0 0 0 1101412173 10 Physicians 826 Missouri 0 0 Internal Medicine 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101412176 1265401475 30 General Hospitals TOTAL RENAL CARE INC 600483229 57 Lake DIALYSIS Outpatient dialysis centers. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1657 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63716.98 0 0 0 0 0 63716.98 0 0 0 1101412181 92 Waiver service provider--Disability (DHS/DRS) 42 Hancock 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 14364.27 0 0 0 0 0 0 0 0 0 0 0 0 0 14364.27 0 0 0 1101412184 1922126390 10 Physicians KAPPIL MARIAM 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 1249 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1759 0 175 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1759 0 175 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29072.59 0 5208.6 0 0 0 0 0 0 34281.19 0 0 0 1101412186 1013100437 24 Speech Therapists BEAVERS COLLEEN 625262126 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4455.31 4455.31 0 0 0 1101412187 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 14 0 0 0 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 6563.27 0 0 0 0 0 0 0 0 0 0 0 0 0 6563.27 0 0 0 1101412199 1801961602 10 Physicians DROBAC STEPHANIE 600771057 200 Cook 0 0 Pediatrics 0 0 0 0 2 0 0 0 0 0 0 18 0 78 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 31 0 118 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 31 0 118 0 0 0 0 0 0 0 0 0 93.1 0 0 0 0 0 0 193.2 0 6635.99 0 0 0 0 0 0 6922.29 0 0 0 1101412211 1811918964 10 Physicians BRECKLIN CAROLYN 606123723 200 Cook 0 0 Nephrology 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 291.06 0 0 0 0 0 0 291.06 0 0 0 1101412212 1710979729 10 Physicians DEYRMENJIAN HOSEP H 600312603 40 Grundy 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 687 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 687 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22647.23 0 0 0 0 0 0 22647.23 0 0 0 1101412224 1144213117 30 General Hospitals REGIONAL MED CENTER MEMPHIS 381032807 844 Tennessee NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 15 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 2402.54 0 0 0 0 21923.59 0 0 0 0 0 0 0 0 0 24326.13 0 0 0 1101412230 1720335458 22 Physical Therapists OVERSTREET COLIN 628121565 36 Franklin 0 0 0 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 0 0 0 0 0 0 0 0 0 0 0 0 1076 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1076 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21485.83 21485.83 0 0 0 1101412235 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10465.65 0 0 0 0 0 0 0 0 0 0 0 0 0 10465.65 0 0 0 1101412247 1881634707 10 Physicians NADIMPALLI RAJA 606575190 200 Cook 0 1 Internal Medicine 0 6 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 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 1101412253 1407817117 10 Physicians KAPUSTIAK JAMES 605276686 30 DuPage 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 1 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3685.79 0 0 0 0 0 0 3685.79 0 0 0 1101412254 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 17704.57 0 0 0 0 0 0 0 0 0 0 0 0 0 17704.57 0 0 0 1101412259 1821098013 10 Physicians ANDERSON DAVID 600105934 57 Lake 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 53 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123 0 211 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123 0 211 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3710.67 0 11003.11 0 0 0 0 0 0 14713.78 0 0 0 1101412273 92 Waiver service provider--Disability (DHS/DRS) 49 Jefferson 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 15898.59 0 0 0 0 0 0 0 0 0 0 0 0 0 15898.59 0 0 0 1101412279 1356342869 10 Physicians CROUGHAN JACK 622233809 96 St Clair 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1247.39 0 0 0 0 0 0 1247.39 0 0 0 1101412289 1699870477 10 Physicians CHERNOFF EDITH 605275993 30 DuPage 0 0 Pediatrics 0 0 0 0 360 0 0 0 0 0 0 0 0 249 0 0 0 0 0 0 0 0 0 714 0 0 0 0 0 0 0 0 388 0 0 0 0 0 0 0 0 0 714 0 0 0 0 0 0 0 0 388 0 0 0 0 0 0 0 0 0 32929.24 0 0 0 0 0 0 0 0 15638.5 0 0 0 0 0 0 48567.74 0 0 0 1101412297 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 186 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 186 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24750 0 0 0 0 0 0 0 0 0 0 0 0 0 24750 0 0 0 1101412301 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24393.6 0 0 0 0 0 0 0 0 0 0 0 0 0 24393.6 0 0 0 1101412308 94 Waiver service provider--Children's support (DHS/DDD) 66 Marion 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 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2898.5 0 0 0 0 0 0 0 0 0 0 0 0 0 2898.5 0 0 0 1101412344 1699860452 10 Physicians MOSHIER BRIAN 527224159 816 Iowa 0 0 Pediatrics 0 0 0 0 2 0 0 0 0 0 0 9 0 5 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 13 0 10 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 13 0 10 0 0 0 0 0 0 0 0 0 268.11 0 0 0 0 0 0 78.77 0 319.1 0 0 0 0 0 0 665.98 0 0 0 1101412345 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14878.87 0 0 0 0 0 0 0 0 0 0 0 0 0 14878.87 0 0 0 1101412346 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 14 0 0 0 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 11973 0 0 0 0 0 0 0 0 0 0 0 0 0 11973 0 0 0 1101412348 1598798779 10 Physicians DELLA TORRE MICAELA 606162333 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 0 309 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 719 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 719 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83990.9 0 0 0 0 0 0 83990.9 0 0 0 1101412350 63 Other Providers of Medical Equipment/Supplies (Non-registered) 816 Iowa 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 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 7639.69 0 0 0 0 0 0 7639.69 0 0 0 1101412353 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7143.5 0 0 0 0 0 0 0 0 0 0 0 0 0 7143.5 0 0 0 1101412361 1356385645 10 Physicians HOOS RICHARD 370723203 844 Tennessee 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1700.39 0 0 0 0 0 0 1700.39 0 0 0 1101412376 1306807763 10 Physicians CHOI SOON JA 605551441 30 DuPage 0 1 Pediatrics 0 122 0 0 116 0 0 0 0 0 0 88 0 139 0 0 0 0 0 0 922 0 0 564 0 0 0 0 0 0 169 0 416 0 0 0 0 0 0 922 0 0 564 0 0 0 0 0 0 169 0 416 0 0 0 0 0 0 1868 0 0 16199.53 0 0 0 0 0 0 1356.42 0 13236.39 0 0 0 0 0 0 32660.34 0 0 0 1101412377 1295767242 16 Nurse Practitioners BURKE KIMBERLY 600155234 57 Lake 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 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 24.69 0 0 0 0 0 0 24.69 0 0 0 1101412378 1902984149 10 Physicians KOLES ELENA 600772953 200 Cook 0 0 General Practice 0 0 0 0 1 0 0 0 0 0 0 0 0 136 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 407 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 407 0 0 0 0 0 0 0 0 0 4.1 0 0 0 0 0 0 0 0 2528.76 0 0 0 0 0 0 2532.86 0 0 0 1101412385 92 Waiver service provider--Disability (DHS/DRS) 49 Jefferson 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 37137.38 0 0 0 0 0 0 0 0 0 0 0 0 0 37137.38 0 0 0 1101412388 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 7409.31 0 0 0 0 0 0 0 0 0 0 0 0 0 7409.31 0 0 0 1101412396 10 Physicians 30 DuPage 0 0 Family Practice 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101412404 1780692863 10 Physicians ROSETT PHILLIP 600761248 57 Lake 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4427.93 0 0 0 0 0 0 4427.93 0 0 0 1101412412 91 Waiver service provider--Adults (DHS/DDD) 97 Stephenson 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 396 0 0 0 0 0 0 0 0 0 0 0 0 0 396 0 0 0 1101412415 1619973765 10 Physicians SADOFF JOHN 622262967 96 St Clair 0 0 Thoracic Surgery 0 0 0 0 0 0 0 0 0 0 0 7 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37.31 0 17462.65 0 0 0 0 0 0 17499.96 0 0 0 1101412425 1831253582 12 Optometrists SEHY MICHAEL 624011859 33 Effingham 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 185.47 0 0 0 0 0 0 185.47 0 0 0 1101412430 1104958966 34 State-operated facility (DHS) UNIT 4464 CYPRESS UPPER CHOATE 629061652 99 Union 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1800 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1043896.2 0 0 0 0 0 0 0 0 0 0 1043896.2 0 0 0 1101412433 1255382834 47 Local Education Agencies EAST ALTON WOOD RIVER HS DIST 620951227 65 Madison 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 711 0 0 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 711 0 0 0 0 308.66 0 0 0 0 0 0 0 0 0 0 0 0 0 10877.18 0 11185.84 0 0 0 1101412448 1760572671 40 Federally Qualified Health Centers AIHS CHGO 606133011 200 Cook 0 1 0 90 75 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 287 296 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 287 296 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 749 17205.6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17954.6 0 0 0 1101412451 1265453856 10 Physicians LIEBMAN REGINA 601262966 30 DuPage 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 76 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 96 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 96 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 936.04 0 1249.17 0 0 0 0 0 0 2185.21 0 0 0 1101412455 91 Waiver service provider--Adults (DHS/DDD) 30 DuPage 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 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24508 0 0 0 0 0 0 0 0 0 0 0 0 0 24508 0 0 0 1101412465 1578551511 16 Nurse Practitioners FUQUA LEHNE GAYLE 627690001 91 Sangamon 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 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 0 230.01 0 0 0 0 0 0 230.01 0 0 0 1101412470 1205805488 30 General Hospitals RUSHVILLE DIALYSIS 626811293 92 Schuyler DIALYSIS Outpatient dialysis centers. 0 0 General Hospital - Adult and Child 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 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 926 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30625.18 0 0 0 0 0 30625.18 0 0 0 1101412489 1851342208 10 Physicians BENSON JEFFREY C. 616033105 80 Peoria 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 403 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 403 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57753.66 0 0 0 0 0 0 57753.66 0 0 0 1101412494 1386851160 16 Nurse Practitioners ROBERTS JENNIFER 610811278 106 Whiteside 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3544.79 0 0 0 0 0 0 3544.79 0 0 0 1101412506 98 Waiver service provider--TBI (DHS/DRS) 80 Peoria 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 14647.39 0 0 0 0 0 0 0 0 0 0 0 0 0 14647.39 0 0 0 1101412509 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 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 5984.03 0 0 0 0 0 0 0 0 0 0 0 0 0 5984.03 0 0 0 1101412518 1699716589 10 Physicians LALA MONA 463123049 815 Indiana 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 301 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 330 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 330 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10106.15 0 0 0 0 0 0 10106.15 0 0 0 1101412537 1992898217 10 Physicians MALCOM RYAN 606472416 200 Cook 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 27 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 4477.86 0 0 0 0 0 0 4477.86 0 0 0 1101412538 1538343876 30 General Hospitals ADVOCATE EUREKA HOSPITAL 615301246 110 Woodford DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 1 0 Hospital childrens mental health 0 0 0 0 0 769 0 0 0 0 12 0 0 0 231 0 0 0 0 0 0 0 0 0 1329 0 0 0 0 12 0 0 0 450 0 0 0 0 0 0 0 0 0 1335 0 0 0 0 29 0 0 0 463 0 0 0 0 0 0 0 0 0 340074.22 0 0 0 0 14350.4 0 0 0 179368.93 0 0 0 0 0 533793.55 0 0 0 1101412558 1427063601 60 Pharmacies BOND DRUG COMPANY OF IL 5282 607144001 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 533 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 2582 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 66452 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.63 0 0 135368.76 0 0 0 135369.39 0 0 0 1101412581 91 Waiver service provider--Adults (DHS/DDD) 33 Effingham 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 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25410 0 0 0 0 0 0 0 0 0 0 0 0 0 25410 0 0 0 1101412600 16 Nurse Practitioners 200 Cook 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37.46 0 0 0 0 0 0 37.46 0 0 0 1101412619 47 Local Education Agencies 49 Jefferson 0 0 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 0 159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5896.17 0 5896.17 0 0 0 1101412626 16 Nurse Practitioners 91 Sangamon 0 0 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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 13381.25 0 0 0 0 0 0 0 0 0 0 0 0 0 13381.25 0 0 0 1101412679 1275511883 10 Physicians MEYERS GARY 600042378 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 1 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 611.79 0 0 0 0 0 0 611.79 0 0 0 1101412681 2100403099 90 Waiver service provider--Elderly (DOA) RENAISSANCE ADULT DAY SRVS INC 606173751 200 Cook 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 2458 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2458 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87441.92 0 0 0 0 0 0 0 0 0 0 0 0 0 87441.92 0 0 0 1101412694 63 Other Providers of Medical Equipment/Supplies (Non-registered) 823 Michigan 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 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 0 796.93 0 0 0 0 0 0 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211464152 821 Maryland 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6950.58 0 0 0 0 6950.58 0 0 0 1101413152 1205872462 10 Physicians FITZPATRICK CAROLYN 603022510 200 Cook 0 1 Family Practice 0 207 0 0 62 0 0 0 0 0 0 33 0 167 0 0 0 0 0 0 1131 0 0 145 0 0 0 0 0 0 46 0 281 0 0 0 0 0 0 1131 0 0 145 0 0 0 0 0 0 46 0 281 0 0 0 0 0 0 2633 0 0 5240.87 0 0 0 0 0 0 125.79 0 10640.83 0 0 0 0 0 0 18640.49 0 0 0 1101413153 1891905097 55 Early Intervention Services SVC WILL GRNDY KANKAKEE CFC 15 604361219 107 Will 0 0 0 1334 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8484 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8484 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 936430.38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 936430.38 0 0 0 1101413160 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23046.48 0 0 0 0 0 0 0 0 0 0 0 0 0 23046.48 0 0 0 1101414342 92 Waiver service provider--Disability (DHS/DRS) 108 Williamson 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 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 5219.24 0 0 0 0 0 0 0 0 0 0 0 0 0 5219.24 0 0 0 1101414350 1871522300 10 Physicians BARTELS STEPHANIE 600042315 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 15 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 0 302.79 0 0 0 0 0 0 302.79 0 0 0 1101414354 14 Chiropractors 42 Hancock 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 29 0 0 0 0 0 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 0 123.12 0 0 0 0 0 0 123.12 0 0 0 1101414395 1164691887 36 Community mental health provider HRDI WOMENS RESIDENTIAL 606362921 200 Cook 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 726 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 699 0 0 726 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 699 0 0 133.2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27394.2 0 0 27527.4 0 0 0 1101414404 1295757086 60 Pharmacies TARGET STORE T 836 601391971 30 DuPage 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 0 0 0 0 0 0 0 0 0 0 0 1717 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43754 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 109362.26 0 0 0 109362.26 0 0 0 1101414405 1952570517 36 Community mental health provider CHRISTOPHER HOUSE 606285010 200 Cook 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 1252 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1355 0 0 1252 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1355 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61364.84 0 0 61364.84 0 0 0 1101414410 1811945389 10 Physicians SCHWER WILLIAM 604821851 200 Cook 0 1 Family Practice 0 27 0 0 6 0 0 0 0 0 0 2 0 39 0 0 0 0 0 0 147 0 0 14 0 0 0 0 0 0 5 0 79 0 0 0 0 0 0 147 0 0 14 0 0 0 0 0 0 5 0 79 0 0 0 0 0 0 363 0 0 218.35 0 0 0 0 0 0 12.72 0 1767.78 0 0 0 0 0 0 2361.85 0 0 0 1101414424 1558329086 10 Physicians KELLY MICHAEL 606120038 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 484.87 0 0 0 0 0 0 484.87 0 0 0 1101414426 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 1867.56 0 0 0 0 0 0 0 0 0 0 0 0 0 1867.56 0 0 0 1101414433 1275881385 16 Nurse Practitioners HOFFMAN DANA 999999999 109 Winnebago 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 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23765.74 0 0 0 0 0 0 23765.74 0 0 0 1101414441 91 Waiver service provider--Adults (DHS/DDD) 50 Jersey 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 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4449.5 0 0 0 0 0 0 0 0 0 0 0 0 0 4449.5 0 0 0 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Pharmacies BOND DRUG COMPANY OF IL 05086 604115422 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1543 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6692 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 150859 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 314000.63 0 0 0 314000.63 0 0 0 1101414478 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 19 0 0 0 0 0 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 9272.05 0 0 0 0 0 0 0 0 0 0 0 0 0 9272.05 0 0 0 1101414481 92 Waiver service provider--Disability (DHS/DRS) 33 Effingham 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9059.78 0 0 0 0 0 0 0 0 0 0 0 0 0 9059.78 0 0 0 1101414494 1174674154 10 Physicians TAO JAMES 605276686 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 421 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 421 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5035.74 0 0 0 0 0 0 5035.74 0 0 0 1101414496 1487879409 55 Early Intervention Services FARK SANDRA 629664755 47 Jackson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 234 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 234 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13113.21 0 0 0 0 0 0 13113.21 0 0 0 1101414500 22 Physical Therapists 71 McHenry 0 0 0 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 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4686.3 4686.3 0 0 0 1101414535 1306885637 10 Physicians QUIRKE PATRICK 605212990 30 DuPage 0 0 Admitting Privileges 0 0 0 0 0 0 0 0 0 0 0 3 0 178 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 288 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 288 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34.38 0 2443.53 0 0 0 0 0 0 2477.91 0 0 0 1101414546 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 14712.13 0 0 0 0 0 0 0 0 0 0 0 0 0 14712.13 0 0 0 1101414550 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 14 0 0 0 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 12094.58 0 0 0 0 0 0 0 0 0 0 0 0 0 12094.58 0 0 0 1101414555 1760477483 10 Physicians BISHOP WARREN 522421082 816 Iowa 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 6 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 0 350.89 0 0 0 0 0 0 350.89 0 0 0 1101414577 1760440259 10 Physicians BOUTIN CHRISTOPHER 601265662 30 DuPage 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 204 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 204 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9695.42 0 0 0 0 0 0 9695.42 0 0 0 1101414588 1033183728 10 Physicians CABLE DAVID 601783192 27 Dekalb 0 0 Cardiovascular Surgery 0 0 0 0 0 0 0 0 0 0 0 2 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24476.03 0 0 0 0 0 0 24476.03 0 0 0 1101414612 1710141551 10 Physicians KOGAN JILLENE 600681127 200 Cook 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 146 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 148 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 148 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 363.83 0 1630.8 0 0 0 0 0 0 1994.63 0 0 0 1101414614 1841251816 10 Physicians LIN OSCAR 620024579 65 Madison 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 1649 0 217 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3177 0 260 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3177 0 260 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65777.65 0 7673.11 0 0 0 0 0 0 73450.76 0 0 0 1101414615 1689626905 13 Podiatrists SARROS ATHANASIA 600622322 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 326 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 830 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 830 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3672.58 0 0 0 0 0 0 3672.58 0 0 0 1101414622 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 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1467670190 29 ICF/MR DIAMONDVIEW 628013742 66 Marion 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 429 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8898 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 824617.85 0 0 0 0 0 0 0 0 0 0 824617.85 0 0 0 1101414774 91 Waiver service provider--Adults (DHS/DDD) 69 Massac 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 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15353.8 0 0 0 0 0 0 0 0 0 0 0 0 0 15353.8 0 0 0 1101414777 1982685897 16 Nurse Practitioners BURNHAM FAYE 601813500 30 DuPage 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 57.66 0 0 0 0 0 0 0 0 2005.68 0 0 0 0 0 0 2063.34 0 0 0 1101414802 16 Nurse Practitioners 30 DuPage 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40.85 0 0 0 0 0 0 40.85 0 0 0 1101414806 1952323693 16 Nurse Practitioners LOKOS CONSTANCE 600073362 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 218.2 0 0 0 0 0 0 218.2 0 0 0 1101414816 92 Waiver service provider--Disability (DHS/DRS) 38 Gallatin 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24185.86 0 0 0 0 0 0 0 0 0 0 0 0 0 24185.86 0 0 0 1101414827 1144270679 11 Dentists LEE ANTHONY 606133217 200 Cook 0 0 General Dentistry 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1412.54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1412.54 0 0 0 1101414835 30 General Hospitals 817 Kansas ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 0 0 0 0 0 3 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 236.17 0 0 0 0 0 0 0 0 236.17 0 0 0 1101415420 1780628008 10 Physicians ARENDS GEORGE R 611112754 109 Winnebago 0 0 Anesthesiology 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 14 0 0 0 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 0 900.64 0 0 0 0 0 0 900.64 0 0 0 1101415440 92 Waiver service provider--Disability (DHS/DRS) 106 Whiteside 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9111.26 0 0 0 0 0 0 0 0 0 0 0 0 0 9111.26 0 0 0 1101415451 1528192556 10 Physicians GOODFRIEND-LEVE RENA N. 602011718 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1834.18 0 0 0 0 0 0 1834.18 0 0 0 1101415455 1922021286 16 Nurse Practitioners BOLEK CARLA 615300000 110 Woodford 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3481.16 0 0 0 0 0 0 3481.16 0 0 0 1101415474 73 Other Transportation Providers ( Non-Registered) 100 Vermilion 0 0 0 0 0 0 0 0 0 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 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 0 258.29 0 0 0 0 0 0 258.29 0 0 0 1101415530 1780601732 10 Physicians YAP FREDERICK 631102515 826 Missouri 0 0 Geriatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1262.81 0 0 0 0 0 0 1262.81 0 0 0 1101415557 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 343.98 0 0 0 0 0 0 0 0 0 0 0 0 0 343.98 0 0 0 1101415579 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16816.34 0 0 0 0 0 0 0 0 0 0 0 0 0 16816.34 0 0 0 1101415592 1861654675 10 Physicians VANDEVEER JANICE 624470640 26 Cumberland 0 0 Family Practice 0 259 0 0 48 0 0 0 0 0 0 97 0 507 0 0 0 0 0 0 2129 0 0 62 0 0 0 0 0 0 182 0 997 0 0 0 0 0 0 2129 0 0 62 0 0 0 0 0 0 182 0 997 0 0 0 0 0 0 5553 0 0 4197.69 0 0 0 0 0 0 725.29 0 50427.42 0 0 0 0 0 0 60903.4 0 0 0 1101415599 1184736621 10 Physicians DONELSON DEBBIE 606197303 200 Cook 0 0 Family Practice 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 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 448.89 0 0 0 0 0 0 448.89 0 0 0 1101415628 1942243381 16 Nurse Practitioners STEWART VERNON M 600450689 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 764.37 0 0 0 0 0 0 764.37 0 0 0 1101415632 92 Waiver service provider--Disability (DHS/DRS) 79 Ogle 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 38122.17 0 0 0 0 0 0 0 0 0 0 0 0 0 38122.17 0 0 0 1101415636 1891770988 10 Physicians SUAREZ VICTOR 605461026 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 1 0 0 0 0 0 0 577 0 272 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1398 0 793 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1398 0 793 0 0 0 0 0 0 0 0 0 6.4 0 0 0 0 0 0 67021.44 0 26232.91 0 0 0 0 0 0 93260.75 0 0 0 1101415641 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 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 2149.41 0 0 0 0 0 0 0 0 0 0 0 0 0 2149.41 0 0 0 1101415674 1285807891 60 Pharmacies WALGREENS 10374 604402202 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 520 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 2640 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 64416 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4.25 0 0 135483.88 0 0 0 135488.13 0 0 0 1101415684 92 Waiver service provider--Disability (DHS/DRS) 54 Kankakee 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 6123.57 0 0 0 0 0 0 0 0 0 0 0 0 0 6123.57 0 0 0 1101415696 1346301173 10 Physicians HONG SUSAN 605276686 30 DuPage 0 1 Internal Medicine 0 10 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 141 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 141 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 638.21 0 0 0 0 0 0 707.21 0 0 0 1101415697 1639107428 10 Physicians ARTHOFER MICHAEL 606946900 200 Cook 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 1313 0 167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1971 0 254 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1971 0 254 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34442.92 0 3899.46 0 0 0 0 0 0 38342.38 0 0 0 1101415701 1477502326 10 Physicians MODI KETKI 606253661 200 Cook 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 0 0 0 150 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 0 0 0 0 0 0 0 0 0 0 0 0 392 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2788.36 0 0 0 0 0 0 2788.36 0 0 0 1101415703 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 27654.12 0 0 0 0 0 0 0 0 0 0 0 0 0 27654.12 0 0 0 1101415705 1013126317 10 Physicians GILLISON CLAUDINE 627949248 91 Sangamon 0 1 Pediatrics 0 86 0 0 132 0 0 0 0 0 0 1 0 173 0 0 0 0 0 0 669 0 0 456 0 0 0 0 0 0 1 0 324 0 0 0 0 0 0 669 0 0 456 0 0 0 0 0 0 1 0 324 0 0 0 0 0 0 1338 0 0 15046 0 0 0 0 0 0 4 0 13149.95 0 0 0 0 0 0 29537.95 0 0 0 1101415714 11 Dentists 96 St Clair 0 0 General Dentistry 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 21.05 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21.05 0 0 0 1101415717 1063537769 11 Dentists HILDEBRAND DARLENE 619240015 31 Edgar 0 0 General Dentistry 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5694.16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5694.16 0 0 0 1101415721 1578844478 16 Nurse Practitioners BHATT VANCHHANA 600842452 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2659.02 0 0 0 0 0 0 2659.02 0 0 0 1101415722 25 Audiologists 852 Wisconsin 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 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 3.42 3.42 0 0 0 1101415731 30 General Hospitals 824 Minnesota NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2562.4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2562.4 0 0 0 1101415743 1932187259 10 Physicians RINK PETER 527227565 816 Iowa 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 6 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106.82 0 613.23 0 0 0 0 0 0 720.05 0 0 0 1101415748 92 Waiver service provider--Disability (DHS/DRS) 19 Champaign 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 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 1055.88 0 0 0 0 0 0 0 0 0 0 0 0 0 1055.88 0 0 0 1101415771 1023085172 10 Physicians BANAAD OMIOTEK MARIA 600773279 200 Cook 0 1 Family Practice 0 204 0 0 51 0 0 0 0 0 0 60 0 302 0 0 0 0 0 0 1377 0 0 89 0 0 0 0 0 0 81 0 850 0 0 0 0 0 0 1377 0 0 89 0 0 0 0 0 0 81 0 850 0 0 0 0 0 0 3526 0 0 2870.89 0 0 0 0 0 0 240.68 0 21228.51 0 0 0 0 0 0 27866.08 0 0 0 1101415786 1093835621 10 Physicians JAIN RENU 601013843 30 DuPage 0 1 Neonatal-Perinatal Medicine 0 154 0 0 197 0 0 0 0 0 0 1 0 222 0 0 0 0 0 0 709 0 0 757 0 0 0 0 0 0 1 0 653 0 0 0 0 0 0 709 0 0 757 0 0 0 0 0 0 1 0 653 0 0 0 0 0 0 1418 0 0 21873.51 0 0 0 0 0 0 4 0 36584.01 0 0 0 0 0 0 59879.52 0 0 0 1101415793 1689852733 94 Waiver service provider--Children's support (DHS/DDD) THE ARC OF WINNBEGO BOONE OGLE 611042230 109 Winnebago 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1541 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1541 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34043.35 0 0 0 0 0 0 0 0 0 0 0 0 0 34043.35 0 0 0 1101415794 1174707467 23 Occupational Therapists GREEN JULIE 627690002 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2422.54 2422.54 0 0 0 1101415801 63 Other Providers of Medical Equipment/Supplies (Non-registered) 96 St Clair 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 176.09 0 0 0 0 176.09 0 0 0 1101415809 92 Waiver service provider--Disability (DHS/DRS) 98 Tazewell 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 1494.67 0 0 0 0 0 0 0 0 0 0 0 0 0 1494.67 0 0 0 1101415813 1891957825 16 Nurse Practitioners BORAWSKI BEATA 606112991 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 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 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4266.17 0 0 0 0 0 0 4266.17 0 0 0 1101415816 1821345489 28 Waiver service provider--Supportive living facility (HFS) OAK HILL SUPPORTIVE LIVING COM 600731302 57 Lake 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 0 413 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10742 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 651812.99 0 0 0 0 0 0 0 0 0 0 0 0 0 651812.99 0 0 0 1101415823 1972502292 16 Nurse Practitioners LINK DOREEN 616157822 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 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 0 0 0 0 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13220.98 0 0 0 0 0 0 13220.98 0 0 0 1101415826 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 2596.72 0 0 0 0 0 0 0 0 0 0 0 0 0 2596.72 0 0 0 1101415827 1326114091 10 Physicians LIPPITZ JONATHON 602011718 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 402 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 443 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 443 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15769.78 0 0 0 0 0 0 15769.78 0 0 0 1101415829 1417962549 60 Pharmacies BOND DRUG COMPANY OF ILLINOIS 604264042 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 1854 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 7070 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 157076 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21.28 0 0 356997.92 0 0 0 357019.2 0 0 0 1101415852 93 Waiver service provider--HIV/AIDS (DHS/DRS) 80 Peoria 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 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 1383.78 0 0 0 0 0 0 0 0 0 0 0 0 0 1383.78 0 0 0 1101415858 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 19703.17 0 0 0 0 0 0 0 0 0 0 0 0 0 19703.17 0 0 0 1101415871 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 16163.2 0 0 0 0 0 0 0 0 0 0 0 0 0 16163.2 0 0 0 1101415884 1073549663 61 Independent Laboratories NEOGENOMICS LABORATORIES INC 339138626 810 Florida 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 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 768.66 0 0 0 0 0 0 0 0 768.66 0 0 0 1101415888 1417997057 10 Physicians CHUA KOK G 605061403 53 Kane 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 12 0 444 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 863 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 863 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71.49 0 11402.75 0 0 0 0 0 0 11474.24 0 0 0 1101415890 97 Waiver service provider--Children's residential (DHS/DDD) 30 DuPage 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 1609 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1609 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 492289.64 0 0 0 0 0 0 0 0 0 0 0 0 0 492289.64 0 0 0 1101415898 91 Waiver service provider--Adults (DHS/DDD) 85 Pulaski 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 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 5401 0 0 0 0 0 0 0 0 0 0 0 0 0 5401 0 0 0 1101415911 1538164645 60 Pharmacies MEDICAL SPECIALISTS PHARMACY 606193100 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 717 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72018 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79502.27 0 0 0 79502.27 0 0 0 1101415917 1730183203 33 Nursing Facilities BALMORAL NURSING HOME 606251001 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 187 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1958 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48500 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3841506.72 0 0 0 0 0 0 0 3841506.72 0 0 0 1101415928 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13892.97 0 0 0 0 0 0 0 0 0 0 0 0 0 13892.97 0 0 0 1101415931 10 Physicians 826 Missouri 0 0 Surgery General 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131.94 0 0 0 0 0 0 131.94 0 0 0 1101415944 1437218666 14 Chiropractors FARRELL DENNIS 613561852 15 Bureau 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 212 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 212 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1892.96 0 0 0 0 0 0 1892.96 0 0 0 1101415946 1861461410 16 Nurse Practitioners ADKINS JULIE 628961957 36 Franklin 0 1 0 161 0 0 15 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 1307 0 0 15 0 0 0 0 0 0 0 0 512 0 0 0 0 0 0 1307 0 0 15 0 0 0 0 0 0 0 0 512 0 0 0 0 0 0 3551 0 0 1294.42 0 0 0 0 0 0 0 0 14760.57 0 0 0 0 0 0 19605.99 0 0 0 1101415948 1194792911 11 Dentists CIMINO VICTOR 601533328 200 Cook 0 0 General Dentistry/Anesthesiology 0 0 0 8 0 0 0 0 0 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 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1418.11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1418.11 0 0 0 1101415954 1144345901 47 Local Education Agencies LINDOP SCHOOL DIST 92 601553930 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2067 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2067 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62373.36 0 62373.36 0 0 0 1101415966 1336245828 30 General Hospitals CHILDRENS HOSPITAL COLORADO 800457106 806 Colorado NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 7 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 0 886.18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 886.18 0 0 0 1101415978 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 15541.86 0 0 0 0 0 0 0 0 0 0 0 0 0 15541.86 0 0 0 1101415984 1205941234 60 Pharmacies METROPOLIS DRUGS 1 629602311 69 Massac 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 744 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9830 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 255302 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 371172.12 0 0 0 371172.12 0 0 0 1101415988 98 Waiver service provider--TBI (DHS/DRS) 47 Jackson 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 21201.38 0 0 0 0 0 0 0 0 0 0 0 0 0 21201.38 0 0 0 1101415996 1831157619 11 Dentists STARSIAK MARY 606342623 200 Cook 0 0 General Dentistry 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 253 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 253 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8343.08 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8343.08 0 0 0 1101416004 1619223500 11 Dentists GAJULA TULASI 999999999 64 Macoupin 0 0 0 0 0 6 0 0 0 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 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 300 0 0 0 1101416029 1942240890 10 Physicians ISLAM NIGEL N 477030359 815 Indiana 0 0 Internal Medicine 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 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 897.99 0 0 0 0 0 0 897.99 0 0 0 1101416039 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 262 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 262 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13217.35 0 0 0 0 0 0 0 0 0 0 0 0 0 13217.35 0 0 0 1101416040 1972679355 10 Physicians EGBUJIOBI LEO 535111842 852 Wisconsin 0 0 Emergency Medicine 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 76.52 0 0 0 0 0 0 76.52 0 0 0 1101416048 1790789360 16 Nurse Practitioners SPREEN NANCY 629595884 108 Williamson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4057.76 0 0 0 0 0 0 4057.76 0 0 0 1101416051 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 20941.93 0 0 0 0 0 0 0 0 0 0 0 0 0 20941.93 0 0 0 1101416054 1083829899 13 Podiatrists SILVERBLATT MANUEL 606141502 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 293 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1186 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1186 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1601.11 0 0 0 0 0 0 1601.11 0 0 0 1101416058 1912286865 30 General Hospitals PALOS PARK DIALYSIS 604621162 200 Cook DIALYSIS Outpatient dialysis centers. 0 0 General Hospital - Adult and Child 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 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 461 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5318.1 0 0 0 0 0 5318.1 0 0 0 1101416065 2100406483 71 Medicar Provider FREEDOM FIRST TRANSPORTATION 605428190 53 Kane 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 0 0 0 1467 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1467 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14668.58 0 0 0 0 0 0 14668.58 0 0 0 1101416068 1396977278 10 Physicians HOYE AUBREY 545218835 852 Wisconsin 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 228.6 0 0 0 0 0 0 228.6 0 0 0 1101416085 10 Physicians 815 Indiana 0 0 Radiology Diagnosis 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10.75 0 0 0 0 0 0 0 0 10.75 0 0 0 1101416097 1801809322 10 Physicians UCKERMAN MARY 601601612 200 Cook 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 282 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 634 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 634 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4144.87 0 0 0 0 0 0 0 0 4144.87 0 0 0 1101416100 1326040981 13 Podiatrists SEHY STEPHEN 631321228 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 187 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 828 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 828 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9494.84 0 0 0 0 0 0 9494.84 0 0 0 1101416104 1871511568 10 Physicians BROOKS CHRISTOPHER 631101010 826 Missouri 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 1 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1.01 0 1742.57 0 0 0 0 0 0 1743.58 0 0 0 1101416115 1841306693 10 Physicians SHAH KETAN 622981592 75 Monroe 0 0 Otorhinolaryngology 0 0 0 0 2 0 0 0 0 0 0 0 0 134 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 296 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 296 0 0 0 0 0 0 0 0 0 40.52 0 0 0 0 0 0 0 0 6393.45 0 0 0 0 0 0 6433.97 0 0 0 1101416149 1346315017 10 Physicians WIET RICHARD 606751611 200 Cook 0 0 Otolaryngology 0 0 0 0 0 0 0 0 0 0 0 0 0 138 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 382 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 382 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21850.27 0 0 0 0 0 0 21850.27 0 0 0 1101416154 1336129642 48 Rural Health Clinics UNION COUNTY OUTPT HLTH CLINIC 629061668 99 Union 0 0 0 0 2049 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8112 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8112 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 301731.83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 301731.83 0 0 0 1101416155 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 0 253 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 253 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6806.37 0 0 0 0 0 0 0 0 0 0 0 0 0 6806.37 0 0 0 1101416201 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8522.56 0 0 0 0 0 0 0 0 0 0 0 0 0 8522.56 0 0 0 1101416229 1548290109 10 Physicians SHIH TIANCHU 605601690 55 Kendall 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 0 0 163 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 543 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 543 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11952.73 0 0 0 0 0 0 11952.73 0 0 0 1101416236 1962438689 10 Physicians ARKEMA HELEN 600898155 57 Lake 0 1 Pediatrics 0 265 0 0 220 0 0 0 0 0 0 73 0 296 0 0 0 0 0 0 2239 0 0 702 0 0 0 0 0 0 77 0 365 0 0 0 0 0 0 2239 0 0 702 0 0 0 0 0 0 77 0 365 0 0 0 0 0 0 4478 0 0 22963.3 0 0 0 0 0 0 703.76 0 15288.28 0 0 0 0 0 0 43433.34 0 0 0 1101416247 1831329200 11 Dentists BOTEZATU VLAD 606222850 200 Cook 0 0 General Dentistry 0 0 0 385 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1590 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1590 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61882.58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61882.58 0 0 0 1101416259 1427227776 14 Chiropractors LANDGREBE CHARLES 604773724 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 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 567.43 0 0 0 0 0 0 567.43 0 0 0 1101416268 1689668964 10 Physicians UHLER JEFFREY 600473217 57 Lake 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 763.56 0 0 0 0 0 0 763.56 0 0 0 1101416270 1568415859 10 Physicians MANYAM VANI 478042770 815 Indiana 0 0 Oncology 0 0 0 0 0 0 0 0 0 0 0 7 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 96 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 96 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 749.26 0 1698.24 0 0 0 0 0 0 2447.5 0 0 0 1101416272 1962512335 10 Physicians ROBERTS J R 604731052 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 214 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 214 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1870.02 0 0 0 0 0 0 1870.02 0 0 0 1101416283 1891762761 10 Physicians LIEBERMAN STEVEN 601901295 30 DuPage 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1522.63 0 0 0 0 0 0 1522.63 0 0 0 1101416294 16 Nurse Practitioners 826 Missouri 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 153.5 0 0 0 0 0 0 153.5 0 0 0 1101416300 1629158662 10 Physicians AFTAB NOZAINA 601484932 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 265 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 265 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2469.87 0 0 0 0 0 0 2469.87 0 0 0 1101416307 1871656314 63 Other Providers of Medical Equipment/Supplies (Non-registered) AMERICAN MEDICAL EQUIPMENT 600894530 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 170 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3677 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3677 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 317427.43 0 16.54 0 0 0 0 317443.97 0 0 0 1101416308 10 Physicians 852 Wisconsin 0 0 Emergency Medicine 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 44 0 0 0 1101416313 1346269966 10 Physicians LOMASNEY JON 606114402 200 Cook 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 210 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 210 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1442.38 0 0 0 0 0 0 0 0 1442.38 0 0 0 1101416315 1194970798 16 Nurse Practitioners DICKEMPER RACHEL 631101010 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230.74 0 0 0 0 0 0 230.74 0 0 0 1101416326 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 14 0 0 0 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 8377.32 0 0 0 0 0 0 0 0 0 0 0 0 0 8377.32 0 0 0 1101416332 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7156.96 0 0 0 0 0 0 0 0 0 0 0 0 0 7156.96 0 0 0 1101416333 1679573901 10 Physicians DRIESSNACK RICHARD 616052507 80 Peoria 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 33 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 840.46 0 11898 0 0 0 0 0 0 12738.46 0 0 0 1101416334 1285892794 16 Nurse Practitioners THURMAN BILLIE 478044010 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 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 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6137.19 0 0 0 0 0 0 6137.19 0 0 0 1101416336 1023041290 10 Physicians KATSOYANNIS GEORGE 606123833 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 2 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21821.66 0 0 0 0 0 0 21821.66 0 0 0 1101416343 1477531580 30 General Hospitals UNIVERSITY HOSPITAL 800452545 806 Colorado ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 0 0 0 0 0 9 0 0 0 0 3 0 0 0 2 0 0 0 0 0 0 0 0 0 11 0 0 0 0 3 0 0 0 2 0 0 0 0 0 0 0 0 0 11 0 0 0 0 5 0 0 0 2 0 0 0 0 0 0 0 0 0 2316.81 0 0 0 0 1293.52 0 0 0 16.03 0 0 0 0 0 3626.36 0 0 0 1101416344 1821030909 63 Other Providers of Medical Equipment/Supplies (Non-registered) ELECTROMED INC 560711134 824 Minnesota 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59793.62 0 0 0 0 0 0 59793.62 0 0 0 1101416364 10 Physicians 53 Kane 0 0 Family Practice 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 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 0 0 0 0 0 0 0 0 0 0 0 1101416366 1912206731 33 Nursing Facilities WAY FAIR NURSING AND REHAB CTR 628371203 104 Wayne 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 482 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13553 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1142859.65 0 0 0 0 0 0 0 1142859.65 0 0 0 1101416369 1023005881 10 Physicians KHANNA RAMESH 601235702 53 Kane 0 0 Urological Surgery 0 0 0 0 0 0 0 0 0 0 0 23 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 287 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 287 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 341.71 0 9211.52 0 0 0 0 0 0 9553.23 0 0 0 1101416377 1578726717 10 Physicians HUTCHENS KELLI 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 290 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 420 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 420 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7904.35 0 0 0 0 0 0 0 0 7904.35 0 0 0 1101416379 1861493652 10 Physicians SCHIFFER MARK 600503151 71 McHenry 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 153 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3192.02 0 274.64 0 0 0 0 0 0 3466.66 0 0 0 1101416382 1164472304 60 Pharmacies ALTAMONT PHARMACY INC 624111408 33 Effingham 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 883 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8815 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 210817 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 297087.49 0 0 0 297087.49 0 0 0 1101416389 1265525760 16 Nurse Practitioners DEWOLFE KELLY A 604022338 200 Cook 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2512.48 0 0 0 0 0 0 2512.48 0 0 0 1101416398 92 Waiver service provider--Disability (DHS/DRS) 107 Will 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 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 0 994.32 0 0 0 0 0 0 0 0 0 0 0 0 0 994.32 0 0 0 1101416403 10 Physicians 200 Cook 0 0 Family Practice 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101416409 1952359655 16 Nurse Practitioners HAUGEN MAUREEN 606143363 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5215.85 0 0 0 0 0 0 5215.85 0 0 0 1101416411 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 20480.66 0 0 0 0 0 0 0 0 0 0 0 0 0 20480.66 0 0 0 1101416418 1720014640 16 Nurse Practitioners RICHARD MARGARET 606112991 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1011.32 0 0 0 0 0 0 1011.32 0 0 0 1101416421 1417188418 10 Physicians MUHAMMAD SAAD 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 510 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 510 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11580.03 0 0 0 0 0 0 11580.03 0 0 0 1101416437 1407970312 22 Physical Therapists GOWAN JULIE 605407411 58 La Salle 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 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 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12320.76 12320.76 0 0 0 1101416439 1447421854 10 Physicians SPIEGEL TIMOTHY 631081301 826 Missouri 0 0 Child/Adolescent Psychiatry Residency 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2191.86 0 0 0 0 0 0 2191.86 0 0 0 1101416457 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5655.34 0 0 0 0 0 0 0 0 0 0 0 0 0 5655.34 0 0 0 1101416458 1265618573 30 General Hospitals VANDALIA DIALYSIS 624712061 34 Fayette DIALYSIS Outpatient dialysis centers. 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3071.36 0 0 0 0 0 3071.36 0 0 0 1101416468 2100406886 98 Waiver service provider--TBI (DHS/DRS) HEALTHCARE PLUS HOMEMAKERS LLC 606412932 200 Cook 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 337432.51 0 0 0 0 0 0 0 0 0 0 0 0 0 337432.51 0 0 0 1101416481 1093047318 36 Community mental health provider HOWARD COUNSELING SERVICES INC 604402396 107 Will 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 829 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 829 0 0 465.51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78976.28 0 0 79441.79 0 0 0 1101416482 10 Physicians 852 Wisconsin 0 0 General Practice 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 96.05 0 0 0 0 0 0 0 0 96.05 0 0 0 1101416486 30 General Hospitals 844 Tennessee ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 0 0 0 0 0 4 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 703.92 0 0 0 0 10961.8 0 0 0 0 0 0 0 0 0 11665.72 0 0 0 1101416487 1427044171 10 Physicians ZIMMERMAN RANDY 600102379 57 Lake 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 2 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59.86 0 1073.55 0 0 0 0 0 0 1133.41 0 0 0 1101416491 1316965916 10 Physicians HILL CLINT PATRICK 420033800 818 Kentucky 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 22 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2476.86 0 16357.58 0 0 0 0 0 0 18834.44 0 0 0 1101416499 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12022.39 0 0 0 0 0 0 0 0 0 0 0 0 0 12022.39 0 0 0 1101416509 93 Waiver service provider--HIV/AIDS (DHS/DRS) 98 Tazewell 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 13316.06 0 0 0 0 0 0 0 0 0 0 0 0 0 13316.06 0 0 0 1101416519 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 7368.65 0 0 0 0 0 0 0 0 0 0 0 0 0 7368.65 0 0 0 1101416534 1548214877 10 Physicians NORMAN TRINA 606281063 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 899 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 952 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 952 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29300.99 0 0 0 0 0 0 29300.99 0 0 0 1101416544 1902853526 10 Physicians FORNARIS IGNACIO 606222850 200 Cook 0 1 General Practice 0 170 0 0 5 0 0 0 0 0 0 4 0 237 0 0 0 0 0 0 1245 0 0 6 0 0 0 0 0 0 7 0 1274 0 0 0 0 0 0 1245 0 0 6 0 0 0 0 0 0 7 0 1274 0 0 0 0 0 0 3561 0 0 136.96 0 0 0 0 0 0 17.89 0 16012.17 0 0 0 0 0 0 19728.02 0 0 0 1101416545 1356369524 30 General Hospitals HENNEPIN COUNTY MEDICAL CENTER 554151829 824 Minnesota NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 18 0 0 0 0 5 0 0 0 3 0 0 0 0 0 0 0 0 0 22 0 0 0 0 5 0 0 0 3 0 0 0 0 0 0 0 0 0 22 0 0 0 0 18 0 0 0 3 0 0 0 0 0 0 0 0 0 1888.89 0 0 0 0 10201.03 0 0 0 466.91 0 0 0 0 0 12556.83 0 0 0 1101416560 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 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Related Group (DRG) system. 0 0 0 0 0 0 29 0 0 0 0 0 0 913 0 0 578 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 3248 0 0 1722 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 3248 0 0 1722 0 0 0 0 0 0 0 0 242.22 0 0 0 0 0 0 16958.81 0 0 267201.56 0 0 0 0 0 284402.59 0 0 0 1101416648 1043388242 10 Physicians WESTPHAL MARK L 629015347 47 Jackson 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 0 0 0 190 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 395 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 395 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23487.65 0 0 0 0 0 0 23487.65 0 0 0 1101416681 1407821077 10 Physicians WATTANAKIT KEATTIYOAT 616145016 80 Peoria 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 7 0 895 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 1408 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 1408 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 187.77 0 24142.75 0 0 0 0 0 0 24330.52 0 0 0 1101416689 1386687556 10 Physicians DASGUPTA TAPAS 606162857 200 Cook 0 0 Physical Medicine/Rehabilitation 0 65 0 0 0 0 0 0 0 0 0 0 0 431 0 0 0 0 0 0 202 0 0 0 0 0 0 0 0 0 0 0 3480 0 0 0 0 0 0 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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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26.64 0 0 0 0 0 0 26.64 0 0 0 1101416791 1932297736 13 Podiatrists HEFFELFINGER LYNN R 610811252 106 Whiteside 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 253 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 253 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1302.28 0 0 0 0 0 0 1302.28 0 0 0 1101416816 92 Waiver service provider--Disability (DHS/DRS) 72 McLean 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 5574.99 0 0 0 0 0 0 0 0 0 0 0 0 0 5574.99 0 0 0 1101416819 1467715276 12 Optometrists BURGETT SARAH 999999999 45 Henry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 453 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 453 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11433.16 0 0 0 0 0 0 11433.16 0 0 0 1101416821 92 Waiver service provider--Disability (DHS/DRS) 30 DuPage 0 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1255365490 10 Physicians MOLITCH MARK 606118709 200 Cook 0 0 Endocrinology 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 979.2 0 0 0 0 0 0 979.2 0 0 0 1101416851 1821109786 10 Physicians NAROTAM PRADEEP 478071057 815 Indiana 0 0 Neurology Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 261 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 261 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61707.06 0 0 0 0 0 0 61707.06 0 0 0 1101416852 1750428116 47 Local Education Agencies MASCOUTAH CU DISTRICT 19 622581362 96 St Clair 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 92 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 3458 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 3458 0 0 0 0 122.2 0 0 0 0 0 0 0 0 0 0 0 0 0 54456.07 0 54578.27 0 0 0 1101416854 1760479679 63 Other Providers of Medical Equipment/Supplies (Non-registered) ALDEN PRINCETON REHAB HLTH CTR 606213767 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 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4791.93 0 0 0 0 0 0 4791.93 0 0 0 1101416857 91 Waiver service provider--Adults (DHS/DDD) 96 St Clair 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 0 334 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 334 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22015.6 0 0 0 0 0 0 0 0 0 0 0 0 0 22015.6 0 0 0 1101416866 1972514594 23 Occupational Therapists CHEN BYERLEY LILLIAN 600933509 200 Cook 0 0 0 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 0 733 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 733 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9202.68 9202.68 0 0 0 1101416867 1275566317 10 Physicians KANDIS ANN 612821804 89 Rock Island 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 247 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 247 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1826.9 0 0 0 0 0 0 1826.9 0 0 0 1101416869 1386857712 16 Nurse Practitioners MACKEY CHRISTINE 601901237 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729 0 0 0 0 0 0 0 0 236 0 0 0 0 0 0 7734 0 0 2999 0 0 0 0 0 0 0 0 236 0 0 0 0 0 0 7734 0 0 2999 0 0 0 0 0 0 0 0 1393 0 0 0 0 0 0 42161.77 0 0 259072.87 0 0 0 0 0 302627.64 0 0 0 1101416965 1487791091 16 Nurse Practitioners LEONARDI JOSEPH 623012834 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 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 1073.63 0 0 0 0 0 0 1073.63 0 0 0 1101416968 1720011919 10 Physicians DASSANI JITENDRA 606575147 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 287 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 287 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5064.62 0 0 0 0 0 0 5064.62 0 0 0 1101416984 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24393.6 0 0 0 0 0 0 0 0 0 0 0 0 0 24393.6 0 0 0 1101416986 1952529919 10 Physicians 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0 0 0 0 0 0 0 0 0 0 0 0 107382.9 107382.9 0 0 0 1101419220 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 39209.88 0 0 0 0 0 0 0 0 0 0 0 0 0 39209.88 0 0 0 1101419232 1609885185 30 General Hospitals BENTON DIALYSIS 628121500 36 Franklin DIALYSIS Outpatient dialysis centers. 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 307 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2703 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65625.07 0 0 0 0 0 65625.07 0 0 0 1101419237 1881620458 10 Physicians KRAVIS DEAN 607141466 200 Cook 0 1 Endocrinology 0 7 0 0 0 0 0 0 0 0 0 0 0 171 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 340 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 340 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 3036.68 0 0 0 0 0 0 3069.68 0 0 0 1101419240 1992952212 36 Community mental health provider THRESHOLDS 606101985 200 Cook 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Henry 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 12249.39 0 0 0 0 0 0 0 0 0 0 0 0 0 12249.39 0 0 0 1101419940 1891951638 10 Physicians PENG YEN YI 627949639 91 Sangamon 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7670.38 0 0 0 0 0 0 7670.38 0 0 0 1101419944 1205853579 60 Pharmacies WAL MART 10 1420 601072255 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 592 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2249 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62273 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77401.36 0 0 0 77401.36 0 0 0 1101419951 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19545.22 0 0 0 0 0 0 0 0 0 0 0 0 0 19545.22 0 0 0 1101419981 1508850694 13 Podiatrists 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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 15994.34 0 0 0 0 0 0 0 0 0 0 0 0 0 15994.34 0 0 0 1101420101 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 20924.76 0 0 0 0 0 0 0 0 0 0 0 0 0 20924.76 0 0 0 1101420106 1326205212 10 Physicians LANGERMAN ALEXANDER 605277594 30 DuPage 0 0 Otolaryngology 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 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 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1156.35 0 0 0 0 0 0 1156.35 0 0 0 1101420109 30 General Hospitals 805 California NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 Children's Hospital 0 0 0 0 0 2 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 122.15 0 0 0 0 3529.32 0 0 0 0 0 0 0 0 0 3651.47 0 0 0 1101420121 1992706360 10 Physicians RABIN BARRY M 606944850 200 Cook 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 909 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1344 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1344 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36369.85 0 1170.74 0 0 0 0 0 0 37540.59 0 0 0 1101420135 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16086.67 0 0 0 0 0 0 0 0 0 0 0 0 0 16086.67 0 0 0 1101420146 1306899216 10 Physicians CHAFFIN EDITH 606196113 200 Cook 0 1 Family Practice 0 1807 0 0 1 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 11901 0 0 2 0 0 0 0 0 0 0 0 152 0 0 0 0 0 0 11901 0 0 2 0 0 0 0 0 0 0 0 152 0 0 0 0 0 0 33969 0 0 48.22 0 0 0 0 0 0 0 0 2825.87 0 0 0 0 0 0 36843.09 0 0 0 1101420158 1043344211 55 Early Intervention Services FECZKO SUSAN 606146005 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 314 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 0 0 0 0 0 0 0 0 0 0 0 0 1258 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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provider--Disability (DHS/DRS) 97 Stephenson 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 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3778.35 0 0 0 0 0 0 0 0 0 0 0 0 0 3778.35 0 0 0 1101420257 1144376872 10 Physicians SHULRUFF REEVA 606091745 200 Cook 0 1 Pediatrics 0 228 0 0 49 0 0 0 0 0 0 1 0 51 0 0 0 0 0 0 594 0 0 142 0 0 0 0 0 0 1 0 75 0 0 0 0 0 0 594 0 0 142 0 0 0 0 0 0 1 0 75 0 0 0 0 0 0 1195 0 0 5210.16 0 0 0 0 0 0 4 0 2871.65 0 0 0 0 0 0 9280.81 0 0 0 1101420258 1114993979 10 Physicians BARHOUM MAAN 600483267 57 Lake 0 0 Endocrinology 0 0 0 0 0 0 0 0 0 0 0 0 0 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 233 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 233 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2443.41 0 0 0 0 0 0 2443.41 0 0 0 1101420272 92 Waiver service provider--Disability (DHS/DRS) 30 DuPage 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 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 3619.39 0 0 0 0 0 0 0 0 0 0 0 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(DHS/DRS) 91 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 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 1677.66 0 0 0 0 0 0 0 0 0 0 0 0 0 1677.66 0 0 0 1101420470 1093774465 10 Physicians VENUGOPAL PARAMESWARAN 606123841 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 332 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 332 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5629.8 0 0 0 0 0 0 5629.8 0 0 0 1101420486 63 Other Providers of Medical Equipment/Supplies (Non-registered) 71 McHenry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7.57 0 3.58 0 0 0 0 11.15 0 0 0 1101420509 1518980226 12 Optometrists TANAKA BLAIR 604401872 107 Will 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 329 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 329 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 395 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 395 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13415.38 0 0 0 0 0 0 13415.38 0 0 0 1101424735 1073680187 10 Physicians WIENER PAULINE 601881935 30 DuPage 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 318 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 318 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 167.03 0 0 0 0 0 0 167.03 0 0 0 1101424744 1558373175 63 Other Providers of Medical Equipment/Supplies (Non-registered) KINETIC ORTHOTICS INC 605581032 200 Cook 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 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8308.07 0 0 0 0 8308.07 0 0 0 1101424747 1841281326 10 Physicians DAVIS RICHARD 600102426 57 Lake 0 1 Internal Medicine 0 19 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 126 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 126 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 379 0 0 0 0 0 0 0 0 0 0 0 1672.03 0 0 0 0 0 0 2051.03 0 0 0 1101424758 2100415176 36 Community mental health provider ONARGA ACADEMY 609551340 46 Iroquois 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 717 0 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 717 0 0 2123.1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41046.73 0 0 43169.83 0 0 0 1101424760 1801855218 10 Physicians WREN KELLY 190442279 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 1 0 725 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 771 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 771 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35.95 0 27725.3 0 0 0 0 0 0 27761.25 0 0 0 1101424780 92 Waiver service provider--Disability (DHS/DRS) 10 Adams 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 19 0 0 0 0 0 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 0 978.92 0 0 0 0 0 0 0 0 0 0 0 0 0 978.92 0 0 0 1101424782 92 Waiver service provider--Disability (DHS/DRS) 104 Wayne 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 16454.74 0 0 0 0 0 0 0 0 0 0 0 0 0 16454.74 0 0 0 1101424794 1871572602 10 Physicians WATSON CAROLYN 420012743 818 Kentucky 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1768.25 0 0 0 0 0 0 0 0 1768.25 0 0 0 1101424800 10 Physicians 815 Indiana 0 0 Anesthesiology 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 268.36 0 0 0 0 0 0 268.36 0 0 0 1101424804 1598805483 10 Physicians WU JACK 604358200 107 Will 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 1065 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37500.16 0 0 0 0 0 0 37500.16 0 0 0 1101424807 1134139363 10 Physicians BENZINGER TAMMIE 631101016 826 Missouri 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 190 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 269 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 269 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10135.95 0 270.19 0 0 0 0 0 0 10406.14 0 0 0 1101424810 92 Waiver service provider--Disability (DHS/DRS) 57 Lake 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 9598.09 0 0 0 0 0 0 0 0 0 0 0 0 0 9598.09 0 0 0 1101424814 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 10376.27 0 0 0 0 0 0 0 0 0 0 0 0 0 10376.27 0 0 0 1101424833 1790716900 10 Physicians BENJOYA ROSS 600771309 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74.42 0 0 0 0 0 0 0 0 74.42 0 0 0 1101424841 1447446257 10 Physicians TAZEEN FARAH 605212962 30 DuPage 0 1 Internal Medicine 0 7 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 2361.43 0 0 0 0 0 0 2413.43 0 0 0 1101424854 1225070014 10 Physicians IANNUCCI THOMAS 600681127 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 354 0 296 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 717 0 722 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 717 0 722 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35247.24 0 43732.64 0 0 0 0 0 0 78979.88 0 0 0 1101424858 1568426260 46 Ambulatory Surgical Treatment Centers PEORIA DAY SURGERY CENTER 616142085 80 Peoria ASTC Ambulatory Surgical Treatment Center. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1294.49 41164.4 0 0 0 0 0 42458.89 0 0 0 1101424865 1376656504 16 Nurse Practitioners MCKINDLES TIMOTHY 601181416 53 Kane 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 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 328.64 0 0 0 0 0 0 328.64 0 0 0 1101424870 1437183456 63 Other Providers of Medical Equipment/Supplies (Non-registered) MED PHARM PHARMACY 478023562 815 Indiana 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 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2717.58 0 0 0 0 0 0 2717.58 0 0 0 1101424875 1144502949 55 Early Intervention Services PANT RUMMY 601921157 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 475 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 475 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43055.5 0 0 0 0 0 0 43055.5 0 0 0 1101424883 1952319154 22 Physical Therapists NOONAN WILLIAM 617391550 61 Livingston 0 0 0 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 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 756.31 756.31 0 0 0 1101424884 1720257678 10 Physicians STORM DOUGLAS 999999999 816 Iowa 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 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2525.6 0 0 0 0 0 0 2525.6 0 0 0 1101424906 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 23346.62 0 0 0 0 0 0 0 0 0 0 0 0 0 23346.62 0 0 0 1101424917 1841208725 10 Physicians MOSTELLO DOROTHEA 630442512 826 Missouri 0 0 Maternal and Fetal Medicine 0 0 0 0 0 0 0 0 0 0 0 51 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2901.52 0 5255.91 0 0 0 0 0 0 8157.43 0 0 0 1101424920 1811951197 10 Physicians VASAVADA RAJIV J 604877581 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 211 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 211 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 917.76 0 0 0 0 0 0 917.76 0 0 0 1101424925 30 General Hospitals 815 Indiana NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 313 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2807.19 0 0 0 0 0 2807.19 0 0 0 1101424926 1386883593 11 Dentists DIETZ GREGORY 615541568 98 Tazewell 0 0 General Dentistry 0 0 0 656 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4007 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4007 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135058.64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135058.64 0 0 0 1101424933 1801876057 10 Physicians DUONG CHRISTINE 600678167 200 Cook 0 1 Pediatrics 0 253 0 0 116 0 0 0 0 0 0 98 0 144 0 0 0 0 0 0 573 0 0 399 0 0 0 0 0 0 119 0 266 0 0 0 0 0 0 573 0 0 399 0 0 0 0 0 0 119 0 266 0 0 0 0 0 0 1146 0 0 12690.28 0 0 0 0 0 0 523.65 0 7443.83 0 0 0 0 0 0 21803.76 0 0 0 1101424945 1710256631 16 Nurse Practitioners KUYKENDALL TAYLOR JESSICA 61354 58 La Salle 0 0 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 29 0 0 0 0 0 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 0 757.31 0 0 0 0 0 0 757.31 0 0 0 1101424962 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 8080.39 0 0 0 0 0 0 0 0 0 0 0 0 0 8080.39 0 0 0 1101424964 1801854856 10 Physicians ROTHBARD ROBIN B. 606751620 200 Cook 0 1 Family Practice 0 49 0 0 14 0 0 0 0 0 0 6 0 89 0 0 0 0 0 0 149 0 0 26 0 0 0 0 0 0 12 0 269 0 0 0 0 0 0 149 0 0 26 0 0 0 0 0 0 12 0 269 0 0 0 0 0 0 348 0 0 898.42 0 0 0 0 0 0 34.98 0 5037.21 0 0 0 0 0 0 6318.61 0 0 0 1101424965 1518963859 10 Physicians RAVIN AMY 631102515 80 Peoria 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 1 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71.9 0 2278.61 0 0 0 0 0 0 2350.51 0 0 0 1101424971 1679748552 10 Physicians DASAR RAJU JAYASRI 604292043 200 Cook 0 0 Family Practice 0 86 0 0 42 0 0 0 0 0 0 52 0 188 0 0 0 0 0 0 644 0 0 102 0 0 0 0 0 0 82 0 385 0 0 0 0 0 0 644 0 0 102 0 0 0 0 0 0 82 0 385 0 0 0 0 0 0 1610 0 0 4063.3 0 0 0 0 0 0 439.17 0 17556.78 0 0 0 0 0 0 23669.25 0 0 0 1101424978 1003862400 10 Physicians GALVIN SHANNON 606118709 200 Cook 0 0 Infectious Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 170 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 170 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3673.17 0 0 0 0 0 0 3673.17 0 0 0 1101424982 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 18342.05 0 0 0 0 0 0 0 0 0 0 0 0 0 18342.05 0 0 0 1101424990 1841262789 10 Physicians PINEDA RAYMUND O 629023988 108 Williamson 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 385 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25701.96 0 0 0 0 0 0 25701.96 0 0 0 1101424992 92 Waiver service provider--Disability (DHS/DRS) 107 Will 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 20794.56 0 0 0 0 0 0 0 0 0 0 0 0 0 20794.56 0 0 0 1101424997 1174530489 30 General Hospitals PEKIN HOSPITAL 615544936 98 Tazewell DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 0 2 0 0 0 2575 0 0 0 0 411 0 0 7 1040 0 0 0 0 0 2 0 0 0 4248 0 0 0 0 477 0 0 7 2187 0 0 0 0 0 2 0 0 0 4248 0 0 0 0 1592 0 0 7 2187 0 0 0 0 0 0 0 0 0 495119.31 0 0 0 0 483336.31 0 0 7963.67 341780.76 0 0 0 0 0 1328200.05 0 0 0 1101425022 1518921659 16 Nurse Practitioners CHERNY LILY 603051817 200 Cook 0 0 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 92 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 1663.11 0 0 0 0 0 0 1663.11 0 0 0 1101425026 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 303 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 303 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17875 0 0 0 0 0 0 0 0 0 0 0 0 0 17875 0 0 0 1101425029 92 Waiver service provider--Disability (DHS/DRS) 98 Tazewell 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 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 0 692.04 0 0 0 0 0 0 0 0 0 0 0 0 0 692.04 0 0 0 1101425031 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 15742.55 0 0 0 0 0 0 0 0 0 0 0 0 0 15742.55 0 0 0 1101425038 1821097924 10 Physicians POSHNI AFTAB 600147449 71 McHenry 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 272 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 272 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2729.16 0 0 0 0 0 0 2729.16 0 0 0 1101425042 1497855886 10 Physicians DERRICK MARVIN 625264163 63 Macon 0 0 Thoracic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14143.96 0 0 0 0 0 0 14143.96 0 0 0 1101425044 36 Community mental health provider 200 Cook 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 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 0 180.2 0 0 180.2 0 0 0 1101425046 10 Physicians 852 Wisconsin 0 0 Pediatrics 0 0 0 0 0 0 0 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 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 578.5 0 0 0 0 0 0 578.5 0 0 0 1101425050 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19758 0 0 0 0 0 0 0 0 0 0 0 0 0 19758 0 0 0 1101425052 1528126836 16 Nurse Practitioners SMITH KAREN 601533328 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 611.59 0 0 0 0 0 0 611.59 0 0 0 1101425057 47 Local Education Agencies 60 Lee 0 0 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 0 187 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 187 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2875.54 0 2875.54 0 0 0 1101425064 1659573129 47 Local Education Agencies MORRIS SCHOOL DIST 54 604503614 40 Grundy 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5280 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5280 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47898.86 0 47898.86 0 0 0 1101425076 1205973856 55 Early Intervention Services MARIS MICHELLE 617239000 62 Logan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 291 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 291 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18986.11 0 0 0 0 0 0 18986.11 0 0 0 1101425078 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 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 43644.35 0 0 0 0 0 0 0 0 0 0 0 0 0 43644.35 0 0 0 1101425083 1104810191 10 Physicians NAGAR CHARULATHA 600621455 200 Cook 0 0 Neurology 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 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1820.38 0 0 0 0 0 0 1820.38 0 0 0 1101425087 1154484673 10 Physicians RODIN MIRIAM 631102515 826 Missouri 0 0 Internal Medicine 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 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 723.25 0 0 0 0 0 0 723.25 0 0 0 1101425088 92 Waiver service provider--Disability (DHS/DRS) 76 Montgomery 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 44398.4 0 0 0 0 0 0 0 0 0 0 0 0 0 44398.4 0 0 0 1101425092 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25018 0 0 0 0 0 0 0 0 0 0 0 0 0 25018 0 0 0 1101425098 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 25892.33 0 0 0 0 0 0 0 0 0 0 0 0 0 25892.33 0 0 0 1101425101 1255373494 10 Physicians PARKER REBECCA 618012396 19 Champaign 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 497 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 538 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 538 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20545.17 0 0 0 0 0 0 20545.17 0 0 0 1101425107 2100415525 71 Medicar Provider METRO EAST TRANSPORT LLC 622341827 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 330 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17674 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17674 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 261574.62 0 0 0 0 0 0 261574.62 0 0 0 1101425116 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 14428.36 0 0 0 0 0 0 0 0 0 0 0 0 0 14428.36 0 0 0 1101425136 1447327036 10 Physicians ZEMAN DAVID 619442460 31 Edgar 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 194 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 317 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 317 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6451.99 0 0 0 0 0 0 6451.99 0 0 0 1101425144 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19547 0 0 0 0 0 0 0 0 0 0 0 0 0 19547 0 0 0 1101425147 1134135726 60 Pharmacies WALGREENS 05144 527322537 816 Iowa 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 683 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5026 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115976 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 195555.84 0 0 0 195555.84 0 0 0 1101425160 1497902761 75 Department of Alcohol and Substance Abuse Provider PROCARE CENTERS 601603902 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 317 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 317 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21293.87 0 0 21293.87 0 0 0 1101425170 2100415588 91 Waiver service provider--Adults (DHS/DDD) MARCFIRST 617612192 72 McLean 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3320986.22 0 0 0 0 0 0 0 0 0 0 0 0 0 3320986.22 0 0 0 1101425179 92 Waiver service provider--Disability (DHS/DRS) 77 Morgan 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8487.83 0 0 0 0 0 0 0 0 0 0 0 0 0 8487.83 0 0 0 1101425192 94 Waiver service 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0 0 0 0 0 0 3536.85 0 0 0 1101425229 1336335967 55 Early Intervention Services CRANE GENA 603042022 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 0 152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8050.29 0 0 0 0 0 0 8050.29 0 0 0 1101425234 1639335193 10 Physicians DAVIS KURTIS 623213551 42 Hancock 0 1 Family Practice 0 610 0 0 209 0 0 0 0 0 0 40 0 390 0 0 0 0 0 0 5541 0 0 1223 0 0 0 0 0 0 62 0 1213 0 0 0 0 0 0 5541 0 0 1223 0 0 0 0 0 0 62 0 1213 0 0 0 0 0 0 14187 0 0 33854.86 0 0 0 0 0 0 1885.58 0 78659.84 0 0 0 0 0 0 128587.28 0 0 0 1101425246 1619184991 16 Nurse Practitioners GARVEY PEGGY 606143363 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1255.74 0 0 0 0 0 0 1255.74 0 0 0 1101425250 1629027958 12 Optometrists LEAHY TIMOTHY 623631447 83 Pike 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 697 0 368 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2087 0 385 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2087 0 385 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40508.96 0 11007.51 0 0 0 0 51516.47 0 0 0 1101425252 92 Waiver service provider--Disability (DHS/DRS) 50 Jersey 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 7091.45 0 0 0 0 0 0 0 0 0 0 0 0 0 7091.45 0 0 0 1101425254 2100415672 90 Waiver service provider--Elderly (DOA) SOUTH EAST ASIA CENTER 606403004 200 Cook 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 3347 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3347 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117855.04 0 0 0 0 0 0 0 0 0 0 0 0 0 117855.04 0 0 0 1101425256 1770534562 91 Waiver service provider--Adults (DHS/DDD) LITTLE CITY FOUNDATION 600674799 200 Cook 0 0 0 0 0 0 0 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75723 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75723 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5489522.31 0 0 0 0 0 0 0 0 0 0 0 0 0 5489522.31 0 0 0 1101425257 1285631838 10 Physicians SAGAN ANNA 606324008 200 Cook 0 1 Family Practice 0 175 0 0 11 0 0 0 0 0 0 10 0 845 0 0 0 0 0 0 341 0 0 25 0 0 0 0 0 0 12 0 1741 0 0 0 0 0 0 341 0 0 25 0 0 0 0 0 0 12 0 1741 0 0 0 0 0 0 839 0 0 861 0 0 0 0 0 0 124.46 0 61389.32 0 0 0 0 0 0 63213.78 0 0 0 1101425266 63 Other Providers of Medical Equipment/Supplies (Non-registered) 816 Iowa 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5301.01 0 0 0 0 5301.01 0 0 0 1101425268 1619926672 10 Physicians OTOOLE JOHN 606123835 200 Cook 0 0 Neurology Surgery 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 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8684.16 0 0 0 0 0 0 8684.16 0 0 0 1101425276 1316902919 10 Physicians GROS WILLIAM H 605252234 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 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MCMANUS TARA 999999999 107 Will 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 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49.26 0 0 0 0 0 0 49.26 0 0 0 1101425294 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4158 0 0 0 0 0 0 0 0 0 0 0 0 0 4158 0 0 0 1101425307 1992034532 16 Nurse Practitioners TISDALE MARY L 616043221 80 Peoria 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 186 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 680 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 680 0 0 0 0 0 0 0 0 0 184.87 0 0 0 0 0 0 0 0 41224.15 0 0 0 0 0 0 41409.02 0 0 0 1101425326 11 Dentists 107 Will 0 0 General Dentistry 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 233.3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 233.3 0 0 0 1101425327 91 Waiver service provider--Adults (DHS/DDD) 30 DuPage 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 0 222 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 222 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16555 0 0 0 0 0 0 0 0 0 0 0 0 0 16555 0 0 0 1101425336 1174545669 10 Physicians SEYMOUR JAY 601871039 30 DuPage 0 1 Family Practice 0 13 0 0 11 0 0 0 0 0 0 3 0 34 0 0 0 0 0 0 82 0 0 11 0 0 0 0 0 0 3 0 86 0 0 0 0 0 0 82 0 0 11 0 0 0 0 0 0 3 0 86 0 0 0 0 0 0 193 0 0 897.12 0 0 0 0 0 0 24.76 0 1608.99 0 0 0 0 0 0 2723.87 0 0 0 1101425344 24 Speech Therapists 97 Stephenson 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 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 0 145.12 145.12 0 0 0 1101425346 1922197268 10 Physicians HUSSAIN SAKHAWAT 606313222 200 Cook 0 1 Gastroenterology 0 8 0 0 0 0 0 0 0 0 0 3 0 349 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 3 0 876 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 3 0 876 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 5.04 0 56403.97 0 0 0 0 0 0 56502.01 0 0 0 1101425368 1629173331 16 Nurse Practitioners TWENHAFEL TERRI 999999999 47 Jackson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 275 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 275 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8016.34 0 0 0 0 0 0 8016.34 0 0 0 1101425382 1790978252 10 Physicians MIKOLAJCZAK PETER 631366111 826 Missouri 0 0 Cardiovascular Diseases 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 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 2466.17 0 0 0 0 0 0 2466.17 0 0 0 1101425389 10 Physicians 852 Wisconsin 0 0 Anesthesiology 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31.14 0 0 0 0 0 0 31.14 0 0 0 1101425394 1487824850 11 Dentists DOLGI WILLIAM 606183935 76 Montgomery 0 0 Orthodontist 0 0 0 104 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 0 0 0 0 0 0 0 0 0 0 0 0 295 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80205.26 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 2170.69 0 0 0 1101425448 10 Physicians 815 Indiana 0 0 Pediatric Pulmonary 0 0 0 0 0 0 0 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 249.51 0 0 0 0 0 0 249.51 0 0 0 1101425452 1366592313 10 Physicians WAGNER WEINER LINDA 606496686 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 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 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2177.77 0 0 0 0 0 0 2177.77 0 0 0 1101425455 1851332159 70 Ambulance Service Providers PARK RIDGE FIRE DEPT 600684182 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 290 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 290 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9618.55 0 0 0 0 0 0 9618.55 0 0 0 1101425459 1891755351 30 General Hospitals METHODIST HOSPITAL OF CHICAGO 606402772 200 Cook DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 0 0 0 0 0 0 0 0 0 0 0 228 0 0 351 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 926 0 0 494 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 926 0 0 494 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5710.69 0 0 12783.43 0 0 0 0 0 18494.12 0 0 0 1101425462 91 Waiver service provider--Adults (DHS/DDD) 89 Rock Island 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 0 306 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 306 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16785.94 0 0 0 0 0 0 0 0 0 0 0 0 0 16785.94 0 0 0 1101425479 1053696674 30 General Hospitals DSI SCOTTSDALE RENAL CENTER 606521779 200 Cook ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 443 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5904 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 128114.43 0 0 0 0 0 128114.43 0 0 0 1101425483 1952352031 10 Physicians BUCZYNA JOHN 616147300 80 Peoria 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 1414 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2436 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 1858 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 57497.63 0 0 0 0 0 0 0 0 0 0 0 9408.75 0 0 0 0 66906.38 0 0 0 1101425524 1861597007 10 Physicians BLUMENTHAL STANLEY 604561135 200 Cook 0 0 Endocrinology 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 112.85 0 0 0 0 0 0 112.85 0 0 0 1101425526 10 Physicians 826 Missouri 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120.2 0 149.5 0 0 0 0 0 0 269.7 0 0 0 1101425528 1447467394 10 Physicians RAMAN KATHLEEN 631101010 826 Missouri 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 1 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 315.42 0 0 0 0 0 0 315.42 0 0 0 1101425531 1144216300 10 Physicians VANHOOSE JAMES 420033813 818 Kentucky 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 229 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 335 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 335 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6888.85 0 342.9 0 0 0 0 0 0 7231.75 0 0 0 1101425535 92 Waiver service provider--Disability (DHS/DRS) 56 Knox 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 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 0 744.52 0 0 0 0 0 0 0 0 0 0 0 0 0 744.52 0 0 0 1101425540 11 Dentists 62 Logan 0 0 General Dentistry 0 0 0 1 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 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 1101425552 1386741403 47 Local Education Agencies CUMBERLAND C U SCHOOL DIST 77 624684214 26 Cumberland 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5482 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5482 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98824.18 0 98824.18 0 0 0 1101425561 1982601001 12 Optometrists KLAUSS REYNOLDS KIRSTEN 620351685 65 Madison 0 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0 0 0 0 0 0 0 0 998.78 0 0 0 0 0 0 0 0 0 0 0 0 0 998.78 0 0 0 1101425672 1992032809 48 Rural Health Clinics MEDICAL ARTS CLINIC 629667049 47 Jackson 0 1 0 728 657 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6602 3846 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6602 3846 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17877 158854.17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 176731.17 0 0 0 1101425673 1568570158 10 Physicians PRENDERGAST MICHAEL 602023456 200 Cook 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 15 0 427 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 1224 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 1224 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 185.47 0 32313.99 0 0 0 0 0 0 32499.46 0 0 0 1101425681 91 Waiver service provider--Adults (DHS/DDD) 30 DuPage 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 0 351 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 351 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17145.17 0 0 0 0 0 0 0 0 0 0 0 0 0 17145.17 0 0 0 1101425690 94 Waiver service provider--Children's support (DHS/DDD) 55 Kendall 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 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0 0 94600.53 0 0 0 1101425703 1740337427 63 Other Providers of Medical Equipment/Supplies (Non-registered) GEO ALLEN SHOES INC 604062406 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 323 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 688 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 688 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15350.47 0 1151.13 0 0 0 0 16501.6 0 0 0 1101425704 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 207 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 207 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12243 0 0 0 0 0 0 0 0 0 0 0 0 0 12243 0 0 0 1101425707 1285966473 47 Local Education Agencies EVANSTON TOWNSHIP HSD 202 602043494 200 Cook 0 0 0 0 0 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 163 0 0 0 0 261 0 0 0 0 0 0 0 0 0 0 0 0 0 4220 0 0 0 0 261 0 0 0 0 0 0 0 0 0 0 0 0 0 4220 0 0 0 0 1343.72 0 0 0 0 0 0 0 0 0 0 0 0 0 114248.05 0 115591.77 0 0 0 1101425715 98 Waiver service provider--TBI (DHS/DRS) 103 Washington 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 35102.26 0 0 0 0 0 0 0 0 0 0 0 0 0 35102.26 0 0 0 1101425721 92 Waiver service provider--Disability (DHS/DRS) 19 Champaign 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9385.83 0 0 0 0 0 0 0 0 0 0 0 0 0 9385.83 0 0 0 1101425725 10 Physicians 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 1862.92 0 0 0 0 0 0 1862.92 0 0 0 1101425729 1003883463 10 Physicians NEMIVANT RAVI 605406551 30 DuPage 0 0 Pulmonary Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2433.88 0 0 0 0 0 0 2433.88 0 0 0 1101425741 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 350 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 350 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12287 0 0 0 0 0 0 0 0 0 0 0 0 0 12287 0 0 0 1101425745 1174517270 10 Physicians MIHALOV MICHAEL 606313707 200 Cook 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 242 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 363 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 363 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2899.55 0 0 0 0 0 0 0 0 2899.55 0 0 0 1101425746 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 14143.12 0 0 0 0 0 0 0 0 0 0 0 0 0 14143.12 0 0 0 1101425749 1255301107 10 Physicians SAUNDERS MARY 627033807 91 Sangamon 0 1 Internal Medicine 0 54 0 0 0 0 0 0 0 0 0 17 0 51 0 0 0 0 0 0 366 0 0 0 0 0 0 0 0 0 31 0 104 0 0 0 0 0 0 366 0 0 0 0 0 0 0 0 0 31 0 104 0 0 0 0 0 0 1071 0 0 0 0 0 0 0 0 0 157.18 0 1445.17 0 0 0 0 0 0 2673.35 0 0 0 1101425760 1013241686 16 Nurse Practitioners MOHRMANN CAROLINE E 631600352 200 Cook 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 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1452.16 0 0 0 0 0 0 1452.16 0 0 0 1101425775 1023021433 10 Physicians MASCHMANN JENNIFER 613621512 15 Bureau 0 0 Obstetric-Gynecology 0 0 0 0 15 0 0 0 0 0 0 101 0 287 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 198 0 912 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 198 0 912 0 0 0 0 0 0 0 0 0 844.01 0 0 0 0 0 0 5098.37 0 86277.2 0 0 0 0 0 0 92219.58 0 0 0 1101425786 98 Waiver service provider--TBI (DHS/DRS) 37 Fulton 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 2064.65 0 0 0 0 0 0 0 0 0 0 0 0 0 2064.65 0 0 0 1101425793 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13609.95 0 0 0 0 0 0 0 0 0 0 0 0 0 13609.95 0 0 0 1101425803 1700808417 60 Pharmacies TARGET T 1167 600257636 200 Cook 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 0 605 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17883 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42420.88 0 0 0 42420.88 0 0 0 1101425809 1699720300 10 Physicians JAVED BADR 600852321 57 Lake 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 281 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 281 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15364.11 0 0 0 0 0 0 15364.11 0 0 0 1101425811 92 Waiver service provider--Disability (DHS/DRS) 30 DuPage 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 5907.81 0 0 0 0 0 0 0 0 0 0 0 0 0 5907.81 0 0 0 1101425814 1740448323 10 Physicians DE LA GARZA LOUIS 604023429 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 240 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 240 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6760.54 0 0 0 0 0 0 6760.54 0 0 0 1101425818 1124009162 12 Optometrists RADFORD SASHA 999999999 61 Livingston 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 236 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 476 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 476 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12678.93 0 3456.2 0 0 0 0 16135.13 0 0 0 1101425821 1063445765 10 Physicians DAUZ VIRGINIA B 625651757 94 Shelby 0 1 Pediatrics 0 47 0 0 20 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 447 0 0 24 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 447 0 0 24 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 894 0 0 1684 0 0 0 0 0 0 0 0 4208.01 0 0 0 0 0 0 6786.01 0 0 0 1101425824 1710932264 10 Physicians PATEL AASITA 601734714 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 453 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 969 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 969 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9245.71 0 0 0 0 0 0 9245.71 0 0 0 1101425830 1609038868 10 Physicians LINK CHAD 477470001 815 Indiana 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3343.3 0 0 0 0 0 0 3343.3 0 0 0 1101425876 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 275 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 275 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14958.9 0 0 0 0 0 0 0 0 0 0 0 0 0 14958.9 0 0 0 1101425881 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 14763.37 0 0 0 0 0 0 0 0 0 0 0 0 0 14763.37 0 0 0 1101425892 1942279435 36 Community mental health provider ALTERNATIVES COUNSELING INC 620340639 65 Madison 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 175 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 175 0 0 549.45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10055.16 0 0 10604.61 0 0 0 1101425911 1740280312 10 Physicians VELDMAN MARIE 604777725 200 Cook 0 1 Family Practice 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 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2490.39 0 0 0 0 0 0 2490.39 0 0 0 1101425913 1215999602 10 Physicians JONES ALEXIS 606123227 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 61 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103 0 408 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103 0 408 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 289.54 0 35810.23 0 0 0 0 0 0 36099.77 0 0 0 1101425919 1104095199 47 Local Education Agencies WESTERN CUSD 12 623121031 83 Pike 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 868 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 868 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6757.95 0 6757.95 0 0 0 1101425920 91 Waiver service provider--Adults (DHS/DDD) 91 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 0 238 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 238 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24626.8 0 0 0 0 0 0 0 0 0 0 0 0 0 24626.8 0 0 0 1101425932 1245211259 10 Physicians MARTINEZ DAVID 600987530 71 McHenry 0 1 Family Practice 0 8 0 0 0 0 0 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 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 1101425933 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 2870.14 0 0 0 0 0 0 0 0 0 0 0 0 0 2870.14 0 0 0 1101425943 1962462820 10 Physicians HOROWITZ RUSSELL 606143363 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 744 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 793 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 793 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31751.34 0 0 0 0 0 0 31751.34 0 0 0 1101425953 1508911801 10 Physicians KWAK JENNY 601533328 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111 0 0 0 0 0 0 0 0 0 0 0 0 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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 9465.45 0 0 0 0 0 0 0 0 0 0 0 0 0 9465.45 0 0 0 1101425976 13 Podiatrists 200 Cook 0 0 0 0 0 0 0 0 0 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 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 0.88 0 0 0 0 0 0 0.88 0 0 0 1101425977 1548440027 10 Physicians EGGENER SCOTT 605276686 30 DuPage 0 0 Urological Surgery 0 0 0 0 0 0 0 0 0 0 0 2 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14.35 0 13416.72 0 0 0 0 0 0 13431.07 0 0 0 1101426005 1881685071 10 Physicians HUSSAIN JABEEN 606441580 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 252 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2013 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2013 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59027.25 0 0 0 0 0 0 59027.25 0 0 0 1101426007 1659373371 10 Physicians WISE STEPHEN 606081610 200 Cook 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 106 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 337.55 0 0 0 1101426497 2100416915 94 Waiver service provider--Children's support (DHS/DDD) JEWISH CHILD AND FAMILY SRVCS 606066920 200 Cook 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 0 533 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 533 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28237.47 0 0 0 0 0 0 0 0 0 0 0 0 0 28237.47 0 0 0 1101426502 1770697716 55 Early Intervention Services SARDINA DEBBIE 600745613 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23635.19 0 0 0 0 0 0 23635.19 0 0 0 1101426523 1740483262 10 Physicians LINAREZ ESTEBAN 603024463 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 171 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 171 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4896.85 0 0 0 0 0 0 4896.85 0 0 0 1101426528 1881613487 10 Physicians SMITH ELBERT B 606171174 200 Cook 0 1 Emergency Medicine 0 71 0 0 0 0 0 0 0 0 0 0 0 760 0 0 0 0 0 0 413 0 0 0 0 0 0 0 0 0 0 0 1200 0 0 0 0 0 0 413 0 0 0 0 0 0 0 0 0 0 0 1200 0 0 0 0 0 0 1239 0 0 0 0 0 0 0 0 0 0 0 31438.75 0 0 0 0 0 0 32677.75 0 0 0 1101426535 1679591978 10 Physicians THOMPSON H GOFF 628644309 49 Jefferson 0 1 Family Practice 0 197 0 0 1 0 0 0 0 0 0 1 0 115 0 0 0 0 0 0 1448 0 0 1 0 0 0 0 0 0 1 0 654 0 0 0 0 0 0 1448 0 0 1 0 0 0 0 0 0 1 0 654 0 0 0 0 0 0 4067 0 0 6.4 0 0 0 0 0 0 2.6 0 6771.98 0 0 0 0 0 0 10847.98 0 0 0 1101426552 10 Physicians 815 Indiana 0 0 Surgery General 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 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 0 245.65 0 0 0 0 0 0 245.65 0 0 0 1101426557 1407966690 10 Physicians GLICKENBERGER ROBERT 611033619 109 Winnebago 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 8 0 222 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 492 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 492 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73.34 0 37511.36 0 0 0 0 0 0 37584.7 0 0 0 1101426558 1023201035 91 Waiver service provider--Adults (DHS/DDD) EARIEN MEEHA 999999999 200 Cook 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 1455 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1455 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105762.98 0 0 0 0 0 0 0 0 0 0 0 0 0 105762.98 0 0 0 1101426563 10 Physicians 200 Cook 0 0 Internal Medicine 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39.05 0 0 0 0 0 0 39.05 0 0 0 1101426579 92 Waiver service provider--Disability (DHS/DRS) 852 Wisconsin 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39029.83 0 0 0 0 0 0 0 0 0 0 0 0 0 39029.83 0 0 0 1101426592 1700194495 10 Physicians RAHMAN RAED 600992676 57 Lake 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118.42 0 0 0 0 0 0 118.42 0 0 0 1101426604 1043337660 63 Other Providers of Medical Equipment/Supplies (Non-registered) ROCKFORD ORTHOPEDIC APPL 611041015 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 214 0 305 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 351 0 590 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 351 0 590 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75553.96 0 116262.86 0 0 0 0 191816.82 0 0 0 1101426607 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 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 16550.37 0 0 0 0 0 0 0 0 0 0 0 0 0 16550.37 0 0 0 1101426613 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15672.1 0 0 0 0 0 0 0 0 0 0 0 0 0 15672.1 0 0 0 1101426625 1265688378 10 Physicians PARKER BRANDON 606143363 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 26 0 194 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 258 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 258 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 278.45 0 10773.48 0 0 0 0 0 0 11051.93 0 0 0 1101426641 1144256017 10 Physicians ALEXANDER JOHN 611082425 109 Winnebago 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 235 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 235 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 306.36 0 0 0 0 0 0 306.36 0 0 0 1101426644 1841289527 10 Physicians BONAMINIO PHYLLIS 604535574 200 Cook 0 0 Rheumatology 0 0 0 0 0 0 0 0 0 0 0 8 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 195 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 195 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.44 0 1395.07 0 0 0 0 0 0 1395.51 0 0 0 1101426648 1063438281 10 Physicians BRIDWELL KEITH 631508170 826 Missouri 0 0 Orthopedic Surgery 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 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 0 294 0 0 0 0 0 0 294 0 0 0 1101426660 1609039163 10 Physicians ABBAS HUMA 605064356 53 Kane 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 4 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 439 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 439 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51.63 0 11048.62 0 0 0 0 0 0 11100.25 0 0 0 1101426664 1083605067 10 Physicians YAJNIK SANTOSH 600077301 200 Cook 0 0 Radiation Oncology 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 0 335 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 335 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5442.02 0 0 0 0 0 0 5442.02 0 0 0 1101426669 1447227269 10 Physicians BONOW ROBERT 606114402 200 Cook 0 0 Cardiology 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 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 0 436.85 0 0 0 0 0 0 436.85 0 0 0 1101426678 1104065291 13 Podiatrists BRYNICZKA ADAM 601772274 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 225.48 0 0 0 0 0 0 225.48 0 0 0 1101426695 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 16639.79 0 0 0 0 0 0 0 0 0 0 0 0 0 16639.79 0 0 0 1101426698 1275575136 10 Physicians PATEL JAYANTIBHAI K 604022217 200 Cook 0 1 Internal Medicine 0 5 0 0 0 0 0 0 0 0 0 0 0 124 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 636 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 636 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 2250.19 0 0 0 0 0 0 2280.19 0 0 0 1101426711 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 237 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 237 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7735.75 0 0 0 0 0 0 0 0 0 0 0 0 0 7735.75 0 0 0 1101426717 1588866040 47 Local Education Agencies SCHUYLER INDUSTRY CUSD 5 626811048 92 Schuyler 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 4412 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 4412 0 0 0 0 100.48 0 0 0 0 0 0 0 0 0 0 0 0 0 62127.81 0 62228.29 0 0 0 1101426718 1073623336 10 Physicians BRETSCHER MARY 627032403 91 Sangamon 0 0 Oncology 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 296 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 296 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50251.7 0 0 0 0 0 0 50251.7 0 0 0 1101426725 1508832072 10 Physicians STEVENS THOMAS S 535979151 852 Wisconsin 0 0 Ophthalmology 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 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 797.02 0 0 0 0 0 0 797.02 0 0 0 1101426729 1952380818 10 Physicians SHATZ RICHARD 620341718 65 Madison 0 0 Plastic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1556.4 0 0 0 0 0 0 1556.4 0 0 0 1101426735 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 10758.08 0 0 0 0 0 0 0 0 0 0 0 0 0 10758.08 0 0 0 1101426743 1336464957 48 Rural Health Clinics CARLE PHYSICIAN GROUP 619532014 29 Douglas 0 1 0 619 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5525 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5525 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13578 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13578 0 0 0 1101426747 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 16932.11 0 0 0 0 0 0 0 0 0 0 0 0 0 16932.11 0 0 0 1101426761 1578582441 16 Nurse Practitioners KUES CYNTHIA 622163807 23 Clinton 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 185 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 185 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1851.45 0 0 0 0 0 0 1851.45 0 0 0 1101426762 1821217696 23 Occupational Therapists RAY LYNN 618223506 19 Champaign 0 0 0 0 0 0 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 19 0 0 0 0 0 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 0 347.62 347.62 0 0 0 1101426768 1154319994 10 Physicians BAKIR MOUHAMAD 627949369 91 Sangamon 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 1 0 307 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 926 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 926 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 150505.88 0 0 0 0 0 0 150505.88 0 0 0 1101426775 1487832804 91 Waiver service provider--Adults (DHS/DDD) RESIDENTIAL OPTIONS INC 62002 65 Madison 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 14655 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14655 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1767693.55 0 0 0 0 0 0 0 0 0 0 0 0 0 1767693.55 0 0 0 1101426786 16 Nurse Practitioners 826 Missouri 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 644.7 0 0 0 0 0 0 644.7 0 0 0 1101426788 1639213630 34 State-operated facility (DHS) UNIT 8177 3C FOX 604201322 61 Livingston 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 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1710 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1192003.65 0 0 0 0 0 0 0 0 0 0 1192003.65 0 0 0 1101426794 1073597795 10 Physicians GELLER STEVEN 601322776 200 Cook 0 0 Pulmonary Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 922 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 922 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2733.7 0 0 0 0 0 0 2733.7 0 0 0 1101426799 1982981833 16 Nurse Practitioners SMITH MELISSA 999999999 19 Champaign 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 14 0 0 0 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 0 336.73 0 0 0 0 0 0 336.73 0 0 0 1101426801 1285678383 10 Physicians VON FISCHER BENJAMIN 605231956 30 DuPage 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 256 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 269 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 269 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8346.24 0 0 0 0 0 0 8346.24 0 0 0 1101426803 1124179817 13 Podiatrists ANDERSON NICOLAS 605462082 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 517 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 517 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11156.86 0 0 0 0 0 0 11156.86 0 0 0 1101426811 1487668224 10 Physicians VARGA PETER 603022109 200 Cook 0 0 Pediatric Cardiology 0 0 0 0 0 0 0 0 0 0 0 21 0 527 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 1052 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 1052 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1141.09 0 28136.58 0 0 0 0 0 0 29277.67 0 0 0 1101426821 10 Physicians 803 Arizona 0 0 Radiology Diagnosis 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100.66 0 0 0 0 0 0 0 0 100.66 0 0 0 1101426839 92 Waiver service provider--Disability (DHS/DRS) 58 La Salle 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3929.37 0 0 0 0 0 0 0 0 0 0 0 0 0 3929.37 0 0 0 1101426842 1417103623 10 Physicians LEE GRACE 606751611 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 885 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 885 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12628.59 0 0 0 0 0 0 12628.59 0 0 0 1101426851 92 Waiver service provider--Disability (DHS/DRS) 88 Richland 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 14162.75 0 0 0 0 0 0 0 0 0 0 0 0 0 14162.75 0 0 0 1101426852 94 Waiver service provider--Children's support (DHS/DDD) 836 Ohio 0 0 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 3955.87 0 0 0 0 0 0 0 0 0 0 0 0 0 3955.87 0 0 0 1101426859 1477668929 10 Physicians SHAH PALMI 606123841 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 2100 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3975 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3975 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25575.61 0 168.51 0 0 0 0 0 0 25744.12 0 0 0 1101426865 1710947353 22 Physical Therapists THOMAS SUE ELLEN 610530206 17 Carroll 0 0 0 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 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1425.09 1425.09 0 0 0 1101426873 1831117142 10 Physicians LEVIN MARK 604023465 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 168 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 627 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 627 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7825.93 0 0 0 0 0 0 7825.93 0 0 0 1101426886 1366510166 60 Pharmacies MEDICAP PHARMACY 629060683 99 Union 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 725 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9059 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 231279 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 335707.4 0 0 0 335707.4 0 0 0 1101426894 1336185511 16 Nurse Practitioners ROBISON SHERI 615544969 98 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0 0 0 0 0 0 0 0 0 0 0 0 0 1781.33 0 0 0 0 0 0 1781.33 0 0 0 1101426916 1851394548 10 Physicians CHEN CORY 606302145 200 Cook 0 1 Internal Medicine 0 115 0 0 0 0 0 0 0 0 0 12 0 170 0 0 0 0 0 0 749 0 0 0 0 0 0 0 0 0 16 0 648 0 0 0 0 0 0 749 0 0 0 0 0 0 0 0 0 16 0 648 0 0 0 0 0 0 2254 0 0 0 0 0 0 0 0 0 41.75 0 20890.15 0 0 0 0 0 0 23185.9 0 0 0 1101426919 2100417337 16 Nurse Practitioners MELICK EMILY 999999999 826 Missouri 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 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1283.78 0 0 0 0 0 0 1283.78 0 0 0 1101426922 10 Physicians 816 Iowa 0 0 Pediatrics 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 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 49.8 0 0 0 0 0 0 49.8 0 0 0 1101426943 10 Physicians 816 Iowa 0 0 Orthopedic Surgery 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 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1815.16 0 0 0 0 0 0 2476.38 0 0 0 1101426988 1316985468 10 Physicians WEARE CHAD 477165348 815 Indiana 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 8 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 0 536.04 0 0 0 0 0 0 536.04 0 0 0 1101426989 1073826392 30 General Hospitals CRYSTAL SPRINGS DIALYSIS 600147301 71 McHenry DIALYSIS Outpatient dialysis centers. 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 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 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3380.94 0 0 0 0 0 3380.94 0 0 0 1101426991 1336246800 10 Physicians HORNER TIMOTHY 618321100 100 Vermilion 0 1 Family Practice 0 56 0 0 19 0 0 0 0 0 0 115 0 267 0 0 0 0 0 0 403 0 0 25 0 0 0 0 0 0 200 0 410 0 0 0 0 0 0 403 0 0 25 0 0 0 0 0 0 200 0 410 0 0 0 0 0 0 1084 0 0 1379 0 0 0 0 0 0 2179.29 0 18793.74 0 0 0 0 0 0 23436.03 0 0 0 1101426998 1972576833 10 Physicians MCGEE EDWIN 606910263 200 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Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 334 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 334 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12562 0 0 0 0 0 0 0 0 0 0 0 0 0 12562 0 0 0 1101427035 1760532709 10 Physicians QAMAR IZHAR 606371447 200 Cook 0 0 Pediatrics 0 0 0 0 102 0 0 0 0 0 0 6 0 393 0 0 0 0 0 0 0 0 0 146 0 0 0 0 0 0 8 0 696 0 0 0 0 0 0 0 0 0 146 0 0 0 0 0 0 8 0 696 0 0 0 0 0 0 0 0 0 1005.74 0 0 0 0 0 0 231.28 0 28678.33 0 0 0 0 0 0 29915.35 0 0 0 1101427039 1477530327 16 Nurse Practitioners NAUMAN ANGELA 622262040 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1102.02 0 0 0 0 0 0 1102.02 0 0 0 1101427045 1174591663 10 Physicians GILVYDIS RIMVYDAS 601344200 53 Kane 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 164 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 226 0 138 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 226 0 138 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3850.94 0 263.3 0 0 0 0 0 0 4114.24 0 0 0 1101427048 91 Waiver service provider--Adults (DHS/DDD) 10 Adams 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 0 159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10349 0 0 0 0 0 0 0 0 0 0 0 0 0 10349 0 0 0 1101427051 55 Early Intervention Services 30 DuPage 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1126.71 0 0 0 0 0 0 1126.71 0 0 0 1101427054 92 Waiver service provider--Disability (DHS/DRS) 71 McHenry 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 22230.42 0 0 0 0 0 0 0 0 0 0 0 0 0 22230.42 0 0 0 1101427056 1801862818 10 Physicians JANUARY CRAIG 535625531 200 Cook 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 38 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 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0 0 112 0 0 0 0 0 0 22 0 392 0 0 0 0 0 0 1283 0 0 2984.71 0 0 0 0 0 0 66.07 0 12225.17 0 0 0 0 0 0 16558.95 0 0 0 1101427161 1548224132 10 Physicians THOMASSON JEFFREY L. 631417129 826 Missouri 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 716.02 0 0 0 0 0 0 0 0 716.02 0 0 0 1101427162 91 Waiver service provider--Adults (DHS/DDD) 71 McHenry 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 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17160 0 0 0 0 0 0 0 0 0 0 0 0 0 17160 0 0 0 1101427172 1871546390 16 Nurse Practitioners GIACALONE LAURA 601181416 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 240.3 0 0 0 0 0 0 240.3 0 0 0 1101427175 1972560688 60 Pharmacies WALGREENS SPECIALTY 10997 151061230 839 Pennsylvania 0 0 0 0 0 0 0 0 0 0 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0 0 1 0 421 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8.5 0 4497.42 0 0 0 0 0 0 4505.92 0 0 0 1101427220 1588865091 10 Physicians HENTZELMAN JOSHUA 622062822 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 153 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 153 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10115.38 0 0 0 0 0 0 10115.38 0 0 0 1101427232 1073741666 10 Physicians NELSON KENT 606313222 30 DuPage 0 1 Pediatrics 0 687 0 0 170 0 0 0 0 0 0 2 0 173 0 0 0 0 0 0 5880 0 0 475 0 0 0 0 0 0 2 0 267 0 0 0 0 0 0 5880 0 0 475 0 0 0 0 0 0 2 0 267 0 0 0 0 0 0 11760 0 0 15144.84 0 0 0 0 0 0 8 0 9742.77 0 0 0 0 0 0 36655.61 0 0 0 1101427239 1083703383 10 Physicians WAQAR SAIAMA 631101010 826 Missouri 0 0 Oncology 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 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29383.94 0 0 0 0 0 0 29383.94 0 0 0 1101427243 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 2706.58 0 0 0 0 0 0 0 0 0 0 0 0 0 2706.58 0 0 0 1101427253 1053335349 10 Physicians CLARK PATRICIA 604519508 107 Will 0 0 Surgery General 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 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2660.94 0 0 0 0 0 0 2660.94 0 0 0 1101427273 1710251814 16 Nurse Practitioners WILKINSON PATRICIA 631101010 826 Missouri 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 47 0 0 0 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 1872.95 0 0 0 0 0 0 1872.95 0 0 0 1101427274 30 General Hospitals 833 New York ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101427287 92 Waiver 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0 0 0 0 0 754190.54 0 0 0 0 0 0 0 0 0 0 754190.54 0 0 0 1101427467 1104037993 10 Physicians MALIK TARIQ 605274503 30 DuPage 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 345 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 743 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 743 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30811.63 0 0 0 0 0 0 30811.63 0 0 0 1101427489 1487804100 28 Waiver service provider--Supportive living facility (HFS) AUTUMN RIDGE SUPPORTIVE LIVING 629951676 52 Johnson 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 346 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8964 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 477938.04 0 0 0 0 0 0 0 0 0 0 0 0 0 477938.04 0 0 0 1101427493 1447289442 16 Nurse Practitioners MATHEY LISA 606112991 200 Cook 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 0 0 0 0 0 0 0 0 23 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 0 0 0 0 0 0 0 0 711.29 0 0 0 0 0 0 711.29 0 0 0 1101427502 1154558963 10 Physicians SHETUNI BRANDON 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 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Family Practice 0 107 0 0 0 0 0 0 0 0 0 7 0 4 0 0 0 0 0 0 884 0 0 0 0 0 0 0 0 0 11 0 4 0 0 0 0 0 0 884 0 0 0 0 0 0 0 0 0 11 0 4 0 0 0 0 0 0 2290 0 0 0 0 0 0 0 0 0 72.75 0 14.8 0 0 0 0 0 0 2377.55 0 0 0 1101427527 92 Waiver service provider--Disability (DHS/DRS) 53 Kane 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 6909.24 0 0 0 0 0 0 0 0 0 0 0 0 0 6909.24 0 0 0 1101427534 10 Physicians 826 Missouri 0 0 Anesthesiology 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 293.92 0 0 0 0 0 0 293.92 0 0 0 1101427549 1093950941 10 Physicians BUSH AMANDA 610081702 13 Boone 0 0 Gynecology 0 0 0 0 0 0 0 0 0 0 0 13 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90.48 0 3348 0 0 0 0 0 0 3438.48 0 0 0 1101427554 1275721250 10 Physicians PISANO JENNIFER 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0 0 0 0 0 0 12879 0 0 0 0 0 0 0 0 0 0 0 0 0 12879 0 0 0 1101427588 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1760 0 0 0 0 0 0 0 0 0 0 0 0 0 1760 0 0 0 1101427593 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39964.93 0 0 0 0 0 0 0 0 0 0 0 0 0 39964.93 0 0 0 1101427594 1134129323 10 Physicians BOTON ROBERT A. 601695208 57 Lake 0 1 Pediatrics 0 251 0 0 179 0 0 0 0 0 0 75 0 176 0 0 0 0 0 0 2369 0 0 528 0 0 0 0 0 0 100 0 368 0 0 0 0 0 0 2369 0 0 528 0 0 0 0 0 0 100 0 368 0 0 0 0 0 0 4738 0 0 16019.93 0 0 0 0 0 0 1322.33 0 16044.93 0 0 0 0 0 0 38125.19 0 0 0 1101427607 1982673166 30 General Hospitals MT GREENWOOD DIALYSIS 606553329 200 Cook DIALYSIS Outpatient dialysis centers. 0 0 General Hospital - 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CHERYL 631101010 826 Missouri 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3351.15 0 0 0 0 0 0 3351.15 0 0 0 1101427637 1649434416 10 Physicians SWANSON HEIDI 999999999 30 DuPage 0 0 0 25 0 0 37 0 0 0 0 0 0 7 0 47 0 0 0 0 0 0 120 0 0 128 0 0 0 0 0 0 7 0 54 0 0 0 0 0 0 120 0 0 128 0 0 0 0 0 0 7 0 54 0 0 0 0 0 0 240 0 0 4276.88 0 0 0 0 0 0 38.11 0 2122.24 0 0 0 0 0 0 6677.23 0 0 0 1101427643 10 Physicians 815 Indiana 0 0 Anesthesiology 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 136.32 0 0 0 0 0 0 136.32 0 0 0 1101427644 30 General Hospitals 845 Texas NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 4 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 0 484.61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 484.61 0 0 0 1101427650 1629067608 10 Physicians BELL ROBBYE 616159506 80 Peoria 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 8 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 296 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 296 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 251.92 0 7403.66 0 0 0 0 0 0 7655.58 0 0 0 1101427661 1114916210 11 Dentists KIM NAJUNG 600261153 200 Cook 0 0 General Dentistry 0 0 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 639 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 639 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19214.44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19214.44 0 0 0 1101427672 1255330361 10 Physicians JAIN DINESH 604775435 200 Cook 0 1 Internal Medicine 0 3 0 0 0 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 533 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 533 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 1816.6 0 0 0 0 0 0 1831.6 0 0 0 1101427675 1912176900 36 Community mental health provider COMPREHENSIVE BEHAVIORAL HLTH 622265010 96 St Clair 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 2018 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2341 0 0 2018 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2341 0 0 2605.32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99927.98 0 0 102533.3 0 0 0 1101427691 1558465583 11 Dentists RAUEN DARDIS SARA 617044910 72 McLean 0 0 General Dentistry 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1594.66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1594.66 0 0 0 1101427702 1548417827 36 Community mental health provider THRESHOLDS 609015547 54 Kankakee 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1351 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1351 0 0 340.49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82379.2 0 0 82719.69 0 0 0 1101427706 13 Podiatrists 57 Lake 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 14 0 0 0 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 41.6 0 0 0 0 0 0 41.6 0 0 0 1101427708 1245537943 16 Nurse Practitioners HELDT ANGELA 609141369 54 Kankakee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49.8 0 0 0 0 0 0 49.8 0 0 0 1101427723 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 26716.17 0 0 0 0 0 0 0 0 0 0 0 0 0 26716.17 0 0 0 1101427727 1083617245 30 General Hospitals ST MARYS HOSPITAL 628013056 66 Marion DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 0 0 0 0 56 0 0 0 0 0 0 3072 0 0 1281 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 16035 0 0 4669 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 16035 0 0 4669 0 0 0 0 0 0 0 0 438.52 0 0 0 0 0 0 112856.32 0 0 451803.52 0 0 0 0 0 565098.36 0 0 0 1101427734 1447444567 16 Nurse Practitioners BARNETT MARISA 605064356 53 Kane 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 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 493.79 0 0 0 0 0 0 493.79 0 0 0 1101427747 92 Waiver service provider--Disability (DHS/DRS) 45 Henry 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2572.05 0 0 0 0 0 0 0 0 0 0 0 0 0 2572.05 0 0 0 1101427752 1881699080 10 Physicians MUNOZ GILBERTO 606118709 200 Cook 0 1 Family Practice 0 27 0 0 3 0 0 0 0 0 0 4 0 36 0 0 0 0 0 0 35 0 0 5 0 0 0 0 0 0 11 0 151 0 0 0 0 0 0 35 0 0 5 0 0 0 0 0 0 11 0 151 0 0 0 0 0 0 88 0 0 91.02 0 0 0 0 0 0 68.71 0 2394.05 0 0 0 0 0 0 2641.78 0 0 0 1101427765 92 Waiver service provider--Disability (DHS/DRS) 66 Marion 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 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19310.76 0 0 0 0 0 0 0 0 0 0 0 0 0 19310.76 0 0 0 1101427768 1114934148 60 Pharmacies BOND DRUG COMPANY OF ILLINOIS 607141408 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2690 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 253.4 0 8600.92 0 0 0 0 0 0 14428.52 0 0 0 1101428868 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 192.98 0 0 0 0 0 0 0 0 0 0 0 0 0 192.98 0 0 0 1101428872 1831174598 10 Physicians CHOWDHURY MOHAMMED 600745551 200 Cook 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 0 0 0 328 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1933 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1933 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4595.99 0 0 0 0 0 0 4595.99 0 0 0 1101428882 92 Waiver service provider--Disability (DHS/DRS) 30 DuPage 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 40487.33 0 0 0 0 0 0 0 0 0 0 0 0 0 40487.33 0 0 0 1101428890 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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(Non-registered) MERCY WOODSTOCK MEDICAL CENTER 600987401 71 McHenry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2055.89 0 2169.71 0 0 0 0 4225.6 0 0 0 1101429170 1326090051 10 Physicians KATZMAN DANIEL 606313716 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 261 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 788 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 788 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12064.63 0 0 0 0 0 0 12064.63 0 0 0 1101429172 1699082115 16 Nurse Practitioners HERTZ LAURA 616157822 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10038.25 0 0 0 0 0 0 10038.25 0 0 0 1101429173 1457564239 16 Nurse Practitioners STEINER HAROLD 622233808 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 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 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2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2022.2 0 0 0 0 0 0 0 0 0 0 0 0 0 2022.2 0 0 0 1101429218 1790840916 10 Physicians CUTTER THOMAS 605276686 30 DuPage 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4530.65 0 0 0 0 0 0 4530.65 0 0 0 1101429221 2100419639 71 Medicar Provider SOUTH ELGIN REHAB HEALTH CARE 601771424 53 Kane 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 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 727.91 0 0 0 0 0 0 727.91 0 0 0 1101429237 30 General Hospitals 810 Florida NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 179.08 0 0 0 0 0 0 0 0 0 0 0 0 0 0 179.08 0 0 0 1101429238 1043358781 10 Physicians COOPER JOSEPH 606118709 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 973.08 0 0 0 0 0 0 973.08 0 0 0 1101429239 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 238 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 238 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11790.55 0 0 0 0 0 0 0 0 0 0 0 0 0 11790.55 0 0 0 1101429246 10 Physicians 30 DuPage 0 0 Family Practice 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 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 0 415.56 0 0 0 0 0 0 415.56 0 0 0 1101429253 1104005578 60 Pharmacies SHOP N SAVE PHARMACY 423 622265613 96 St Clair 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 0 523 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12415 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17842.95 0 0 0 17842.95 0 0 0 1101429254 94 Waiver service provider--Children's support (DHS/DDD) 107 Will 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 643.5 0 0 0 0 0 0 0 0 0 0 0 0 0 643.5 0 0 0 1101429261 1215983374 10 Physicians NEWMAN REBECCA L 606112615 200 Cook 0 0 Pediatrics 0 0 0 0 7 0 0 0 0 0 0 0 0 107 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 210 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 210 0 0 0 0 0 0 0 0 0 569.14 0 0 0 0 0 0 0 0 6310.17 0 0 0 0 0 0 6879.31 0 0 0 1101429268 1336172121 10 Physicians KONANUR RAMAPRASAD 617613558 72 McLean 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 259 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 259 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2616.44 0 0 0 0 0 0 2616.44 0 0 0 1101429292 10 Physicians 816 Iowa 0 0 Pediatrics 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 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 96 0 0 0 0 0 0 96 0 0 0 1101429319 1205095528 10 Physicians BUCHANAN 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2495 0 0 0 0 0 0 294 0 1713 0 0 0 0 0 0 6451 0 0 64712.06 0 0 0 0 0 0 4563.34 0 117994.57 0 0 0 0 0 0 193720.97 0 0 0 1101429385 1518166461 10 Physicians MOHIUDDIN MOHTASHAM 606081732 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 404 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22408.9 0 0 0 0 0 0 22408.9 0 0 0 1101429388 1144398645 12 Optometrists PATEL SONYA 601062822 30 DuPage 0 0 Therapeutic Pharmaceutical Agents 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 0 173 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 173 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5067.41 0 0 0 0 0 0 5067.41 0 0 0 1101429412 92 Waiver service provider--Disability (DHS/DRS) 90 Saline 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5038.32 0 0 0 0 0 0 0 0 0 0 0 0 0 5038.32 0 0 0 1101429413 92 Waiver service provider--Disability (DHS/DRS) 93 Scott 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 28832.56 0 0 0 0 0 0 0 0 0 0 0 0 0 28832.56 0 0 0 1101429416 1205042975 10 Physicians RYAN CLODAGH 605581442 200 Cook 0 1 General Practice 0 13 0 0 6 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 39 0 0 9 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 39 0 0 9 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 87 0 0 556.69 0 0 0 0 0 0 0 0 1295.07 0 0 0 0 0 0 1938.76 0 0 0 1101429440 33 Nursing Facilities 823 Michigan 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 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 140972 0 0 0 0 0 0 0 140972 0 0 0 1101429445 1902906852 10 Physicians COREY SETH 606112991 200 Cook 0 0 Pediatrics 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 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3262.16 0 0 0 0 0 0 3262.16 0 0 0 1101429454 1548204662 16 Nurse Practitioners SANTANGELO SUSAN 609013661 54 Kankakee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1784.13 0 0 0 0 0 0 1784.13 0 0 0 1101429457 10 Physicians 815 Indiana 0 0 Cardiovascular Diseases 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 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 0.68 0 0 0 0 0 0 0.68 0 0 0 1101429465 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6141.91 0 0 0 0 0 0 0 0 0 0 0 0 0 6141.91 0 0 0 1101429467 1831187665 64 Imaging Services CLINTON IMAGING SERVICES LLC 527322940 816 Iowa 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 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 3048.46 0 0 0 0 0 0 3048.46 0 0 0 1101429477 1316948987 10 Physicians GAITHER DOUGLAS 600852161 816 Iowa 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 345 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 382 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 382 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14023.33 0 0 0 0 0 0 14023.33 0 0 0 1101429489 1538372800 10 Physicians OGDEN MARGARET ALLISON 631600352 200 Cook 0 0 Otolaryngology 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 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 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2641.34 0 0 0 0 0 0 2641.34 0 0 0 1101429493 1598806929 10 Physicians WITTKOPF MARIA 600052382 200 Cook 0 0 Otorhinolaryngology 0 0 0 0 1 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 15.2 0 0 0 0 0 0 0 0 1948.18 0 0 0 0 0 0 1963.38 0 0 0 1101429521 1851388268 10 Physicians GRANADA WILFREDO A 600992616 57 Lake 0 1 Internal Medicine 0 130 0 0 0 0 0 0 0 0 0 0 0 301 0 0 0 0 0 0 939 0 0 0 0 0 0 0 0 0 0 0 524 0 0 0 0 0 0 939 0 0 0 0 0 0 0 0 0 0 0 524 0 0 0 0 0 0 2738 0 0 0 0 0 0 0 0 0 0 0 9884.98 0 0 0 0 0 0 12622.98 0 0 0 1101429522 91 Waiver service provider--Adults (DHS/DDD) 64 Macoupin 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 0 342 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 342 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20223.28 0 0 0 0 0 0 0 0 0 0 0 0 0 20223.28 0 0 0 1101429528 92 Waiver service provider--Disability (DHS/DRS) 19 Champaign 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 19372.86 0 0 0 0 0 0 0 0 0 0 0 0 0 19372.86 0 0 0 1101429534 1952581373 10 Physicians GAMINO AMIE 606123861 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 568 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 568 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15654.47 0 0 0 0 0 0 15654.47 0 0 0 1101429539 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5541.3 0 0 0 0 0 0 0 0 0 0 0 0 0 5541.3 0 0 0 1101429550 1255341970 10 Physicians ORKIN BRUCE 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6216.87 0 0 0 0 0 0 6216.87 0 0 0 1101429556 1841382371 10 Physicians LANGEHENNIG PATRICIA 604324315 107 Will 0 1 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2135.28 0 0 0 0 0 0 2135.28 0 0 0 1101429564 92 Waiver service provider--Disability (DHS/DRS) 107 Will 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 28838.74 0 0 0 0 0 0 0 0 0 0 0 0 0 28838.74 0 0 0 1101429576 25 Audiologists 53 Kane 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 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 5.73 5.73 0 0 0 1101429581 1104836444 16 Nurse Practitioners LAGER KAREN 622861820 87 Randolph 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 170 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 175 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 175 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27919.67 0 0 0 0 0 0 27919.67 0 0 0 1101429594 1942228028 10 Physicians GRAHAM WILLIAM 641843225 53 Kane 0 0 Pulmonary Diseases 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 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 770.54 0 0 0 0 0 0 770.54 0 0 0 1101429600 10 Physicians 816 Iowa 0 0 Anesthesiology 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 260.95 0 0 0 0 0 0 260.95 0 0 0 1101429603 1821097395 10 Physicians PEPPERS FRANK 614012899 56 Knox 0 1 Pediatrics 0 224 0 0 285 0 0 0 0 0 0 0 0 414 0 0 0 0 0 0 1843 0 0 1153 0 0 0 0 0 0 0 0 857 0 0 0 0 0 0 1843 0 0 1153 0 0 0 0 0 0 0 0 857 0 0 0 0 0 0 3686 0 0 36711.29 0 0 0 0 0 0 0 0 33407.45 0 0 0 0 0 0 73804.74 0 0 0 1101429605 1467520924 10 Physicians RUMILLA ALFREDO 606472915 200 Cook 0 0 General Practice 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 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2854.59 0 0 0 0 0 0 2854.59 0 0 0 1101429621 1871511352 10 Physicians GOLDFARB CHARLES 631101032 826 Missouri 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 1 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9.15 0 3414.1 0 0 0 0 0 0 3423.25 0 0 0 1101429626 10 Physicians 200 Cook 0 0 Anesthesiology 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 14 0 0 0 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 1413 0 0 0 0 0 0 1413 0 0 0 1101429648 1982676656 10 Physicians FULTON ZACHARY 610326942 97 Stephenson 0 1 Family 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Clair 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9554.74 0 0 0 0 0 0 0 0 0 0 0 0 0 9554.74 0 0 0 1101431712 1821043944 10 Physicians OUYANG DAVID 602011718 200 Cook 0 0 Maternal and Fetal Medicine 0 0 0 0 0 0 0 0 0 0 0 474 0 209 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 777 0 396 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 777 0 396 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22448 0 20755.39 0 0 0 0 0 0 43203.39 0 0 0 1101431717 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11937.75 0 0 0 0 0 0 0 0 0 0 0 0 0 11937.75 0 0 0 1101431735 10 Physicians 852 Wisconsin 0 0 Endocrinology 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 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 0 122.15 0 0 0 0 0 0 122.15 0 0 0 1101431748 10 Physicians 852 Wisconsin 0 0 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1902840325 36 Community mental health provider STEPPING STONES OF ROCKFORD 611035207 109 Winnebago 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 682 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9225 0 0 682 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9225 0 0 13691.14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 664582.4 0 0 678273.54 0 0 0 1101431929 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28211.15 0 0 0 0 0 0 0 0 0 0 0 0 0 28211.15 0 0 0 1101431943 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 1701.72 0 0 0 0 0 0 0 0 0 0 0 0 0 1701.72 0 0 0 1101431949 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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MICHELOTTI MICHAEL 611033669 109 Winnebago 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 247 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 247 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11686.71 0 0 0 0 0 0 11686.71 0 0 0 1101432131 1922315126 16 Nurse Practitioners KEYS LISA 606112991 200 Cook 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 201 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 201 0 0 0 0 0 0 0 0 0 46.15 0 0 0 0 0 0 0 0 3898.9 0 0 0 0 0 0 3945.05 0 0 0 1101432139 1265447338 60 Pharmacies WALGREENS 06885 539657902 852 Wisconsin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2032 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4166.79 0 0 0 4166.79 0 0 0 1101432165 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 3784.38 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 137.7 0 572.09 0 0 0 0 0 0 709.79 0 0 0 1101432200 1811192867 10 Physicians GILVYDIS DARIUS 605407430 30 DuPage 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 376 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 502 0 201 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 502 0 201 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6712.52 0 2989.82 0 0 0 0 0 0 9702.34 0 0 0 1101432212 92 Waiver service provider--Disability (DHS/DRS) 63 Macon 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 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 5753.71 0 0 0 0 0 0 0 0 0 0 0 0 0 5753.71 0 0 0 1101432213 1538103791 10 Physicians GUDENKAUF TAMI SUE 520017320 816 Iowa 0 0 Emergency Medicine 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 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 684.29 0 0 0 0 0 0 684.29 0 0 0 1101432215 1316976624 10 Physicians KANDULA NAMRATHA 606113092 200 Cook 0 1 Internal Medicine 0 4 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 695.99 0 0 0 0 0 0 722.99 0 0 0 1101432226 1699856237 10 Physicians KIM ANDREW 606112991 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 196 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 196 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11800.17 0 0 0 0 0 0 11800.17 0 0 0 1101432232 1720130065 25 Audiologists BOSTON DEANNA 620562033 76 Montgomery 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20364.32 20364.32 0 0 0 1101432238 1992797260 10 Physicians AL KHABBAZ ANTOUN 611020311 109 Winnebago 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 7 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39.22 0 33545.6 0 0 0 0 0 0 33584.82 0 0 0 1101432244 1023190337 10 Physicians GROSS HENRY R 616144675 80 Peoria 0 1 Family Practice 0 129 0 0 69 0 0 0 0 0 0 36 0 267 0 0 0 0 0 0 880 0 0 166 0 0 0 0 0 0 41 0 534 0 0 0 0 0 0 880 0 0 166 0 0 0 0 0 0 41 0 534 0 0 0 0 0 0 2290 0 0 5873.35 0 0 0 0 0 0 276.97 0 19224.54 0 0 0 0 0 0 27664.86 0 0 0 1101432245 92 Waiver service provider--Disability (DHS/DRS) 21 Clark 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 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 0 522.14 0 0 0 0 0 0 0 0 0 0 0 0 0 522.14 0 0 0 1101432246 1164485363 30 General Hospitals ST MARY MEDICAL CENTER 614011251 56 Knox DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 0 1 0 0 0 2179 0 0 0 0 498 0 0 0 1453 0 0 0 0 0 1 0 0 0 3512 0 0 0 0 559 0 0 0 2510 0 0 0 0 0 1 0 0 0 3512 0 0 0 0 1627 0 0 0 2531 0 0 0 0 0 16.8 0 0 0 422250.49 0 0 0 0 772335.28 0 0 0 597026.28 0 0 0 0 0 1791628.85 0 0 0 1101432284 1871863985 33 Nursing Facilities SOUTHVIEW MANOR NURSING CENTER 606163817 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 444 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10294 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1080965.23 0 0 0 0 0 0 0 1080965.23 0 0 0 1101432299 10 Physicians 815 Indiana 0 0 Radiology Diagnosis 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31.35 0 0 0 0 0 0 0 0 31.35 0 0 0 1101432300 1568539211 16 Nurse Practitioners GLASS JANETTE 623213551 62 Logan 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 242 0 0 0 0 0 0 0 0 0 64 0 0 0 0 0 0 0 0 343 0 0 0 0 0 0 0 0 0 64 0 0 0 0 0 0 0 0 343 0 0 0 0 0 0 0 0 0 1189.55 0 0 0 0 0 0 0 0 10347.58 0 0 0 0 0 0 11537.13 0 0 0 1101432311 1225033178 10 Physicians FERGUSON HOMER 622261919 96 St Clair 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 0 0 141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 243 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 243 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3812.13 0 0 0 0 0 0 3812.13 0 0 0 1101432318 16 Nurse Practitioners 63 Macon 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37.21 0 0 0 0 0 0 37.21 0 0 0 1101432324 1326064544 10 Physicians MAJERUS ELAINE 631101010 826 Missouri 0 0 Oncology 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 0 286 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 286 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83404.1 0 0 0 0 0 0 83404.1 0 0 0 1101432347 1043497548 40 Federally Qualified Health Centers ANNA JONESBORO COMM HS HLTH CR 629061625 99 Union 0 1 School-based 0 40 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 318 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 318 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 852 41.63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 893.63 0 0 0 1101432365 1386634517 70 Ambulance Service Providers MONROE CO AMBULANCE SERV 622981142 75 Monroe 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 400 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 400 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21267.36 0 0 0 0 0 0 21267.36 0 0 0 1101432384 1164518460 10 Physicians KANDULA PRASAD 622694111 96 St Clair 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 413 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 994 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 994 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5610.18 0 0 0 0 0 0 5610.18 0 0 0 1101432385 1932291069 10 Physicians KVIRIKADZE NELLY 600852161 57 Lake 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2418.35 0 0 0 0 0 0 2418.35 0 0 0 1101432391 1356545065 97 Waiver service provider--Children's residential (DHS/DDD) CANIER PATRICIA 610327630 97 Stephenson 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 0 774 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 774 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28060.25 0 0 0 0 0 0 0 0 0 0 0 0 0 28060.25 0 0 0 1101432397 1841241676 16 Nurse Practitioners HARRIS MARTHA 631282106 826 Missouri 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 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 690.69 0 0 0 0 0 0 690.69 0 0 0 1101432399 1477562866 10 Physicians JOHNSON DECHOW DENISE 614012875 56 Knox 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 933 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 933 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1517.96 0 0 0 0 0 0 1517.96 0 0 0 1101432407 1528151248 16 Nurse Practitioners SCHERR LISA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 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 99.2 0 0 0 0 0 0 99.2 0 0 0 1101432411 30 General Hospitals 803 Arizona NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 548 0 0 0 0 0 0 0 0 0 0 0 0 0 0 548 0 0 0 1101432419 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 25809.04 0 0 0 0 0 0 0 0 0 0 0 0 0 25809.04 0 0 0 1101432420 1659399970 10 Physicians RAMINSKI DAVID 604674547 200 Cook 0 0 Urology 0 0 0 0 0 0 0 0 0 0 0 2 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 136.64 0 0 0 0 0 0 136.64 0 0 0 1101432428 91 Waiver service provider--Adults (DHS/DDD) 107 Will 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 19 0 0 0 0 0 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 3007.4 0 0 0 0 0 0 0 0 0 0 0 0 0 3007.4 0 0 0 1101432432 1427226141 24 Speech Therapists WARNES CATHY 618649774 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18803.08 18803.08 0 0 0 1101432437 1750486981 10 Physicians MEGAHED MD AMR 601933553 200 Cook 0 1 Pediatrics 0 410 0 0 206 0 0 0 0 0 0 131 0 358 0 0 0 0 0 0 3324 0 0 884 0 0 0 0 0 0 176 0 583 0 0 0 0 0 0 3324 0 0 884 0 0 0 0 0 0 176 0 583 0 0 0 0 0 0 6648 0 0 24676 0 0 0 0 0 0 1499.43 0 24624.3 0 0 0 0 0 0 57447.73 0 0 0 1101432439 1790707503 60 Pharmacies TARGET PHARMACY T 867 604401508 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 447 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34338.73 0 0 0 34338.73 0 0 0 1101432447 1831116920 10 Physicians LAVIE ELI 600151830 57 Lake 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 0 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 234 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 234 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5157.13 0 0 0 0 0 0 5157.13 0 0 0 1101432455 92 Waiver service provider--Disability (DHS/DRS) 51 Jo Daviess 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 54589.22 0 0 0 0 0 0 0 0 0 0 0 0 0 54589.22 0 0 0 1101432461 1437285475 16 Nurse Practitioners RISSER CRAIG 618012530 19 Champaign 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 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 275.15 0 0 0 0 0 0 275.15 0 0 0 1101432462 1699764845 11 Dentists HUFF ALINA 606084204 200 Cook 0 0 General Dentistry 0 0 0 201 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1285 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1285 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33742.12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33742.12 0 0 0 1101432474 63 Other Providers of Medical Equipment/Supplies (Non-registered) 815 Indiana 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 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10235.95 0 0 0 0 0 0 10235.95 0 0 0 1101432475 92 Waiver service provider--Disability (DHS/DRS) 90 Saline 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 22675.6 0 0 0 0 0 0 0 0 0 0 0 0 0 22675.6 0 0 0 1101432488 1114009891 10 Physicians HALLOWAY MAHMOUD A 604062318 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 24 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103.39 0 3206.82 0 0 0 0 0 0 3310.21 0 0 0 1101432494 1962401240 10 Physicians REHAL HARKAMAL 604264264 200 Cook 0 0 Infectious Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 387 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1259 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1259 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17728.1 0 0 0 0 0 0 17728.1 0 0 0 1101432497 1629058102 10 Physicians FARMER ROBERT 622651811 23 Clinton 0 1 Family Practice 0 15 0 0 0 0 0 0 0 0 0 59 0 1 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 102 0 1 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 102 0 1 0 0 0 0 0 0 138 0 0 0 0 0 0 0 0 0 939.16 0 42.5 0 0 0 0 0 0 1119.66 0 0 0 1101432499 1245367853 12 Optometrists KATS IRENE 600893708 200 Cook 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 1646 0 1108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3283 0 1145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3283 0 1145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91192.49 0 32726.81 0 0 0 0 123919.3 0 0 0 1101432508 1851593313 47 Local Education Agencies SANDOVAL CC SCH DIST 501 628820100 66 Marion 0 0 0 0 0 0 0 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 1006 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1006 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2952.63 0 2952.63 0 0 0 1101432515 1164447645 10 Physicians SALEM RIAD 606118709 200 Cook 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 14 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 149.67 0 4416.28 0 0 0 0 0 0 4565.95 0 0 0 1101432522 1962424671 60 Pharmacies TARGET STORE T 1888 607061202 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 460 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1984 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49333 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63870.52 0 0 0 63870.52 0 0 0 1101432547 30 General Hospitals 845 Texas ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 103.53 0 0 0 0 0 0 0 0 1848 0 0 0 0 0 1951.53 0 0 0 1101432555 1932137577 10 Physicians MEHTA UDAY 602011718 200 Cook 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 699 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 871 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 871 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13726.67 0 1854.59 0 0 0 0 0 0 15581.26 0 0 0 1101432557 60 Pharmacies 816 Iowa 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 6 0 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 0 103.02 0 0 0 103.02 0 0 0 1101432559 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12064.35 0 0 0 0 0 0 0 0 0 0 0 0 0 12064.35 0 0 0 1101432562 94 Waiver service provider--Children's support (DHS/DDD) 72 McLean 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 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9372 0 0 0 0 0 0 0 0 0 0 0 0 0 9372 0 0 0 1101432564 1245237304 10 Physicians FURRY JOHN 625213810 63 Macon 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 1 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 353 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 353 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.31 0 7788.99 0 0 0 0 0 0 7789.3 0 0 0 1101432582 1770547309 10 Physicians VAISHNAV PRAKASH 606740018 27 Dekalb 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 568 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 568 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2670.38 0 0 0 0 0 0 2670.38 0 0 0 1101432590 16 Nurse Practitioners 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19933.35 0 0 0 0 0 0 0 0 0 0 0 0 0 19933.35 0 0 0 1101434378 1699909887 10 Physicians SRINIVASAN ANAND 602011780 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 367 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 367 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23809.54 0 0 0 0 0 0 23809.54 0 0 0 1101434386 1679531453 10 Physicians JONES BRUCE 637035095 826 Missouri 0 0 Thoracic Surgery 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 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 9537.57 0 0 0 0 0 0 9537.57 0 0 0 1101434387 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16722.43 0 0 0 0 0 0 0 0 0 0 0 0 0 16722.43 0 0 0 1101434388 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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SHOP 999999999 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 186 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4665 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46620.11 0 0 0 46620.11 0 0 0 1101434485 1609800481 10 Physicians STUCK GARY 604532670 200 Cook 0 0 Family Practice 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 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 0 702.09 0 0 0 0 0 0 702.09 0 0 0 1101434488 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 6650.34 0 0 0 0 0 0 0 0 0 0 0 0 0 6650.34 0 0 0 1101434490 92 Waiver service provider--Disability (DHS/DRS) 63 Macon 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 21972.45 0 0 0 0 0 0 0 0 0 0 0 0 0 21972.45 0 0 0 1101434506 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23300.14 0 0 0 0 0 0 0 0 0 0 0 0 0 23300.14 0 0 0 1101434525 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 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 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 0 854.78 0 0 0 0 0 0 0 0 0 0 0 0 0 854.78 0 0 0 1101434533 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 2901.07 0 0 0 0 0 0 0 0 0 0 0 0 0 2901.07 0 0 0 1101434551 1861679557 10 Physicians HUNT BRYAN 532264837 72 McLean 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72.57 0 0 0 0 0 0 0 0 72.57 0 0 0 1101434559 1801839154 10 Physicians YOUSIF DANIEL J 601262966 30 DuPage 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 1 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3690.67 0 0 0 0 0 0 3690.67 0 0 0 1101434561 14 Chiropractors 89 Rock Island 0 0 0 0 0 0 0 0 0 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 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 0 153 0 0 0 0 0 0 153 0 0 0 1101434570 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13612.5 0 0 0 0 0 0 0 0 0 0 0 0 0 13612.5 0 0 0 1101434580 1013164391 10 Physicians CHAKEER RIDHA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 515 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 515 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8289.45 0 0 0 0 0 0 8289.45 0 0 0 1101434599 1376547802 10 Physicians PROPHETE ROBERT Y 630177402 826 Missouri 0 0 Urological Surgery 0 0 0 0 0 0 0 0 0 0 0 14 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35.26 0 3919.43 0 0 0 0 0 0 3954.69 0 0 0 1101434603 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 27260.42 0 0 0 0 0 0 0 0 0 0 0 0 0 27260.42 0 0 0 1101434612 1043235245 10 Physicians SMYSER CHRISTOPHER 631101010 826 Missouri 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2835.38 0 0 0 0 0 0 2835.38 0 0 0 1101434619 1134418742 91 Waiver service provider--Adults (DHS/DDD) LAJINESS ASHLEY 606576188 200 Cook 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4739 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4739 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 142436.58 0 0 0 0 0 0 0 0 0 0 0 0 0 142436.58 0 0 0 1101434632 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 14117.95 0 0 0 0 0 0 0 0 0 0 0 0 0 14117.95 0 0 0 1101434639 1285633693 12 Optometrists THOMAS TINA 615719646 98 Tazewell 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2070.97 0 907.68 0 0 0 0 2978.65 0 0 0 1101434653 1477575306 10 Physicians SAMLAN SCOTT 601234717 53 Kane 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 321 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 391 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 391 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10344.15 0 0 0 0 0 0 10344.15 0 0 0 1101434679 1508857269 10 Physicians ACHUFUSI ONYEBUCHI 463201931 815 Indiana 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1948.91 0 0 0 0 0 0 1948.91 0 0 0 1101434701 1235254624 63 Other Providers of Medical Equipment/Supplies (Non-registered) GULBRANDSON ORTHOTICS 600132806 71 McHenry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 810.98 0 6442.83 0 0 0 0 7253.81 0 0 0 1101434703 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7202.94 0 0 0 0 0 0 0 0 0 0 0 0 0 7202.94 0 0 0 1101434709 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6639.14 0 0 0 0 0 0 0 0 0 0 0 0 0 6639.14 0 0 0 1101434720 1558456210 36 Community mental health provider LOCUST STREET RESOURCE CENTER 626261316 64 Macoupin 0 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 0 866 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 866 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18927.54 0 0 18927.54 0 0 0 1101434765 1083615728 70 Ambulance Service Providers VILLAGE OF CLARENDON HILLS FD 605141352 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 971.48 0 0 0 0 0 0 971.48 0 0 0 1101434786 1821089970 12 Optometrists MORELAND AMBER 629062242 99 Union 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 586 0 305 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1215 0 311 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1215 0 311 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29966.86 0 8841.6 0 0 0 0 38808.46 0 0 0 1101434787 1275615353 10 Physicians AMER MICHAEL D. 602011718 200 Cook 0 0 Neonatology 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 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0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1145.74 0 0 0 0 0 0 1145.74 0 0 0 1101434881 1669444709 10 Physicians ALGHAFEER IBRAHIM S 601783175 27 Dekalb 0 0 Rheumatology 0 0 0 0 0 0 0 0 0 0 0 87 0 236 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 246 0 794 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 246 0 794 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13699.02 0 29422.8 0 0 0 0 0 0 43121.82 0 0 0 1101434889 1831486380 11 Dentists RANA DEEPT 627026309 91 Sangamon 0 0 General Dentistry 0 0 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 561 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 561 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14531.3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14531.3 0 0 0 1101434896 1649273319 10 Physicians LEE CARL 535461626 852 Wisconsin 0 0 Otorhinolaryngology 0 0 0 0 0 0 0 0 0 0 0 1 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3560.39 0 0 0 0 0 0 3560.39 0 0 0 1101434897 1932111242 16 Nurse Practitioners WOO JENNIFER 606232460 200 Cook 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 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 4627.76 0 0 0 0 0 0 4627.76 0 0 0 1101434910 92 Waiver service provider--Disability (DHS/DRS) 90 Saline 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10190.52 0 0 0 0 0 0 0 0 0 0 0 0 0 10190.52 0 0 0 1101434917 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 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 34797.05 0 0 0 0 0 0 0 0 0 0 0 0 0 34797.05 0 0 0 1101434918 1144253980 10 Physicians ROCHESTER DAVID 602011718 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 678 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 843 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 843 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10226.54 0 7.65 0 0 0 0 0 0 10234.19 0 0 0 1101434927 1649299348 16 Nurse Practitioners CRAVENS THOMAS 631101010 826 Missouri 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 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1900.67 0 0 0 0 0 0 1900.67 0 0 0 1101434930 92 Waiver service provider--Disability (DHS/DRS) 30 DuPage 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 4221.91 0 0 0 0 0 0 0 0 0 0 0 0 0 4221.91 0 0 0 1101434937 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15502.38 0 0 0 0 0 0 0 0 0 0 0 0 0 15502.38 0 0 0 1101434938 92 Waiver service provider--Disability (DHS/DRS) 63 Macon 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5711.82 0 0 0 0 0 0 0 0 0 0 0 0 0 5711.82 0 0 0 1101434944 92 Waiver service provider--Disability (DHS/DRS) 42 Hancock 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 15102.86 0 0 0 0 0 0 0 0 0 0 0 0 0 15102.86 0 0 0 1101434945 2100425363 97 Waiver service provider--Children's residential (DHS/DDD) WADE ERIN 611114418 109 Winnebago 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4826.15 0 0 0 0 0 0 0 0 0 0 0 0 0 4826.15 0 0 0 1101434953 1720032311 10 Physicians ANALYTIS PETER 604501237 40 Grundy 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 231 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 555 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 555 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17425.59 0 0 0 0 0 0 17425.59 0 0 0 1101434961 10 Physicians 816 Iowa 0 0 Internal Medicine 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 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Cook 0 0 Plastic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 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 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6901.23 0 0 0 0 0 0 6901.23 0 0 0 1101434997 1366508814 10 Physicians FURMAN SUBASHINI 475911038 815 Indiana 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 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 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3536.06 0 0 0 0 0 0 3536.06 0 0 0 1101434999 1518974559 60 Pharmacies WALGREEN CO 06408 616145552 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 1959 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 8342 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 191100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78.51 0 0 482257.04 0 0 0 482335.55 0 0 0 1101435002 24 Speech Therapists 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 23 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 0 0 0 0 0 0 0 0 1665.36 1665.36 0 0 0 1101435004 1619029931 11 Dentists MENEGAS WILLIAM 606523504 200 Cook 0 0 General Dentistry 0 0 0 3316 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12843 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12843 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 367268.86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 367268.86 0 0 0 1101435006 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 3081.18 0 0 0 0 0 0 0 0 0 0 0 0 0 3081.18 0 0 0 1101435007 1023068731 60 Pharmacies "LINDAS PHARMACY, INC" 606162013 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 939 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3545 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107906 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 152575 0 0 0 152575 0 0 0 1101435013 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24710.91 0 0 0 0 0 0 0 0 0 0 0 0 0 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501 0 0 0 0 0 0 1274 0 0 7 0 0 0 0 0 0 32 0 501 0 0 0 0 0 0 3581 0 0 615.44 0 0 0 0 0 0 63.34 0 17584.58 0 0 0 0 0 0 21844.36 0 0 0 1101435058 1144237413 10 Physicians CANN STEPHEN 600933636 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 124.34 0 0 0 0 0 0 124.34 0 0 0 1101435062 1467482794 10 Physicians GABRIEL HELENA 606114402 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 288 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 357 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 357 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10600.1 0 150.74 0 0 0 0 0 0 10750.84 0 0 0 1101435067 1992855175 10 Physicians FILIPOV DOUGLAS 618012500 19 Champaign 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 471 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 670 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 670 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21817.43 0 0 0 0 0 0 21817.43 0 0 0 1101435073 16 Nurse Practitioners 826 Missouri 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0 24 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 286 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 286 0 0 1257.91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23995.42 0 0 25253.33 0 0 0 1101435889 14 Chiropractors 53 Kane 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76.59 0 0 0 0 0 0 76.59 0 0 0 1101435912 1427144096 47 Local Education Agencies PALESTINE CUSD 3 624511244 25 Crawford 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 101 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 101 0 0 0 0 133.18 0 0 0 0 0 0 0 0 0 0 0 0 0 949.09 0 1082.27 0 0 0 1101435920 1265629786 10 Physicians WASIUDDIN ROOHI 606227712 200 Cook 0 1 Pediatrics 0 765 0 0 1119 0 0 0 0 0 0 608 0 1619 0 0 0 0 0 0 6788 0 0 3854 0 0 0 0 0 0 965 0 3293 0 0 0 0 0 0 6788 0 0 3854 0 0 0 0 0 0 965 0 3293 0 0 0 0 0 0 13584 0 0 122612.38 0 0 0 0 0 0 8075.19 0 131497.71 0 0 0 0 0 0 275769.28 0 0 0 1101435927 92 Waiver service 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0 0 324.98 0 0 0 0 0 0 5.5 0 1072.84 0 0 0 0 0 0 1403.32 0 0 0 1101435975 1982833869 22 Physical Therapists DALE AMANDA 600257645 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2410.67 2410.67 0 0 0 1101435984 1942369145 10 Physicians STAHL KRISTIN 622347428 65 Madison 0 1 Pediatrics 0 57 0 0 210 0 0 0 0 0 0 123 0 299 0 0 0 0 0 0 372 0 0 558 0 0 0 0 0 0 193 0 532 0 0 0 0 0 0 372 0 0 558 0 0 0 0 0 0 193 0 532 0 0 0 0 0 0 744 0 0 12444.83 0 0 0 0 0 0 1551.36 0 16282.8 0 0 0 0 0 0 31022.99 0 0 0 1101435991 92 Waiver service provider--Disability (DHS/DRS) 47 Jackson 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23038.6 0 0 0 0 0 0 0 0 0 0 0 0 0 23038.6 0 0 0 1101435994 92 Waiver service provider--Disability (DHS/DRS) 64 Macoupin 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 28037.56 0 0 0 0 0 0 0 0 0 0 0 0 0 28037.56 0 0 0 1101435995 1215025762 60 Pharmacies MERCY PROFESSIONAL BLDG PHARM 605061459 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 464 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11527 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20667.8 0 0 0 20667.8 0 0 0 1101436017 1184690570 46 Ambulatory Surgical Treatment Centers PAIN CARE SURGERY 629595841 108 Williamson ASTC Ambulatory Surgical Treatment Center. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 430 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1514 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1514 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360096.89 0 0 0 0 0 360096.89 0 0 0 1101436020 1124017124 10 Physicians KULA JOHN 616159506 80 Peoria 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 1 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 215 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 215 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33685.32 0 0 0 0 0 0 33685.32 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3429.74 0 0 0 0 0 0 3429.74 0 0 0 1101436064 16 Nurse Practitioners 96 St Clair 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 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 0 111.35 0 0 0 0 0 0 111.35 0 0 0 1101436072 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 16198.11 0 0 0 0 0 0 0 0 0 0 0 0 0 16198.11 0 0 0 1101436077 2100426495 71 Medicar Provider JM MEDICAL TRANSPORTATION 604264726 200 Cook 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 2694 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2694 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20167.16 0 0 0 0 0 0 20167.16 0 0 0 1101436094 1144208612 10 Physicians NELSON SUSAN 600902979 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 1 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43.16 0 0 0 0 0 0 43.16 0 0 0 1101436103 30 General Hospitals 823 Michigan NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 71.19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71.19 0 0 0 1101436104 1447267240 12 Optometrists IRVINE WM J 627046517 91 Sangamon 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 393 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 782 0 388 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 782 0 388 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22818.02 0 11081.34 0 0 0 0 33899.36 0 0 0 1101436110 1568606051 40 Federally Qualified Health Centers SLADE HEALTH CENTER 601202104 53 Kane 0 1 Direct Access 0 73 595 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 303 2551 0 203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 303 2551 0 203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 762 130669.08 0 0 0 0 0 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1101436598 1265498083 10 Physicians JACOB CAROLYN 606545826 200 Cook 0 0 Dermatology 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 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 805.32 0 0 0 0 0 0 805.32 0 0 0 1101436599 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 18417.4 0 0 0 0 0 0 0 0 0 0 0 0 0 18417.4 0 0 0 1101436603 1942421144 10 Physicians AHMED ACHAL 600146260 200 Cook 0 0 Endocrinology 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 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2471.88 0 0 0 0 0 0 2471.88 0 0 0 1101436606 1477660256 10 Physicians RIERMAIER MICHAEL 601232304 53 Kane 0 1 Obstetric-Gynecology 0 21 0 0 2 0 0 0 0 0 0 81 0 526 0 0 0 0 0 0 107 0 0 2 0 0 0 0 0 0 112 0 1840 0 0 0 0 0 0 107 0 0 2 0 0 0 0 0 0 112 0 1840 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 188 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 188 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4322.86 0 0 0 0 0 0 4322.86 0 0 0 1101436635 1447277967 16 Nurse Practitioners POTTER DAVID 63110 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 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 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1740.39 0 0 0 0 0 0 1740.39 0 0 0 1101436646 1053305540 10 Physicians DAVIS DAVID 624420399 21 Clark 0 0 Family Practice 0 0 0 0 37 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 37 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 3.1 0 0 0 0 0 0 3.1 0 0 0 1101436661 1679518518 10 Physicians AIJAZ MAIMOONA 604355835 107 Will 0 1 Internal Medicine 0 32 0 0 1 0 0 0 0 0 0 7 0 76 0 0 0 0 0 0 142 0 0 1 0 0 0 0 0 0 9 0 250 0 0 0 0 0 0 142 0 0 1 0 0 0 0 0 0 9 0 250 0 0 0 0 0 0 442 0 0 4.1 0 0 0 0 0 0 45.46 0 6498.25 0 0 0 0 0 0 6989.81 0 0 0 1101436680 1841207859 60 Pharmacies WALGREENS #03652 630262338 826 Missouri 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 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 932 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 972.02 0 0 0 972.02 0 0 0 1101436682 1669586228 16 Nurse Practitioners MINORE LAURA J 611112754 109 Winnebago 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 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94.62 0 0 0 0 0 0 94.62 0 0 0 1101436698 1427076124 10 Physicians LUEDER GREGG 631101077 826 Missouri 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 14 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 230 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 230 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 975.81 0 26699.62 0 0 0 0 0 0 27675.43 0 0 0 1101436709 92 Waiver service provider--Disability (DHS/DRS) 55 Kendall 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 8513.97 0 0 0 0 0 0 0 0 0 0 0 0 0 8513.97 0 0 0 1101436714 1861756090 60 Pharmacies CVS PHARMACY 2375 601153020 27 Dekalb 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 705 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4345 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 109871 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 175135.31 0 0 0 175135.31 0 0 0 1101436719 1528020690 10 Physicians AMATO LAWRENCE 600731302 57 Lake 0 0 Internal Medicine 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 61 0 0 0 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 0 101.25 0 0 0 0 0 0 101.25 0 0 0 1101436733 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 0 845.97 0 0 0 0 0 0 0 0 0 0 0 0 0 845.97 0 0 0 1101436739 1811903073 10 Physicians LINDSTROM STEPHANIE 616360001 98 Tazewell 0 1 Family Practice 0 311 0 0 45 0 0 0 0 0 0 48 0 168 0 0 0 0 0 0 2688 0 0 88 0 0 0 0 0 0 65 0 403 0 0 0 0 0 0 2688 0 0 88 0 0 0 0 0 0 65 0 403 0 0 0 0 0 0 6710 0 0 4653.96 0 0 0 0 0 0 409.98 0 17431.76 0 0 0 0 0 0 29205.7 0 0 0 1101436748 1780660878 28 Waiver service provider--Supportive living facility (HFS) POINTE AT KILPATRICK 604452513 200 Cook 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 996 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24489 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1463794.87 0 0 0 0 0 0 0 0 0 0 0 0 0 1463794.87 0 0 0 1101436775 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11364.34 0 0 0 0 0 0 0 0 0 0 0 0 0 11364.34 0 0 0 1101436803 1205085958 10 Physicians JAYAKUMAR UDAI 606127323 200 Cook 0 0 Internal Medicine 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 2028.14 0 0 0 0 0 0 2028.14 0 0 0 1101436807 1134166747 10 Physicians ZYGIEL JOHN 999999999 37 Fulton 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 475 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 525 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 525 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15985.06 0 0 0 0 0 0 15985.06 0 0 0 1101436810 1932153103 10 Physicians GORDON ALEXANDER 600162359 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 57 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 147 0 223 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 147 0 223 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 249.82 0 7149.01 0 0 0 0 0 0 7398.83 0 0 0 1101436842 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14713.89 0 0 0 0 0 0 0 0 0 0 0 0 0 14713.89 0 0 0 1101436848 1215063870 10 Physicians HICKS SARAH 606313222 200 Cook 0 1 Internal Medicine 0 303 0 0 0 0 0 0 0 0 0 2 0 154 0 0 0 0 0 0 2357 0 0 0 0 0 0 0 0 0 2 0 248 0 0 0 0 0 0 2357 0 0 0 0 0 0 0 0 0 2 0 248 0 0 0 0 0 0 6991 0 0 0 0 0 0 0 0 0 5.93 0 8546.6 0 0 0 0 0 0 15543.53 0 0 0 1101436856 1417181116 10 Physicians CONCEPCION FREDERMAN 606777004 200 Cook 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 624 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1660 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1660 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19496.4 0 0 0 0 0 0 19496.4 0 0 0 1101436859 1497958912 10 Physicians YU TUNGOL DEBBIE 601429558 71 McHenry 0 1 Internal Medicine 0 4 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 88 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 88 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 1332.75 0 0 0 0 0 0 1365.75 0 0 0 1101436867 1417132093 36 Community mental health provider GRAND PRAIRIE SERVICES 604661414 200 Cook 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 556 0 0 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 556 0 0 9914.21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34545.67 0 0 44459.88 0 0 0 1101436877 1720068554 10 Physicians OLSON JAMES 537151849 852 Wisconsin 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 43 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1432.8 0 133.96 0 0 0 0 0 0 1566.76 0 0 0 1101436891 1992891238 63 Other Providers of Medical Equipment/Supplies (Non-registered) COMFORT MEDICAL LLC 999999999 810 Florida 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9812.18 0 0 0 0 0 0 9812.18 0 0 0 1101436929 92 Waiver service provider--Disability (DHS/DRS) 99 Union 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 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40760.79 0 0 0 0 0 0 0 0 0 0 0 0 0 40760.79 0 0 0 1101436930 1063472405 10 Physicians GUCCI MICHAEL 625213883 63 Macon 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 765 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 868 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 868 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32183.35 0 0 0 0 0 0 32183.35 0 0 0 1101436951 1669593570 55 Early Intervention Services DUMMER SUSAN 600303493 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 168 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 168 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20769.72 0 0 0 0 0 0 20769.72 0 0 0 1101436955 1508894981 28 Waiver service provider--Supportive living facility (HFS) BARTON SENIOR RESIDENCE CHGO 606081244 200 Cook 0 0 0 0 0 0 0 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1653 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38375 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2790129.86 0 0 0 0 0 0 0 0 0 0 0 0 0 2790129.86 0 0 0 1101436960 1235173675 10 Physicians DAVILA VICTOR 631101076 826 Missouri 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 821.56 0 0 0 0 0 0 821.56 0 0 0 1101436963 1164463782 16 Nurse Practitioners GREENE BRENDA 600268042 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 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 0 191.52 0 0 0 0 0 0 191.52 0 0 0 1101436970 1699779538 10 Physicians SMITH DANIEL 625491224 63 Macon 0 1 Family Practice 0 22 0 0 15 0 0 0 0 0 0 10 0 58 0 0 0 0 0 0 176 0 0 33 0 0 0 0 0 0 13 0 142 0 0 0 0 0 0 176 0 0 33 0 0 0 0 0 0 13 0 142 0 0 0 0 0 0 488 0 0 2139.55 0 0 0 0 0 0 55.29 0 3893.48 0 0 0 0 0 0 6576.32 0 0 0 1101436978 92 Waiver service provider--Disability (DHS/DRS) 105 White 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 6435.95 0 0 0 0 0 0 0 0 0 0 0 0 0 6435.95 0 0 0 1101436981 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 306 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 306 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15210.25 0 0 0 0 0 0 0 0 0 0 0 0 0 15210.25 0 0 0 1101436983 91 Waiver service provider--Adults (DHS/DDD) 109 Winnebago 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 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 10955.99 0 0 0 0 0 0 0 0 0 0 0 0 0 10955.99 0 0 0 1101436985 1629178512 10 Physicians WESLY JADWIGA 627032403 91 Sangamon 0 0 Endocrinology 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1248.45 0 0 0 0 0 0 1248.45 0 0 0 1101436996 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 1446.5 0 0 0 0 0 0 0 0 0 0 0 0 0 1446.5 0 0 0 1101437000 1437182979 10 Physicians STEVOFF CHRISTIAN 601533304 200 Cook 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8275.91 0 0 0 0 0 0 8275.91 0 0 0 1101437001 1447280284 30 General Hospitals LORETTO HOSPITAL 606445059 200 Cook DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 0 0 0 0 0 2723 0 0 0 0 1150 0 0 111 470 0 0 0 0 0 0 0 0 0 3927 0 0 0 0 1463 0 0 553 1143 0 0 0 0 0 0 0 0 0 3967 0 0 0 0 8406 0 0 1775 1438 0 0 0 0 0 0 0 0 0 792541.41 0 0 0 0 6000416.46 0 0 216946.47 157637.23 0 0 0 0 0 7167541.57 0 0 0 1101437024 1841320686 23 Occupational Therapists SIMMONS NANCY 628983325 49 Jefferson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 473 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 473 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36934.39 36934.39 0 0 0 1101437028 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 6238.06 0 0 0 0 0 0 0 0 0 0 0 0 0 6238.06 0 0 0 1101437034 1972601243 10 Physicians KWEDAR JOHN 627032403 91 Sangamon 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4854 0 0 0 0 0 0 4854 0 0 0 1101437035 1275643488 10 Physicians ULRICH GARY 478044010 815 Indiana 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 28 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 725.42 0 18157.24 0 0 0 0 0 0 18882.66 0 0 0 1101437038 98 Waiver service provider--TBI (DHS/DRS) 46 Iroquois 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 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 6228.4 0 0 0 0 0 0 0 0 0 0 0 0 0 6228.4 0 0 0 1101437040 1396725016 63 Other Providers of Medical Equipment/Supplies (Non-registered) DUMED H H CARE AND UNIFORMS 520021052 816 Iowa 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 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4464.53 0 0 0 0 0 0 4464.53 0 0 0 1101437051 1750431698 10 Physicians OLSKY MARK 535661569 852 Wisconsin 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 196.54 0 0 0 0 0 0 196.54 0 0 0 1101437057 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3114.36 0 0 0 0 0 0 0 0 0 0 0 0 0 3114.36 0 0 0 1101437065 92 Waiver service provider--Disability (DHS/DRS) 18 Cass 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 17320.83 0 0 0 0 0 0 0 0 0 0 0 0 0 17320.83 0 0 0 1101437088 1629067038 10 Physicians SRECKOVIC GEORGE 604624687 200 Cook 0 0 Urology 0 0 0 0 0 0 0 0 0 0 0 13 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 218 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 218 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25.08 0 4954.79 0 0 0 0 0 0 4979.87 0 0 0 1101437091 1568426245 10 Physicians CRANDALL MARIE 606118709 200 Cook 0 0 Surgery-Abdomen 0 0 0 0 0 0 0 0 0 0 0 5 0 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 146.25 0 9451.26 0 0 0 0 0 0 9597.51 0 0 0 1101437092 1275584153 55 Early Intervention Services CHIRIKOS DEBBIE 601029685 71 McHenry 0 0 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 0 347 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 347 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32773.66 0 0 0 0 0 0 32773.66 0 0 0 1101437094 1790731180 60 Pharmacies OSCO DRUG 3720 604416631 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 27612 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41.54 0 0 56305.63 0 0 0 56347.17 0 0 0 1101437106 2100427524 90 Waiver service provider--Elderly (DOA) HELP AT HOME INC 606023206 200 Cook 0 0 0 0 0 0 0 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7903 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7903 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 384605.93 0 0 0 0 0 0 0 0 0 0 0 0 0 384605.93 0 0 0 1101437113 1689665572 33 Nursing Facilities HERITAGE HEALTH CHILLICOTHE 615232258 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 501 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13692 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1112147.39 0 0 0 0 0 0 0 1112147.39 0 0 0 1101437126 1003940263 23 Occupational Therapists SZYMANSKI MONIKA 606146005 200 Cook 0 0 0 0 0 0 0 0 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 0 351 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 351 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25905 25905 0 0 0 1101437140 1992097174 60 Pharmacies MARIANOS PHARMACY 8502 600611538 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5515 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11336.08 0 0 0 11336.08 0 0 0 1101437141 1184727984 10 Physicians MANNIX CHRISTINA 631102515 826 Missouri 0 0 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Physicians 815 Indiana 0 0 Cardiology 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27.3 0 0 0 0 0 0 27.3 0 0 0 1101437220 92 Waiver service provider--Disability (DHS/DRS) 57 Lake 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 0 368.48 0 0 0 0 0 0 0 0 0 0 0 0 0 368.48 0 0 0 1101437222 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 1936 0 0 0 0 0 0 0 0 0 0 0 0 0 1936 0 0 0 1101437242 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 41710.46 0 0 0 0 0 0 0 0 0 0 0 0 0 41710.46 0 0 0 1101437249 10 Physicians 53 Kane 0 0 Family Practice 0 0 0 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Cook 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 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 8674.63 0 0 0 0 0 0 0 0 0 0 0 0 0 8674.63 0 0 0 1101437412 1114998713 10 Physicians STONE ARVEY 607145611 200 Cook 0 0 Internal Medicine 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 0 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3443.36 0 0 0 0 0 0 3443.36 0 0 0 1101437426 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 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 0 794.6 0 0 0 0 0 0 0 0 0 0 0 0 0 794.6 0 0 0 1101437435 1942401906 47 Local Education Agencies FREEBURG C C SCHOOL DIST 70 622431534 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1629 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1629 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19518.13 0 19518.13 0 0 0 1101437439 10 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600481317 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 229 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 841 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21545 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54589.6 0 0 0 54589.6 0 0 0 1101438721 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 3427.67 0 0 0 0 0 0 0 0 0 0 0 0 0 3427.67 0 0 0 1101438723 1710299870 55 Early Intervention Services BALCERAK GENEVIEVE 605047281 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 393 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 393 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22484.2 0 0 0 0 0 0 22484.2 0 0 0 1101438751 1952421042 10 Physicians AUGUSTIN JOEL 606123291 200 Cook 0 1 Family Practice 0 83 0 0 17 0 0 0 0 0 0 12 0 109 0 0 0 0 0 0 178 0 0 40 0 0 0 0 0 0 17 0 245 0 0 0 0 0 0 178 0 0 40 0 0 0 0 0 0 17 0 245 0 0 0 0 0 0 436 0 0 1416.18 0 0 0 0 0 0 92.27 0 3679.95 0 0 0 0 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PEORIA 616144340 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 873 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18613 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1235993.82 0 0 0 0 0 0 0 1235993.82 0 0 0 1101438845 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11909.47 0 0 0 0 0 0 0 0 0 0 0 0 0 11909.47 0 0 0 1101438864 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 14 0 0 0 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 8482.49 0 0 0 0 0 0 0 0 0 0 0 0 0 8482.49 0 0 0 1101438866 92 Waiver service provider--Disability (DHS/DRS) 22 Clay 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7588.08 0 0 0 0 0 0 0 0 0 0 0 0 0 7588.08 0 0 0 1101438871 1487608055 70 Ambulance Service Providers LIFESTAR AMBULANCE SERVICE INC 628012326 66 Marion 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1006 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3961 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3961 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 195560.42 0 0 0 0 0 0 195560.42 0 0 0 1101438874 1023285566 28 Waiver service provider--Supportive living facility (HFS) HAWTHORNE INN OF PRINCETON 613561878 15 Bureau 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 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4230 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 229240.17 0 0 0 0 0 0 0 0 0 0 0 0 0 229240.17 0 0 0 1101438885 1992923742 10 Physicians PATEL DADHIJA 604652302 200 Cook 0 1 Internal Medicine 0 30 0 0 0 0 0 0 0 0 0 5 0 140 0 0 0 0 0 0 224 0 0 0 0 0 0 0 0 0 7 0 252 0 0 0 0 0 0 224 0 0 0 0 0 0 0 0 0 7 0 252 0 0 0 0 0 0 672 0 0 0 0 0 0 0 0 0 12 0 11960.6 0 0 0 0 0 0 12644.6 0 0 0 1101438892 93 Waiver service provider--HIV/AIDS (DHS/DRS) 65 Madison 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 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 324 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9408.61 0 0 0 0 0 0 9408.61 0 0 0 1101438913 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 30121.34 0 0 0 0 0 0 0 0 0 0 0 0 0 30121.34 0 0 0 1101438915 1942491162 73 Other Transportation Providers ( Non-Registered) RICHLAND MANOR 624500010 88 Richland 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 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 208.61 0 0 0 0 0 0 208.61 0 0 0 1101438921 1255357562 10 Physicians GELTMAN EDWARD M 631082212 826 Missouri 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 241 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 241 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2980.01 0 0 0 0 0 0 2980.01 0 0 0 1101438928 1154682433 16 Nurse Practitioners BEHNAN LEGORRETA ELIZABETH 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Physicians HAMMING KATHERINE 607145611 200 Cook 0 0 Otorhinolaryngology 0 0 0 0 15 0 0 0 0 0 0 0 0 213 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 580 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 580 0 0 0 0 0 0 0 0 0 220.38 0 0 0 0 0 0 0 0 35956.24 0 0 0 0 0 0 36176.62 0 0 0 1101438970 10 Physicians 816 Iowa 0 0 Neurology 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101438981 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6478.76 0 0 0 0 0 0 0 0 0 0 0 0 0 6478.76 0 0 0 1101438985 92 Waiver service provider--Disability (DHS/DRS) 97 Stephenson 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 22069.07 0 0 0 0 0 0 0 0 0 0 0 0 0 22069.07 0 0 0 1101438997 1134464316 36 Community mental health provider TAZWOOD MENTAL HEALTH CTR INC 615301707 110 Woodford 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 252 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 252 0 0 1848 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14238 0 0 16086 0 0 0 1101438999 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 16451.01 0 0 0 0 0 0 0 0 0 0 0 0 0 16451.01 0 0 0 1101439011 91 Waiver service provider--Adults (DHS/DDD) 107 Will 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 3201 0 0 0 0 0 0 0 0 0 0 0 0 0 3201 0 0 0 1101439013 1467449280 33 Nursing Facilities ALDEN VALLEY RIDGE REHAB HCC 601082135 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1571 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37748 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4061881.94 0 0 0 0 0 0 0 4061881.94 0 0 0 1101439014 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 1121.24 0 0 0 0 0 0 0 0 0 0 0 0 0 1121.24 0 0 0 1101439015 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 12707.01 0 0 0 0 0 0 0 0 0 0 0 0 0 12707.01 0 0 0 1101439038 1386660322 10 Physicians AWAH JOHN 605233808 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 242 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3030 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3030 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26135.79 0 0 0 0 0 0 26135.79 0 0 0 1101439045 1265443915 33 Nursing Facilities ALPINE FIRESIDE HEALTH CENTER 611144806 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 189 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5468 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 486116.62 0 0 0 0 0 0 0 486116.62 0 0 0 1101439054 16 Nurse Practitioners 826 Missouri 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 0 132.81 0 0 0 0 0 0 132.81 0 0 0 1101439081 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11709.5 0 0 0 0 0 0 0 0 0 0 0 0 0 11709.5 0 0 0 1101439086 91 Waiver service provider--Adults (DHS/DDD) 110 Woodford 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 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9381.66 0 0 0 0 0 0 0 0 0 0 0 0 0 9381.66 0 0 0 1101439097 1568482123 10 Physicians PROPECK TIM 633014405 826 Missouri 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 8 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 0 101.98 0 0 0 0 0 0 0 0 101.98 0 0 0 1101439099 1649267006 10 Physicians UMANA UKEME 629594437 108 Williamson 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 31 0 589 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 1550 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 1550 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 646.25 0 115163.23 0 0 0 0 0 0 115809.48 0 0 0 1101439100 1033206198 70 Ambulance Service Providers ROLLING MEADOWS FIRE DEPT 600082052 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 173 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 468 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 468 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13992.86 0 0 0 0 0 0 13992.86 0 0 0 1101439108 1497859128 60 Pharmacies FRANKLIN PHARMACY INC 601311753 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 554 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14743 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32414.84 0 0 0 32414.84 0 0 0 1101439110 1366497877 12 Optometrists FRITH THERESA 604062118 200 Cook 0 0 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service provider--TBI (DHS/DRS) 200 Cook 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 3015.53 0 0 0 0 0 0 0 0 0 0 0 0 0 3015.53 0 0 0 1101440653 1306156500 10 Physicians SULKOWSKI JESSICA 608052703 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 1 0 0 0 0 0 0 44 0 86 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 112 0 199 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 112 0 199 0 0 0 0 0 0 0 0 0 85.65 0 0 0 0 0 0 76.57 0 23216.17 0 0 0 0 0 0 23378.39 0 0 0 1101440657 1821078213 30 General Hospitals HILLSBORO AREA HOSPITAL 620491912 76 Montgomery DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 1 0 0 0 0 0 0 0 0 0 0 0 0 598 0 0 393 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1877 0 0 2202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1877 0 0 2202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17671.36 0 0 364045.74 0 0 0 0 0 381717.1 0 0 0 1101440671 91 Waiver service provider--Adults (DHS/DDD) 57 Lake 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 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Waiver service provider--TBI (DHS/DRS) 200 Cook 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 5225.96 0 0 0 0 0 0 0 0 0 0 0 0 0 5225.96 0 0 0 1101440755 1447283692 10 Physicians NEPOMUCENO REYNALDO 609142325 54 Kankakee 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 5 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41.89 0 2963.67 0 0 0 0 0 0 3005.56 0 0 0 1101440760 1881644714 10 Physicians NAGARAJ DEVIKA 637035049 826 Missouri 0 0 Pediatrics 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 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3924.34 0 0 0 0 0 0 3924.34 0 0 0 1101440764 1053330613 25 Audiologists PYLE KELLY 617042101 72 McLean 0 0 0 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 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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Service Providers LUCAS AMBULANCE SERVICES 605255061 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 601 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 601 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118.58 0 0 0 0 0 0 118.58 0 0 0 1101440901 10 Physicians 200 Cook 0 0 General Practice 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 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31.47 0 0 0 0 0 0 31.47 0 0 0 1101440902 1841311735 10 Physicians HOUSEWORTH WM 619202522 24 Coles 0 0 Gynecology 0 0 0 0 4 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 220 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 220 0 0 0 0 0 0 0 0 0 400.53 0 0 0 0 0 0 0 0 22274.45 0 0 0 0 0 0 22674.98 0 0 0 1101440908 92 Waiver service provider--Disability (DHS/DRS) 29 Douglas 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 12385.82 0 0 0 0 0 0 0 0 0 0 0 0 0 12385.82 0 0 0 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AIR EVAC EMS INC 477101627 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58292.4 0 0 0 0 0 0 58292.4 0 0 0 1101442155 1568567030 10 Physicians DELBUSTO PAUL 606731281 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 1 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33.42 0 44.74 0 0 0 0 0 0 78.16 0 0 0 1101442158 1962481366 10 Physicians WERRIES BARRY 626501136 77 Morgan 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 147 0 214 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 243 0 565 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 243 0 565 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4275.74 0 27967.44 0 0 0 0 0 0 32243.18 0 0 0 1101442165 1588657753 10 Physicians AXELROD ALAN 606081610 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 1 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 167.21 0 0 0 1101443758 92 Waiver service provider--Disability (DHS/DRS) 97 Stephenson 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 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 1696.7 0 0 0 0 0 0 0 0 0 0 0 0 0 1696.7 0 0 0 1101443759 1982615175 10 Physicians VANVOORHEES BENJAMIN 606124325 200 Cook 0 1 Internal Medicine 0 56 0 0 40 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 326 0 0 65 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 326 0 0 65 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 652 0 0 3347.58 0 0 0 0 0 0 0 0 6589.71 0 0 0 0 0 0 10589.29 0 0 0 1101443765 1407091523 60 Pharmacies WALGREENS #12303 622263107 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 209 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 886 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22633 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54015.66 0 0 0 54015.66 0 0 0 1101443775 1760407886 16 Nurse Practitioners HENNESSEY JAMES 631101010 826 Missouri 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 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 494.87 0 0 0 0 0 0 494.87 0 0 0 1101443777 1811170244 55 Early Intervention Services GOMEZ MELISSA 610723230 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 358 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 358 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32836.18 0 0 0 0 0 0 32836.18 0 0 0 1101443779 92 Waiver service provider--Disability (DHS/DRS) 30 DuPage 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8039.99 0 0 0 0 0 0 0 0 0 0 0 0 0 8039.99 0 0 0 1101443780 1194774570 10 Physicians BRENNAN MAURA 606253664 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 1 0 0 0 0 0 0 20 0 116 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 31 0 207 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 31 0 207 0 0 0 0 0 0 0 0 0 104.96 0 0 0 0 0 0 1728.94 0 25265.13 0 0 0 0 0 0 27099.03 0 0 0 1101443782 1801047832 28 Waiver service provider--Supportive living facility (HFS) HERITAGE WOODS OF MCHENRY 600505424 71 McHenry 0 0 0 0 0 0 0 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33716 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2120406 0 0 0 0 0 0 0 0 0 0 0 0 0 2120406 0 0 0 1101443800 2100434218 91 Waiver service provider--Adults (DHS/DDD) COUNTRYSIDE ASSOCIATION 600742028 57 Lake 0 0 0 0 0 0 0 0 342 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41201 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41201 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2366037.98 0 0 0 0 0 0 0 0 0 0 0 0 0 2366037.98 0 0 0 1101443801 1316024086 10 Physicians CHOU CARMEL 606123723 200 Cook 0 0 Oncology 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 66 0 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 86.94 0 0 0 0 0 0 86.94 0 0 0 1101443810 1215909056 12 Optometrists BRTVA DENNIS 617040910 72 McLean 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1694.05 0 0 0 0 0 0 1694.05 0 0 0 1101443811 1770696767 10 Physicians HYDERI ABBAS 606127246 200 Cook 0 1 Family Practice 0 188 0 0 17 0 0 0 0 0 0 16 0 133 0 0 0 0 0 0 1053 0 0 28 0 0 0 0 0 0 31 0 236 0 0 0 0 0 0 1053 0 0 28 0 0 0 0 0 0 31 0 236 0 0 0 0 0 0 2889 0 0 1563.06 0 0 0 0 0 0 92.68 0 21765.75 0 0 0 0 0 0 26310.49 0 0 0 1101443821 1073707113 60 Pharmacies TARGET STORE T 2293 604465061 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 521 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22450.45 0 0 0 22450.45 0 0 0 1101443834 1871521351 13 Podiatrists ANGLIM ROBERT 607064277 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 455 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2407 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2407 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1938.7 0 0 0 0 0 0 1938.7 0 0 0 1101443838 1447368071 30 General Hospitals GOOD SHEPHERD HOSPITAL 600101919 57 Lake DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 0 1 0 0 0 1667 0 0 0 0 520 0 0 4 1197 0 0 0 0 0 1 0 0 0 2368 0 0 0 0 653 0 0 4 2241 0 0 0 0 0 1 0 0 0 2407 0 0 0 0 2770 0 0 4 2267 0 0 0 0 0 0 0 0 0 488251.25 0 0 0 0 1486825.27 0 0 6964.15 497290.44 0 0 0 0 0 2479331.11 0 0 0 1101443852 1316173867 10 Physicians MOHSIN SANA 999999999 54 Kankakee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1848.38 0 0 0 0 0 0 1848.38 0 0 0 1101443869 1053407486 10 Physicians KARIMI FARID 604112463 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 370 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 370 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7746.33 0 0 0 0 0 0 7746.33 0 0 0 1101443884 16 Nurse Practitioners 826 Missouri 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 112.07 112.07 0 0 0 1101443918 1124308168 55 Early Intervention Services CALHOUN TINA 625499704 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 872 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 872 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39546.57 0 0 0 0 0 0 39546.57 0 0 0 1101443923 1578642377 16 Nurse Practitioners SALAZAR MARISA 600561922 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 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 0 387.57 0 0 0 0 0 0 387.57 0 0 0 1101443926 92 Waiver service provider--Disability (DHS/DRS) 106 Whiteside 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 10452.48 0 0 0 0 0 0 0 0 0 0 0 0 0 10452.48 0 0 0 1101443932 1073742664 10 Physicians BLOEMER ERIC 624671134 33 Effingham 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2779.64 0 0 0 0 0 0 2779.64 0 0 0 1101443937 1619993078 10 Physicians PATZIK SHAYLE B 604631029 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 878 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1215 0 218 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1215 0 218 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21541.61 0 4648.71 0 0 0 0 0 0 26190.32 0 0 0 1101443943 1932318649 10 Physicians LEVENTIS JOHN 600315712 57 Lake 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 2 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 186 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 186 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16.4 0 958.23 0 0 0 0 0 0 974.63 0 0 0 1101443994 1639148356 10 Physicians NULTY WILLIAM 615719615 98 Tazewell 0 0 Internal Medicine 0 0 0 0 5 0 0 0 0 0 0 1 0 24 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 2 0 33 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 2 0 33 0 0 0 0 0 0 0 0 0 355.79 0 0 0 0 0 0 4.28 0 1652.01 0 0 0 0 0 0 2012.08 0 0 0 1101444005 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 19074.62 0 0 0 0 0 0 0 0 0 0 0 0 0 19074.62 0 0 0 1101444006 1114914884 13 Podiatrists PARIKH SHERMI 606295041 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 228 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 228 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2468.78 0 0 0 0 0 0 2468.78 0 0 0 1101444014 92 Waiver service provider--Disability (DHS/DRS) 55 Kendall 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 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 17466.67 0 0 0 0 0 0 0 0 0 0 0 0 0 17466.67 0 0 0 1101444026 92 Waiver service provider--Disability (DHS/DRS) 71 McHenry 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 23 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 0 0 0 0 0 0 0 0 15566.9 0 0 0 0 0 0 0 0 0 0 0 0 0 15566.9 0 0 0 1101444035 1700867033 33 Nursing Facilities LEE MANOR NURSING HM 600181514 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 224 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1584 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39935 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4543647.39 0 0 0 0 0 0 0 4543647.39 0 0 0 1101444041 91 Waiver service provider--Adults (DHS/DDD) 63 Macon 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 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6385.5 0 0 0 0 0 0 0 0 0 0 0 0 0 6385.5 0 0 0 1101444047 1558471896 10 Physicians YEAGLEY THOMAS 478044086 815 Indiana 0 0 Obstetric-Gynecology 0 0 0 0 3 0 0 0 0 0 0 53 0 90 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 250 0 360 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 250 0 360 0 0 0 0 0 0 0 0 0 97.24 0 0 0 0 0 0 5850.36 0 42006.78 0 0 0 0 0 0 47954.38 0 0 0 1101444050 1104841402 10 Physicians SMITH NORM 605276686 30 DuPage 0 0 Urology 0 0 0 0 0 0 0 0 0 0 0 7 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100.45 0 7179.09 0 0 0 0 0 0 7279.54 0 0 0 1101444052 1538341060 10 Physicians GORBONOS ALEX 627949665 91 Sangamon 0 0 Urological Surgery 0 0 0 0 0 0 0 0 0 0 0 12 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 368 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 368 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 250.85 0 31564.02 0 0 0 0 0 0 31814.87 0 0 0 1101444055 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9144.3 0 0 0 0 0 0 0 0 0 0 0 0 0 9144.3 0 0 0 1101444071 1205967791 24 Speech Therapists GULLEY PAULETTE 606173848 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 430 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3485 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3485 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 296696.98 296696.98 0 0 0 1101444075 1013955426 70 Ambulance Service Providers BOURBONNAIS FIRE DEPARTMENT 609142102 54 Kankakee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 538 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 538 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17106.52 0 0 0 0 0 0 17106.52 0 0 0 1101444089 2100434507 71 Medicar Provider FAMILY TRANSPORTATION 604731008 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11012 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11012 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70645.67 0 0 0 0 0 0 70645.67 0 0 0 1101444102 92 Waiver service provider--Disability (DHS/DRS) 10 Adams 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 0 347.49 0 0 0 0 0 0 0 0 0 0 0 0 0 347.49 0 0 0 1101444104 1255404885 10 Physicians STOLLER WALTER 606118709 200 Cook 0 0 Endocrinology 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1222.9 0 0 0 0 0 0 1222.9 0 0 0 1101444105 1982828190 13 Podiatrists LEAHY MEGAN 606465726 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1404.25 0 0 0 0 0 0 1404.25 0 0 0 1101444120 98 Waiver service provider--TBI (DHS/DRS) 53 Kane 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 3536.14 0 0 0 0 0 0 0 0 0 0 0 0 0 3536.14 0 0 0 1101444130 1285649582 60 Pharmacies BOND DRUG COMPANY OF IL 514 601081129 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 305 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1629 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 38531 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3.93 0 0 113855.04 0 0 0 113858.97 0 0 0 1101444131 1245542323 16 Nurse Practitioners CASTRO LISA 477131227 815 Indiana 0 0 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 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 739.39 0 0 0 0 0 0 739.39 0 0 0 1101444132 1952318990 60 Pharmacies WALGREEN CO 6000 463751202 815 Indiana 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 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2330.27 0 0 0 2330.27 0 0 0 1101444148 1891816898 55 Early Intervention Services KENDRYNA SHEILA 604291619 200 Cook 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 0 389 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 389 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33321.13 0 0 0 0 0 0 33321.13 0 0 0 1101444162 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10740.8 0 0 0 0 0 0 0 0 0 0 0 0 0 10740.8 0 0 0 1101444179 1619008737 47 Local Education Agencies MEDINAH SCH DIST 11 601721406 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22597.98 0 22597.98 0 0 0 1101444181 1063436988 10 Physicians TYLER LAMARR 600771057 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 48 0 183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 495 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 495 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3376.98 0 38579.55 0 0 0 0 0 0 41956.53 0 0 0 1101444216 1669524344 10 Physicians HUSAIN ALIYA 605276686 200 Cook 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 259 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 540 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 540 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5497.62 0 0 0 0 0 0 0 0 5497.62 0 0 0 1101444224 92 Waiver service provider--Disability (DHS/DRS) 91 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 7384.75 0 0 0 0 0 0 0 0 0 0 0 0 0 7384.75 0 0 0 1101444235 1851371264 10 Physicians BARTEL ERIC 601342578 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 21 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 446.51 0 4211.63 0 0 0 0 0 0 4658.14 0 0 0 1101444237 92 Waiver service provider--Disability (DHS/DRS) 40 Grundy 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 16069.59 0 0 0 0 0 0 0 0 0 0 0 0 0 16069.59 0 0 0 1101444245 1588605695 10 Physicians MEHTA NEIL 608052746 200 Cook 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 229 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 229 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2773.68 0 0 0 0 0 0 2773.68 0 0 0 1101444265 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 2580.73 0 0 0 0 0 0 0 0 0 0 0 0 0 2580.73 0 0 0 1101444269 1710954300 10 Physicians KRIKORIAN RAFFI 631271358 826 Missouri 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 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Marion 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 36243.08 0 0 0 0 0 0 0 0 0 0 0 0 0 36243.08 0 0 0 1101444300 1336350446 10 Physicians FLICK AMY 637015230 826 Missouri 0 0 Maternal and Fetal Medicine 0 0 0 0 0 0 0 0 0 0 0 25 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2193.59 0 4752.35 0 0 0 0 0 0 6945.94 0 0 0 1101444319 70 Ambulance Service Providers 815 Indiana 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 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 0 483.46 0 0 0 0 0 0 483.46 0 0 0 1101444320 10 Physicians 816 Iowa 0 0 Anesthesiology 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 0 447.27 0 0 0 0 0 0 447.27 0 0 0 1101444321 10 Physicians 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 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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 0 0 0 0 0 0 0 0 24965.78 0 0 0 0 0 0 0 0 0 0 0 0 0 24965.78 0 0 0 1101444386 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 289 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 289 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23479.5 0 0 0 0 0 0 0 0 0 0 0 0 0 23479.5 0 0 0 1101444389 1619146263 33 Nursing Facilities FREEPORT REHAB AND HEALTH CARE 610324580 97 Stephenson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4407 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 411754.87 0 0 0 0 0 0 0 411754.87 0 0 0 1101444394 92 Waiver service provider--Disability (DHS/DRS) 106 Whiteside 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 20147.16 0 0 0 0 0 0 0 0 0 0 0 0 0 20147.16 0 0 0 1101444400 1215922000 10 Physicians MCGRANAHAN MARK 622321720 96 St Clair 0 1 Pediatrics 0 39 0 0 93 0 0 0 0 0 0 20 0 85 0 0 0 0 0 0 306 0 0 329 0 0 0 0 0 0 32 0 222 0 0 0 0 0 0 306 0 0 329 0 0 0 0 0 0 32 0 222 0 0 0 0 0 0 612 0 0 10229.21 0 0 0 0 0 0 402.77 0 9401.39 0 0 0 0 0 0 20645.37 0 0 0 1101444406 92 Waiver service provider--Disability (DHS/DRS) 10 Adams 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 14 0 0 0 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 20170.11 0 0 0 0 0 0 0 0 0 0 0 0 0 20170.11 0 0 0 1101444412 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 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 2863.42 0 0 0 0 0 0 0 0 0 0 0 0 0 2863.42 0 0 0 1101444422 60 Pharmacies 826 Missouri 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 901.71 0 0 0 901.71 0 0 0 1101444425 1356369813 10 Physicians PARKS BECKY 631101007 826 Missouri 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 852.09 0 0 0 0 0 0 852.09 0 0 0 1101444426 1952354342 10 Physicians MAZZULLO LISA 606114402 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 1 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20.02 0 1864.13 0 0 0 0 0 0 1884.15 0 0 0 1101444427 1528195070 34 State-operated facility (DHS) UNIT 3163 HOME 3 KILEY 600856263 57 Lake 0 0 0 0 0 0 0 0 0 0 0 7 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 0 630 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 473955.89 0 0 0 0 0 0 0 0 0 0 473955.89 0 0 0 1101444435 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 21052.36 0 0 0 0 0 0 0 0 0 0 0 0 0 21052.36 0 0 0 1101444462 1659475242 10 Physicians BARBER FREDERICK A 607074143 200 Cook 0 0 Family Practice 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 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 218.22 0 0 0 0 0 0 218.22 0 0 0 1101444467 1801875182 10 Physicians MOBARHAN SOHRAB 606123988 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6269.7 0 0 0 0 0 0 6269.7 0 0 0 1101444469 1902062219 10 Physicians MUKHERJEE AMITA 605064356 53 Kane 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 10 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 188.23 0 753.75 0 0 0 0 0 0 941.98 0 0 0 1101444490 1407950421 10 Physicians KULSAKDINUN RACHEL 600050000 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 979.25 0 0 0 0 0 0 979.25 0 0 0 1101444498 1316938384 10 Physicians SWEENEY PATRICK 600681270 200 Cook 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1027.17 0 0 0 0 0 0 1027.17 0 0 0 1101444513 1437332541 10 Physicians HOBSON MICHAEL J 462061026 63 Macon 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2213.93 0 0 0 0 0 0 2213.93 0 0 0 1101444514 2100434932 71 Medicar Provider Z AND E TRANSPORTATION 608272236 200 Cook 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 0 0 0 0 0 0 0 0 3299 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3299 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26355.17 0 0 0 0 0 0 26355.17 0 0 0 1101444519 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 8777.07 0 0 0 0 0 0 0 0 0 0 0 0 0 8777.07 0 0 0 1101444521 1740367606 24 Speech Therapists SPICER AMY 619389253 24 Coles 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 476 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 476 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34138.39 34138.39 0 0 0 1101444531 1003864539 10 Physicians IVANKOVICH DANIEL 606476905 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 11 0 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 652 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 652 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131.46 0 30669.38 0 0 0 0 0 0 30800.84 0 0 0 1101444533 91 Waiver service provider--Adults (DHS/DDD) 57 Lake 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 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23984.83 0 0 0 0 0 0 0 0 0 0 0 0 0 23984.83 0 0 0 1101444535 1073618427 10 Physicians WITTELS BERNARD 606222743 200 Cook 0 0 Anesthesiology 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 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21141.25 0 0 0 0 0 0 21141.25 0 0 0 1101444548 1033157292 10 Physicians ROSSI ALFRED N 617470267 98 Tazewell 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 251 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 251 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2183.09 0 0 0 0 0 0 2183.09 0 0 0 1101444551 92 Waiver service provider--Disability (DHS/DRS) 81 Perry 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 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 9960.58 0 0 0 0 0 0 0 0 0 0 0 0 0 9960.58 0 0 0 1101444557 1952357485 60 Pharmacies OSCO DRUG 3013 604406568 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1016 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27582 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45772.4 0 0 0 45772.4 0 0 0 1101444561 1821178617 11 Dentists WHITTAKER ROBERT 601342706 53 Kane 0 0 Oral Surgery 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2025.65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2025.65 0 0 0 1101444567 1467770941 25 Audiologists FILER SARAH 611075336 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 654 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 654 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60230.76 60230.76 0 0 0 1101444568 1790908200 36 Community mental health provider BRIDGEWAY INC 614012482 56 Knox 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2925 0 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2925 0 0 4132.51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108286.6 0 0 112419.11 0 0 0 1101444603 1932296472 30 General Hospitals INGALLS MEMORIAL HOSPITAL 604263558 200 Cook DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adults Section 0 3 494 0 0 8272 0 0 0 0 1733 0 0 0 2699 0 0 0 0 0 10 1943 0 0 12554 0 0 0 0 2137 0 0 0 5756 0 0 0 0 0 14 2060 0 0 12554 0 0 0 0 10147 0 0 0 6316 0 0 0 0 0 107.9 103126.57 0 0 1846363.65 0 0 0 0 4259745.72 0 0 0 724884.97 0 0 0 0 0 6934228.81 0 0 0 1101444604 1508973918 10 Physicians HALBECK CHARLES 631418118 826 Missouri 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 756 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 756 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7949.12 0 0 0 0 0 0 7949.12 0 0 0 1101444631 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 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 0 778.52 0 0 0 0 0 0 0 0 0 0 0 0 0 778.52 0 0 0 1101444659 1316112766 10 Physicians CAPERS CELESTE 631101002 826 Missouri 0 0 Pediatrics 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 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8744.88 0 0 0 0 0 0 8744.88 0 0 0 1101444665 16 Nurse Practitioners 23 Clinton 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 0 0 0 0 0 0 0 0 0 0 0 1101444666 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 7679.35 0 0 0 0 0 0 0 0 0 0 0 0 0 7679.35 0 0 0 1101444689 1447239165 10 Physicians CRICKARD GEORGE 623014038 10 Adams 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 409 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 922 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 922 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63112.36 0 0 0 0 0 0 63112.36 0 0 0 1101444690 1861422594 16 Nurse Practitioners PAICE JUDITH 606112578 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1602.25 0 0 0 0 0 0 1602.25 0 0 0 1101444722 1568575918 10 Physicians LEVINE JERROLD 606743462 200 Cook 0 0 Nephrology 0 0 0 0 0 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10822.9 0 0 0 0 0 0 10822.9 0 0 0 1101444730 1275637126 60 Pharmacies CVS PHARMACY 5688 601033001 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 503 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 12863 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.7 0 0 49758.84 0 0 0 49759.54 0 0 0 1101444746 1669811501 28 Waiver service provider--Supportive living facility (HFS) PARK POINT SUPPORTIVE LIVING 604502508 40 Grundy 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 242 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 413944.94 0 0 0 0 0 0 0 0 0 0 0 0 0 413944.94 0 0 0 1101444747 1851398218 10 Physicians FIDAI GULZAR S 601239406 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 1532.55 0 0 0 0 999.72 0 0 0 0 0 0 0 0 0 2532.27 0 0 0 1101445866 1083828818 55 Early Intervention Services KURANISHI SUSAN 606185302 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 0 392 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 0 0 0 0 0 0 0 0 0 0 0 0 21575.8 0 0 0 0 0 0 21575.8 0 0 0 1101445880 92 Waiver service provider--Disability (DHS/DRS) 89 Rock Island 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 18047.29 0 0 0 0 0 0 0 0 0 0 0 0 0 18047.29 0 0 0 1101445888 1518096833 24 Speech Therapists KISNER CROSBY BETHANY 601151955 27 Dekalb 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1098 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1098 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78732.89 78732.89 0 0 0 1101445893 10 Physicians 852 Wisconsin 0 0 Radiology Diagnosis 0 0 0 0 0 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 126.18 0 0 0 0 0 0 0 0 126.18 0 0 0 1101445895 1376706630 10 Physicians FOSTER RISHA 605256539 200 Cook 0 0 Urology 0 0 0 0 0 0 0 0 0 0 0 5 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25.11 0 1661.23 0 0 0 0 0 0 1686.34 0 0 0 1101445896 1619195062 55 Early Intervention Services WALKER DEBRA 604784859 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 448 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 448 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41853.72 0 0 0 0 0 0 41853.72 0 0 0 1101445903 1902894983 10 Physicians BROADBENT JOHN 420037914 818 Kentucky 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 8 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 2611.4 0 0 0 0 0 0 2611.4 0 0 0 1101445904 1124097951 10 Physicians SIDDIQUI AKHTAR 605044385 30 DuPage 0 0 Pulmonary Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 221 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 912 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 912 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7102.9 0 0 0 0 0 0 7102.9 0 0 0 1101445915 1609035674 60 Pharmacies NORTH SUBURBAN PHARMACY 600772903 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 578 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5856 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166325 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73256.46 0 0 0 73256.46 0 0 0 1101445918 1649472556 10 Physicians BLOCK ALISSA 600611365 57 Lake 0 1 Pediatrics 0 117 0 0 72 0 0 0 0 0 0 5 0 113 0 0 0 0 0 0 962 0 0 92 0 0 0 0 0 0 5 0 168 0 0 0 0 0 0 962 0 0 92 0 0 0 0 0 0 5 0 168 0 0 0 0 0 0 1924 0 0 6909.63 0 0 0 0 0 0 66.8 0 7769.19 0 0 0 0 0 0 16669.62 0 0 0 1101445935 2100436353 91 Waiver service provider--Adults (DHS/DDD) MOSAIC OF ILLINOIS 614552206 70 McDonough 0 0 0 0 0 0 0 0 241 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93402 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93402 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10621560.04 0 0 0 0 0 0 0 0 0 0 0 0 0 10621560.04 0 0 0 1101445940 1477532232 10 Physicians FLORENCE NEAL 606465738 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 502 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 502 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7091.67 0 0 0 0 0 0 7091.67 0 0 0 1101445965 10 Physicians 200 Cook 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 963.2 0 0 0 0 0 0 963.2 0 0 0 1101445966 1598718603 30 General Hospitals MERCY HOSP OF JANESVILLE INC 535482940 852 Wisconsin NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 7 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125.44 0 0 248.98 0 0 0 0 0 374.42 0 0 0 1101445972 1407889447 16 Nurse Practitioners CIPPARRONE KRISTINA 605151561 30 DuPage 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17.9 0 0 0 0 0 0 17.9 0 0 0 1101445973 1568460681 51 Community Health Agencies - In home EASTER SEALS DUPAGE FOX VALLEY 601812877 30 DuPage 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1090 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1090 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52310.29 0 0 0 0 0 0 0 0 0 0 0 0 52310.29 0 0 0 1101445976 1558433243 60 Pharmacies MOODY PHARMACY 622861678 87 Randolph 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 643 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5309 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 126281 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 210445.1 0 0 0 210445.1 0 0 0 1101445979 2100436397 90 Waiver service provider--Elderly (DOA) "HELP AT HOME, LLC" 606023312 200 Cook 0 0 0 0 0 0 0 0 636 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58992 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58992 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3605081.02 0 0 0 0 0 0 0 0 0 0 0 0 0 3605081.02 0 0 0 1101445992 1588654057 10 Physicians KUNZELMAN JOSEPH 624541167 25 Crawford 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 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 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 549.71 0 0 0 0 0 0 549.71 0 0 0 1101446006 1609858646 11 Dentists KHOURI RHONDA 604551821 200 Cook 0 0 General Dentistry 0 0 0 273 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1413 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1413 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42656.48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42656.48 0 0 0 1101446009 1972502979 10 Physicians VAZQUEZ JOHN 606127239 200 Cook 0 0 Anesthesiology 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 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3237.13 0 0 0 0 0 0 3237.13 0 0 0 1101446017 98 Waiver service provider--TBI (DHS/DRS) 98 Tazewell 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 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 0 755.03 0 0 0 0 0 0 0 0 0 0 0 0 0 755.03 0 0 0 1101446028 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20584.39 0 0 0 0 0 0 0 0 0 0 0 0 0 20584.39 0 0 0 1101446038 1306865639 10 Physicians SIMON JEREMY 606313707 200 Cook 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 430 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 572 0 225 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 572 0 225 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11405.79 0 6873.34 0 0 0 0 0 0 18279.13 0 0 0 1101446040 10 Physicians 826 Missouri 0 0 Endocrinology 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 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 0 350.85 0 0 0 0 0 0 350.85 0 0 0 1101446043 30 General Hospitals 832 New Mexico ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 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 0 155.31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 155.31 0 0 0 1101446053 1861480055 10 Physicians GEHRMANN FREDERICK 626501136 77 Morgan 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28066.82 0 0 0 0 0 0 28066.82 0 0 0 1101446055 1295716488 11 Dentists YNES MICHAEL 600992329 57 Lake 0 0 General Dentistry 0 0 0 142 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 0 0 0 0 0 766 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24993.89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24993.89 0 0 0 1101446072 1861443301 10 Physicians DAVIS RYAN 637035049 826 Missouri 0 0 Pediatrics 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 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2715.35 0 0 0 0 0 0 2715.35 0 0 0 1101446076 1679674857 16 Nurse Practitioners WALKER VONDA 622265360 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 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 9121.63 0 0 0 0 0 0 9121.63 0 0 0 1101446100 1730226457 16 Nurse Practitioners MACHICAO CARLOS 628642341 49 Jefferson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 389 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 473 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 473 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26332.83 0 0 0 0 0 0 26332.83 0 0 0 1101446111 10 Physicians 200 Cook 0 0 Pediatric Nephrology 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 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 63.95 0 0 0 0 0 0 63.95 0 0 0 1101446113 1407939846 10 Physicians DAFER RIMA 600261301 200 Cook 0 0 Neurology 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 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2752.68 0 0 0 0 0 0 2752.68 0 0 0 1101446119 1356556369 10 Physicians POPOVIC ALEKSANDRA 605212962 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 367 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 367 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3119.63 0 0 0 0 0 0 3119.63 0 0 0 1101446124 1720094345 36 Community mental health provider COMPREHENSIVE BEHAVIORAL HLTH 622072066 96 St Clair 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 1085 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1176 0 0 1085 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1176 0 0 1431.9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66044.65 0 0 67476.55 0 0 0 1101446127 1134114812 10 Physicians NAWAS SAMMY 604532658 200 Cook 0 0 Cardiovascular Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3944.62 0 0 0 0 0 0 3944.62 0 0 0 1101446128 1659353779 10 Physicians BLOOM RONALD 600761260 200 Cook 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1939.04 0 0 0 0 0 0 1939.04 0 0 0 1101446147 91 Waiver service provider--Adults (DHS/DDD) 57 Lake 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 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17503.5 0 0 0 0 0 0 0 0 0 0 0 0 0 17503.5 0 0 0 1101446151 1467608513 10 Physicians DOSHI POOJA 608052701 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 4 0 0 0 0 0 0 89 0 129 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 273 0 392 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 273 0 392 0 0 0 0 0 0 0 0 0 73.58 0 0 0 0 0 0 724.98 0 37925.15 0 0 0 0 0 0 38723.71 0 0 0 1101446165 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 18871 0 0 0 0 0 0 0 0 0 0 0 0 0 18871 0 0 0 1101446174 91 Waiver service provider--Adults (DHS/DDD) 54 Kankakee 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 0 343 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 343 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23133 0 0 0 0 0 0 0 0 0 0 0 0 0 23133 0 0 0 1101446189 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 238 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 238 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15450.96 0 0 0 0 0 0 0 0 0 0 0 0 0 15450.96 0 0 0 1101446195 1225166721 55 Early Intervention Services FIELD ELLEN 600153630 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 251 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 251 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17429.17 0 0 0 0 0 0 17429.17 0 0 0 1101446198 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 129.45 0 0 0 0 0 0 0 0 0 0 0 0 0 129.45 0 0 0 1101446204 92 Waiver service provider--Disability (DHS/DRS) 53 Kane 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2129 0 0 0 0 0 0 0 0 0 0 0 0 0 2129 0 0 0 1101446210 1609922715 63 Other Providers of Medical Equipment/Supplies (Non-registered) ACME O AND P LAB INC 606492019 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44.3 0 1715.92 0 0 0 0 1760.22 0 0 0 1101446229 1851343990 10 Physicians GOCKE JOHN E 605231956 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 208 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 208 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1485.45 0 0 0 0 0 0 1485.45 0 0 0 1101446239 1902808611 10 Physicians WHEELER WENDELL 604731506 200 Cook 0 1 Pediatrics 0 1254 0 0 719 0 0 0 0 0 0 480 0 669 0 0 0 0 0 0 11775 0 0 2596 0 0 0 0 0 0 791 0 1554 0 0 0 0 0 0 11775 0 0 2596 0 0 0 0 0 0 791 0 1554 0 0 0 0 0 0 23598 0 0 84878.29 0 0 0 0 0 0 3036.47 0 81825 0 0 0 0 0 0 193337.76 0 0 0 1101446255 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 1777.32 0 0 0 0 0 0 0 0 0 0 0 0 0 1777.32 0 0 0 1101446256 1881685873 10 Physicians SZCZERBA STEFAN 606123714 200 Cook 0 0 Plastic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6967.67 0 0 0 0 0 0 6967.67 0 0 0 1101446261 92 Waiver service provider--Disability (DHS/DRS) 71 McHenry 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 0 119.66 0 0 0 0 0 0 0 0 0 0 0 0 0 119.66 0 0 0 1101446273 10 Physicians 815 Indiana 0 0 Psychiatry 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 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 0 398.7 0 0 0 0 0 0 398.7 0 0 0 1101446274 1043297997 10 Physicians FORSYTHE SEAN 601533328 200 Cook 0 0 Pulmonary Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 170 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 451 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 451 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6487.44 0 0 0 0 0 0 6487.44 0 0 0 1101446299 1124272547 30 General Hospitals ADVOCATE CONDELL MEDICAL CTR 600483204 57 Lake DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 0 0 0 0 81 0 0 0 0 0 0 2626 0 0 1985 0 0 0 0 0 0 0 0 151 0 0 0 0 0 0 7454 0 0 5885 0 0 0 0 0 0 0 0 151 0 0 0 0 0 0 7454 0 0 5885 0 0 0 0 0 0 0 0 726.23 0 0 0 0 0 0 42921.62 0 0 849935.18 0 0 0 0 0 893583.03 0 0 0 1101446303 1629050307 10 Physicians MCCAIN SEAN 629595884 108 Williamson 0 1 Family Practice 0 232 0 0 1 0 0 0 0 0 0 10 0 623 0 0 0 0 0 0 1637 0 0 1 0 0 0 0 0 0 14 0 767 0 0 0 0 0 0 1637 0 0 1 0 0 0 0 0 0 14 0 767 0 0 0 0 0 0 3950 0 0 77.87 0 0 0 0 0 0 72.98 0 25682.73 0 0 0 0 0 0 29783.58 0 0 0 1101446308 1609066489 10 Physicians FRANZ JULIE 606118709 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 45 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 573.19 0 1550.74 0 0 0 0 0 0 2123.93 0 0 0 1101446314 1831140797 10 Physicians DULCE HUGO 601011857 30 DuPage 0 1 Family Practice 0 100 0 0 120 0 0 0 0 0 0 93 0 185 0 0 0 0 0 0 451 0 0 561 0 0 0 0 0 0 192 0 384 0 0 0 0 0 0 451 0 0 561 0 0 0 0 0 0 192 0 384 0 0 0 0 0 0 909 0 0 13289.11 0 0 0 0 0 0 500.61 0 13762.96 0 0 0 0 0 0 28461.68 0 0 0 1101446327 11 Dentists 62 Logan 0 0 General Dentistry 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 442.05 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 442.05 0 0 0 1101446331 1447498910 10 Physicians SIWY GRAZYNA 606123723 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 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610219118 60 Lee 0 0 Childrens mental health 0 700 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1520 0 0 2462 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13581 0 0 2462 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13581 0 0 94670.43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1150369.27 0 0 1245039.7 0 0 0 1101446506 1386881688 10 Physicians ALSHOBAKI MANSOUR 604631190 200 Cook 0 1 Family Practice 0 330 0 0 28 0 0 0 0 0 0 0 0 243 0 0 0 0 0 0 420 0 0 52 0 0 0 0 0 0 0 0 552 0 0 0 0 0 0 420 0 0 52 0 0 0 0 0 0 0 0 552 0 0 0 0 0 0 1120 0 0 2861.17 0 0 0 0 0 0 0 0 34778.44 0 0 0 0 0 0 38759.61 0 0 0 1101446508 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10351 0 0 0 0 0 0 0 0 0 0 0 0 0 10351 0 0 0 1101446510 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15279 0 0 0 0 0 0 0 0 0 0 0 0 0 15279 0 0 0 1101446517 1437121472 10 Physicians LEE GRACE 604532600 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 1156 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1565 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1565 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21410.46 0 1848.92 0 0 0 0 0 0 23259.38 0 0 0 1101446522 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 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 5802.5 0 0 0 0 0 0 0 0 0 0 0 0 0 5802.5 0 0 0 1101446541 10 Physicians 200 Cook 0 0 Obstetric-Gynecology 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 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4383.8 0 0 0 0 0 0 4383.8 0 0 0 1101446542 16 Nurse Practitioners 200 Cook 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37.5 0 0 0 0 0 0 37.5 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3413.95 0 0 0 0 0 0 0 0 0 0 0 0 0 3413.95 0 0 0 1101446586 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 109 0 0 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 8151 0 0 0 0 0 0 0 0 0 0 0 0 0 8151 0 0 0 1101446599 1831107895 30 General Hospitals BARNES JEWISH WEST COUNTY HOSP 631416337 826 Missouri NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 97 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 612 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 612 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3305.56 0 0 591.19 0 0 0 0 0 3896.75 0 0 0 1101446621 1992716914 13 Podiatrists CORTESE C J 617612137 72 McLean 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 0 188 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 188 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2335.65 0 0 0 0 0 0 2335.65 0 0 0 1101446631 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 17781.85 0 0 0 0 0 0 0 0 0 0 0 0 0 17781.85 0 0 0 1101446633 12 Optometrists 200 Cook 0 0 Therapeutic Pharmaceutical Agents 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101446634 1881698280 10 Physicians QUINTERO LOUIS 623014096 10 Adams 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 0 0 0 412 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1017 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1017 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28542.47 0 0 0 0 0 0 28542.47 0 0 0 1101446642 1336221019 30 General Hospitals SOUTH LAKE HOSPITAL 347111979 810 Florida NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 907.05 0 0 0 0 0 0 0 0 0 0 0 0 0 0 907.05 0 0 0 1101446646 1679695654 55 Early Intervention Services SPEARS BARBARA 604661605 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 644 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 644 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38229.31 0 0 0 0 0 0 38229.31 0 0 0 1101446657 92 Waiver service provider--Disability (DHS/DRS) 91 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 69756.23 0 0 0 0 0 0 0 0 0 0 0 0 0 69756.23 0 0 0 1101446662 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10967.55 0 0 0 0 0 0 0 0 0 0 0 0 0 10967.55 0 0 0 1101446670 1770683443 10 Physicians MOSLEY ROBERT 627032403 91 Sangamon 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8682.87 0 0 0 0 0 0 8682.87 0 0 0 1101446671 1578563441 33 Nursing Facilities FAIR OAKS REHAB AND HCC 610802227 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 616 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16289 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1558721.02 0 0 0 0 0 0 0 1558721.02 0 0 0 1101446674 1124323522 47 Local Education Agencies LINCOLN WAY COMM HS DIST 210 604513801 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 308 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 308 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6427.78 0 6427.78 0 0 0 1101446675 1215058276 47 Local Education Agencies EAST MAINE SCHOOL DISTRICT 63 600161512 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 255 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9639 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9639 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 174969.07 0 174969.07 0 0 0 1101446679 1043380710 22 Physical Therapists KARRA LALITHA 604872139 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99315.38 99315.38 0 0 0 1101446683 92 Waiver service provider--Disability (DHS/DRS) 10 Adams 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 55519.97 0 0 0 0 0 0 0 0 0 0 0 0 0 55519.97 0 0 0 1101446692 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 36326.95 0 0 0 0 0 0 0 0 0 0 0 0 0 36326.95 0 0 0 1101446712 1659482651 16 Nurse Practitioners CABRERA JOSELINE R 600453490 57 Lake 0 0 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 19 0 0 0 0 0 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 0 380.75 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 3520.61 0 0 0 0 0 0 0 0 3520.61 0 0 0 1101446726 1477736676 10 Physicians THOMPSON KATHERINE 605276686 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 176 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 176 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1125.48 0 0 0 0 0 0 1125.48 0 0 0 1101446730 91 Waiver service provider--Adults (DHS/DDD) 19 Champaign 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 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8923.75 0 0 0 0 0 0 0 0 0 0 0 0 0 8923.75 0 0 0 1101446732 1538321153 10 Physicians NIKTE PRITI 999999999 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 316 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 316 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2639.23 0 0 0 0 0 0 2639.23 0 0 0 1101446737 91 Waiver service provider--Adults (DHS/DDD) 96 St Clair 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 0 235 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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NARUNATVANICH DAVID 613542757 58 La Salle 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 1028 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1252 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1252 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46893.3 0 0 0 0 0 0 46893.3 0 0 0 1101447519 1225266422 10 Physicians BUKHARI MUSSARAT 619389253 24 Coles 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 272 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 697 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 697 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14979.7 0 0 0 0 0 0 14979.7 0 0 0 1101447523 1528080231 60 Pharmacies TARGET T 1213 604394755 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 442 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9978 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21964.69 0 0 0 21964.69 0 0 0 1101447525 1942228101 10 Physicians JONES STEVEN 615301246 110 Woodford 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 16 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 375 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 375 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34857.11 0 0 0 0 0 0 34857.11 0 0 0 1101447937 92 Waiver service provider--Disability (DHS/DRS) 49 Jefferson 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 22566.25 0 0 0 0 0 0 0 0 0 0 0 0 0 22566.25 0 0 0 1101447940 1912285024 16 Nurse Practitioners WILHOUR MAI 604489360 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 0 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 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1678.69 0 0 0 0 0 0 1678.69 0 0 0 1101447952 10 Physicians 91 Sangamon 0 0 Psychiatry 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 42.5 0 0 0 0 0 0 42.5 0 0 0 1101447953 92 Waiver service provider--Disability (DHS/DRS) 106 Whiteside 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 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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 3910.5 0 0 0 0 0 0 0 0 0 0 0 0 0 3910.5 0 0 0 1101447984 2100438402 10 Physicians BLEICHROTH CYNTHIA 637015230 826 Missouri 0 0 Internal Medicine 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 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 999.37 0 0 0 0 0 0 999.37 0 0 0 1101447997 1396777371 10 Physicians SCHOLL KIMBERLY 601334869 30 DuPage 0 1 Family Practice 0 4 0 0 2 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 22 0 0 2 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 22 0 0 2 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 47 0 0 176.52 0 0 0 0 0 0 0 0 247.76 0 0 0 0 0 0 471.28 0 0 0 1101448008 1548277874 10 Physicians ROSMAN LISA 600771057 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4561.92 0 0 0 0 0 0 4561.92 0 0 0 1101448020 1811997380 10 Physicians LAKHO MAZHAR 622265366 96 St Clair 0 1 Internal 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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 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1975.76 0 0 0 0 0 0 1975.76 0 0 0 1101448142 10 Physicians 97 Stephenson 0 0 Oncology 0 0 0 0 0 0 0 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 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 0 297.15 0 0 0 0 0 0 297.15 0 0 0 1101448169 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10724.81 0 0 0 0 0 0 0 0 0 0 0 0 0 10724.81 0 0 0 1101448174 1922090331 12 Optometrists FISH WILLIAM E 616033717 80 Peoria 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 212 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 212 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3620.29 0 0 0 0 0 0 3620.29 0 0 0 1101448192 1700862406 16 Nurse Practitioners MYKLEBY CONNIE 527221655 816 Iowa 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 345.39 0 0 0 0 0 0 345.39 0 0 0 1101448196 1801829247 10 Physicians PIGATO JOSEPH 609013695 54 Kankakee 0 0 Urology 0 0 0 0 0 0 0 0 0 0 0 51 0 176 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 879 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 879 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 309.06 0 11912.39 0 0 0 0 0 0 12221.45 0 0 0 1101448211 1043371529 60 Pharmacies DISTRICT DRUGS AND COMPOUNDING 612018715 89 Rock Island 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 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2268 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12241.98 0 0 0 12241.98 0 0 0 1101448223 1407856503 10 Physicians MORTON JEFFREY 616157485 80 Peoria 0 1 Family Practice 0 3 0 0 0 0 0 0 0 0 0 3 0 5 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 4 0 5 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 4 0 5 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 9.03 0 265.73 0 0 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463111799 815 Indiana DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 0 2 0 0 0 1352 0 0 0 0 176 0 0 0 132 0 0 0 0 0 2 0 0 0 1871 0 0 0 0 203 0 0 0 258 0 0 0 0 0 2 0 0 0 1871 0 0 0 0 1026 0 0 0 258 0 0 0 0 0 0 0 0 0 261894.04 0 0 0 0 685437.61 0 0 0 35906.88 0 0 0 0 0 983238.53 0 0 0 1101448302 92 Waiver service provider--Disability (DHS/DRS) 108 Williamson 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 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 3123.01 0 0 0 0 0 0 0 0 0 0 0 0 0 3123.01 0 0 0 1101448305 91 Waiver service provider--Adults (DHS/DDD) 89 Rock Island 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 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4036.62 0 0 0 0 0 0 0 0 0 0 0 0 0 4036.62 0 0 0 1101448306 92 Waiver service provider--Disability (DHS/DRS) 10 Adams 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 43 0 0 0 0 0 0 0 0 0 0 0 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Pathology 0 0 0 0 0 0 0 0 0 0 0 225 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 296 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 296 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5205.8 0 0 0 0 0 0 0 0 5205.8 0 0 0 1101450472 10 Physicians 57 Lake 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 77.2 0 0 0 0 0 0 77.2 0 0 0 1101450473 1881851400 10 Physicians SELK NATALIE 608051441 200 Cook 0 0 Nephrology 0 0 0 0 0 0 0 0 0 0 0 11 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 818 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 818 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94.94 0 11680.31 0 0 0 0 0 0 11775.25 0 0 0 1101450475 1508822701 10 Physicians DOLD OLIVER 625263950 63 Macon 0 0 Neurology Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 237 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 237 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15835.24 0 0 0 0 0 0 15835.24 0 0 0 1101450482 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 14773.57 0 0 0 0 0 0 0 0 0 0 0 0 0 14773.57 0 0 0 1101450491 1740261262 10 Physicians FLAUM LISA 606118709 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 15 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 110 0 816 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 110 0 816 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 834.68 0 170061.88 0 0 0 0 0 0 170896.56 0 0 0 1101450501 1457590408 10 Physicians YANG TINA 618229678 19 Champaign 0 1 Family Practice 0 68 0 0 7 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 473 0 0 10 0 0 0 0 0 0 0 0 131 0 0 0 0 0 0 473 0 0 10 0 0 0 0 0 0 0 0 131 0 0 0 0 0 0 1193 0 0 118.59 0 0 0 0 0 0 0 0 4117.81 0 0 0 0 0 0 5429.4 0 0 0 1101450502 91 Waiver service provider--Adults (DHS/DDD) 26 Cumberland 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 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12505.61 0 0 0 0 0 0 0 0 0 0 0 0 0 12505.61 0 0 0 1101450523 1295751436 10 Physicians SVRAKIC DRAGAN 631101010 826 Missouri 0 0 Psychiatry 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 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 0 329.81 0 0 0 0 0 0 329.81 0 0 0 1101450525 1023379831 10 Physicians PYANT DAN PULLO COURTNEY 610323801 97 Stephenson 0 0 Obstetric-Gynecology 0 0 0 0 25 0 0 0 0 0 0 204 0 445 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 414 0 1870 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 414 0 1870 0 0 0 0 0 0 0 0 0 1190.62 0 0 0 0 0 0 16936.51 0 182766.93 0 0 0 0 0 0 200894.06 0 0 0 1101450531 1548233067 25 Audiologists HARTMAN ANNELIESE M 610119597 13 Boone 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 754 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 754 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49165.86 49165.86 0 0 0 1101450534 1316187966 24 Speech Therapists VOKAC EMILY 601622110 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 412 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 412 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26231.35 26231.35 0 0 0 1101450548 1710947882 10 Physicians BRANDMAN JAMES 606113092 200 Cook 0 0 Oncology 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 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20100.45 0 0 0 0 0 0 20100.45 0 0 0 1101450551 10 Physicians 823 Michigan 0 0 Radiology Diagnosis 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14.67 0 0 0 0 0 0 0 0 14.67 0 0 0 1101450562 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 8581.55 0 0 0 0 0 0 0 0 0 0 0 0 0 8581.55 0 0 0 1101450563 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8196.44 0 0 0 0 0 0 0 0 0 0 0 0 0 8196.44 0 0 0 1101450569 1861487423 10 Physicians JONES ANDREA 606930623 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 3 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107.85 0 10380.04 0 0 0 0 0 0 10487.89 0 0 0 1101450585 1487817565 12 Optometrists LE TANYA 605174653 30 DuPage 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 367 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 729 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 729 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21475.84 0 0 0 0 0 0 21475.84 0 0 0 1101450587 1700892247 60 Pharmacies WALGREEN CO 09299 625254457 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1750 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 8867 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 217340 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7.86 0 0 375114.5 0 0 0 375122.36 0 0 0 1101450591 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13831.86 0 0 0 0 0 0 0 0 0 0 0 0 0 13831.86 0 0 0 1101450599 1356355465 10 Physicians DURST LEAH 610324865 97 Stephenson 0 1 Internal Medicine 0 61 0 0 0 0 0 0 0 0 0 0 0 468 0 0 0 0 0 0 282 0 0 0 0 0 0 0 0 0 0 0 525 0 0 0 0 0 0 282 0 0 0 0 0 0 0 0 0 0 0 525 0 0 0 0 0 0 800 0 0 0 0 0 0 0 0 0 0 0 25643.32 0 0 0 0 0 0 26443.32 0 0 0 1101450606 92 Waiver service provider--Disability (DHS/DRS) 98 Tazewell 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 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11981.08 0 0 0 0 0 0 0 0 0 0 0 0 0 11981.08 0 0 0 1101450613 1962448357 10 Physicians BAYER KUZNETSOV VICTOR 600252425 200 Cook 0 1 Pediatrics 0 251 0 0 259 0 0 0 0 0 0 106 0 317 0 0 0 0 0 0 2156 0 0 642 0 0 0 0 0 0 133 0 616 0 0 0 0 0 0 2156 0 0 642 0 0 0 0 0 0 133 0 616 0 0 0 0 0 0 4312 0 0 24435.64 0 0 0 0 0 0 1482.58 0 32912.53 0 0 0 0 0 0 63142.75 0 0 0 1101450615 1942299870 10 Physicians KIPP MICHAEL 605276686 30 DuPage 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 0 0 281 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 709 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 709 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28902.11 0 0 0 0 0 0 28902.11 0 0 0 1101450647 1770580029 10 Physicians ATIA GEORGE 600101809 57 Lake 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 22 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 421 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 421 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 269.75 0 17606.24 0 0 0 0 0 0 17875.99 0 0 0 1101450653 1548578339 16 Nurse Practitioners HINOJOSA CYNTHIA 606123845 200 Cook 0 0 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 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4204.15 0 0 0 0 0 0 4204.15 0 0 0 1101450659 1346274636 16 Nurse Practitioners GILES GERALD 620026722 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6118.42 0 0 0 0 0 0 6118.42 0 0 0 1101450660 1376667360 23 Occupational Therapists BUNCH KRISTIE 634353332 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 376 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 376 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18033.98 18033.98 0 0 0 1101450664 92 Waiver service provider--Disability (DHS/DRS) 37 Fulton 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4921.3 0 0 0 0 0 0 0 0 0 0 0 0 0 4921.3 0 0 0 1101450672 10 Physicians 816 Iowa 0 0 Internal Medicine 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101450692 92 Waiver service provider--Disability (DHS/DRS) 58 La Salle 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 7571.91 0 0 0 0 0 0 0 0 0 0 0 0 0 7571.91 0 0 0 1101450700 1295717643 10 Physicians MEHTA BHUPAT 605211755 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 892 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 892 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19284.28 0 0 0 0 0 0 19284.28 0 0 0 1101450715 10 Physicians 826 Missouri 0 0 Internal Medicine 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35.05 0 0 0 0 0 0 35.05 0 0 0 1101450717 1861454035 10 Physicians LI YU 612652917 89 Rock Island 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 194 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 194 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2852.59 0 0 0 0 0 0 0 0 2852.59 0 0 0 1101450718 1366453466 10 Physicians SIEGFRIED BRYAN 620881334 64 Macoupin 0 0 Internal Medicine 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 172.03 0 0 0 0 0 0 172.03 0 0 0 1101450721 1578581633 10 Physicians THAKUR NARESH 606751293 200 Cook 0 1 Internal Medicine 0 3 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 99 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 99 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 2053.7 0 0 0 0 0 0 2077.7 0 0 0 1101450726 1033112230 30 General Hospitals ST JUDE CHILDRENS RESEARCH HSP 381053678 844 Tennessee NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 Children's Hospital 0 0 0 0 0 0 0 0 0 0 8 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 0 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 161168.52 0 0 0 79332.57 0 0 0 0 0 240501.09 0 0 0 1101450730 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 601.76 0 0 0 0 0 0 0 0 0 0 0 0 0 601.76 0 0 0 1101450740 1407925720 10 Physicians GARRITY PATRICK 554860362 63 Macon 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 687 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 740 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 740 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26186.37 0 0 0 0 0 0 26186.37 0 0 0 1101450743 1609013481 11 Dentists ALDALLAL AMJAD 999999999 200 Cook 0 0 0 0 0 719 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2820 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2820 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93697.6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93697.6 0 0 0 1101450744 1720166176 63 Other Providers of Medical Equipment/Supplies (Non-registered) LINCARE INC 609152435 54 Kankakee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 292 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2629 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2629 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71766.39 0 0 0 0 0 0 71766.39 0 0 0 1101450745 24 Speech 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 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 1727 1727 0 0 0 1101450746 1427153618 10 Physicians WARAKOMSKI ROMUALD 604222136 200 Cook 0 1 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1162.05 0 0 0 0 0 0 1162.05 0 0 0 1101450752 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11380.38 0 0 0 0 0 0 0 0 0 0 0 0 0 11380.38 0 0 0 1101450754 1659366839 10 Physicians SALEM ANAD 629011408 47 Jackson 0 1 Family Practice 0 202 0 0 60 0 0 0 0 0 0 45 0 526 0 0 0 0 0 0 1929 0 0 134 0 0 0 0 0 0 70 0 1239 0 0 0 0 0 0 1929 0 0 134 0 0 0 0 0 0 70 0 1239 0 0 0 0 0 0 4793 0 0 7055.83 0 0 0 0 0 0 220.22 0 38662.01 0 0 0 0 0 0 50731.06 0 0 0 1101450763 92 Waiver service provider--Disability (DHS/DRS) 96 St Clair 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 5478.15 0 0 0 0 0 0 0 0 0 0 0 0 0 5478.15 0 0 0 1101450766 1700985777 10 Physicians JOSHI KIRIT 606252591 200 Cook 0 1 Internal Medicine 0 18 0 0 0 0 0 0 0 0 0 0 0 266 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 1436 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 1436 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 7175.21 0 0 0 0 0 0 7232.21 0 0 0 1101450768 1376785667 60 Pharmacies WALGREENS 12555 611088231 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 467 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2273 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55340 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 113794.19 0 0 0 113794.19 0 0 0 1101450770 1093909962 10 Physicians CHEONG ALICE 606118709 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3943.42 0 0 0 0 0 0 3943.42 0 0 0 1101450782 2100441200 92 Waiver service provider--Disability (DHS/DRS) AMERICAN ACCORD FOOD CORP 606497182 200 Cook 0 0 0 0 0 0 0 0 270 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2354 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2354 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 742696.26 0 0 0 0 0 0 0 0 0 0 0 0 0 742696.26 0 0 0 1101450783 10 Physicians 852 Wisconsin 0 0 Endocrinology 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 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 0 126 0 0 0 0 0 0 126 0 0 0 1101450787 94 Waiver service provider--Children's support (DHS/DDD) 55 Kendall 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 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 2761 0 0 0 0 0 0 0 0 0 0 0 0 0 2761 0 0 0 1101450794 1962498113 10 Physicians GARNEAU ROBERT 420033813 818 Kentucky 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 242 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 367 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 367 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8170.98 0 497.54 0 0 0 0 0 0 8668.52 0 0 0 1101450797 1780767897 33 Nursing Facilities MT VERNON HEALTH CARE CENTER 628646224 49 Jefferson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 933 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24851 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1781589.76 0 0 0 0 0 0 0 1781589.76 0 0 0 1101450810 1760482160 10 Physicians SANWALANI SHANKAR 604263558 200 Cook 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2105.56 0 0 0 0 0 0 2105.56 0 0 0 1101450845 98 Waiver service provider--TBI (DHS/DRS) 852 Wisconsin 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 12292.27 0 0 0 0 0 0 0 0 0 0 0 0 0 12292.27 0 0 0 1101450847 1700853272 10 Physicians KOVALSKY DON 628643649 49 Jefferson 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 490 0 601 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 855 0 1362 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 855 0 1362 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37967.87 0 109944.16 0 0 0 0 0 0 147912.03 0 0 0 1101450871 1982648259 10 Physicians AL KAADE SAMER 631102515 826 Missouri 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 14 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 138 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 138 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 503.27 0 14002.77 0 0 0 0 0 0 14506.04 0 0 0 1101450895 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 24120.64 0 0 0 0 0 0 0 0 0 0 0 0 0 24120.64 0 0 0 1101450909 1609858729 63 Other Providers of Medical Equipment/Supplies (Non-registered) EDGEPARK MEDICAL SUPPLIES 440872300 836 Ohio 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 852 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 852 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15493.84 0 174.8 0 0 0 0 15668.64 0 0 0 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Provider SAFEWAY TRANSPORT SERVICES 606172749 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5260 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5260 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60287.97 0 0 0 0 0 0 60287.97 0 0 0 1101453563 1023081809 10 Physicians ROWLEY VINCENT 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 1930 0 351 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2781 0 491 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2781 0 491 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55710.49 0 7576.75 0 0 0 0 0 0 63287.24 0 0 0 1101453571 1841241858 60 Pharmacies REMCO MEDICAL INC 604352475 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 820 0 0 246 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 820 0 0 6400 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51319.27 0 0 8914.9 0 0 0 60234.17 0 0 0 1101453575 1952509473 10 Physicians ROGERS DENNIE 611033655 109 Winnebago 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 255 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 486 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 486 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13555.97 0 5406.72 0 0 0 0 0 0 18962.69 0 0 0 1101453586 1124020821 13 Podiatrists KUSUNOSE RICHARD 600622322 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 419 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1690 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1690 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8030.49 0 0 0 0 0 0 8030.49 0 0 0 1101453593 92 Waiver service provider--Disability (DHS/DRS) 97 Stephenson 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 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 4906.76 0 0 0 0 0 0 0 0 0 0 0 0 0 4906.76 0 0 0 1101453595 10 Physicians 836 Ohio 0 0 Pediatric Radiology 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82.67 0 0 0 0 0 0 0 0 82.67 0 0 0 1101453600 1447567334 63 Other Providers of Medical Equipment/Supplies (Non-registered) BVM HEALTHCARE INC 601941331 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 404 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2169 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2169 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182865.51 0 1338.02 0 0 0 0 184203.53 0 0 0 1101453607 1396706750 30 General Hospitals DIXON KIDNEY CENTER 610211015 60 Lee ARS-LS Long-term stay hospitals paid under an ARS 0 0 0 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 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2023 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73828.53 0 0 0 0 0 73828.53 0 0 0 1101453608 92 Waiver service provider--Disability (DHS/DRS) 68 Mason 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 16494.18 0 0 0 0 0 0 0 0 0 0 0 0 0 16494.18 0 0 0 1101453624 1821322751 28 Waiver service provider--Supportive living facility (HFS) BROOKSTONE ESTATES OF TUSCOLA 619537836 29 Douglas 0 0 0 0 0 0 0 0 20 0 0 0 0 0 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 2318 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132004.79 0 0 0 0 0 0 0 0 0 0 0 0 0 132004.79 0 0 0 1101453629 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 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 0 905.45 0 0 0 0 0 0 0 0 0 0 0 0 0 905.45 0 0 0 1101453633 1679509327 16 Nurse Practitioners KO JOCELYN 606123723 200 Cook 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 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101453635 1962494633 11 Dentists AHMED NASIR 606412147 200 Cook 0 0 General Dentistry 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 256 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 256 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7864.55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7864.55 0 0 0 1101453648 1023271137 13 Podiatrists CARLSON RUSSELL 528071575 816 Iowa 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 690 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 690 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 810 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 502443.87 0 0 0 0 0 0 0 0 0 0 502443.87 0 0 0 1101453819 1790038099 48 Rural Health Clinics MEMORIAL PHYSICIAN SERVICES 626759467 73 Menard 0 1 0 448 547 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3519 2834 0 236 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3519 2834 0 236 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9044 116918.72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125962.72 0 0 0 1101453822 1477579605 10 Physicians MCMANUS WILLIAM 631101077 826 Missouri 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 43 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 1795.04 0 0 0 0 0 0 1795.04 0 0 0 1101453824 94 Waiver service provider--Children's support (DHS/DDD) 65 Madison 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 0 462 0 0 0 0 0 0 0 0 0 0 0 0 0 462 0 0 0 1101453828 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 4659.18 0 0 0 0 0 0 0 0 0 0 0 0 0 4659.18 0 0 0 1101453833 1780663500 10 Physicians MINITER MICHAEL 612015394 89 Rock Island 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 451 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 451 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9799.72 0 0 0 0 0 0 9799.72 0 0 0 1101453840 1366415986 10 Physicians EDELMAN FREDERICK 535625531 852 Wisconsin 0 0 Child Neurology 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 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2188.32 0 0 0 0 0 0 2188.32 0 0 0 1101453851 91 Waiver service provider--Adults (DHS/DDD) 96 St Clair 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 0 349 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 349 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23878.25 0 0 0 0 0 0 0 0 0 0 0 0 0 23878.25 0 0 0 1101453852 1639253701 10 Physicians GHANI MANSURA 627011034 91 Sangamon 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 0 0 670 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1153 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1153 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16939.76 0 0 0 0 0 0 16939.76 0 0 0 1101453871 1881604569 16 Nurse Practitioners RINK LINDA 600442203 57 Lake 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 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 14.23 0 0 0 0 0 0 14.23 0 0 0 1101453873 1215914270 33 Nursing Facilities GROSSE POINTE MANOR 607144515 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1421 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30495 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4526523.85 0 0 0 0 0 0 0 4526523.85 0 0 0 1101453883 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 14608.68 0 0 0 0 0 0 0 0 0 0 0 0 0 14608.68 0 0 0 1101453886 1841396603 55 Early Intervention Services TESSIER ELISA 605407506 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14527.31 0 0 0 0 0 0 14527.31 0 0 0 1101453890 1821070939 10 Physicians CHI KENNETH 600761224 200 Cook 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 5 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 310.6 0 4860.68 0 0 0 0 0 0 5171.28 0 0 0 1101453916 1699882084 10 Physicians TAN ERNESTO T 604355128 107 Will 0 0 Urological Surgery 0 0 0 0 0 0 0 0 0 0 0 7 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105.96 0 1083.96 0 0 0 0 0 0 1189.92 0 0 0 1101453932 10 Physicians 823 Michigan 0 0 Radiology Diagnosis 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 58.73 0 0 0 0 0 0 0 0 58.73 0 0 0 1101453940 1477835544 10 Physicians BREWER AUDREY 606232460 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3264.01 0 0 0 0 0 0 3264.01 0 0 0 1101453941 1467521146 30 General Hospitals ST JOSEPH HEALTH CENTER 633012893 826 Missouri NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 68 0 0 0 0 24 0 0 0 10 0 0 0 0 0 0 0 0 0 85 0 0 0 0 24 0 0 0 18 0 0 0 0 0 0 0 0 0 85 0 0 0 0 148 0 0 0 18 0 0 0 0 0 0 0 0 0 14568.24 0 0 0 0 70005.2 0 0 0 7470.38 0 0 0 0 0 92043.82 0 0 0 1101453957 1669673620 47 Local Education Agencies MACON PIATT COUNTY SPEC ED DIS 625231013 63 Macon 0 0 0 0 0 0 358 0 0 0 0 0 0 0 0 0 0 0 0 0 1648 0 0 0 0 632 0 0 0 0 0 0 0 0 0 0 0 0 0 49499 0 0 0 0 632 0 0 0 0 0 0 0 0 0 0 0 0 0 49499 0 0 0 0 3885.96 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13464 0 0 0 0 0 0 0 0 0 0 0 0 0 13464 0 0 0 1101454015 1457546129 63 Other Providers of Medical Equipment/Supplies (Non-registered) KHOSHABA SARGISS 606573017 200 Cook 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 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9393.66 0 0 0 0 0 0 9393.66 0 0 0 1101454033 1093754632 10 Physicians SINGH PADAMJIT 605611510 30 DuPage 0 1 Internal Medicine 0 47 0 0 0 0 0 0 0 0 0 1 0 50 0 0 0 0 0 0 342 0 0 0 0 0 0 0 0 0 1 0 212 0 0 0 0 0 0 342 0 0 0 0 0 0 0 0 0 1 0 212 0 0 0 0 0 0 999 0 0 0 0 0 0 0 0 0 3.33 0 3716.32 0 0 0 0 0 0 4718.65 0 0 0 1101454039 1083612857 10 Physicians JACKSON DOUGLAS 601232300 53 Kane 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1710.01 0 0 0 0 0 0 1710.01 0 0 0 1101454040 1801852926 10 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0 0 0 0 0 0 0 0 0 0 0 0 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 189 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 189 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21192.23 0 0 0 0 0 0 21192.23 0 0 0 1101454140 1508895459 63 Other Providers of Medical Equipment/Supplies (Non-registered) TIBRO MEDICAL 841073609 846 Utah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1887 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1887 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19125.02 0 396.92 0 0 0 0 19521.94 0 0 0 1101454144 1568701704 16 Nurse Practitioners CHACKO SUSAN 600073754 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2429.69 0 0 0 0 0 0 2429.69 0 0 0 1101454160 1710953815 10 Physicians JANSS GERTA 606118709 200 Cook 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 789.61 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 1016.7 0 0 0 0 0 0 0 0 0 0 0 0 0 1016.7 0 0 0 1101454188 1578740031 62 Opticians / Optical Companies COLUMBIA OPTICAL CENTER 622362305 75 Monroe 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 560.96 0 0 0 0 560.96 0 0 0 1101454189 92 Waiver service provider--Disability (DHS/DRS) 106 Whiteside 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 21594.77 0 0 0 0 0 0 0 0 0 0 0 0 0 21594.77 0 0 0 1101454193 1982766432 10 Physicians CIFU ADAM 605276686 30 DuPage 0 1 Internal Medicine 0 18 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 123 0 0 0 0 0 0 0 0 0 0 0 1543.61 0 0 0 0 0 0 1666.61 0 0 0 1101454203 1932335668 16 Nurse Practitioners KEEDY MICHAEL 616145069 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 525 0 0 127 0 0 0 0 0 0 13 0 127 0 0 0 0 0 0 1217 0 0 4327.53 0 0 0 0 0 0 73.89 0 5363.09 0 0 0 0 0 0 10981.51 0 0 0 1101454304 92 Waiver service provider--Disability (DHS/DRS) 49 Jefferson 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 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 5357.53 0 0 0 0 0 0 0 0 0 0 0 0 0 5357.53 0 0 0 1101454309 1598809055 16 Nurse Practitioners SKLADZIEN BERNADETTE 602011718 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107.62 0 0 0 0 0 0 107.62 0 0 0 1101454310 1366534729 10 Physicians SIDDIQUI ZAKI 606252958 200 Cook 0 1 Pediatrics 0 1521 0 0 903 0 0 0 0 0 0 540 0 1623 0 0 0 0 0 0 7345 0 0 3362 0 0 0 0 0 0 830 0 3669 0 0 0 0 0 0 7345 0 0 3362 0 0 0 0 0 0 830 0 3669 0 0 0 0 0 0 15376 0 0 86179.44 0 0 0 0 0 0 3507.92 0 146346.2 0 0 0 0 0 0 251409.56 0 0 0 1101454332 92 Waiver service provider--Disability (DHS/DRS) 63 Macon 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 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 2378.64 0 0 0 0 0 0 0 0 0 0 0 0 0 2378.64 0 0 0 1101454340 98 Waiver service provider--TBI (DHS/DRS) 104 Wayne 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 5354.29 0 0 0 0 0 0 0 0 0 0 0 0 0 5354.29 0 0 0 1101454349 1710992854 60 Pharmacies BOND DRUG COMPANY OF IL 468 601012819 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 2137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 9026 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 200548 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20.58 0 0 433239.04 0 0 0 433259.62 0 0 0 1101454350 1023124617 70 Ambulance Service Providers VILLAGE OF HANOVER PARK 601334301 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 241 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 620 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 620 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33230.92 0 0 0 0 0 0 33230.92 0 0 0 1101454355 1740498500 24 Speech Therapists ROGNER STACY A 600518996 71 McHenry 0 0 0 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 0 245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19422.34 19422.34 0 0 0 1101454365 16 Nurse Practitioners 200 Cook 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66.4 0 0 0 0 0 0 66.4 0 0 0 1101454371 1871513655 52 Certified local public health department MCLEAN COUNTY HEALTH DEPT 617015048 72 McLean 0 0 0 0 2516 0 2009 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5839 0 7258 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5839 0 7258 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59806.66 0 60197.46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120004.12 0 0 0 1101454389 13 Podiatrists 200 Cook 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70.08 0 0 0 0 0 0 70.08 0 0 0 1101454407 1316988389 10 Physicians FURLIN JOSEPH 601604156 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 72 0 0 0 0 0 0 202 0 965 0 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 296 0 4099 0 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 296 0 4099 0 0 0 0 0 0 0 0 0 1368.78 0 0 0 0 0 0 10227.41 0 353542.44 0 0 0 0 0 0 365138.63 0 0 0 1101454418 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 25736.15 0 0 0 0 0 0 0 0 0 0 0 0 0 25736.15 0 0 0 1101454427 1740351972 33 Nursing Facilities JACKSON SQ NURSING REHAB CTR 606444332 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 337 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2080 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52027 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6289068.02 0 0 0 0 0 0 0 6289068.02 0 0 0 1101454439 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 271 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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GARRETT JACQUELYN 631366188 826 Missouri 0 0 Dermatology 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 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 51.96 0 0 0 0 0 0 51.96 0 0 0 1101454491 16 Nurse Practitioners 852 Wisconsin 0 0 0 0 0 0 0 0 0 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 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 0 317.34 0 0 0 0 0 0 317.34 0 0 0 1101454505 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 21201.08 0 0 0 0 0 0 0 0 0 0 0 0 0 21201.08 0 0 0 1101454513 10 Physicians 852 Wisconsin 0 0 Pediatrics 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 184.91 0 0 0 0 0 0 184.91 0 0 0 1101454520 1861469496 10 Physicians HASS MELINDA 612656812 89 Rock Island 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 171 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 171 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10724.02 0 0 0 0 0 0 10724.02 0 0 0 1101454522 92 Waiver service provider--Disability (DHS/DRS) 77 Morgan 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 1361.95 0 0 0 0 0 0 0 0 0 0 0 0 0 1361.95 0 0 0 1101454529 1912981242 10 Physicians WAZWAZ HESHAM 604535288 200 Cook 0 0 Internal Medicine 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 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 163.68 0 0 0 0 0 0 163.68 0 0 0 1101454535 1063466597 10 Physicians VORA ANAND 600483757 57 Lake 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 33 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1026.13 0 3759.48 0 0 0 0 0 0 4785.61 0 0 0 1101454547 1235140328 10 Physicians HUGGE CHRISTOPHER 631102515 826 Missouri 0 0 Pediatric Hematology Oncology 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5141.18 0 0 0 0 0 0 5141.18 0 0 0 1101454549 1447206677 10 Physicians LIN JOHNNY 606124861 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 85 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 285 0 279 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 285 0 279 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1309.08 0 6277.24 0 0 0 0 0 0 7586.32 0 0 0 1101454555 1336157213 16 Nurse Practitioners KEEGAN MARY 631102515 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32.04 0 0 0 0 0 0 32.04 0 0 0 1101454560 1881806784 10 Physicians SHETH VEERAL 604522780 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 2 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54.41 0 9951.41 0 0 0 0 0 0 10005.82 0 0 0 1101454569 1831136019 10 Physicians JACOB SUSAN 601334869 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 50 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 610.05 0 5211.41 0 0 0 0 0 0 5821.46 0 0 0 1101454575 1598751034 10 Physicians BREBACH GREGORY 600105934 57 Lake 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 21 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 470.58 0 5142.52 0 0 0 0 0 0 5613.1 0 0 0 1101454580 1760562474 10 Physicians FANG HSIEN TA 603024420 200 Cook 0 0 Nephrology 0 0 0 0 0 0 0 0 0 0 0 0 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 514 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 514 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3020.29 0 0 0 0 0 0 3020.29 0 0 0 1101454581 1316197858 10 Physicians SEITZ IRIS 600532127 200 Cook 0 0 Plastic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1712.21 0 0 0 0 0 0 1712.21 0 0 0 1101454582 1013185693 10 Physicians NGUMI PAUL G 606361107 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 1 0 0 0 0 0 0 99 0 169 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 227 0 336 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 227 0 336 0 0 0 0 0 0 0 0 0 14.6 0 0 0 0 0 0 556.86 0 27233.66 0 0 0 0 0 0 27805.12 0 0 0 1101454587 1821366063 16 Nurse Practitioners ALLISON CAROLINE 600442203 57 Lake 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 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 278.43 0 0 0 0 0 0 278.43 0 0 0 1101454588 98 Waiver service provider--TBI (DHS/DRS) 103 Washington 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 15057.54 0 0 0 0 0 0 0 0 0 0 0 0 0 15057.54 0 0 0 1101454594 1851575039 10 Physicians KHAN AHMIR 606422607 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1312.8 0 0 0 0 0 0 1312.8 0 0 0 1101454617 1427075126 10 Physicians HUANG PAMELA 605615038 30 DuPage 0 1 Pediatrics 0 16 0 0 27 0 0 0 0 0 0 7 0 44 0 0 0 0 0 0 59 0 0 65 0 0 0 0 0 0 9 0 54 0 0 0 0 0 0 59 0 0 65 0 0 0 0 0 0 9 0 54 0 0 0 0 0 0 118 0 0 2296.41 0 0 0 0 0 0 81.26 0 2124.54 0 0 0 0 0 0 4620.21 0 0 0 1101454622 1184660052 30 General Hospitals ARA CRYSTAL LAKE DIALYSIS LLC 600147933 71 McHenry DIALYSIS Outpatient dialysis centers. 0 0 General Hospital - Adult and Child 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 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 503 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 821.24 0 0 0 0 0 821.24 0 0 0 1101454623 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 18 0 0 0 0 0 0 0 0 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Physicians CHINWUBA EBELE 604358200 107 Will 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 1302 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1383 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1383 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60875.58 0 0 0 0 0 0 60875.58 0 0 0 1101454725 92 Waiver service provider--Disability (DHS/DRS) 83 Pike 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 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31419.2 0 0 0 0 0 0 0 0 0 0 0 0 0 31419.2 0 0 0 1101454738 1114064672 10 Physicians BETMAN SHELLY 606112867 200 Cook 0 1 Internal Medicine 0 15 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 142.94 0 0 0 0 0 0 232.94 0 0 0 1101454751 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1126.67 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 3600.9 0 0 0 1101454803 1104939362 10 Physicians MATES STEVEN 600508409 71 McHenry 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3219.84 0 0 0 0 0 0 3219.84 0 0 0 1101454809 1700999703 10 Physicians TALLEY DAVID 420037901 818 Kentucky 0 0 Cardiovascular Diseases 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 0 185 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 185 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2613.54 0 0 0 0 0 0 2613.54 0 0 0 1101454810 1942219639 13 Podiatrists THORNTON MARTHA 612311365 74 Mercer 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 288 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 288 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4513.12 0 0 0 0 0 0 4513.12 0 0 0 1101454811 10 Physicians 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 3 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28.7 0 22.87 0 0 0 0 0 0 51.57 0 0 0 1101454822 1316101181 10 Physicians ABRAHAM ALIN 601228942 200 Cook 0 1 Internal Medicine 0 23 0 0 9 0 0 0 0 0 0 13 0 60 0 0 0 0 0 0 154 0 0 22 0 0 0 0 0 0 17 0 109 0 0 0 0 0 0 154 0 0 22 0 0 0 0 0 0 17 0 109 0 0 0 0 0 0 383 0 0 1070.16 0 0 0 0 0 0 91.29 0 3631.87 0 0 0 0 0 0 5176.32 0 0 0 1101454844 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 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 7272.8 0 0 0 0 0 0 0 0 0 0 0 0 0 7272.8 0 0 0 1101454845 1902916133 63 Other Providers of Medical Equipment/Supplies (Non-registered) CAREPAKS MEDICAL SUPPLIES 617617723 72 McLean 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 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 513.67 0 0 0 0 0 0 513.67 0 0 0 1101454868 1437324084 10 Physicians PATEL AMIT 601901295 30 DuPage 0 0 Urology 0 0 0 0 0 0 0 0 0 0 0 7 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21.54 0 4130.32 0 0 0 0 0 0 4151.86 0 0 0 1101454885 1558451716 36 Community mental health provider MENTAL HEALTH CENTERS OF W ILL 623531300 14 Brown 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1743 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1743 0 0 1188.12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83799.43 0 0 84987.55 0 0 0 1101454892 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19613.41 0 0 0 0 0 0 0 0 0 0 0 0 0 19613.41 0 0 0 1101454907 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 219.43 0 0 0 0 0 0 0 0 0 0 0 0 0 219.43 0 0 0 1101454933 1962610642 10 Physicians FRIEDRICHS JASON 601783192 27 Dekalb 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 1 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49.8 0 4950.02 0 0 0 0 0 0 4999.82 0 0 0 1101454951 10 Physicians 852 Wisconsin 0 0 Pediatrics 0 0 0 0 2 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 80.37 0 0 0 0 0 0 0 0 127.55 0 0 0 0 0 0 207.92 0 0 0 1101454961 1851344907 30 General Hospitals NORTH MEMORIAL MEDICAL CENTER 554222926 824 Minnesota NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 13 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 3787.95 0 0 0 0 75176.45 0 0 0 0 0 0 0 0 0 78964.4 0 0 0 1101454987 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6450.34 0 0 0 0 0 0 0 0 0 0 0 0 0 6450.34 0 0 0 1101454999 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21518.68 0 0 0 0 0 0 0 0 0 0 0 0 0 21518.68 0 0 0 1101455002 1659493922 10 Physicians OSIPOV ROBERT 999999999 76 Montgomery 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 244 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 484 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 484 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54416.78 0 0 0 0 0 0 54416.78 0 0 0 1101455031 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 345 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 345 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19347.9 0 0 0 0 0 0 0 0 0 0 0 0 0 19347.9 0 0 0 1101455045 1528033776 10 Physicians CERULLO LEONARD 600761267 200 Cook 0 0 Neurology Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1117.22 0 16.92 0 0 0 0 0 0 1134.14 0 0 0 1101455171 1629003397 10 Physicians KIM HOWARD 606173983 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 1927 0 250 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2657 0 331 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2657 0 331 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41379.39 0 5065.61 0 0 0 0 0 0 46445 0 0 0 1101455187 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 21751.95 0 0 0 0 0 0 0 0 0 0 0 0 0 21751.95 0 0 0 1101455189 16 Nurse Practitioners 200 Cook 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 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 0 449.35 0 0 0 0 0 0 449.35 0 0 0 1101455191 1528162252 10 Physicians KULSAKDINUN PAMORN 601232304 53 Kane 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 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0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 131 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 131 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 393 0 0 0 0 0 0 0 0 0 0 0 1805.91 0 0 0 0 0 0 2198.91 0 0 0 1101456494 1255412193 10 Physicians TAKHTEHCHIAN DARIUSH 600681130 200 Cook 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 1 0 208 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 440 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 440 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3.82 0 6521.9 0 0 0 0 0 0 6525.72 0 0 0 1101456496 1508811068 10 Physicians PUETZ JOHN 630442512 826 Missouri 0 0 Pediatrics 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 654.02 0 0 0 0 0 0 654.02 0 0 0 1101456498 14 Chiropractors 65 Madison 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 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 0 198.14 0 0 0 0 0 0 198.14 0 0 0 1101456509 2100446927 71 Medicar Provider RAILS 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0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1402.12 0 0 0 0 0 0 1402.12 0 0 0 1101457244 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 41418.39 0 0 0 0 0 0 0 0 0 0 0 0 0 41418.39 0 0 0 1101457245 1508050683 16 Nurse Practitioners CONKLIN ANGELA 610531461 17 Carroll 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 310 0 0 0 0 0 0 0 0 0 318 0 0 0 0 0 0 0 0 949 0 0 0 0 0 0 0 0 0 318 0 0 0 0 0 0 0 0 949 0 0 0 0 0 0 0 0 0 11920.78 0 0 0 0 0 0 0 0 34322.16 0 0 0 0 0 0 46242.94 0 0 0 1101457256 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 11853.2 0 0 0 0 0 0 0 0 0 0 0 0 0 11853.2 0 0 0 1101457258 1164464491 32 Rehabilitation Hospitals INST OF PHYSICAL MED AND REHAB 616142932 80 Peoria REHAB Rehabilitation hospitals paid a Per Diem rate. 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7451.28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7451.28 0 0 0 1101457260 92 Waiver service provider--Disability (DHS/DRS) 33 Effingham 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 4838.26 0 0 0 0 0 0 0 0 0 0 0 0 0 4838.26 0 0 0 1101457268 1912015710 47 Local Education Agencies PAXTON BUCKLEY LODA CUSD 10 609571461 35 Ford 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1387 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1387 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13074.89 0 13074.89 0 0 0 1101457271 1548418239 10 Physicians TESIC VERA 605276686 30 DuPage 0 0 Clinical Pathology 0 0 0 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 237 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 237 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 665.17 0 0 0 0 0 0 0 0 665.17 0 0 0 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0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18674.03 0 0 0 0 0 0 0 0 0 0 0 0 0 18674.03 0 0 0 1101457315 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 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 12196.84 0 0 0 0 0 0 0 0 0 0 0 0 0 12196.84 0 0 0 1101457319 1184789844 60 Pharmacies ROLET PHARMACY INC 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 745 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19732 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 483643 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 960721.32 0 0 0 960721.32 0 0 0 1101457320 92 Waiver service provider--Disability (DHS/DRS) 107 Will 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 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 2788.82 0 0 0 0 0 0 0 0 0 0 0 0 0 2788.82 0 0 0 1101457328 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 304 0 0 0 0 0 0 0 0 0 0 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0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5932.75 0 0 0 0 0 0 0 0 0 0 0 0 0 5932.75 0 0 0 1101457356 1669487807 60 Pharmacies WALGREEN CO 3036 631361419 826 Missouri 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 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1212 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1117.67 0 0 0 1117.67 0 0 0 1101457365 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 23974.88 0 0 0 0 0 0 0 0 0 0 0 0 0 23974.88 0 0 0 1101457366 1548484629 10 Physicians CREUTZBURG GINA 606118709 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 90 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 112 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 112 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2034.03 0 513.55 0 0 0 0 0 0 2547.58 0 0 0 1101457384 10 Physicians 826 Missouri 0 0 Surgery General 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33.95 0 0 0 0 0 0 33.95 0 0 0 1101457385 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 5268.81 0 0 0 0 0 0 0 0 0 0 0 0 0 5268.81 0 0 0 1101457406 1982830444 22 Physical Therapists HENRY KATHLEEN 606571014 200 Cook 0 0 0 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 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10310.92 10310.92 0 0 0 1101457431 1023171543 10 Physicians VINCI LISA 605275993 30 DuPage 0 1 Internal Medicine 0 55 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 441 0 0 0 0 0 0 0 0 0 0 0 938.42 0 0 0 0 0 0 1379.42 0 0 0 1101457432 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37743.04 0 0 0 0 0 0 0 0 0 0 0 0 0 37743.04 0 0 0 1101457438 1467458240 63 Other Providers of Medical Equipment/Supplies (Non-registered) MED SERV EQUIPMENT CORP 600742030 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8279.28 0 0 0 0 0 0 8279.28 0 0 0 1101457441 1790760965 10 Physicians GOROVITIS ANATOLY 604402192 107 Will 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 24 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 387.59 0 3742.11 0 0 0 0 0 0 4129.7 0 0 0 1101457442 1467626705 11 Dentists CAMODECA SILVIO 606472418 200 Cook 0 0 General Dentistry 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2038.57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2038.57 0 0 0 1101457444 1679649388 10 Physicians JABER NABIL 604353455 107 Will 0 1 Pediatrics 0 1223 0 0 545 0 0 0 0 0 0 126 0 701 0 0 0 0 0 0 7747 0 0 1733 0 0 0 0 0 0 168 0 1594 0 0 0 0 0 0 7747 0 0 1733 0 0 0 0 0 0 168 0 1594 0 0 0 0 0 0 15495 0 0 66319.55 0 0 0 0 0 0 825.82 0 71711.3 0 0 0 0 0 0 154351.67 0 0 0 1101457452 1497755094 33 Nursing Facilities UNIVERSITY NURSING AND RHB CTR 620253961 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 872 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21450 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1972242.22 0 0 0 0 0 0 0 1972242.22 0 0 0 1101457455 1831297548 10 Physicians LIN MALI 601533328 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 380.86 0 0 0 0 0 0 380.86 0 0 0 1101457458 30 General Hospitals 803 Arizona ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 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 0 378.41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 378.41 0 0 0 1101457468 1003052150 10 Physicians RODNEY SIMI 605212962 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 450 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 450 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15212.3 0 0 0 0 0 0 15212.3 0 0 0 1101457472 1174634927 10 Physicians ANGSPATT SOMPONGSE 604522134 200 Cook 0 1 Pediatrics 0 54 0 0 31 0 0 0 0 0 0 2 0 36 0 0 0 0 0 0 307 0 0 78 0 0 0 0 0 0 2 0 68 0 0 0 0 0 0 307 0 0 78 0 0 0 0 0 0 2 0 68 0 0 0 0 0 0 616 0 0 2332.34 0 0 0 0 0 0 8 0 2933.2 0 0 0 0 0 0 5889.54 0 0 0 1101457487 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8197.16 0 0 0 0 0 0 0 0 0 0 0 0 0 8197.16 0 0 0 1101457513 1720193584 30 General Hospitals BIO MEDICAL APPLICATIONS 629013344 47 Jackson DIALYSIS Outpatient dialysis centers. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13643.85 0 0 0 0 0 13643.85 0 0 0 1101457541 16 Nurse Practitioners 72 McLean 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101457542 1770585259 10 Physicians PRITIKIN JORDAN 606022762 200 Cook 0 0 Otolaryngology 0 0 0 0 0 0 0 0 0 0 0 5 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62.7 0 1711.98 0 0 0 0 0 0 1774.68 0 0 0 1101457551 1396743647 10 Physicians SADOWSKI DAWN 600052407 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 3 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71.9 0 66.11 0 0 0 0 0 0 138.01 0 0 0 1101457560 1780989905 63 Other Providers of Medical Equipment/Supplies (Non-registered) NORTHERN ILLINOIS MEDICAL CTR 600505501 71 McHenry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 214 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 214 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9051.89 0 0 0 0 0 0 9051.89 0 0 0 1101457573 1871642041 10 Physicians SHAY SANIT 616061533 80 Peoria 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 8 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 561.2 0 2934.31 0 0 0 0 0 0 3495.51 0 0 0 1101457583 1720045164 33 Nursing Facilities TOULON REHAB HEALTH CARE CTR 614830209 95 Stark 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 0 644 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15799 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1085305.8 0 0 0 0 0 0 0 1085305.8 0 0 0 1101457584 1023086550 10 Physicians RAO GOUTHAM 600261373 200 Cook 0 1 Family Practice 0 377 0 0 14 0 0 0 0 0 0 14 0 89 0 0 0 0 0 0 2713 0 0 34 0 0 0 0 0 0 14 0 151 0 0 0 0 0 0 2713 0 0 34 0 0 0 0 0 0 14 0 151 0 0 0 0 0 0 7018 0 0 1351.57 0 0 0 0 0 0 86.74 0 5439.3 0 0 0 0 0 0 13895.61 0 0 0 1101457602 10 Physicians 826 Missouri 0 0 Emergency Medicine 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101457624 1548285612 10 Physicians MAES HOLLY 618324363 100 Vermilion 0 0 Pediatrics 0 696 0 0 533 0 0 0 0 0 0 294 0 689 0 0 0 0 0 0 6147 0 0 2690 0 0 0 0 0 0 439 0 2381 0 0 0 0 0 0 6147 0 0 2690 0 0 0 0 0 0 439 0 2381 0 0 0 0 0 0 12294 0 0 58415.97 0 0 0 0 0 0 4377.42 0 96790.58 0 0 0 0 0 0 171877.97 0 0 0 1101457630 1194982983 10 Physicians BHAYANI MIHIR K. 602011718 200 Cook 0 0 Otolaryngology 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 216 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 216 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15446.82 0 0 0 0 0 0 15446.82 0 0 0 1101457632 16 Nurse Practitioners 200 Cook 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 10.5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10.5 0 0 0 1101457648 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 847.55 0 0 0 0 0 0 0 0 0 0 0 0 0 847.55 0 0 0 1101457654 30 General Hospitals 845 Texas NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 358.76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 358.76 0 0 0 1101457658 10 Physicians 12 Bond 0 0 Pediatrics 0 0 0 0 2 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 2 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 1851 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1851 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47016.05 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47016.05 0 0 0 1101458665 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 8840.98 0 0 0 0 0 0 0 0 0 0 0 0 0 8840.98 0 0 0 1101458673 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 14 0 0 0 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 9011.62 0 0 0 0 0 0 0 0 0 0 0 0 0 9011.62 0 0 0 1101458674 92 Waiver service provider--Disability (DHS/DRS) 107 Will 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 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 11853.91 0 0 0 0 0 0 0 0 0 0 0 0 0 11853.91 0 0 0 1101458677 1679584981 16 Nurse Practitioners BORCHARDT MALGORZATA 631101010 826 Missouri 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 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 407.67 0 0 0 0 0 0 407.67 0 0 0 1101458688 1699826669 10 Physicians MONTNER STEVEN 605275993 30 DuPage 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 1577 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2573 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2573 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15419.39 0 0 0 0 0 0 0 0 15419.39 0 0 0 1101458693 1346204260 10 Physicians MANGLANO RAMON 604062426 200 Cook 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 1 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16.1 0 5771.8 0 0 0 0 0 0 5787.9 0 0 0 1101458700 1750386215 12 Optometrists CROUCH NATHAN A 625269461 28 De Witt 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 259 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 833 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 833 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15346.56 0 3030.18 0 0 0 0 18376.74 0 0 0 1101458704 1184691651 39 Hospice ADVOCATE HOSPICE 605151160 30 DuPage 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 316 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5729 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 989249.34 0 0 0 0 0 0 0 0 0 0 0 989249.34 0 0 0 1101458706 1861682965 10 Physicians JARRETT OLAMIDE 606127323 200 Cook 0 1 Infectious Diseases 0 26 0 0 0 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 158 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 158 0 0 0 0 0 0 150 0 0 0 0 0 0 0 0 0 0 0 10996.62 0 0 0 0 0 0 11146.62 0 0 0 1101458710 1689655136 10 Physicians KERSHAW KIRSTEN 600143549 71 McHenry 0 1 Pediatrics 0 10 0 0 9 0 0 0 0 0 0 3 0 11 0 0 0 0 0 0 55 0 0 10 0 0 0 0 0 0 4 0 17 0 0 0 0 0 0 55 0 0 10 0 0 0 0 0 0 4 0 17 0 0 0 0 0 0 110 0 0 718.24 0 0 0 0 0 0 9.31 0 772.85 0 0 0 0 0 0 1610.4 0 0 0 1101458714 1306825435 10 Physicians KOGAN MONICA 606124861 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 143 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 314 0 366 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 314 0 366 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8306.66 0 33167.28 0 0 0 0 0 0 41473.94 0 0 0 1101458717 1295846251 10 Physicians KRAUSE PHILIP 600761226 200 Cook 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 0 0 342 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 815 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 815 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11165.78 0 0 0 0 0 0 11165.78 0 0 0 1101458718 91 Waiver service provider--Adults (DHS/DDD) 61 Livingston 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 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4359.04 0 0 0 0 0 0 0 0 0 0 0 0 0 4359.04 0 0 0 1101458727 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 0 775.14 0 0 0 0 0 0 0 0 0 0 0 0 0 775.14 0 0 0 1101458749 1083630487 63 Other Providers of Medical Equipment/Supplies (Non-registered) FAIR HAVENS CHRISTIAN HOME 625214010 63 Macon 0 0 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 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 3481.87 0 0 0 0 0 0 3481.87 0 0 0 1101458750 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 938.75 0 0 0 0 0 0 0 0 0 0 0 0 0 938.75 0 0 0 1101458757 93 Waiver service provider--HIV/AIDS (DHS/DRS) 815 Indiana 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 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 2979.3 0 0 0 0 0 0 0 0 0 0 0 0 0 2979.3 0 0 0 1101458774 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 19547.38 0 0 0 0 0 0 0 0 0 0 0 0 0 19547.38 0 0 0 1101458778 1235189689 10 Physicians PALMORE MARY 606173909 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 3 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99.89 0 449.04 0 0 0 0 0 0 548.93 0 0 0 1101458786 1750322277 10 Physicians WHELAN ROBERT 477165348 815 Indiana 0 0 Anesthesiology 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 1919.21 0 0 0 0 0 0 1919.21 0 0 0 1101458788 11 Dentists 200 Cook 0 0 General Dentistry 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114.35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114.35 0 0 0 1101458793 10 Physicians 852 Wisconsin 0 0 Pediatrics 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 48 0 0 0 1101458794 1871656082 30 General Hospitals ST MARYS HOSPITAL MILWAUKEE 532114508 852 Wisconsin NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 4 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 4 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 4 0 0 0 0 2 0 0 0 1 0 0 0 0 0 0 0 0 0 976.4 0 0 0 0 1289.62 0 0 0 170.83 0 0 0 0 0 2436.85 0 0 0 1101458795 1699845263 11 Dentists OATES HENRY C 611148004 109 Winnebago 0 0 0 0 0 400 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1991 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1991 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51737.33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51737.33 0 0 0 1101458804 92 Waiver service provider--Disability (DHS/DRS) 63 Macon 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61054.78 0 0 0 0 0 0 0 0 0 0 0 0 0 61054.78 0 0 0 1101458822 1194780049 10 Physicians ALLA HIMABINDU 612656138 89 Rock Island 0 1 Family Practice 0 70 0 0 16 0 0 0 0 0 0 26 0 115 0 0 0 0 0 0 580 0 0 25 0 0 0 0 0 0 51 0 219 0 0 0 0 0 0 580 0 0 25 0 0 0 0 0 0 51 0 219 0 0 0 0 0 0 2194 0 0 1108.35 0 0 0 0 0 0 215.02 0 4715.71 0 0 0 0 0 0 8233.08 0 0 0 1101458829 1154575892 10 Physicians DEY NEELENDU 631101010 826 Missouri 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2836.43 0 0 0 0 0 0 2836.43 0 0 0 1101458845 1710009923 10 Physicians PARSAEI SHEKOFEH 606123714 30 DuPage 0 0 Anesthesiology 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 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 185.26 0 0 0 0 0 0 185.26 0 0 0 1101458847 1568628485 10 Physicians BARAL SHAILESH 629029000 47 Jackson 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 289 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 289 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5780.99 0 0 0 0 0 0 5780.99 0 0 0 1101458851 1356443337 13 Podiatrists RAHEEM KAREEM 600773701 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2654 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6957 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6957 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7547.63 0 0 0 0 0 0 7547.63 0 0 0 1101458857 92 Waiver service provider--Disability (DHS/DRS) 98 Tazewell 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 18382.74 0 0 0 0 0 0 0 0 0 0 0 0 0 18382.74 0 0 0 1101458861 1285821868 16 Nurse Practitioners LEMUS GABRIEL 605855676 107 Will 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 378 0 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 1105 0 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 1105 0 0 0 0 0 0 0 0 0 4164.74 0 0 0 0 0 0 0 0 47003.04 0 0 0 0 0 0 51167.78 0 0 0 1101458872 1568481083 10 Physicians WONG HAK 606118709 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 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 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8251.16 0 0 0 0 0 0 8251.16 0 0 0 1101458881 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 646.8 0 0 0 0 0 0 0 0 0 0 0 0 0 646.8 0 0 0 1101458886 1275708752 70 Ambulance Service Providers MERCY AMBULANCE SERVICES LLC 611114367 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 278 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 732 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 732 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77948.7 0 0 0 0 0 0 77948.7 0 0 0 1101458890 16 Nurse Practitioners 826 Missouri 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 81.3 0 0 0 0 0 0 81.3 0 0 0 1101458897 1124053848 10 Physicians DABROWSKI MELINDA 618012500 19 Champaign 0 0 Obstetric-Gynecology 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 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1638.78 0 0 0 0 0 0 1638.78 0 0 0 1101458903 1902033954 10 Physicians DASARAJU RADHIKA 627031944 91 Sangamon 0 0 Pediatrics 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1739.13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1739.13 0 0 0 1101458908 1184637480 10 Physicians SLUTZKY MARC 606118709 200 Cook 0 0 Neurology 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 23 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 0 0 0 0 0 0 0 0 414.04 0 0 0 0 0 0 414.04 0 0 0 1101458914 91 Waiver service provider--Adults (DHS/DDD) 100 Vermilion 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 0 203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18617.5 0 0 0 0 0 0 0 0 0 0 0 0 0 18617.5 0 0 0 1101458927 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23336.38 0 0 0 0 0 0 0 0 0 0 0 0 0 23336.38 0 0 0 1101458930 13 Podiatrists 816 Iowa 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 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 23.6 0 0 0 0 0 0 23.6 0 0 0 1101458933 1639125552 60 Pharmacies OSCO DRUG 3519 600261198 200 Cook 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 0 0 0 367 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9087 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25004.56 0 0 0 25004.56 0 0 0 1101458941 1689860405 22 Physical Therapists URSO ELIZABETH 606573019 200 Cook 0 0 0 0 0 0 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 1065 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1065 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76539.24 76539.24 0 0 0 1101458943 1881785558 63 Other Providers of Medical Equipment/Supplies (Non-registered) FITZSIMMONS SURGICAL SUPPLY 464103001 815 Indiana 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 0 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3618.21 0 0 0 0 0 0 3618.21 0 0 0 1101458979 1588640924 10 Physicians RONIN DAVID I 606313222 200 Cook 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 0 0 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 521 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 521 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5018.57 0 0 0 0 0 0 5018.57 0 0 0 1101458996 1962491225 10 Physicians GOWDA BETTAIAH 528073480 816 Iowa 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4814.87 0 0 0 0 0 0 4814.87 0 0 0 1101459016 1871578583 60 Pharmacies SULLIVAN DRUGS 620691609 64 Macoupin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 424 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4728 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118241 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 343798.84 0 0 0 343798.84 0 0 0 1101459018 91 Waiver service provider--Adults (DHS/DDD) 63 Macon 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 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9631.12 0 0 0 0 0 0 0 0 0 0 0 0 0 9631.12 0 0 0 1101459023 10 Physicians 200 Cook 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 168.85 0 0 0 0 0 0 168.85 0 0 0 1101459037 1588776017 10 Physicians KLEIN THOMAS 606101042 200 Cook 0 1 Family Practice 0 1 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 440.7 0 0 0 0 0 0 449.7 0 0 0 1101459063 91 Waiver service provider--Adults (DHS/DDD) 107 Will 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 82 0 0 0 0 0 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 10010 0 0 0 0 0 0 0 0 0 0 0 0 0 10010 0 0 0 1101459082 1003993734 16 Nurse Practitioners KALE PETER 618012530 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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Agencies - In Home 42 Hancock 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 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 0 720 0 0 0 0 0 0 720 0 0 0 1101459982 1760744825 12 Optometrists MOTHERSBAUGH ERIK 606163878 200 Cook 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 345 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 345 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7130.44 0 0 0 0 0 0 7130.44 0 0 0 1101459983 92 Waiver service provider--Disability (DHS/DRS) 37 Fulton 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 10320.18 0 0 0 0 0 0 0 0 0 0 0 0 0 10320.18 0 0 0 1101459990 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 4753.11 0 0 0 0 0 0 0 0 0 0 0 0 0 4753.11 0 0 0 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COLETTA'S OF ILLINOIS, INC" 604876294 107 Will 0 0 0 0 0 0 0 0 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8190477.2 0 0 0 0 0 0 0 0 0 0 0 0 0 8190477.2 0 0 0 1101460442 1861580383 10 Physicians SIMON MELISSA 606118709 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 2 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 216 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 216 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24.72 0 24563.67 0 0 0 0 0 0 24588.39 0 0 0 1101460443 1114114873 33 Nursing Facilities ROSEWOOD CARE CTR EAST PEORIA 616114928 98 Tazewell 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 537 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1167757.84 0 0 0 0 0 0 0 1167757.84 0 0 0 1101460448 1184691354 10 Physicians SHOLITON SHARON 606123227 200 Cook 0 1 Emergency Medicine 0 337 0 0 187 0 0 0 0 0 0 28 0 245 0 0 0 0 0 0 794 0 0 450 0 0 0 0 0 0 34 0 282 0 0 0 0 0 0 794 0 0 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Cook 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18013.5 0 0 0 0 0 0 0 0 0 0 0 0 0 18013.5 0 0 0 1101461710 1487727731 10 Physicians BHATTACHARYA ISHAN 612656138 89 Rock Island 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 1 0 218 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 590 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 590 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3.33 0 38714.55 0 0 0 0 0 0 38717.88 0 0 0 1101461712 1487835138 10 Physicians BISCOTAKIS EVANGELOS 607063267 200 Cook 0 1 Family Practice 0 124 0 0 27 0 0 0 0 0 0 3 0 118 0 0 0 0 0 0 873 0 0 45 0 0 0 0 0 0 3 0 287 0 0 0 0 0 0 873 0 0 45 0 0 0 0 0 0 3 0 287 0 0 0 0 0 0 2205 0 0 2251.18 0 0 0 0 0 0 12 0 8297.69 0 0 0 0 0 0 12765.87 0 0 0 1101461718 1538102652 10 Physicians KARACIC THERESA L. 606118709 200 Cook 0 1 Pediatrics 0 38 0 0 21 0 0 0 0 0 0 9 0 23 0 0 0 0 0 0 101 0 0 77 0 0 0 0 0 0 9 0 25 0 0 0 0 0 0 101 0 0 77 0 0 0 0 0 0 9 0 25 0 0 0 0 0 0 202 0 0 2234.52 0 0 0 0 0 0 47.87 0 1017.75 0 0 0 0 0 0 3502.14 0 0 0 1101461740 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 7146.2 0 0 0 0 0 0 0 0 0 0 0 0 0 7146.2 0 0 0 1101461756 1316010937 60 Pharmacies KROGER PHARMACY J 657 615712170 98 Tazewell 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1377 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35637 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64075.78 0 0 0 64075.78 0 0 0 1101461761 1144599796 16 Nurse Practitioners ANTALICK AMY 631101010 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 128.54 0 0 0 0 0 0 128.54 0 0 0 1101461766 1205015898 10 Physicians PARKAR TABASSUM 477470001 815 Indiana 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1249.91 0 0 0 0 0 0 1249.91 0 0 0 1101461771 92 Waiver service provider--Disability (DHS/DRS) 63 Macon 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 6845.27 0 0 0 0 0 0 0 0 0 0 0 0 0 6845.27 0 0 0 1101461781 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 254 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 254 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22248.05 0 0 0 0 0 0 0 0 0 0 0 0 0 22248.05 0 0 0 1101461783 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 12798.95 0 0 0 0 0 0 0 0 0 0 0 0 0 12798.95 0 0 0 1101461793 1356352447 10 Physicians HARTZEN MARLA 600681270 200 Cook 0 0 Psychiatry 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 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 173.24 0 0 0 0 0 0 173.24 0 0 0 1101461813 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7695.01 0 0 0 0 0 0 0 0 0 0 0 0 0 7695.01 0 0 0 1101461817 1376671966 11 Dentists PIRO RONNIE 606474640 200 Cook 0 0 General Dentistry 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 518 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 518 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19218.91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19218.91 0 0 0 1101461820 1053439208 24 Speech Therapists FLETCHER CHRISTINE M 616141290 110 Woodford 0 0 0 0 0 0 0 0 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 0 377 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 377 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27082.6 27082.6 0 0 0 1101461836 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 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 3500.17 0 0 0 0 0 0 0 0 0 0 0 0 0 3500.17 0 0 0 1101461851 1356474696 11 Dentists PERMAN JEFFREY 606283125 200 Cook 0 0 General Dentistry 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 330 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 330 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10040.15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10040.15 0 0 0 1101461863 1699842245 10 Physicians DENBERG PETER 600442203 57 Lake 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 5 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21363.11 0 0 0 0 0 0 21363.11 0 0 0 1101461866 1134347909 10 Physicians STEVENSON BERNADETTE 600681129 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 279 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 279 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6406.26 0 0 0 0 0 0 6406.26 0 0 0 1101461875 1336189588 10 Physicians SAPP BRIAN 600319176 57 Lake 0 1 Pediatrics 0 252 0 0 136 0 0 0 0 0 0 58 0 142 0 0 0 0 0 0 2123 0 0 349 0 0 0 0 0 0 104 0 385 0 0 0 0 0 0 2123 0 0 349 0 0 0 0 0 0 104 0 385 0 0 0 0 0 0 4246 0 0 13791.35 0 0 0 0 0 0 762.81 0 25252.78 0 0 0 0 0 0 44052.94 0 0 0 1101461882 1659648061 16 Nurse Practitioners FIRKUS JAMIE 601533328 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99.2 0 0 0 0 0 0 99.2 0 0 0 1101461883 92 Waiver service provider--Disability (DHS/DRS) 53 Kane 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 1790.73 0 0 0 0 0 0 0 0 0 0 0 0 0 1790.73 0 0 0 1101461909 1639284995 10 Physicians WIPFLER EARL JOHN 614621007 80 Peoria 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 320 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 336 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 336 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11004.04 0 0 0 0 0 0 11004.04 0 0 0 1101461939 92 Waiver service provider--Disability (DHS/DRS) 73 Menard 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 34077.74 0 0 0 0 0 0 0 0 0 0 0 0 0 34077.74 0 0 0 1101461962 1164514238 63 Other Providers of Medical Equipment/Supplies (Non-registered) IN HOME MEDICAL 619389375 24 Coles 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1020 0 639 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5810 0 700 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5810 0 700 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 279191.9 0 51635.25 0 0 0 0 330827.15 0 0 0 1101461973 1538275227 16 Nurse Practitioners WOCHNER NICOLE 619389258 24 Coles 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 23 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 0 0 0 0 0 0 0 0 100.14 0 0 0 0 0 0 100.14 0 0 0 1101461974 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 47 0 0 0 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 48188 0 0 0 0 0 0 0 0 0 0 0 0 0 48188 0 0 0 1101462010 92 Waiver service provider--Disability (DHS/DRS) 106 Whiteside 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 13359.98 0 0 0 0 0 0 0 0 0 0 0 0 0 13359.98 0 0 0 1101462015 1245287085 10 Physicians LUNDY JAMES 619444141 31 Edgar 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 234 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 278 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 278 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7020.23 0 0 0 0 0 0 7020.23 0 0 0 1101462016 1386641751 10 Physicians DUBOE FRED 601945029 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 591.43 0 0 0 0 0 0 591.43 0 0 0 1101462023 92 Waiver service provider--Disability (DHS/DRS) 37 Fulton 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15373.06 0 0 0 0 0 0 0 0 0 0 0 0 0 15373.06 0 0 0 1101462024 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 190 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6970.04 0 0 0 0 0 0 0 0 0 0 0 0 0 6970.04 0 0 0 1101462025 1316109721 63 Other Providers of Medical Equipment/Supplies (Non-registered) BANDYS MEDICAL EQUIPMENT 624012004 33 Effingham 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 320 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 320 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15812.7 0 467.04 0 0 0 0 16279.74 0 0 0 1101462032 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 19 0 0 0 0 0 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 19658.94 0 0 0 0 0 0 0 0 0 0 0 0 0 19658.94 0 0 0 1101462041 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 2354.44 0 0 0 0 0 0 0 0 0 0 0 0 0 2354.44 0 0 0 1101462056 1003838111 10 Physicians ST VILLE EDWARD 532331305 852 Wisconsin 0 0 Radiology Diagnosis 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 317.39 0 0 0 0 0 0 0 0 317.39 0 0 0 1101462069 1649479296 10 Physicians MAGIDOW MICHAEL 600893500 57 Lake 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 846 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 846 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1517.19 0 0 0 0 0 0 1517.19 0 0 0 1101462077 92 Waiver service provider--Disability (DHS/DRS) 12 Bond 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 9870.91 0 0 0 0 0 0 0 0 0 0 0 0 0 9870.91 0 0 0 1101462086 1659314607 10 Physicians YEO SEINKHIONG 606594019 200 Cook 0 1 Internal Medicine 0 46 0 0 0 0 0 0 0 0 0 0 0 571 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 3335 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 3335 0 0 0 0 0 0 220 0 0 0 0 0 0 0 0 0 0 0 49415.19 0 0 0 0 0 0 49635.19 0 0 0 1101462114 1730189598 10 Physicians GOLDFLIES MITCHELL 606462901 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 14 0 999 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 2348 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 2348 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 576.18 0 120600.77 0 0 0 0 0 0 121176.95 0 0 0 1101462118 94 Waiver service provider--Children's support (DHS/DDD) 23 Clinton 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 0 214.5 0 0 0 0 0 0 0 0 0 0 0 0 0 214.5 0 0 0 1101462145 1841236254 16 Nurse Practitioners JONES JEFFREY 616150001 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 354 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 354 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15966.48 0 0 0 0 0 0 15966.48 0 0 0 1101462146 1669463394 11 Dentists BROY HORACE 606533903 200 Cook 0 0 General Dentistry 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4528.57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4528.57 0 0 0 1101462162 1366485831 10 Physicians CLARKE PETER M 606123714 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 239.3 0 0 0 0 0 0 239.3 0 0 0 1101462164 1992906218 10 Physicians GIULIANOTTI PIER 606127232 200 Cook 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18177.43 0 0 0 0 0 0 18177.43 0 0 0 1101462165 1295903359 10 Physicians GALUE GUSTAVO 616151941 30 DuPage 0 1 Family Practice 0 17 0 0 4 0 0 0 0 0 0 67 0 184 0 0 0 0 0 0 120 0 0 4 0 0 0 0 0 0 71 0 328 0 0 0 0 0 0 120 0 0 4 0 0 0 0 0 0 71 0 328 0 0 0 0 0 0 340 0 0 222.72 0 0 0 0 0 0 227.66 0 10986.77 0 0 0 0 0 0 11777.15 0 0 0 1101462174 1558302570 30 General Hospitals LEE MEMORIAL HOSPITAL 339022218 810 Florida NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5839.23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5839.23 0 0 0 1101462185 1780742163 70 Ambulance Service Providers D P MURPHY AMBULANCE CO 600307814 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 847 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2699 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2699 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 110243.2 0 0 0 0 0 0 110243.2 0 0 0 1101462190 16 Nurse Practitioners 815 Indiana 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76.75 0 0 0 0 0 0 76.75 0 0 0 1101462193 94 Waiver service provider--Children's support (DHS/DDD) 107 Will 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 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 0 806.3 0 0 0 0 0 0 0 0 0 0 0 0 0 806.3 0 0 0 1101462207 1053403675 10 Physicians PEDERSEN PAUL 617042101 72 McLean 0 1 Internal Medicine 0 1 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 520.71 0 0 0 0 0 0 556.71 0 0 0 1101462209 1740386218 33 Nursing Facilities GOOD SAMARITAN FLANAGAN 617409036 61 Livingston 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 233 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6384 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 560024.73 0 0 0 0 0 0 0 560024.73 0 0 0 1101462220 1174542377 70 Ambulance Service Providers EVANSTON FIRE DEPT 602013527 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 457 0 0 0 0 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Cook 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 7 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 71.62 0 0 0 0 0 0 71.62 0 0 0 1101462268 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14575.5 0 0 0 0 0 0 0 0 0 0 0 0 0 14575.5 0 0 0 1101462280 91 Waiver service provider--Adults (DHS/DDD) 90 Saline 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 0 326 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 326 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24915 0 0 0 0 0 0 0 0 0 0 0 0 0 24915 0 0 0 1101462295 1760484257 10 Physicians HAN LONG 600442203 57 Lake 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 227 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 227 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48762.43 0 0 0 0 0 0 48762.43 0 0 0 1101462325 1437156718 14 Chiropractors COCHRAN 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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 34762.34 0 0 0 0 0 0 0 0 0 0 0 0 0 34762.34 0 0 0 1101462421 1588742282 10 Physicians SINSHEIMER ERICA 600773705 200 Cook 0 0 Endocrinology 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1318.61 0 0 0 0 0 0 1318.61 0 0 0 1101462423 1083631527 10 Physicians LEVINE MARK 631101093 826 Missouri 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 3 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17.67 0 2073.69 0 0 0 0 0 0 2091.36 0 0 0 1101462425 1578572798 24 Speech Therapists JOHNSTON CHRISTINA 626290314 91 Sangamon 0 0 0 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 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17081.02 17081.02 0 0 0 1101462433 1881721207 16 Nurse Practitioners DE OCAMPO MARIA 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0 1569.55 0 0 0 0 0 0 2069.32 0 0 0 1101462521 11 Dentists 200 Cook 0 0 General Dentistry 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 47.75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47.75 0 0 0 1101462539 1649387051 10 Physicians MORGAN GEORGE 601265000 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1843.58 0 0 0 0 0 0 1843.58 0 0 0 1101462540 1154371193 10 Physicians PENNEPALLI RAJENDRA 609220067 46 Iroquois 0 1 Internal Medicine 0 5 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 110 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 110 0 0 0 0 0 0 130 0 0 0 0 0 0 0 0 0 0 0 2042.03 0 0 0 0 0 0 2172.03 0 0 0 1101462549 1740365808 10 Physicians BABER RIAZ A 605636510 30 DuPage 0 0 Psychiatry 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 0 262 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 850.38 850.38 0 0 0 1101462598 1215916671 10 Physicians MARTIN PETER 627810002 91 Sangamon 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 2 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12.02 0 15487.24 0 0 0 0 0 0 15499.26 0 0 0 1101462617 91 Waiver service provider--Adults (DHS/DDD) 91 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 0 257 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 257 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21879 0 0 0 0 0 0 0 0 0 0 0 0 0 21879 0 0 0 1101462618 1013963537 10 Physicians DULCZEWSKA MILLER MIROSLAWA 606463730 200 Cook 0 1 Pediatrics 0 67 0 0 5 0 0 0 0 0 0 6 0 47 0 0 0 0 0 0 149 0 0 20 0 0 0 0 0 0 6 0 111 0 0 0 0 0 0 149 0 0 20 0 0 0 0 0 0 6 0 111 0 0 0 0 0 0 298 0 0 595.82 0 0 0 0 0 0 91.58 0 1333.46 0 0 0 0 0 0 2318.86 0 0 0 1101462624 1538268628 10 Physicians KHUSRO QAZI 615544936 98 Tazewell 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 478 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 478 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19495.92 0 0 0 0 0 0 19495.92 0 0 0 1101462626 1790920981 10 Physicians RYBKA EDWARD 604532670 200 Cook 0 1 Family Practice 0 127 0 0 73 0 0 0 0 0 0 52 0 195 0 0 0 0 0 0 822 0 0 183 0 0 0 0 0 0 65 0 282 0 0 0 0 0 0 822 0 0 183 0 0 0 0 0 0 65 0 282 0 0 0 0 0 0 2090 0 0 6643.44 0 0 0 0 0 0 254.04 0 10353.93 0 0 0 0 0 0 19341.41 0 0 0 1101462627 1275694937 16 Nurse Practitioners COVENTRY MARY 625264170 63 Macon 0 0 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 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 454.55 0 0 0 0 0 0 454.55 0 0 0 1101462628 92 Waiver service provider--Disability (DHS/DRS) 60 Lee 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 14 0 0 0 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 4346.14 0 0 0 0 0 0 0 0 0 0 0 0 0 4346.14 0 0 0 1101462634 91 Waiver service provider--Adults (DHS/DDD) 57 Lake 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 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2734.6 0 0 0 0 0 0 0 0 0 0 0 0 0 2734.6 0 0 0 1101462642 1295753614 10 Physicians THAWLEY STANLEY E 631101010 826 Missouri 0 0 Otorhinolaryngology 0 0 0 0 0 0 0 0 0 0 0 0 0 15 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 0 146.57 0 0 0 0 0 0 146.57 0 0 0 1101462651 1467474957 16 Nurse Practitioners VITTORIO KIMBERLY 610327119 97 Stephenson 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 290 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 1761 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 1761 0 0 0 0 0 0 0 0 0 241.86 0 0 0 0 0 0 0 0 100345.88 0 0 0 0 0 0 100587.74 0 0 0 1101462657 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 16701.78 0 0 0 0 0 0 0 0 0 0 0 0 0 16701.78 0 0 0 1101462658 1427020544 10 Physicians WOLS MATTHEW 610681764 79 Ogle 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 1140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1395 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1395 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55628.41 0 0 0 0 0 0 55628.41 0 0 0 1101462663 1902909153 10 Physicians WAGNER JEAN 622321219 96 St Clair 0 1 Pediatrics 0 30 0 0 84 0 0 0 0 0 0 9 0 68 0 0 0 0 0 0 292 0 0 271 0 0 0 0 0 0 10 0 150 0 0 0 0 0 0 292 0 0 271 0 0 0 0 0 0 10 0 150 0 0 0 0 0 0 584 0 0 8702.46 0 0 0 0 0 0 132.24 0 5842.96 0 0 0 0 0 0 15261.66 0 0 0 1101462677 1306964937 34 State-operated facility (DHS) UNIT 4790 BLDG 704A SHAPIRO 609015018 54 Kankakee 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 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1679 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1124163.38 0 0 0 0 0 0 0 0 0 0 1124163.38 0 0 0 1101462693 1437154507 10 Physicians CARROLL JOSIAH FK 612443321 89 Rock Island 0 1 Family Practice 0 89 0 0 4 0 0 0 0 0 0 56 0 22 0 0 0 0 0 0 369 0 0 4 0 0 0 0 0 0 96 0 53 0 0 0 0 0 0 369 0 0 4 0 0 0 0 0 0 96 0 53 0 0 0 0 0 0 832 0 0 307.36 0 0 0 0 0 0 532.83 0 1431.04 0 0 0 0 0 0 3103.23 0 0 0 1101462702 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 36664.77 0 0 0 0 0 0 0 0 0 0 0 0 0 36664.77 0 0 0 1101462707 92 Waiver service provider--Disability (DHS/DRS) 98 Tazewell 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 7254.07 0 0 0 0 0 0 0 0 0 0 0 0 0 7254.07 0 0 0 1101462718 1073624425 10 Physicians PODRASKY DAVID 999999999 815 Indiana 0 0 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 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 837.88 0 0 0 0 0 0 837.88 0 0 0 1101462727 30 General Hospitals 803 Arizona NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 908.28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 908.28 0 0 0 1101462754 94 Waiver service provider--Children's support (DHS/DDD) 31 Edgar 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 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1330.09 0 0 0 0 0 0 0 0 0 0 0 0 0 1330.09 0 0 0 1101462764 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 299 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 299 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20868 0 0 0 0 0 0 0 0 0 0 0 0 0 20868 0 0 0 1101462769 91 Waiver service provider--Adults (DHS/DDD) 65 Madison 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 0 439 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 439 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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MICHAEL W 624541137 25 Crawford 0 0 Family Practice 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 23 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 0 0 0 0 0 0 0 0 489.7 0 0 0 0 0 0 489.7 0 0 0 1101464647 1306904131 10 Physicians KHATER RUSSELL 604353435 107 Will 0 0 Obstetric-Gynecology 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 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4513.04 0 0 0 0 0 0 4513.04 0 0 0 1101464659 1114961208 12 Optometrists DZIUBA ELIZABETH 601911531 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 275 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 275 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7369.6 0 0 0 0 0 0 7369.6 0 0 0 1101464687 91 Waiver service provider--Adults (DHS/DDD) 53 Kane 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 0 253 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 253 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17154.5 0 0 0 0 0 0 0 0 0 0 0 0 0 17154.5 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 12751.99 0 0 0 0 0 0 0 0 0 0 0 0 0 12751.99 0 0 0 1101464865 1548203268 10 Physicians LENZ BRIAN 630318014 826 Missouri 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 295.33 0 0 0 0 0 0 295.33 0 0 0 1101464878 1457330870 40 Federally Qualified Health Centers FRIEND FAMILY HLTH CTR WEST 606361526 200 Cook 0 1 0 2024 1096 0 246 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7206 3455 0 612 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7206 3455 0 612 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20192 211156.01 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 231348.01 0 0 0 1101464881 36 Community mental health provider 57 Lake 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 725 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 725 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 210729.63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 210729.63 0 0 0 1101464900 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 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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 12976.26 0 0 0 0 0 0 0 0 0 0 0 0 0 12976.26 0 0 0 1101464939 1235128109 10 Physicians RAO KRISHNA 627949639 91 Sangamon 0 0 Hematology 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 242 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 242 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23235.72 0 0 0 0 0 0 23235.72 0 0 0 1101464941 11 Dentists 65 Madison 0 0 General Dentistry 0 0 0 2 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 0 317.95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 317.95 0 0 0 1101464943 10 Physicians 815 Indiana 0 0 Ophthalmology 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160.98 0 0 0 0 0 0 160.98 0 0 0 1101464963 92 Waiver service provider--Disability (DHS/DRS) 99 Union 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 24633.81 0 0 0 0 0 0 0 0 0 0 0 0 0 24633.81 0 0 0 1101464981 1497860621 55 Early Intervention Services ROSS YOCKEY CATHERINE 624502623 88 Richland 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4377.24 0 0 0 0 0 0 4377.24 0 0 0 1101464998 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 23921.77 0 0 0 0 0 0 0 0 0 0 0 0 0 23921.77 0 0 0 1101465001 1386681906 10 Physicians BRANIECKI MARYLEE 606124325 200 Cook 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 318 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 318 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28388.24 0 0 0 0 0 0 0 0 28388.24 0 0 0 1101465005 1689620114 60 Pharmacies OSCO DRUG 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CARLE MEDICAL SUPPLY 619384121 24 Coles 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 445 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2962 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2962 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 112365.43 0 1137.59 0 0 0 0 113503.02 0 0 0 1101465181 1780612465 10 Physicians STILES BRUCE 611042315 109 Winnebago 0 1 Family Practice 0 18 0 0 32 0 0 0 0 0 0 20 0 100 0 0 0 0 0 0 137 0 0 76 0 0 0 0 0 0 23 0 178 0 0 0 0 0 0 137 0 0 76 0 0 0 0 0 0 23 0 178 0 0 0 0 0 0 298 0 0 3063.55 0 0 0 0 0 0 153.6 0 3799.99 0 0 0 0 0 0 7315.14 0 0 0 1101465193 1184756181 11 Dentists CAVITT MARY 604356135 107 Will 0 0 General Dentistry 0 0 0 362 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 981 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 981 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27659.25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27659.25 0 0 0 1101465200 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 12135.9 0 0 0 0 0 0 0 0 0 0 0 0 0 12135.9 0 0 0 1101465214 1659362929 10 Physicians FISHER GRAEME 628646262 49 Jefferson 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11747.52 0 0 0 0 0 0 11747.52 0 0 0 1101465224 92 Waiver service provider--Disability (DHS/DRS) 24 Coles 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9282.29 0 0 0 0 0 0 0 0 0 0 0 0 0 9282.29 0 0 0 1101465228 1003087909 10 Physicians GEEVARGHESE BESSEY 999999999 200 Cook 0 0 Pediatrics 0 0 0 0 1 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 113 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 113 0 0 0 0 0 0 0 0 0 6.4 0 0 0 0 0 0 0 0 4724.72 0 0 0 0 0 0 4731.12 0 0 0 1101465230 1104811967 70 Ambulance Service Providers VILLAGE OF BOLINGBROOK 604402800 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 367 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1038 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1038 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41337.07 0 0 0 0 0 0 41337.07 0 0 0 1101465233 91 Waiver service provider--Adults (DHS/DDD) 80 Peoria 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 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6626.83 0 0 0 0 0 0 0 0 0 0 0 0 0 6626.83 0 0 0 1101465258 1518112267 10 Physicians TATKA KEITH 608052701 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 874 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 944 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 944 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24868.77 0 0 0 0 0 0 24868.77 0 0 0 1101465265 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 20996.79 0 0 0 0 0 0 0 0 0 0 0 0 0 20996.79 0 0 0 1101465267 1043267461 10 Physicians DIETERICH MARK 602011718 200 Cook 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 247 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 415 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 415 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4357.12 0 0 0 0 0 0 0 0 4357.12 0 0 0 1101465286 30 General Hospitals 818 Kentucky ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2127.65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2127.65 0 0 0 1101465298 1790727659 10 Physicians RUSSO CRAIG 627024947 91 Sangamon 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 2548 0 227 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3414 0 246 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3414 0 246 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59755.63 0 2455.18 0 0 0 0 0 0 62210.81 0 0 0 1101465300 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 7009.08 0 0 0 0 0 0 0 0 0 0 0 0 0 7009.08 0 0 0 1101465315 1639160658 11 Dentists FISHER LARRY 606405255 200 Cook 0 0 General Dentistry 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11543.23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11543.23 0 0 0 1101465321 1982764148 10 Physicians JAYARAM SHEELA 604522134 30 DuPage 0 1 Pediatrics 0 101 0 0 20 0 0 0 0 0 0 4 0 22 0 0 0 0 0 0 372 0 0 41 0 0 0 0 0 0 4 0 35 0 0 0 0 0 0 372 0 0 41 0 0 0 0 0 0 4 0 35 0 0 0 0 0 0 744 0 0 1841.47 0 0 0 0 0 0 16 0 1607.03 0 0 0 0 0 0 4208.5 0 0 0 1101465347 1114170339 12 Optometrists THAI MATTHEW 600852240 57 Lake 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1755.15 0 0 0 0 0 0 1755.15 0 0 0 1101465348 91 Waiver service provider--Adults (DHS/DDD) 106 Whiteside 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 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 224.4 0 0 0 0 0 0 0 0 0 0 0 0 0 224.4 0 0 0 1101465381 1053520700 10 Physicians MOUGOLIAS DIMITRIOS 600774302 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 629 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 663 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 663 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24184.78 0 0 0 0 0 0 24184.78 0 0 0 1101465421 30 General Hospitals 810 Florida NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 325.7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 325.7 0 0 0 1101465433 1013168202 28 Waiver service provider--Supportive living facility (HFS) GLENHAVEN GARDENS OF ALTON 620026700 65 Madison 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 877 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1114137.04 0 0 0 0 0 0 0 0 0 0 0 0 0 1114137.04 0 0 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0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 119.62 0 0 0 0 0 0 119.62 0 0 0 1101466380 92 Waiver service provider--Disability (DHS/DRS) 89 Rock Island 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 18934.43 0 0 0 0 0 0 0 0 0 0 0 0 0 18934.43 0 0 0 1101466400 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19003.94 0 0 0 0 0 0 0 0 0 0 0 0 0 19003.94 0 0 0 1101466404 1205808201 16 Nurse Practitioners SIMS KATHERINE M 627034514 826 Missouri 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 0 0 0 0 0 0 0 0 23 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 0 0 0 0 0 0 0 0 751.75 0 0 0 0 0 0 751.75 0 0 0 1101466409 1124322516 10 Physicians SCHWARTZ LEWIS 605277594 30 DuPage 0 0 Vascular Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 440.88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 371.18 0 0 812.06 0 0 0 1101468953 92 Waiver service provider--Disability (DHS/DRS) 53 Kane 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 2633.62 0 0 0 0 0 0 0 0 0 0 0 0 0 2633.62 0 0 0 1101468961 92 Waiver service provider--Disability (DHS/DRS) 70 McDonough 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 11235.2 0 0 0 0 0 0 0 0 0 0 0 0 0 11235.2 0 0 0 1101468962 1568670859 36 Community mental health provider NEUMANN FAMILY SERVICES 606253706 200 Cook 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 2672 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5777 0 0 2672 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5777 0 0 15782.78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 168668.63 0 0 184451.41 0 0 0 1101468965 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 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provider--Adults (DHS/DDD) 200 Cook 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 0 176 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 176 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23659.8 0 0 0 0 0 0 0 0 0 0 0 0 0 23659.8 0 0 0 1101469027 25 Audiologists 852 Wisconsin 0 0 0 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 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 0 211.33 211.33 0 0 0 1101469028 1912109596 10 Physicians WECHSLER JOSHUA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 195 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 195 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2.48 0 13025.96 0 0 0 0 0 0 13028.44 0 0 0 1101469036 1568477172 10 Physicians DODWELL DAVID 627042173 91 Sangamon 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 1 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 254 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 254 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11556.64 0 0 0 0 0 0 11556.64 0 0 0 1101469070 1871743203 10 Physicians ALLEN NADINE 606123833 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10064.73 0 0 0 0 0 0 10064.73 0 0 0 1101469071 1134335821 47 Local Education Agencies MASSAC UNIT DISTRICT 1 629600530 69 Massac 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5896 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5896 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78841.08 0 78841.08 0 0 0 1101469092 92 Waiver service provider--Disability (DHS/DRS) 53 Kane 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 18167.25 0 0 0 0 0 0 0 0 0 0 0 0 0 18167.25 0 0 0 1101469094 1205123635 36 Community mental health provider SINNISSIPPI CENTERS INC 610814151 106 Whiteside 0 0 0 392 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 789 0 0 1175 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4808 0 0 1175 0 0 0 0 0 0 0 0 0 0 0 0 0 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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 28801.53 0 0 0 0 0 0 0 0 0 0 0 0 0 28801.53 0 0 0 1101469121 1922114115 36 Community mental health provider SINNISSIPPI CENTERS INC 610531469 17 Carroll 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 1713 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5956 0 0 1713 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5956 0 0 1439.64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 254110.54 0 0 255550.18 0 0 0 1101469137 1043250228 10 Physicians SACHDEVA SUDESH 600154936 200 Cook 0 0 Psychiatry 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 0 330 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 330 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7325.67 0 0 0 0 0 0 7325.67 0 0 0 1101469151 1245236298 10 Physicians PIMENTEL ROBERT 527221644 816 Iowa 0 0 Obstetric-Gynecology 0 0 0 0 2 0 0 0 0 0 0 7 0 137 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 7 0 492 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 7 0 492 0 0 0 0 0 0 0 0 0 18.16 0 0 0 0 0 0 347.46 0 40673.91 0 0 0 0 0 0 41039.53 0 0 0 1101469153 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0 0 0 0 0 0 3 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59.4 0 1287.81 0 0 0 0 0 0 1347.21 0 0 0 1101469215 1164585683 10 Physicians REAU NANCY 605275993 30 DuPage 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6209.52 0 0 0 0 0 0 6209.52 0 0 0 1101469219 1811053978 10 Physicians SANDESARA KALYAN 600251196 200 Cook 0 1 Pediatrics 0 2515 0 0 1889 0 0 0 0 0 0 850 0 1798 0 0 0 0 0 0 24056 0 0 8105 0 0 0 0 0 0 1556 0 4921 0 0 0 0 0 0 24056 0 0 8105 0 0 0 0 0 0 1556 0 4921 0 0 0 0 0 0 48113 0 0 238360.22 0 0 0 0 0 0 4632.17 0 175295.69 0 0 0 0 0 0 466401.08 0 0 0 1101469225 1619081668 10 Physicians SHELDAHL AMY 631101010 826 Missouri 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 959.76 0 0 0 0 0 0 959.76 0 0 0 1101469228 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Morgan 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 1157.35 0 0 0 0 0 0 0 0 0 0 0 0 0 1157.35 0 0 0 1101469498 1568579407 10 Physicians SOMMERVILLE DREW 477101721 815 Indiana 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 336 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 336 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33613.26 0 0 0 0 0 0 33613.26 0 0 0 1101469502 92 Waiver service provider--Disability (DHS/DRS) 25 Crawford 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 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 5621.86 0 0 0 0 0 0 0 0 0 0 0 0 0 5621.86 0 0 0 1101469516 92 Waiver service provider--Disability (DHS/DRS) 56 Knox 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 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 2784.9 0 0 0 0 0 0 0 0 0 0 0 0 0 2784.9 0 0 0 1101469525 1699972893 10 Physicians HUMPHREY 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101470248 1710993274 60 Pharmacies WALGREENS 10424 606471056 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 1010 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 3183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 73972 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14.06 0 0 153701.01 0 0 0 153715.07 0 0 0 1101470251 1194743815 10 Physicians WALLACE COLLEEN 631101002 826 Missouri 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1920.6 0 0 0 0 0 0 1920.6 0 0 0 1101470259 1689637639 10 Physicians DAGO PEDRO LUIS 606113092 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 211 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 391 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 391 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14258.33 0 0 0 0 0 0 14258.33 0 0 0 1101470261 55 Early Intervention Services 57 Lake 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 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1868.72 0 0 0 0 0 0 1868.72 0 0 0 1101470265 1295753952 14 Chiropractors LONDOS AARON 601103619 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 367 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 367 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2423.01 0 0 0 0 0 0 2423.01 0 0 0 1101470266 1033248208 10 Physicians MCCLYMONT NEIL C 946081826 826 Missouri 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 729 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 805 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 805 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23191.08 0 0 0 0 0 0 23191.08 0 0 0 1101470272 1285946673 10 Physicians NATHAN SUSAN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2386.02 0 0 0 0 0 0 2386.02 0 0 0 1101470277 1477819886 40 Federally Qualified Health Centers COMMUNITY HEALTH CARE 999999999 89 Rock Island 0 0 0 214 217 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1608 679 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1608 679 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5580 19268.91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24848.91 0 0 0 1101470299 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 9421.22 0 0 0 0 0 0 0 0 0 0 0 0 0 9421.22 0 0 0 1101470317 1144556853 47 Local Education Agencies MERCER COUNTY SCHOOL DIST 404 612312100 74 Mercer 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2391 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2391 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13263.33 0 13263.33 0 0 0 1101470326 92 Waiver service provider--Disability (DHS/DRS) 69 Massac 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 15153.94 0 0 0 0 0 0 0 0 0 0 0 0 0 15153.94 0 0 0 1101470331 98 Waiver service provider--TBI (DHS/DRS) 92 Schuyler 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 3386.25 0 0 0 0 0 0 0 0 0 0 0 0 0 3386.25 0 0 0 1101470338 1972527315 10 Physicians GIRARD SCOTT 600442203 57 Lake 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4430.98 0 0 0 0 0 0 4430.98 0 0 0 1101470346 1952355786 10 Physicians MATTINGLY JOHN 622262070 96 St Clair 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 5 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60.05 0 1324.82 0 0 0 0 0 0 1384.87 0 0 0 1101470355 1841469319 47 Local Education Agencies GENEVA CUSD 304 601341307 53 Kane 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 124 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 3314 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 3314 0 0 0 0 791.36 0 0 0 0 0 0 0 0 0 0 0 0 0 66066.14 0 66857.5 0 0 0 1101470357 1124099064 10 Physicians PATEL BIREN 604631256 200 Cook 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 2013 0 173 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3430 0 188 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3430 0 188 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91183.72 0 3369.78 0 0 0 0 0 0 94553.5 0 0 0 1101470360 1700807575 10 Physicians MUNIZ JAVIER 629483619 108 Williamson 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 1245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1995 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1995 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16233.37 0 0 0 0 0 0 16233.37 0 0 0 1101470371 1285740043 10 Physicians LIU BENJAMIN 606118709 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 388 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 506 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 506 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20052.51 0 0 0 0 0 0 0 0 20052.51 0 0 0 1101470376 1013991868 10 Physicians MCINTOSH MARCY 601975594 30 DuPage 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 821 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1477 0 169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1477 0 169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17217.97 0 1671.58 0 0 0 0 0 0 18889.55 0 0 0 1101470386 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 237 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 237 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18653.21 0 0 0 0 0 0 0 0 0 0 0 0 0 18653.21 0 0 0 1101470387 98 Waiver service provider--TBI (DHS/DRS) 80 Peoria 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7318.86 0 0 0 0 0 0 0 0 0 0 0 0 0 7318.86 0 0 0 1101470405 1477754430 47 Local Education Agencies ELEMENTARY SCHOOL DIST 159 604431058 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 456 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7269 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7269 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120837.23 0 120837.23 0 0 0 1101470419 1568550499 10 Physicians RAVIV STACY 602011718 200 Cook 0 0 Pulmonary Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 240 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 240 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4822.25 0 0 0 0 0 0 4822.25 0 0 0 1101470441 1306855481 10 Physicians FALOUJI FANAN 600154868 57 Lake 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 568 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 568 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3585.74 0 0 0 0 0 0 3585.74 0 0 0 1101470444 1871592378 10 Physicians PRUSEK DOROTHY 601262321 30 DuPage 0 1 Internal Medicine 0 7 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 112 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 112 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 1388.03 0 0 0 0 0 0 1463.03 0 0 0 1101470455 10 Physicians 826 Missouri 0 0 Neonatology 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 324.88 0 0 0 0 0 0 324.88 0 0 0 1101470463 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 21067.75 0 0 0 0 0 0 0 0 0 0 0 0 0 21067.75 0 0 0 1101470465 50 Home Health Agencies - In Home 200 Cook 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 144 0 0 0 0 0 0 144 0 0 0 1101470466 92 Waiver service provider--Disability (DHS/DRS) 92 Schuyler 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 8381.59 0 0 0 0 0 0 0 0 0 0 0 0 0 8381.59 0 0 0 1101470469 94 Waiver service provider--Children's support (DHS/DDD) 98 Tazewell 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 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2160.54 0 0 0 0 0 0 0 0 0 0 0 0 0 2160.54 0 0 0 1101470474 1275707127 29 ICF/MR BENJAMIN GREEN FIELD RESIDENCE 600480520 57 Lake 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 0 275 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7330 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 655925.25 0 0 0 0 0 0 0 0 0 0 655925.25 0 0 0 1101470477 55 Early Intervention Services 107 Will 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 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2234.92 0 0 0 0 0 0 2234.92 0 0 0 1101470495 1114023512 30 General Hospitals THE WOMENS HOSPITAL 476308940 815 Indiana NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 46 0 0 0 0 91 0 0 4 46 0 0 0 0 0 0 0 0 0 80 0 0 0 0 92 0 0 4 123 0 0 0 0 0 0 0 0 0 80 0 0 0 0 409 0 0 4 123 0 0 0 0 0 0 0 0 0 19465.5 0 0 0 0 254803.01 0 0 8296.12 31740.77 0 0 0 0 0 314305.4 0 0 0 1101470499 1376579722 10 Physicians NEWSOME EDITH 611112754 109 Winnebago 0 0 Anesthesiology 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 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2004.95 0 0 0 0 0 0 2004.95 0 0 0 1101470501 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6584.97 0 0 0 0 0 0 0 0 0 0 0 0 0 6584.97 0 0 0 1101470502 1033316567 63 Other Providers of Medical Equipment/Supplies (Non-registered) ORSINI HOME MEDICAL EQUIPMENT 600072516 200 Cook 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 0 171 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 171 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8861.23 0 0 0 0 0 0 8861.23 0 0 0 1101470505 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 660 0 0 0 0 0 0 0 0 0 0 0 0 0 660 0 0 0 1101470509 1932204286 16 Nurse Practitioners DUKE REBECCA 606118709 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 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 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 279.13 0 0 0 0 0 0 279.13 0 0 0 1101470518 1689748667 10 Physicians BRUNEAU KIMBERLY 604405125 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 4 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 233.09 0 14229.71 0 0 0 0 0 0 14462.8 0 0 0 1101470528 1952326019 10 Physicians ELAHI SEEMA 606591283 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 534 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 632 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 632 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15354.92 0 0 0 0 0 0 15354.92 0 0 0 1101470547 1669687307 10 Physicians WALLACE JAMES 605276686 30 DuPage 0 0 Oncology 0 0 0 0 0 0 0 0 0 0 0 6 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 557 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 557 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81.28 0 7139.23 0 0 0 0 0 0 7220.51 0 0 0 1101470569 1992775340 10 Physicians ANDREWS JOHN 606118709 200 Cook 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5464.2 0 0 0 0 0 0 5464.2 0 0 0 1101470575 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12014.27 0 0 0 0 0 0 0 0 0 0 0 0 0 12014.27 0 0 0 1101470586 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 364 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 364 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23558.7 0 0 0 0 0 0 0 0 0 0 0 0 0 23558.7 0 0 0 1101470593 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 16318.71 0 0 0 0 0 0 0 0 0 0 0 0 0 16318.71 0 0 0 1101470610 1164442703 10 Physicians WONG WAYNE 601265658 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 307 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 307 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3441.14 0 0 0 0 0 0 3441.14 0 0 0 1101470634 1790013027 16 Nurse Practitioners GALAMBOS TARA 463123049 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50.35 0 0 0 0 0 0 50.35 0 0 0 1101470638 91 Waiver service provider--Adults (DHS/DDD) 10 Adams 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 0 349 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 349 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23916.96 0 0 0 0 0 0 0 0 0 0 0 0 0 23916.96 0 0 0 1101470645 1447413919 10 Physicians MOHIUDDIN GHOUSE 600052349 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 153 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 604 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 604 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21383.28 0 0 0 0 0 0 21383.28 0 0 0 1101470656 1003015355 70 Ambulance Service Providers MURRAYVILLE WOODSON EAS 626688022 77 Morgan 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 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2123.75 0 0 0 0 0 0 2123.75 0 0 0 1101470671 1750692612 22 Physical Therapists OROURKE LAUREN 600681143 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1373.43 1373.43 0 0 0 1101470676 1356320253 10 Physicians MYERS CLIFFORD 616145021 80 Peoria 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 1 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2.31 0 1595.25 0 0 0 0 0 0 1597.56 0 0 0 1101470678 1720023732 60 Pharmacies SCHNUCKS PHARMACY 146 620024856 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 241 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 294.37 0 0 0 1101471674 1285649012 10 Physicians OKAFOR LAWRENCE 604732003 200 Cook 0 1 Internal Medicine 0 10 0 0 0 0 0 0 0 0 0 5 0 75 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 5 0 101 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 5 0 101 0 0 0 0 0 0 201 0 0 0 0 0 0 0 0 0 23.95 0 3526.66 0 0 0 0 0 0 3751.61 0 0 0 1101471675 1851510770 10 Physicians DERHAMMER NATHAN 601533328 200 Cook 0 1 Pediatrics 0 311 0 0 166 0 0 0 0 0 0 0 0 241 0 0 0 0 0 0 2593 0 0 314 0 0 0 0 0 0 0 0 423 0 0 0 0 0 0 2593 0 0 314 0 0 0 0 0 0 0 0 423 0 0 0 0 0 0 5620 0 0 16341.92 0 0 0 0 0 0 0 0 16548.12 0 0 0 0 0 0 38510.04 0 0 0 1101471685 10 Physicians 836 Ohio 0 0 Pediatrics 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68.84 0 0 0 0 0 0 68.84 0 0 0 1101471689 30 General Hospitals 823 Michigan NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 1593.77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1593.77 0 0 0 1101471693 92 Waiver service provider--Disability (DHS/DRS) 81 Perry 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1081.35 0 0 0 0 0 0 0 0 0 0 0 0 0 1081.35 0 0 0 1101471729 1871540443 10 Physicians MANGAHAS EDMUND 606123833 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 233 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 287 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 287 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39648.19 0 0 0 0 0 0 39648.19 0 0 0 1101471738 92 Waiver service provider--Disability (DHS/DRS) 71 McHenry 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 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26011.47 0 0 0 0 0 0 0 0 0 0 0 0 0 26011.47 0 0 0 1101471743 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6986.19 0 0 0 0 0 0 0 0 0 0 0 0 0 6986.19 0 0 0 1101471744 1346287521 10 Physicians GOLDSTEIN RACHEL 600852161 57 Lake 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 818 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 878 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 878 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32820.03 0 0 0 0 0 0 32820.03 0 0 0 1101471752 1184794281 10 Physicians JANKELOWITZ LARRY 606313716 57 Lake 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 248 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 802 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 802 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11980.56 0 0 0 0 0 0 11980.56 0 0 0 1101471754 98 Waiver service provider--TBI (DHS/DRS) 80 Peoria 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 27323.29 0 0 0 0 0 0 0 0 0 0 0 0 0 27323.29 0 0 0 1101471760 1861620874 11 Dentists GRINDLING KYLE 606122228 200 Cook 0 0 General Dentistry 0 0 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 589 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 589 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20179.29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20179.29 0 0 0 1101471768 91 Waiver service provider--Adults (DHS/DDD) 57 Lake 0 0 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59839 0 0 0 0 0 0 0 0 0 0 0 0 0 59839 0 0 0 1101471772 1790788578 30 General Hospitals MASSAC MEMORIAL HOSPITAL 629600850 69 Massac DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 1 0 0 0 0 0 29 0 0 0 0 0 0 1397 0 0 657 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 7639 0 0 2322 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 7639 0 0 2322 0 0 0 0 0 0 0 0 514.4 0 0 0 0 0 0 61865.78 0 0 248565.62 0 0 0 0 0 310945.8 0 0 0 1101471773 91 Waiver service provider--Adults (DHS/DDD) 57 Lake 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 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20636 0 0 0 0 0 0 0 0 0 0 0 0 0 20636 0 0 0 1101471778 1346405941 33 Nursing Facilities GIBSON COMMUNITY HOSPITAL ANNE 609362002 35 Ford 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 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1818 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 169680.4 0 0 0 0 0 0 0 169680.4 0 0 0 1101471785 1922179175 10 Physicians KIRK MICHAEL 622981568 75 Monroe 0 1 Family Practice 0 199 0 0 30 0 0 0 0 0 0 31 0 233 0 0 0 0 0 0 1856 0 0 41 0 0 0 0 0 0 36 0 390 0 0 0 0 0 0 1856 0 0 41 0 0 0 0 0 0 36 0 390 0 0 0 0 0 0 4526 0 0 2621.7 0 0 0 0 0 0 287.32 0 19191.03 0 0 0 0 0 0 26626.05 0 0 0 1101471798 1700046869 10 Physicians LOTH ANNEMARIE 631102515 826 Missouri 0 0 Psychiatry 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 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2430.59 0 0 0 0 0 0 2430.59 0 0 0 1101471809 1427019934 10 Physicians MEHTA AJAY 601202125 53 Kane 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 995 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1358 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1358 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24295.68 0 1922 0 0 0 0 0 0 26217.68 0 0 0 1101471819 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17115 0 0 0 0 0 0 0 0 0 0 0 0 0 17115 0 0 0 1101471823 1619017431 11 Dentists CHUY MARGARITA 607121027 200 Cook 0 0 General Dentistry 0 0 0 12 0 0 0 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 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1445.65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1445.65 0 0 0 1101471825 1235170960 16 Nurse Practitioners FLANDERS ROBYN 606751611 200 Cook 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 19 0 0 0 0 0 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 0 514.08 0 0 0 0 0 0 514.08 0 0 0 1101471832 1871584946 10 Physicians PATEL GAURANG 625264163 63 Macon 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 317 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 317 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4912.46 0 0 0 0 0 0 4912.46 0 0 0 1101471836 10 Physicians 57 Lake 0 0 Obstetric-Gynecology 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 129.04 0 0 0 0 0 0 129.04 0 0 0 1101471841 1285616300 10 Physicians MEREL NINA 600761260 200 Cook 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 310.01 0 0 0 0 0 0 310.01 0 0 0 1101471842 36 Community mental health provider 200 Cook 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 66.6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5634.04 0 0 5700.64 0 0 0 1101471851 2100462269 71 Medicar Provider S AND T GROUP OF ILLINOIS INC 601364046 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19828 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19828 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130141.94 0 0 0 0 0 0 130141.94 0 0 0 1101471852 1619966645 12 Optometrists ALBINA NAJIB 604592293 200 Cook 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 1274 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2573 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2573 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63600.07 0 3132.64 0 0 0 0 66732.71 0 0 0 1101471863 1043348584 34 State-operated facility (DHS) UNIT 3267 HOME 17 KILEY 600856263 57 Lake 0 0 0 0 0 0 0 0 0 0 0 6 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 0 0 0 0 0 0 0 0 540 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 408583.11 0 0 0 0 0 0 0 0 0 0 408583.11 0 0 0 1101471871 1992933923 10 Physicians WELLS TABATHA 627949670 91 Sangamon 0 0 Emergency Medicine 0 0 0 0 4 0 0 0 0 0 0 2 0 25 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 2 0 30 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 2 0 30 0 0 0 0 0 0 0 0 0 64.35 0 0 0 0 0 0 46.23 0 10158.7 0 0 0 0 0 0 10269.28 0 0 0 1101471881 1730289273 10 Physicians AVINASHI AALOK 606228151 200 Cook 0 0 Neonatal-Perinatal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 344 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 344 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37554.5 0 0 0 0 0 0 37554.5 0 0 0 1101471904 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4758.8 0 0 0 0 0 0 0 0 0 0 0 0 0 4758.8 0 0 0 1101471907 1982624698 63 Other Providers of Medical Equipment/Supplies (Non-registered) SAINT FRANCIS HOME MED EQUIP 637035049 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 283 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 283 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10538.17 0 0 0 0 0 0 10538.17 0 0 0 1101471920 1134177728 10 Physicians KANNEL PHILIP 620024569 65 Madison 0 0 Otorhinolaryngology 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 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1727.68 0 0 0 0 0 0 1727.68 0 0 0 1101471921 1821257833 10 Physicians DASMUNSHI NEHA 601533328 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 3 0 148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36.06 0 29957.16 0 0 0 0 0 0 29993.22 0 0 0 1101471923 2100462341 90 Waiver service provider--Elderly (DOA) THE GOLDEN YEARS ADULT SUPPORT 622265543 96 St Clair 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2211 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2211 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105824.93 0 0 0 0 0 0 0 0 0 0 0 0 0 105824.93 0 0 0 1101471930 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 24739.76 0 0 0 0 0 0 0 0 0 0 0 0 0 24739.76 0 0 0 1101471937 92 Waiver service provider--Disability (DHS/DRS) 68 Mason 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 664 0 0 0 0 0 0 0 0 0 0 0 0 0 664 0 0 0 1101471967 1205803483 10 Physicians NEALE PETER 604732274 200 Cook 0 1 Family Practice 0 0 0 0 1 0 0 0 0 0 0 1 0 92 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 330 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 330 0 0 0 0 0 0 0 0 0 84.62 0 0 0 0 0 0 2.6 0 1406.73 0 0 0 0 0 0 1493.95 0 0 0 1101471978 1811131527 10 Physicians DENHAM DAPHNE 600621453 200 Cook 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4.05 0 0 0 0 0 0 4.05 0 0 0 1101471983 1700084548 10 Physicians ESTRADA JOHN 606154906 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47865.48 0 0 0 0 0 0 47865.48 0 0 0 1101472000 2100462418 71 Medicar Provider NOKOMIS REHAB HLTH CARE CTR 620751442 76 Montgomery 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1058 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1058 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14986.87 0 0 0 0 0 0 14986.87 0 0 0 1101472003 1427255777 28 Waiver service provider--Supportive living facility (HFS) ASBURY COURT RETIREMENT COMMU 600181862 200 Cook 0 0 0 0 0 0 0 0 174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1461 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36339 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2311774.25 0 0 0 0 0 0 0 0 0 0 0 0 0 2311774.25 0 0 0 1101472009 1750322624 60 Pharmacies CVS PHARMACY 08732 606474056 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 629 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68731 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 92170.69 0 0 0 92170.69 0 0 0 1101472017 92 Waiver service provider--Disability (DHS/DRS) 96 St Clair 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 9504.93 0 0 0 0 0 0 0 0 0 0 0 0 0 9504.93 0 0 0 1101472018 1225077837 10 Physicians CROWLEY BRIAN 609013675 54 Kankakee 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 395 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 441 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 441 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14811.2 0 0 0 0 0 0 14811.2 0 0 0 1101472046 1780636720 10 Physicians PAPAZIAN KATHLEEN 605231956 30 DuPage 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 912 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1022 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1022 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46797.21 0 0 0 0 0 0 46797.21 0 0 0 1101472065 1255508768 10 Physicians SYMANSKI RICHARD 604501463 40 Grundy 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 1670 0 329 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2637 0 625 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2637 0 625 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71208.98 0 11642.54 0 0 0 0 0 0 82851.52 0 0 0 1101472067 1669497921 10 Physicians PITZELE HENRY 606777007 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 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 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2347.77 0 0 0 0 0 0 2347.77 0 0 0 1101472069 92 Waiver service provider--Disability (DHS/DRS) 107 Will 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5630.91 0 0 0 0 0 0 0 0 0 0 0 0 0 5630.91 0 0 0 1101472085 1922375864 16 Nurse Practitioners LINDSAY MEGHAN 606123833 200 Cook 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 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1106.33 0 0 0 0 0 0 1106.33 0 0 0 1101472097 1083623425 10 Physicians CLAVIER ALEJANDRO 606292504 200 Cook 0 1 Pediatrics 0 0 0 0 153 0 0 0 0 0 0 0 0 144 0 0 0 0 0 0 0 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HOCKETT DAVID 601375783 30 DuPage 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 236 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 248 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 248 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8582.15 0 0 0 0 0 0 8582.15 0 0 0 1101472135 1124163845 25 Audiologists OCONNER CATHLEEN 605044512 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4666.14 4666.14 0 0 0 1101472142 92 Waiver service provider--Disability (DHS/DRS) 45 Henry 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 9176.19 0 0 0 0 0 0 0 0 0 0 0 0 0 9176.19 0 0 0 1101472143 1023258944 60 Pharmacies WAL MART PHARMACY 10 4641 601429634 71 McHenry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 173 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 687 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17517 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35213.13 0 0 0 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1199 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18668.78 0 1229.99 0 0 0 0 0 0 19898.77 0 0 0 1101473171 1871673491 10 Physicians TISSIER BRADLEY 622691953 96 St Clair 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 17 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1032.98 0 15937.29 0 0 0 0 0 0 16970.27 0 0 0 1101473182 1386608099 10 Physicians LAVAVEJ SRIPEN 613562538 15 Bureau 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 1 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2.58 0 773.34 0 0 0 0 0 0 775.92 0 0 0 1101473183 1154443539 24 Speech Therapists HERMANSON ELIZABETH 604513153 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14185.48 14185.48 0 0 0 1101473208 1699880567 10 Physicians GUREVICIUS JUOZAS 601262966 30 DuPage 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6661.48 0 0 0 0 0 0 6661.48 0 0 0 1101473218 1750303335 10 Physicians ENGELS JOHN 631463119 826 Missouri 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 10 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 381.34 0 0 0 0 0 0 0 0 381.34 0 0 0 1101473219 1194705442 10 Physicians FAIDLEY CHERYL 612656866 89 Rock Island 0 0 Obstetric-Gynecology 0 0 0 0 2 0 0 0 0 0 0 17 0 56 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 25 0 92 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 25 0 92 0 0 0 0 0 0 0 0 0 209.92 0 0 0 0 0 0 596.62 0 6858.05 0 0 0 0 0 0 7664.59 0 0 0 1101473235 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 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 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 1604.18 0 0 0 0 0 0 0 0 0 0 0 0 0 1604.18 0 0 0 1101473240 1649331711 60 Pharmacies BASINGER'S PRIMARY CARE PHARMA 604363172 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 325 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1789 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46980 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54170 0 0 0 54170 0 0 0 1101473241 1184683138 30 General Hospitals LITCHFIELD DIALYSIS 620561775 76 Montgomery DIALYSIS Outpatient dialysis centers. 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 256 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2425 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63348.63 0 0 0 0 0 63348.63 0 0 0 1101473258 92 Waiver service provider--Disability (DHS/DRS) 63 Macon 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 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 2721.66 0 0 0 0 0 0 0 0 0 0 0 0 0 2721.66 0 0 0 1101473260 1710964663 10 Physicians ESPIRITU BALTAZAR 601533304 200 Cook 0 0 Allergy-Immunization 0 0 0 0 0 0 0 0 0 0 0 0 0 205 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 324 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 324 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27190.1 0 0 0 0 0 0 27190.1 0 0 0 1101473277 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15234.55 0 0 0 0 0 0 0 0 0 0 0 0 0 15234.55 0 0 0 1101473280 1063691830 10 Physicians KASSAR MOHAMAD 463212905 815 Indiana 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 2 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 348 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 348 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27.27 0 1867.36 0 0 0 0 0 0 1894.63 0 0 0 1101473293 1780691972 24 Speech Therapists NARLOCK MARCELLA 527323953 816 Iowa 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5277.15 5277.15 0 0 0 1101473321 14 Chiropractors 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 224.09 0 82.35 0 0 0 0 0 0 306.44 0 0 0 1101473348 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 17025.29 0 0 0 0 0 0 0 0 0 0 0 0 0 17025.29 0 0 0 1101473361 1235154659 10 Physicians SILVA EUGENE 601783192 27 Dekalb 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 1 0 209 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 403 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 403 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11.46 0 3462.1 0 0 0 0 0 0 3473.56 0 0 0 1101473364 1366651192 10 Physicians BRINKMAN MIKALA 616147300 80 Peoria 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 1546 0 178 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2011 0 258 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2011 0 258 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44832.76 0 3766.04 0 0 0 0 0 0 48598.8 0 0 0 1101473367 34 State-operated facility (DHS) 57 Lake 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 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 270 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 202419.95 0 0 0 0 0 0 0 0 0 0 202419.95 0 0 0 1101473380 1649265133 13 Podiatrists SCHERER MICHAEL 614012897 56 Knox 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 294 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 944 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 944 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6693.26 0 0 0 0 0 0 6693.26 0 0 0 1101473381 10 Physicians 852 Wisconsin 0 0 Internal Medicine 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 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 0 100.1 0 0 0 0 0 0 100.1 0 0 0 1101473388 1285734665 10 Physicians MARSCHKE MICHAEL 602011718 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2182.58 0 0 0 0 0 0 2182.58 0 0 0 1101473393 1386779460 60 Pharmacies CALIGOR RX INC 100281406 833 New York 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 0 128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4715 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108310 0 0 0 108310 0 0 0 1101473407 10 Physicians 200 Cook 0 1 Family Practice 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51.35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51.35 0 0 0 1101473412 1962435677 10 Physicians SATO KENT 606118709 200 Cook 0 0 Radiology Therapeutic 0 0 0 0 0 0 0 0 0 0 0 58 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 246 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 246 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 408.15 0 13387.99 0 0 0 0 0 0 13796.14 0 0 0 1101473413 1144437815 16 Nurse Practitioners JACKSON RUTH 627949639 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8659.32 0 0 0 0 0 0 8659.32 0 0 0 1101473420 1780938746 36 Community mental health provider ONARGA ACADEMY 999999999 46 Iroquois 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 491 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6310 0 0 491 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6310 0 0 16570.37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 332779.04 0 0 349349.41 0 0 0 1101473422 1740267756 10 Physicians MEDINA HELIODORO 601344205 53 Kane 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 236 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 236 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13008.04 0 0 0 0 0 0 13008.04 0 0 0 1101473438 1225074727 10 Physicians GUITART JOAN 606118709 200 Cook 0 0 Dermatopathology 0 0 0 0 0 0 0 0 0 0 0 189 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 255 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 255 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4455.22 0 371.2 0 0 0 0 0 0 4826.42 0 0 0 1101473442 1962599829 10 Physicians JALAL SAIMA 601756515 53 Kane 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1301.13 0 0 0 0 0 0 1301.13 0 0 0 1101473445 1184705931 30 General Hospitals VALLEY WEST COMMUNITY HOSPITAL 605482587 27 Dekalb DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 1 0 General Hospital - Adult and Child 0 0 0 0 0 1962 0 0 0 0 241 0 0 2 784 0 0 0 0 0 0 0 0 0 3188 0 0 0 0 257 0 0 2 1294 0 0 0 0 0 0 0 0 0 3218 0 0 0 0 560 0 0 2 1539 0 0 0 0 0 0 0 0 0 1445795.64 0 0 0 0 387741.07 0 0 6228.25 1045696.67 0 0 0 0 0 2885461.63 0 0 0 1101473447 1770654808 11 Dentists HIRSH RANDALL 604263483 200 Cook 0 0 General Dentistry 0 0 0 20 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 0 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1939.37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1939.37 0 0 0 1101473455 1275853970 36 Community mental health provider LSSI OF ILLINOIS 612017187 89 Rock Island 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 210 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 210 0 0 165.81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13347.15 0 0 13512.96 0 0 0 1101473463 1184631715 10 Physicians EVANS WAYNE 601533328 200 Cook 0 0 Maternal and Fetal Medicine 0 0 0 0 0 0 0 0 0 0 0 413 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 672 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 672 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18639.64 0 1275.2 0 0 0 0 0 0 19914.84 0 0 0 1101473472 1639373228 10 Physicians THAMPI BETSY 601691065 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1660.11 0 0 0 0 0 0 1660.11 0 0 0 1101473486 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 13622.96 0 0 0 0 0 0 0 0 0 0 0 0 0 13622.96 0 0 0 1101473494 1003187030 60 Pharmacies WALGREENS 15004 606132923 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 660 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 2814 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 68689 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 245.97 0 0 170631.56 0 0 0 170877.53 0 0 0 1101473495 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7432.71 0 0 0 0 0 0 0 0 0 0 0 0 0 7432.71 0 0 0 1101473498 92 Waiver service provider--Disability (DHS/DRS) 815 Indiana 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 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 3711.21 0 0 0 0 0 0 0 0 0 0 0 0 0 3711.21 0 0 0 1101473500 16 Nurse Practitioners 816 Iowa 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 245.6 0 0 0 0 0 0 245.6 0 0 0 1101473501 1194755843 10 Physicians HEREDIA ELIZABETH 601871037 30 DuPage 0 1 Facial Plastic Surgery 0 37 0 0 16 0 0 0 0 0 0 3 0 21 0 0 0 0 0 0 268 0 0 75 0 0 0 0 0 0 10 0 36 0 0 0 0 0 0 268 0 0 75 0 0 0 0 0 0 10 0 36 0 0 0 0 0 0 644 0 0 2458.79 0 0 0 0 0 0 47.11 0 1527.12 0 0 0 0 0 0 4677.02 0 0 0 1101473522 1962418079 11 Dentists HAUG KIMBERLY D 620025657 65 Madison 0 0 General Dentistry 0 0 0 384 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 850 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 850 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 210145.3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 210145.3 0 0 0 1101473537 1881729465 24 Speech Therapists SCHAAKE PATRICE 620024427 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 312 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 312 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23318.2 23318.2 0 0 0 1101473538 1578653994 10 Physicians GUERRA RAFAEL PEREZ 604033155 107 Will 0 1 General Practice 0 57 0 0 2 0 0 0 0 0 0 0 0 146 0 0 0 0 0 0 263 0 0 3 0 0 0 0 0 0 0 0 316 0 0 0 0 0 0 263 0 0 3 0 0 0 0 0 0 0 0 316 0 0 0 0 0 0 746 0 0 260.89 0 0 0 0 0 0 0 0 14212.07 0 0 0 0 0 0 15218.96 0 0 0 1101473541 94 Waiver service provider--Children's support (DHS/DDD) 30 DuPage 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1790.2 0 0 0 0 0 0 0 0 0 0 0 0 0 1790.2 0 0 0 1101473554 16 Nurse Practitioners 25 Crawford 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61.4 0 0 0 0 0 0 61.4 0 0 0 1101473557 1770578304 10 Physicians BALABANOVA ANTOANETA 600073362 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 221 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 460 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 460 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11818.14 0 0 0 0 0 0 11818.14 0 0 0 1101473575 1174581482 10 Physicians GAMBLA JENNIFER 604624683 200 Cook 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 1 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60.1 0 1671.03 0 0 0 0 0 0 1731.13 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 393 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 393 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8279.7 0 8279.7 0 0 0 1101473782 92 Waiver service provider--Disability (DHS/DRS) 98 Tazewell 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 29 0 0 0 0 0 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 13296.45 0 0 0 0 0 0 0 0 0 0 0 0 0 13296.45 0 0 0 1101473790 1306851084 10 Physicians GHIDEY YOHANNES 622072328 96 St Clair 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2984.33 0 0 0 0 0 0 2984.33 0 0 0 1101473797 1174779789 10 Physicians QUATTROMANI ERIN 631102539 826 Missouri 0 0 Emergency Medicine 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 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 905.64 0 0 0 0 0 0 905.64 0 0 0 1101473803 93 Waiver service 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1417974049 10 Physicians GARWOOD SARAH 631101002 826 Missouri 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 8 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 0 581.17 0 0 0 0 0 0 581.17 0 0 0 1101473849 1871590422 10 Physicians REBSAMEN SUSAN 535625531 852 Wisconsin 0 0 Radiology Diagnosis 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 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2202.14 0 0 0 0 0 0 0 0 2202.14 0 0 0 1101473852 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 14 0 0 0 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 12062.99 0 0 0 0 0 0 0 0 0 0 0 0 0 12062.99 0 0 0 1101473858 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 351 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 351 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11341.75 0 0 0 0 0 0 0 0 0 0 0 0 0 11341.75 0 0 0 1101473859 62 Opticians / Optical Companies 22 Clay 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 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 85.8 0 0 0 0 85.8 0 0 0 1101473860 1588673628 30 General Hospitals MEMORIAL MEDICAL CENTER 600987509 71 McHenry DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 0 4 73 0 0 1907 0 0 0 0 405 0 0 0 844 0 0 0 0 0 4 113 0 0 2789 0 0 0 0 482 0 0 0 2122 0 0 0 0 0 12 397 0 0 2789 0 0 0 0 2283 0 0 0 2128 0 0 0 0 0 0 27039.03 0 0 433659.88 0 0 0 0 728332.25 0 0 0 190561.56 0 0 0 0 0 1379592.72 0 0 0 1101473867 1366459562 10 Physicians VIDANOVIC VLADIMIR 606124356 200 Cook 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4767.33 0 0 0 0 0 0 4767.33 0 0 0 1101473870 98 Waiver service provider--TBI 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Physicians ZAKIEH NASSER 604536459 200 Cook 0 0 Pulmonary Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 296 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 737 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 737 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11984.6 0 0 0 0 0 0 11984.6 0 0 0 1101473911 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 14590.38 0 0 0 0 0 0 0 0 0 0 0 0 0 14590.38 0 0 0 1101473914 1669413522 10 Physicians SNEDEGAR CLINTON 999999999 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 207 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 316 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 316 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18533.01 0 0 0 0 0 0 18533.01 0 0 0 1101473917 92 Waiver service provider--Disability (DHS/DRS) 98 Tazewell 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 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 2931.85 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11075.75 11075.75 0 0 0 1101474566 1851408728 10 Physicians BONTHIUS DANIEL JOSEPH 522421009 816 Iowa 0 0 Child Neurology 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 867.6 0 0 0 0 0 0 867.6 0 0 0 1101474570 1073621736 47 Local Education Agencies VERMILION ASSOC OF SPEC EDUC 618345176 100 Vermilion 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 342 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6331 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6331 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56997.02 0 56997.02 0 0 0 1101474576 1801099098 47 Local Education Agencies CALHOUN COMM UNIT SCH DIST 40 620470387 16 Calhoun 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 738 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 738 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10621.29 0 10621.29 0 0 0 1101474590 92 Waiver service provider--Disability 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General 0 0 0 0 0 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 274 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 274 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19294.3 0 0 0 0 0 0 19294.3 0 0 0 1101474932 1366649162 12 Optometrists BARNES RYAN 606311567 200 Cook 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 1614 0 484 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2018 0 484 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2018 0 484 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2968.66 0 13469.57 0 0 0 0 16438.23 0 0 0 1101474941 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 305 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 305 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17358 0 0 0 0 0 0 0 0 0 0 0 0 0 17358 0 0 0 1101474950 1326071887 10 Physicians LORET DE MOLA JULIO 627949639 91 Sangamon 0 0 Reproductive Endocrinology 0 0 0 0 0 0 0 0 0 0 0 13 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2773.15 0 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0 0 0 0 0 0 0 0 0 0 0 8826.95 0 0 0 1101474981 1275550105 33 Nursing Facilities REGENCY CARE OF STERLING 610819040 106 Whiteside 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 0 684 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16796 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1475529.02 0 0 0 0 0 0 0 1475529.02 0 0 0 1101475005 1447204375 33 Nursing Facilities ILLINI RESTORATIVE CARE 612821834 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 226 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6303 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 597683.93 0 0 0 0 0 0 0 597683.93 0 0 0 1101475006 1255694568 16 Nurse Practitioners WYDRA MARGUERITE 606751611 30 DuPage 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 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5076.06 0 0 0 0 0 0 5076.06 0 0 0 1101475007 1922054691 60 Pharmacies OSCO DRUG 3268 601072948 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 1118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 30061 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72.97 0 0 32942.08 0 0 0 33015.05 0 0 0 1101475015 1477583532 10 Physicians GANJU SHIBAN 604301145 24 Coles 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 242 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 242 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2244.56 0 0 0 0 0 0 2244.56 0 0 0 1101475028 1821103821 36 Community mental health provider TRILOGY INC 606262805 200 Cook 0 0 0 869 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1174 0 0 12620 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71709 0 0 12620 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71709 0 0 658941.46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5566417.78 0 0 6225359.24 0 0 0 1101475030 1841300464 10 Physicians BIESTER ELAINE 601301543 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 414.51 0 0 0 0 0 0 414.51 0 0 0 1101475031 1700973435 10 Physicians MOORE DUANE 631101010 826 Missouri 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1621.7 0 0 0 0 0 0 1621.7 0 0 0 1101475035 1871540237 30 General Hospitals MIAMI CHILDRENS HOSPITAL 331553009 810 Florida NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 Children's Hospital 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 666.13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 666.13 0 0 0 1101475041 1588650386 10 Physicians ABBAS MOHAMMED 463836914 815 Indiana 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 125 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1798.65 0 32.31 0 0 0 0 0 0 1830.96 0 0 0 1101475049 1972504751 10 Physicians PANIO PASCHAL 604301411 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 2 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18.3 0 4356.24 0 0 0 0 0 0 4374.54 0 0 0 1101475078 1629021977 10 Physicians RON JENNIFER 605595573 30 DuPage 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 736 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 794 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 794 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28642.65 0 0 0 0 0 0 28642.65 0 0 0 1101475082 1811153786 10 Physicians JANOWIAK CHRISTINE 606143363 200 Cook 0 0 Pediatrics 0 0 0 0 8 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 812.83 0 0 0 0 0 0 0 0 492.89 0 0 0 0 0 0 1305.72 0 0 0 1101475094 1417056540 60 Pharmacies PHARMORE DRUGS LLC 600764012 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4009 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52427 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1072802 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1687581.54 0 0 0 1687581.54 0 0 0 1101475095 92 Waiver service provider--Disability (DHS/DRS) 11 Alexander 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 15234.13 0 0 0 0 0 0 0 0 0 0 0 0 0 15234.13 0 0 0 1101475101 1689875643 47 Local Education Agencies BREMEN CHSD DIST 228 604453755 200 Cook 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 600 0 0 0 0 261 0 0 0 0 0 0 0 0 0 0 0 0 0 6046 0 0 0 0 261 0 0 0 0 0 0 0 0 0 0 0 0 0 6046 0 0 0 0 1579.3 0 0 0 0 0 0 0 0 0 0 0 0 0 137837.24 0 139416.54 0 0 0 1101475104 1447276274 10 Physicians PUYO CARLOS 631101010 826 Missouri 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9675.63 0 0 0 0 0 0 9675.63 0 0 0 1101475110 1245426980 10 Physicians BARKATULLAH SAMEER 604404302 107 Will 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 396 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 396 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12157.27 0 0 0 0 0 0 12157.27 0 0 0 1101475119 1730320490 24 Speech Therapists REINA BETH 604513736 107 Will 0 0 0 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 0 209 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 209 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15184.21 15184.21 0 0 0 1101475124 94 Waiver service provider--Children's support (DHS/DDD) 97 Stephenson 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 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9009 0 0 0 0 0 0 0 0 0 0 0 0 0 9009 0 0 0 1101475128 1811978471 11 Dentists ROMO GENARO 606321825 200 Cook 0 0 General Dentistry 0 0 0 762 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3490 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3490 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 142365.57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 142365.57 0 0 0 1101475132 1205148806 12 Optometrists CONDIE JESSICA 606164201 200 Cook 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 324 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 736 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 736 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14157.45 0 0 0 0 0 0 14157.45 0 0 0 1101475136 1689739781 10 Physicians LEKOVIC MARKO 604532699 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 5 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 467.33 0 34426.63 0 0 0 0 0 0 34893.96 0 0 0 1101475142 1427301308 30 General Hospitals GENESIS MEDICAL CENTER ALEDO 999999999 74 Mercer DIALYSIS Outpatient dialysis centers. 0 0 0 0 0 0 22 0 0 0 0 0 0 457 0 0 422 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 2778 0 0 730 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 2778 0 0 730 0 0 0 0 0 0 0 0 109.63 0 0 0 0 0 0 14283.22 0 0 44007.02 0 0 0 0 0 58399.87 0 0 0 1101475150 1154322865 10 Physicians MARTINEZ SALUD G 606184309 200 Cook 0 1 Family Practice 0 223 0 0 24 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 422 0 0 48 0 0 0 0 0 0 0 0 194 0 0 0 0 0 0 422 0 0 48 0 0 0 0 0 0 0 0 194 0 0 0 0 0 0 996 0 0 1861.76 0 0 0 0 0 0 0 0 4836.19 0 0 0 0 0 0 7693.95 0 0 0 1101475152 1568576783 10 Physicians HARVEY ELIZABETH 605406540 30 DuPage 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9480.51 0 0 0 0 0 0 9480.51 0 0 0 1101475158 92 Waiver service provider--Disability (DHS/DRS) 30 DuPage 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14721.65 0 0 0 0 0 0 0 0 0 0 0 0 0 14721.65 0 0 0 1101475166 1295761252 60 Pharmacies SHOPKO PHARMACY 2139 623013712 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1469 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11248 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 259867 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 541600.66 0 0 0 541600.66 0 0 0 1101475170 1154640274 40 Federally Qualified Health Centers HEARTLAND HEALTH CTR HIBBARD 606255018 200 Cook 0 1 0 34 483 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 109 2276 0 170 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 109 2276 0 170 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 258 147388.54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 147646.54 0 0 0 1101475174 1285728022 10 Physicians SIMANTEL AMY 535661569 852 Wisconsin 0 1 Internal Medicine 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 297 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 297 0 0 0 1101475181 1851347389 60 Pharmacies OSCO DRUG 3465 600771312 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 314 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1631 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39518 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78539.89 0 0 0 78539.89 0 0 0 1101475199 1972750743 10 Physicians ERICSON ERIC 604292186 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 225 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 225 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2229.32 0 0 0 0 0 0 2229.32 0 0 0 1101475202 1295954790 24 Speech Therapists LOWERY ELIZABETH 608036307 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1031 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1031 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53176.58 53176.58 0 0 0 1101475210 10 Physicians 200 Cook 0 0 Plastic Surgery 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101475217 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 16636.36 0 0 0 0 0 0 0 0 0 0 0 0 0 16636.36 0 0 0 1101475218 10 Physicians 852 Wisconsin 0 0 Anesthesiology 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 153.5 0 0 0 0 0 0 153.5 0 0 0 1101475221 1750376869 10 Physicians RADZEVICIUS EVALDAS 999999999 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 798 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 798 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27484.98 0 0 0 0 0 0 27484.98 0 0 0 1101475233 1902117708 11 Dentists THARP STEVEN 606322945 200 Cook 0 0 General Dentistry 0 0 0 294 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53358.88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53358.88 0 0 0 1101475242 1265446827 10 Physicians HAMILL GEOFFREY 631463119 826 Missouri 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29.53 0 0 0 0 0 0 0 0 29.53 0 0 0 1101475244 92 Waiver service provider--Disability (DHS/DRS) 63 Macon 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 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 17724.86 0 0 0 0 0 0 0 0 0 0 0 0 0 17724.86 0 0 0 1101475247 1578536058 63 Other Providers of Medical Equipment/Supplies (Non-registered) AMERICAN HOMEPATIENT 628646736 49 Jefferson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1053 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1053 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40341.38 0 0 0 0 0 0 40341.38 0 0 0 1101475248 10 Physicians 852 Wisconsin 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 580.22 0 0 0 0 0 0 580.22 0 0 0 1101475254 1295852663 70 Ambulance Service Providers STAR AMBULANCE 610328736 97 Stephenson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 491 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4543 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4543 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117711.44 0 0 0 0 0 0 117711.44 0 0 0 1101475256 1164439279 40 Federally Qualified Health Centers ASIAN HUMAN SERVICES FAMILY 606594100 200 Cook 0 1 0 2006 1903 0 588 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13906 10388 0 1667 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13906 10388 0 1667 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34817 570853.06 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 605670.06 0 0 0 1101475258 1932195880 10 Physicians CHITTIVELU SUBRAMANYAM 617013534 72 McLean 0 0 Pulmonary Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 265 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 657 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 657 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17097.45 0 0 0 0 0 0 17097.45 0 0 0 1101475260 1942380886 10 Physicians VINJE THOMAS 610811252 17 Carroll 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 275 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 275 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20442.7 0 0 0 0 0 0 20442.7 0 0 0 1101475274 1104103290 60 Pharmacies CORAM ALTERNATE SITE SRVC INC 618212405 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 250 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2554 0 0 296 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2554 0 0 1802 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 509428.99 0 0 265862.86 0 0 0 775291.85 0 0 0 1101475283 55 Early 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0 0 0 1101475319 98 Waiver service provider--TBI (DHS/DRS) 97 Stephenson 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 7833.73 0 0 0 0 0 0 0 0 0 0 0 0 0 7833.73 0 0 0 1101475336 1588630719 10 Physicians DANG VERN 600352472 57 Lake 0 1 Internal Medicine 0 1 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 572.09 0 0 0 0 0 0 578.09 0 0 0 1101475338 1891986907 10 Physicians PATEL SUBHASH 616021005 80 Peoria 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 0 0 348 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 738 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 738 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10909.97 0 0 0 0 0 0 10909.97 0 0 0 1101475350 1134104219 60 Pharmacies SULLIVAN DRUGS INC 620331516 64 Macoupin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 937 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9214 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 222831 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 390071.07 0 0 0 390071.07 0 0 0 1101475352 1225024508 10 Physicians ANDREONI JOHN 604631029 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 811 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 811 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10066.89 0 0 0 0 0 0 10066.89 0 0 0 1101475357 1104137140 10 Physicians WILLIAMS SHERRY 619111214 29 Douglas 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 6 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 0 330.91 0 0 0 0 0 0 330.91 0 0 0 1101475361 1386642445 10 Physicians SONG GINA 601754830 53 Kane 0 1 Pediatrics 0 166 0 0 95 0 0 0 0 0 0 44 0 135 0 0 0 0 0 0 1306 0 0 202 0 0 0 0 0 0 52 0 325 0 0 0 0 0 0 1306 0 0 202 0 0 0 0 0 0 52 0 325 0 0 0 0 0 0 2612 0 0 9061.15 0 0 0 0 0 0 433.89 0 14170.92 0 0 0 0 0 0 26277.96 0 0 0 1101475363 1033114137 10 Physicians REILLY PRESTON 601342542 53 Kane 0 0 Surgery General 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2365.65 0 0 0 0 0 0 2365.65 0 0 0 1101475368 1780641852 10 Physicians COVLIN MICHAEL 628642857 49 Jefferson 0 0 Obstetric-Gynecology 0 0 0 0 8 0 0 0 0 0 0 642 0 1328 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 905 0 2431 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 905 0 2431 0 0 0 0 0 0 0 0 0 251.82 0 0 0 0 0 0 35052.88 0 227842.13 0 0 0 0 0 0 263146.83 0 0 0 1101475376 1952406639 10 Physicians GATES D 629011474 47 Jackson 0 0 Obstetric-Gynecology 0 0 0 0 9 0 0 0 0 0 0 460 0 442 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 1530 0 1637 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 1530 0 1637 0 0 0 0 0 0 0 0 0 357.79 0 0 0 0 0 0 61223.12 0 191231.57 0 0 0 0 0 0 252812.48 0 0 0 1101475387 1801076237 60 Pharmacies DREXLER DRUGS INC 606283126 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 538 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 2547 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 63275 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 526.5 0 0 60620.14 0 0 0 61146.64 0 0 0 1101475422 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 0 280 0 0 0 0 0 0 0 0 0 0 0 0 0 280 0 0 0 1101475430 1366510992 10 Physicians HONG IM SUN 637035049 826 Missouri 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 0 0 0 183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 521 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 521 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13792.9 0 0 0 0 0 0 13792.9 0 0 0 1101475438 1326040098 10 Physicians HAY DONALD 610327119 97 Stephenson 0 1 Family Practice 0 321 0 0 24 0 0 0 0 0 0 56 0 281 0 0 0 0 0 0 2421 0 0 53 0 0 0 0 0 0 71 0 748 0 0 0 0 0 0 2421 0 0 53 0 0 0 0 0 0 71 0 748 0 0 0 0 0 0 7010 0 0 2425.9 0 0 0 0 0 0 899.8 0 24095.75 0 0 0 0 0 0 34431.45 0 0 0 1101475460 98 Waiver service provider--TBI (DHS/DRS) 65 Madison 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 33468.81 0 0 0 0 0 0 0 0 0 0 0 0 0 33468.81 0 0 0 1101475463 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 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 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 3483.38 0 0 0 0 0 0 0 0 0 0 0 0 0 3483.38 0 0 0 1101475467 1407075740 24 Speech Therapists DOWLING KAREN 605862358 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 619 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 619 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43686.04 43686.04 0 0 0 1101475474 1649274366 12 Optometrists SIMPSON PATRICIA 604413690 107 Will 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 136 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 264 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 264 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6395.29 0 2604.71 0 0 0 0 9000 0 0 0 1101475475 30 General Hospitals 811 Georgia NON-COST "Non-cost reporting hospitals, paid a Per Diem 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Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1289 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1289 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81226.93 81226.93 0 0 0 1101475612 1639205255 10 Physicians PENN MARK 605231956 30 DuPage 0 1 Emergency Medicine 0 140 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 220 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 220 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 528 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 528 0 0 0 1101475613 1245225499 10 Physicians PATEL ARVIND 606291813 200 Cook 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 766 0 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1112 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1112 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35941.84 0 2273.11 0 0 0 0 0 0 38214.95 0 0 0 1101475637 10 Physicians 816 Iowa 0 0 Orthopedic Surgery 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 549.85 0 0 0 0 0 0 549.85 0 0 0 1101475639 1174587059 10 Physicians CORBOY JACQUELINE 606143363 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 449 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 478 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 478 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18043.6 0 0 0 0 0 0 18043.6 0 0 0 1101475640 98 Waiver service provider--TBI (DHS/DRS) 107 Will 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 4648.28 0 0 0 0 0 0 0 0 0 0 0 0 0 4648.28 0 0 0 1101475645 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 257 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 257 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12252.9 0 0 0 0 0 0 0 0 0 0 0 0 0 12252.9 0 0 0 1101475666 92 Waiver service provider--Disability (DHS/DRS) 30 DuPage 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37344.46 0 0 0 0 0 0 0 0 0 0 0 0 0 37344.46 0 0 0 1101475672 1831306968 10 Physicians PRYOR LANDON 611148011 109 Winnebago 0 0 Plastic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3938.99 0 0 0 0 0 0 3938.99 0 0 0 1101475677 92 Waiver service provider--Disability (DHS/DRS) 96 St Clair 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 17874.04 0 0 0 0 0 0 0 0 0 0 0 0 0 17874.04 0 0 0 1101475678 1467431411 10 Physicians LIND HEIDE 622072326 96 St Clair 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 349 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 349 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3693.53 0 0 0 0 0 0 0 0 3693.53 0 0 0 1101475679 1780642678 10 Physicians GLOSSON LISA 600987509 71 McHenry 0 1 Family Practice 0 14 0 0 11 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 67 0 0 22 0 0 0 0 0 0 0 0 187 0 0 0 0 0 0 67 0 0 22 0 0 0 0 0 0 0 0 187 0 0 0 0 0 0 137 0 0 1051.15 0 0 0 0 0 0 0 0 3455.37 0 0 0 0 0 0 4643.52 0 0 0 1101475689 1295896827 11 Dentists SALAMAH MOHAMMED 604361243 107 Will 0 0 General Dentistry 0 0 0 368 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2783 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2783 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 129168.96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 129168.96 0 0 0 1101475695 92 Waiver service provider--Disability (DHS/DRS) 96 St Clair 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 13537.72 0 0 0 0 0 0 0 0 0 0 0 0 0 13537.72 0 0 0 1101475696 1043283401 10 Physicians KIM DAVID 476308909 815 Indiana 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 0 0 0 7 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 3611.01 0 0 0 0 0 0 3611.01 0 0 0 1101475698 1790750834 10 Physicians WYHINNY GEORGE 600166850 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 4 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 860 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 860 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21277.22 0 0 0 0 0 0 21277.22 0 0 0 1101475712 1730148834 10 Physicians WALSH CURTIS 604678788 200 Cook 0 0 Emergency Medicine 0 0 0 0 2 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 178 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 178 0 0 0 0 0 0 0 0 0 30.4 0 0 0 0 0 0 0 0 5452.75 0 0 0 0 0 0 5483.15 0 0 0 1101475726 1194764621 10 Physicians TERRELL MARK 601181454 53 Kane 0 0 Anesthesiology 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 29 0 0 0 0 0 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 2.76 0 0 0 0 0 0 2.76 0 0 0 1101475730 1508948357 39 Hospice MERCY HOME CARE HOSPICE 610749732 17 Carroll 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7226.93 0 0 0 0 0 0 0 0 0 0 0 7226.93 0 0 0 1101475735 92 Waiver service provider--Disability (DHS/DRS) 56 Knox 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9491.99 0 0 0 0 0 0 0 0 0 0 0 0 0 9491.99 0 0 0 1101475750 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14997.39 0 0 0 0 0 0 0 0 0 0 0 0 0 14997.39 0 0 0 1101475752 1649279274 10 Physicians THOMPSON KEVIN 601232300 53 Kane 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 424 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 503 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 503 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19537.89 0 0 0 0 0 0 19537.89 0 0 0 1101475754 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23918.4 0 0 0 0 0 0 0 0 0 0 0 0 0 23918.4 0 0 0 1101475756 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 10947.2 0 0 0 0 0 0 0 0 0 0 0 0 0 10947.2 0 0 0 1101475758 98 Waiver service provider--TBI (DHS/DRS) 108 Williamson 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 17121.09 0 0 0 0 0 0 0 0 0 0 0 0 0 17121.09 0 0 0 1101475760 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 31722.01 0 0 0 0 0 0 0 0 0 0 0 0 0 31722.01 0 0 0 1101475767 1073606323 10 Physicians NYI SHAI 617649774 61 Livingston 0 0 Obstetric-Gynecology 0 0 0 0 11 0 0 0 0 0 0 22 0 362 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 22 0 1414 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 22 0 1414 0 0 0 0 0 0 0 0 0 345.39 0 0 0 0 0 0 51.3 0 119879.45 0 0 0 0 0 0 120276.14 0 0 0 1101475777 1831171750 10 Physicians DAVARAPALLI RAMADEVI 604404950 107 Will 0 0 Internal Medicine 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 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 589.54 0 0 0 0 0 0 589.54 0 0 0 1101475789 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 40852.33 0 0 0 0 0 0 0 0 0 0 0 0 0 40852.33 0 0 0 1101475798 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 332 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 332 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22055 0 0 0 0 0 0 0 0 0 0 0 0 0 22055 0 0 0 1101475799 1639294952 10 Physicians CHANDLER STEVEN 606313222 109 Winnebago 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 70 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 136 0 519 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 136 0 519 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1687.96 0 23842.11 0 0 0 0 0 0 25530.07 0 0 0 1101475821 1245538149 33 Nursing Facilities MIDWEST REHAB AND RESPIRATORY 622266552 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1020 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20315 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2291539.82 0 0 0 0 0 0 0 2291539.82 0 0 0 1101475823 1760683726 47 Local Education Agencies SIGNAL HILL SCHOOL DIST 181 622231644 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9845.04 0 9845.04 0 0 0 1101475841 1427130392 10 Physicians GORMAN MATTHEW 615719239 98 Tazewell 0 1 Internal Medicine 0 14 0 0 0 0 0 0 0 0 0 2 0 20 0 0 0 0 0 0 121 0 0 0 0 0 0 0 0 0 2 0 28 0 0 0 0 0 0 121 0 0 0 0 0 0 0 0 0 2 0 28 0 0 0 0 0 0 332 0 0 0 0 0 0 0 0 0 18.3 0 890.12 0 0 0 0 0 0 1240.42 0 0 0 1101475854 92 Waiver service provider--Disability (DHS/DRS) 37 Fulton 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6380.81 0 0 0 0 0 0 0 0 0 0 0 0 0 6380.81 0 0 0 1101475856 91 Waiver service provider--Adults (DHS/DDD) 88 Richland 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 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11679.25 0 0 0 0 0 0 0 0 0 0 0 0 0 11679.25 0 0 0 1101475864 1144432501 48 Rural Health Clinics COMPREHENSIVE HEALTH CENTER 629600866 69 Massac 0 1 0 663 172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4907 1334 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4907 1334 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12491 58618.36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71109.36 0 0 0 1101475885 1194724013 10 Physicians GRIFFITH DAVID O 452132664 836 Ohio 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 539.36 0 0 0 0 0 0 0 0 539.36 0 0 0 1101475899 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 2149.16 0 0 0 0 0 0 0 0 0 0 0 0 0 2149.16 0 0 0 1101475902 91 Waiver service provider--Adults (DHS/DDD) 106 Whiteside 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 0 221 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 221 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11202.62 0 0 0 0 0 0 0 0 0 0 0 0 0 11202.62 0 0 0 1101475921 1922066380 10 Physicians FREDRICKSON SARA 601082674 30 DuPage 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 7 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 222.58 0 1937.7 0 0 0 0 0 0 2160.28 0 0 0 1101475923 1669587069 13 Podiatrists BEAUPIED JOHN 606251115 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 171 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 171 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 656.73 0 0 0 0 0 0 656.73 0 0 0 1101475925 1588760524 10 Physicians SALTA RAUL 606601114 200 Cook 0 0 Neurology 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 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3904.37 0 0 0 0 0 0 3904.37 0 0 0 1101475926 1891877213 10 Physicians DAVE AMARISH 600987401 71 McHenry 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 29 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 527 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 527 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2147.14 0 3060.73 0 0 0 0 0 0 5207.87 0 0 0 1101475933 1609063205 11 Dentists LAMPROPOULOS PELAGIA 604532432 200 Cook 0 0 General Dentistry 0 0 0 1643 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7310 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7310 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 209821.74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 209821.74 0 0 0 1101475935 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 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 24704.34 0 0 0 0 0 0 0 0 0 0 0 0 0 24704.34 0 0 0 1101475940 92 Waiver service provider--Disability (DHS/DRS) 53 Kane 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 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 1951.1 0 0 0 0 0 0 0 0 0 0 0 0 0 1951.1 0 0 0 1101475954 1417977851 10 Physicians KURGANOFF JORGE 606472634 200 Cook 0 1 Internal Medicine 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 161 0 0 0 1101475968 1528185238 34 State-operated facility (DHS) UNIT 4391 BLDG 313B SHAPIRO 609015018 54 Kankakee 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 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1589 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1049109.17 0 0 0 0 0 0 0 0 0 0 1049109.17 0 0 0 1101475971 1396821237 52 Certified local public health department CLARK COUNTY HEALTH DEPT 624420266 21 Clark 0 0 0 0 490 0 485 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 858 0 1250 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 858 0 1250 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11038.14 0 13927.77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24965.91 0 0 0 1101475979 1588640049 10 Physicians TOULEIMAT BSHER ABDUL ILAH 604264260 200 Cook 0 0 Pulmonary Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 251 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 973 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 973 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8005.72 0 0 0 0 0 0 8005.72 0 0 0 1101475986 1104996115 10 Physicians ENGELKEMEIR JEAN 606101042 200 Cook 0 1 Family Practice 0 187 0 0 115 0 0 0 0 0 0 7 0 431 0 0 0 0 0 0 953 0 0 255 0 0 0 0 0 0 7 0 591 0 0 0 0 0 0 953 0 0 255 0 0 0 0 0 0 7 0 591 0 0 0 0 0 0 2184 0 0 4710.44 0 0 0 0 0 0 27.33 0 15947.39 0 0 0 0 0 0 22869.16 0 0 0 1101475995 1447343470 10 Physicians DEGEUS JENNIFER 600451688 57 Lake 0 1 Pediatrics 0 8 0 0 16 0 0 0 0 0 0 18 0 40 0 0 0 0 0 0 20 0 0 63 0 0 0 0 0 0 36 0 51 0 0 0 0 0 0 20 0 0 63 0 0 0 0 0 0 36 0 51 0 0 0 0 0 0 40 0 0 1674.95 0 0 0 0 0 0 274.15 0 2810.91 0 0 0 0 0 0 4800.01 0 0 0 1101475996 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12820.44 0 0 0 0 0 0 0 0 0 0 0 0 0 12820.44 0 0 0 1101476023 1902850910 10 Physicians NEWMAN DANIEL C 606576017 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 37 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 195 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 195 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220.67 0 899.76 0 0 0 0 0 0 1120.43 0 0 0 1101476039 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 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 3886.19 0 0 0 0 0 0 0 0 0 0 0 0 0 3886.19 0 0 0 1101476054 1073509113 33 Nursing Facilities CARRIER MILLS NURSING REHAB CT 629170068 90 Saline 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 0 910 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1952615.55 0 0 0 0 0 0 0 1952615.55 0 0 0 1101476061 1629115951 12 Optometrists WOJCIK RICHARD E 604461840 107 Will 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 66 0 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3622.61 0 1731.01 0 0 0 0 5353.62 0 0 0 1101476064 1023252780 10 Physicians SULLIVAN MEGAN 606118709 200 Cook 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1038.18 0 0 0 0 0 0 0 0 1038.18 0 0 0 1101476075 93 Waiver service provider--HIV/AIDS (DHS/DRS) 109 Winnebago 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 16313.7 0 0 0 0 0 0 0 0 0 0 0 0 0 16313.7 0 0 0 1101476076 1598757304 12 Optometrists GYSIN JOHN 616041320 80 Peoria 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 195 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 438 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 438 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11584.31 0 697.82 0 0 0 0 12282.13 0 0 0 1101476082 91 Waiver service provider--Adults (DHS/DDD) 63 Macon 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 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5308.87 0 0 0 0 0 0 0 0 0 0 0 0 0 5308.87 0 0 0 1101476108 1407844517 10 Physicians GUPTA SAMIR 604356565 107 Will 0 0 Pathology 0 0 0 0 9 0 0 0 0 0 0 2177 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 17105 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 17105 0 0 0 0 0 0 0 0 0 0 0 52.38 0 0 0 0 0 0 75086.48 0 0 0 0 0 0 0 0 75138.86 0 0 0 1101476116 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 940.01 0 0 0 0 0 0 0 0 0 0 0 0 0 940.01 0 0 0 1101476117 1043269038 70 Ambulance Service Providers WEST DUNDEE FIRE DEPARTMENT 601182104 53 Kane 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 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2663.26 0 0 0 0 0 0 2663.26 0 0 0 1101476125 92 Waiver service provider--Disability (DHS/DRS) 41 Hamilton 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2597.38 0 0 0 0 0 0 0 0 0 0 0 0 0 2597.38 0 0 0 1101476130 91 Waiver service provider--Adults (DHS/DDD) 53 Kane 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 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12375 0 0 0 0 0 0 0 0 0 0 0 0 0 12375 0 0 0 1101476143 1558413583 11 Dentists ENRIQUEZ BETSY 606163438 200 Cook 0 0 General Dentistry 0 0 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 494 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 494 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14778.21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14778.21 0 0 0 1101476145 1568454700 36 Community mental health provider ENGLEWOOD MHC 606212032 200 Cook 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 112 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 549 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 549 0 0 5178.15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38530.87 0 0 43709.02 0 0 0 1101476146 92 Waiver service provider--Disability (DHS/DRS) 97 Stephenson 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 11496.19 0 0 0 0 0 0 0 0 0 0 0 0 0 11496.19 0 0 0 1101476149 1528264090 11 Dentists PATEL HETAL 606324011 200 Cook 0 0 General Dentistry 0 0 0 422 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2030 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2030 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48597.11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48597.11 0 0 0 1101476153 1730101114 16 Nurse Practitioners KOWALCZYK PAUL 604611010 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6261.1 0 0 0 0 0 0 6261.1 0 0 0 1101476154 1558348268 10 Physicians KLEIN SUSAN 625264371 63 Macon 0 1 Family Practice 0 86 0 0 27 0 0 0 0 0 0 25 0 175 0 0 0 0 0 0 459 0 0 64 0 0 0 0 0 0 40 0 227 0 0 0 0 0 0 459 0 0 64 0 0 0 0 0 0 40 0 227 0 0 0 0 0 0 1329 0 0 2445.33 0 0 0 0 0 0 491.65 0 18419.26 0 0 0 0 0 0 22685.24 0 0 0 1101476159 1912927534 10 Physicians MANARD WILLIAM 631102515 826 Missouri 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 2 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7.9 0 77.2 0 0 0 0 0 0 85.1 0 0 0 1101476161 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 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 0 356.4 0 0 0 0 0 0 0 0 0 0 0 0 0 356.4 0 0 0 1101476169 1487987707 10 Physicians LOPEZ ALICIA 608053109 200 Cook 0 1 Pediatrics 0 36 0 0 119 0 0 0 0 0 0 16 0 165 0 0 0 0 0 0 99 0 0 353 0 0 0 0 0 0 16 0 250 0 0 0 0 0 0 99 0 0 353 0 0 0 0 0 0 16 0 250 0 0 0 0 0 0 198 0 0 11142.77 0 0 0 0 0 0 104.02 0 10131.65 0 0 0 0 0 0 21576.44 0 0 0 1101476172 1669449336 10 Physicians DESAI NARENDRA M 600315705 57 Lake 0 0 Otorhinolaryngology 0 0 0 0 0 0 0 0 0 0 0 0 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 331 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 331 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12453.8 0 0 0 0 0 0 12453.8 0 0 0 1101476177 1467411009 10 Physicians PANIAMOGAN CALEB 612015351 89 Rock Island 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 357 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 396 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 396 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13811.06 0 0 0 0 0 0 13811.06 0 0 0 1101476182 1699973842 10 Physicians LEES DANIA 601533328 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 2 0 174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5559.01 0 0 0 0 0 0 5559.01 0 0 0 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0 1101477176 1437321577 10 Physicians RIEGER BRENT 601533328 200 Cook 0 1 Internal Medicine 0 276 0 0 203 0 0 0 0 0 0 0 0 334 0 0 0 0 0 0 2213 0 0 246 0 0 0 0 0 0 0 0 520 0 0 0 0 0 0 2213 0 0 246 0 0 0 0 0 0 0 0 520 0 0 0 0 0 0 5220 0 0 19463.87 0 0 0 0 0 0 0 0 22924.62 0 0 0 0 0 0 47608.49 0 0 0 1101477193 1083630925 10 Physicians HECKER ROGER 606313222 200 Cook 0 1 Internal Medicine 0 30 0 0 0 0 0 0 0 0 0 9 0 31 0 0 0 0 0 0 204 0 0 0 0 0 0 0 0 0 13 0 67 0 0 0 0 0 0 204 0 0 0 0 0 0 0 0 0 13 0 67 0 0 0 0 0 0 595 0 0 0 0 0 0 0 0 0 43.44 0 2982.81 0 0 0 0 0 0 3621.25 0 0 0 1101477208 1578539813 13 Podiatrists PATEL NARENDRA R 601953203 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2066.38 0 0 0 0 0 0 2066.38 0 0 0 1101477209 92 Waiver service provider--Disability (DHS/DRS) 19 Champaign 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 7355.1 0 0 0 0 0 0 0 0 0 0 0 0 0 7355.1 0 0 0 1101477212 1174583660 36 Community mental health provider CHILDRENS HOME ASSOC OF IL 616045252 80 Peoria 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17800 0 0 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17800 0 0 26266.06 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 521874.34 0 0 548140.4 0 0 0 1101477226 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 230 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12784.75 0 0 0 0 0 0 0 0 0 0 0 0 0 12784.75 0 0 0 1101477231 92 Waiver service provider--Disability (DHS/DRS) 107 Will 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 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 2479.11 0 0 0 0 0 0 0 0 0 0 0 0 0 2479.11 0 0 0 1101477258 1326275413 10 Physicians KARI MARUTI 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 216 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 216 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6531.67 0 0 0 0 0 0 6531.67 0 0 0 1101477259 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12204 0 0 0 0 0 0 0 0 0 0 0 0 0 12204 0 0 0 1101477264 1750482022 30 General Hospitals CHILDRENS HOSP OF WISCONSIN 532013055 852 Wisconsin CHILDRENS Hospital designated as childrens hospitals and paid a Per Diem rate. 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 549 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 549 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2989.2 0 0 0 0 0 0 0 0 2989.2 0 0 0 1101477265 1154309755 10 Physicians GOLDVEKHT IRINA 600042378 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 3 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8.12 0 344.35 0 0 0 0 0 0 352.47 0 0 0 1101477279 1174569438 30 General Hospitals HOPEDALE HOSPITAL 617477525 98 Tazewell DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 1 0 0 0 0 0 2 0 0 0 0 0 0 59 0 0 156 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 298 0 0 247 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 298 0 0 247 0 0 0 0 0 0 0 0 7.98 0 0 0 0 0 0 1926.07 0 0 11369.49 0 0 0 0 0 13303.54 0 0 0 1101477287 1952312498 71 Medicar Provider INTEGRITY 601237827 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1025 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14804 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14804 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 167156.73 0 0 0 0 0 0 167156.73 0 0 0 1101477300 92 Waiver service provider--Disability (DHS/DRS) 852 Wisconsin 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 2698.67 0 0 0 0 0 0 0 0 0 0 0 0 0 2698.67 0 0 0 1101477305 1346218401 10 Physicians SATAR WAGIH 476701045 815 Indiana 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 9 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 504.13 0 11306.86 0 0 0 0 0 0 11810.99 0 0 0 1101477311 30 General Hospitals 850 Washington ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 526.74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 526.74 0 0 0 1101477313 1588622682 10 Physicians BRAUN RYAN 606123841 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 1328 0 426 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1924 0 490 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1924 0 490 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39487.44 0 3233.86 0 0 0 0 0 0 42721.3 0 0 0 1101477328 1578544664 10 Physicians HUSSEINI AMER 606561804 200 Cook 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 816 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3216 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3216 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27241.17 0 0 0 0 0 0 27241.17 0 0 0 1101477336 1750583266 47 Local Education Agencies DEPUE UNIT SCHOOL DIST 103 613220675 15 Bureau 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1911 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1911 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42084.01 0 42084.01 0 0 0 1101477345 1093815342 10 Physicians SELLETT JOHN 618215923 19 Champaign 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 7 0 313 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 317 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 317 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70.56 0 14508.53 0 0 0 0 0 0 14579.09 0 0 0 1101477359 1629116736 12 Optometrists PAWLYK GEORGE 600762778 200 Cook 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46.46 0 0 0 0 0 0 46.46 0 0 0 1101477363 1083643118 40 Federally Qualified Health Centers LAKE COUNTY HEALTH DEPARTMENT 600641618 57 Lake 0 1 0 4640 3388 0 1553 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40350 14524 0 4713 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40350 14524 0 4713 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95093 866954.27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 962047.27 0 0 0 1101477369 1306896634 10 Physicians MIZERA ANGELIQUE 606253645 200 Cook 0 0 Physical Medicine/Rehabilitation 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 0 0 0 244 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 244 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1579.23 0 0 0 0 0 0 1579.23 0 0 0 1101477385 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 15198.3 0 0 0 0 0 0 0 0 0 0 0 0 0 15198.3 0 0 0 1101477386 1972792281 36 Community mental health provider HABILITATIVE SYSTEMS INC 606242304 200 Cook 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 273 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 241 0 0 273 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 241 0 0 19529.51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22274.74 0 0 41804.25 0 0 0 1101477390 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 13419.34 0 0 0 0 0 0 0 0 0 0 0 0 0 13419.34 0 0 0 1101477391 91 Waiver service provider--Adults (DHS/DDD) 96 St Clair 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 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11842.85 0 0 0 0 0 0 0 0 0 0 0 0 0 11842.85 0 0 0 1101477393 16 Nurse Practitioners 826 Missouri 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72.75 0 0 0 0 0 0 72.75 0 0 0 1101477397 1649273905 10 Physicians RAMSEY LINDA 476308940 815 Indiana 0 0 Obstetric-Gynecology 0 0 0 0 1 0 0 0 0 0 0 9 0 13 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 36 0 64 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 36 0 64 0 0 0 0 0 0 0 0 0 32.83 0 0 0 0 0 0 1197.56 0 6152.2 0 0 0 0 0 0 7382.59 0 0 0 1101477401 1346325701 70 Ambulance Service Providers MASCOUTAH AMBULANCE SERVICE 622582030 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1652.2 0 0 0 0 0 0 1652.2 0 0 0 1101477416 91 Waiver service provider--Adults (DHS/DDD) 107 Will 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 0 261 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 261 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16515.8 0 0 0 0 0 0 0 0 0 0 0 0 0 16515.8 0 0 0 1101477417 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 8108.43 0 0 0 0 0 0 0 0 0 0 0 0 0 8108.43 0 0 0 1101477420 1861449753 10 Physicians TEPPER ARNOLD 630173408 826 Missouri 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 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 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 782.47 0 0 0 0 0 0 782.47 0 0 0 1101477423 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 251 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 251 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20156.45 0 0 0 0 0 0 0 0 0 0 0 0 0 20156.45 0 0 0 1101477428 92 Waiver service provider--Disability (DHS/DRS) 89 Rock Island 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 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 3720.92 0 0 0 0 0 0 0 0 0 0 0 0 0 3720.92 0 0 0 1101477436 16 Nurse Practitioners 24 Coles 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 0 1101477438 1518034693 75 Department of Alcohol and Substance Abuse Provider HAYMARKET HOUSE ADVANCE PARENT 606072202 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1237 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1289 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 163896.35 0 0 163896.35 0 0 0 1101477451 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 9311.69 0 0 0 0 0 0 0 0 0 0 0 0 0 9311.69 0 0 0 1101477462 92 Waiver service provider--Disability (DHS/DRS) 97 Stephenson 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 16874.29 0 0 0 0 0 0 0 0 0 0 0 0 0 16874.29 0 0 0 1101477469 1437302221 63 Other Providers of Medical Equipment/Supplies (Non-registered) HERITAGE MANOR ELGIN LLC 601207875 53 Kane 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 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7945.31 0 0 0 0 0 0 7945.31 0 0 0 1101477476 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 14799.89 0 0 0 0 0 0 0 0 0 0 0 0 0 14799.89 0 0 0 1101477489 1104028661 47 Local Education Agencies UNITED CUSD 304 614629221 102 Warren 0 0 0 0 0 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 0 539 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 539 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8575.73 0 8575.73 0 0 0 1101477510 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 11533.43 0 0 0 0 0 0 0 0 0 0 0 0 0 11533.43 0 0 0 1101477534 94 Waiver service provider--Children's support (DHS/DDD) 57 Lake 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 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 0 392.25 0 0 0 0 0 0 0 0 0 0 0 0 0 392.25 0 0 0 1101477539 92 Waiver service provider--Disability (DHS/DRS) 90 Saline 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6169.88 0 0 0 0 0 0 0 0 0 0 0 0 0 6169.88 0 0 0 1101477545 1447361308 10 Physicians REED PHILIP 478074214 815 Indiana 0 0 Pediatrics 0 0 0 0 1 0 0 0 0 0 0 2 0 6 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 4 0 9 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 4 0 9 0 0 0 0 0 0 0 0 0 32.15 0 0 0 0 0 0 33.97 0 253.14 0 0 0 0 0 0 319.26 0 0 0 1101477547 1205803293 10 Physicians MORRIS DAVID 606740018 200 Cook 0 1 Pediatrics 0 7 0 0 3 0 0 0 0 0 0 9 0 22 0 0 0 0 0 0 24 0 0 4 0 0 0 0 0 0 12 0 28 0 0 0 0 0 0 24 0 0 4 0 0 0 0 0 0 12 0 28 0 0 0 0 0 0 48 0 0 166.94 0 0 0 0 0 0 89.19 0 371.6 0 0 0 0 0 0 675.73 0 0 0 1101477552 1023097102 10 Physicians CHARNOGURSKY GERALD 601533304 200 Cook 0 0 Endocrinology 0 0 0 0 0 0 0 0 0 0 0 0 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3508.89 0 0 0 0 0 0 3508.89 0 0 0 1101477562 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 11715.74 0 0 0 0 0 0 0 0 0 0 0 0 0 11715.74 0 0 0 1101477567 1982664736 10 Physicians PATEL SAMIR 604533767 200 Cook 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 178 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 178 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9749.61 0 0 0 0 0 0 9749.61 0 0 0 1101477568 1356430631 12 Optometrists COMBS STEPHEN 601073367 200 Cook 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 8 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 0 235.46 0 0 0 0 0 0 235.46 0 0 0 1101477574 91 Waiver service provider--Adults (DHS/DDD) 107 Will 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 0 250 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 250 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22258.2 0 0 0 0 0 0 0 0 0 0 0 0 0 22258.2 0 0 0 1101477581 1518153881 10 Physicians SKIBLEY LINDSAY 606116649 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4787.34 0 0 0 0 0 0 4787.34 0 0 0 1101477592 10 Physicians 200 Cook 0 0 Radiology 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 0 0 0 0 0 0 0 0 0 0 0 0 0 1101477596 92 Waiver service provider--Disability (DHS/DRS) 13 Boone 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 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 19945.95 0 0 0 0 0 0 0 0 0 0 0 0 0 19945.95 0 0 0 1101477619 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1716 0 0 0 0 0 0 0 0 0 0 0 0 0 1716 0 0 0 1101477631 1114977063 10 Physicians JONES MARCIA 610811252 106 Whiteside 0 1 Family Practice 0 524 0 0 188 0 0 0 0 0 0 95 0 598 0 0 0 0 0 0 5246 0 0 457 0 0 0 0 0 0 135 0 1838 0 0 0 0 0 0 5246 0 0 457 0 0 0 0 0 0 135 0 1838 0 0 0 0 0 0 12786 0 0 23137.58 0 0 0 0 0 0 835.84 0 67646.21 0 0 0 0 0 0 104405.63 0 0 0 1101477654 1922255041 10 Physicians TRITT MICHAEL 601604039 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 392 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 429 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 429 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13960.84 0 0 0 0 0 0 13960.84 0 0 0 1101477658 1477743847 16 Nurse Practitioners BRENNAN STEPHANIE 600761238 200 Cook 0 0 0 0 0 0 198 0 0 0 0 0 0 0 0 820 0 0 0 0 0 0 0 0 0 428 0 0 0 0 0 0 0 0 1295 0 0 0 0 0 0 0 0 0 428 0 0 0 0 0 0 0 0 1295 0 0 0 0 0 0 0 0 0 9204.69 0 0 0 0 0 0 0 0 56744.16 0 0 0 0 0 0 65948.85 0 0 0 1101477671 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3878.2 0 0 0 0 0 0 0 0 0 0 0 0 0 3878.2 0 0 0 1101477673 1700083250 16 Nurse Practitioners PARMELEY DANIEL 631101010 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 404.65 0 0 0 0 0 0 404.65 0 0 0 1101477682 1407962541 10 Physicians ALEXANDRE JEAN 601604156 200 Cook 0 1 Obstetric-Gynecology 0 50 0 0 3 0 0 0 0 0 0 96 0 296 0 0 0 0 0 0 130 0 0 3 0 0 0 0 0 0 121 0 846 0 0 0 0 0 0 130 0 0 3 0 0 0 0 0 0 121 0 846 0 0 0 0 0 0 376 0 0 261.92 0 0 0 0 0 0 7714.69 0 70092.83 0 0 0 0 0 0 78445.44 0 0 0 1101477685 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 14 0 0 0 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 8744.76 0 0 0 0 0 0 0 0 0 0 0 0 0 8744.76 0 0 0 1101477689 1619925963 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1811930621 10 Physicians MICHAELS ELIZABETH 600451674 57 Lake 0 1 Pediatrics 0 2 0 0 14 0 0 0 0 0 0 7 0 13 0 0 0 0 0 0 8 0 0 20 0 0 0 0 0 0 11 0 14 0 0 0 0 0 0 8 0 0 20 0 0 0 0 0 0 11 0 14 0 0 0 0 0 0 16 0 0 1041.85 0 0 0 0 0 0 56.62 0 686.82 0 0 0 0 0 0 1801.29 0 0 0 1101478129 1659324317 10 Physicians MALLOY COLLEEN 606143363 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11152.74 0 0 0 0 0 0 11152.74 0 0 0 1101478131 1851364517 10 Physicians CHA JIN 463212905 815 Indiana 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5150.55 0 0 0 0 0 0 5150.55 0 0 0 1101478132 1487817995 10 Physicians SHEYBANI ARSHAM 999999999 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 43 0 0 0 0 0 0 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2408.31 0 0 0 1101478203 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1698.23 0 0 0 0 0 0 0 0 0 0 0 0 0 1698.23 0 0 0 1101478211 1306844899 10 Physicians HERMAN MARTIN 600681168 200 Cook 0 0 Neurology Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 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 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6174.03 0 0 0 0 0 0 6174.03 0 0 0 1101478216 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14427.63 0 0 0 0 0 0 0 0 0 0 0 0 0 14427.63 0 0 0 1101478219 1184783862 10 Physicians KIRSCHBAUM JAMES 535625531 852 Wisconsin 0 0 Radiology 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 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 11 0 169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 141.91 0 10299.2 0 0 0 0 0 0 10441.11 0 0 0 1101478241 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 1335.91 0 0 0 0 0 0 0 0 0 0 0 0 0 1335.91 0 0 0 1101478246 1134181829 10 Physicians PETHKAR SANJAY 605855676 107 Will 0 1 Internal Medicine 0 1833 0 0 167 0 0 0 0 0 0 250 0 922 0 0 0 0 0 0 14227 0 0 437 0 0 0 0 0 0 412 0 2716 0 0 0 0 0 0 14227 0 0 437 0 0 0 0 0 0 412 0 2716 0 0 0 0 0 0 41511 0 0 15074.26 0 0 0 0 0 0 2455.08 0 90491.54 0 0 0 0 0 0 149531.88 0 0 0 1101478263 92 Waiver service provider--Disability (DHS/DRS) 99 Union 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14730.04 0 0 0 0 0 0 0 0 0 0 0 0 0 14730.04 0 0 0 1101478272 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 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provider--Adults (DHS/DDD) 200 Cook 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 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13150.5 0 0 0 0 0 0 0 0 0 0 0 0 0 13150.5 0 0 0 1101478311 92 Waiver service provider--Disability (DHS/DRS) 63 Macon 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 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10214.71 0 0 0 0 0 0 0 0 0 0 0 0 0 10214.71 0 0 0 1101478313 1770700536 11 Dentists KOSTRUBALA CRAIG 604641257 200 Cook 0 0 General Dentistry 0 0 0 506 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2221 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2221 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76789.39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76789.39 0 0 0 1101478315 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 120 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 0 0 0 0 0 0 0 0 0 0 0 0 7603.2 0 0 0 0 0 0 0 0 0 0 0 0 0 7603.2 0 0 0 1101478345 1730318148 10 Physicians ADAJAR ALLAN 606261620 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 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 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9795.12 0 0 0 0 0 0 9795.12 0 0 0 1101478350 11 Dentists 57 Lake 0 0 General Dentistry 0 0 0 1 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 60.92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60.92 0 0 0 1101478354 1881799476 16 Nurse Practitioners DEWAELE GUZMAN LUCINDA 604319063 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 250 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 250 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6058.12 0 0 0 0 0 0 6058.12 0 0 0 1101478355 1659327328 60 Pharmacies OSCO DRUG 3220 600073668 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 455 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11667 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15725.03 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 874.02 0 0 0 0 0 0 874.02 0 0 0 1101478450 92 Waiver service provider--Disability (DHS/DRS) 53 Kane 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13380.29 0 0 0 0 0 0 0 0 0 0 0 0 0 13380.29 0 0 0 1101478461 1396082681 16 Nurse Practitioners ISMAIL HALA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 449 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42907.62 0 0 0 0 0 0 42907.62 0 0 0 1101478469 10 Physicians 815 Indiana 0 0 Rheumatology 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 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 0 294.96 0 0 0 0 0 0 294.96 0 0 0 1101478490 1548293673 10 Physicians MEHARD WILLIAM 631282702 826 Missouri 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 66 0 8 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 442 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 943 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 943 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9949.79 0 0 0 0 0 0 0 0 9949.79 0 0 0 1101478542 91 Waiver service provider--Adults (DHS/DDD) 30 DuPage 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 0 193 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 193 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22305.86 0 0 0 0 0 0 0 0 0 0 0 0 0 22305.86 0 0 0 1101478549 1467737189 16 Nurse Practitioners CERRENTANO ELIZABETH 606552219 200 Cook 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 122.05 0 0 0 0 0 0 0 0 219.66 0 0 0 0 0 0 341.71 0 0 0 1101478561 1518078450 10 Physicians KIM JAMES B 605638669 53 Kane 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9808.6 0 0 0 0 0 0 9808.6 0 0 0 1101478580 1306830567 10 Physicians SCHIERER GREGORY 614012897 56 Knox 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 104 0 277 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 164 0 854 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 164 0 854 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2001.3 0 28156.69 0 0 0 0 0 0 30157.99 0 0 0 1101478587 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16896 0 0 0 0 0 0 0 0 0 0 0 0 0 16896 0 0 0 1101478596 1477839710 63 Other Providers of Medical Equipment/Supplies (Non-registered) OPTECH ORTHOTICS JOLIET 999999999 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180.26 0 2533.83 0 0 0 0 2714.09 0 0 0 1101478597 92 Waiver service provider--Disability (DHS/DRS) 63 Macon 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 14 0 0 0 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 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0 0 0 0 0 0 4 0 487 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15.96 0 3892.72 0 0 0 0 0 0 3908.68 0 0 0 1101478667 1114106119 10 Physicians MANDUJANO ALICIA 606575190 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 1 0 0 0 0 0 0 656 0 291 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1724 0 730 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1724 0 730 0 0 0 0 0 0 0 0 0 32.83 0 0 0 0 0 0 40142.48 0 21536.7 0 0 0 0 0 0 61712.01 0 0 0 1101478668 1326066887 10 Physicians ROTHBAUM ROBERT 631101077 826 Missouri 0 0 Pediatrics 0 0 0 0 2 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 33.31 0 0 0 0 0 0 0 0 5132.73 0 0 0 0 0 0 5166.04 0 0 0 1101478671 2100469089 92 Waiver service provider--Disability (DHS/DRS) SPECIAL CARE NURSES OF 604822050 200 Cook 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 0 205 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 205 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 260820.11 0 0 0 0 0 0 0 0 0 0 0 0 0 260820.11 0 0 0 1101478674 1154598381 55 Early Intervention Services GARCIA ELISSA 606264237 200 Cook 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 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4632.03 0 0 0 0 0 0 4632.03 0 0 0 1101478690 1275561193 10 Physicians MACGREGOR SCOTT 602011718 200 Cook 0 0 Maternal and Fetal Medicine 0 0 0 0 0 0 0 0 0 0 0 569 0 216 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 998 0 395 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 998 0 395 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28096.8 0 16557.65 0 0 0 0 0 0 44654.45 0 0 0 1101478691 98 Waiver service provider--TBI (DHS/DRS) 65 Madison 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 1525.1 0 0 0 0 0 0 0 0 0 0 0 0 0 1525.1 0 0 0 1101478695 1982768040 12 Optometrists PETERSON ROBERT 600504249 71 McHenry 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2291.99 0 1332.18 0 0 0 0 3624.17 0 0 0 1101478714 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16318.81 0 0 0 0 0 0 0 0 0 0 0 0 0 16318.81 0 0 0 1101478725 1083602031 33 Nursing Facilities HARBOR CREST HOME INC 612521020 106 Whiteside 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 272 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8058 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 566386.55 0 0 0 0 0 0 0 566386.55 0 0 0 1101478727 1043351026 10 Physicians HELDING PHILLIP 605218608 30 DuPage 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 269 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 269 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6765.44 0 0 0 0 0 0 6765.44 0 0 0 1101478728 1205826369 24 Speech Therapists LOBODZINSKI KAREN 600028423 57 Lake 0 0 0 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 0 0 0 0 0 0 0 0 404 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 404 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30160.14 30160.14 0 0 0 1101478730 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22840.99 0 0 0 0 0 0 0 0 0 0 0 0 0 22840.99 0 0 0 1101478734 92 Waiver service provider--Disability (DHS/DRS) 38 Gallatin 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 14976.77 0 0 0 0 0 0 0 0 0 0 0 0 0 14976.77 0 0 0 1101478744 1619078466 10 Physicians TENQUIST JANE 631102515 826 Missouri 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10000.65 0 0 0 0 0 0 10000.65 0 0 0 1101478747 1245283761 10 Physicians PAMATMAT NESTOR 614011299 56 Knox 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 3978 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21490 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21490 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80270.2 0 0 0 0 0 0 0 0 80270.2 0 0 0 1101478778 92 Waiver service provider--Disability (DHS/DRS) 57 Lake 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 19159.04 0 0 0 0 0 0 0 0 0 0 0 0 0 19159.04 0 0 0 1101478789 1447265756 60 Pharmacies WALGREEN CO 5239 528043329 816 Iowa 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 456 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16818.61 0 0 0 16818.61 0 0 0 1101478795 10 Physicians 72 McLean 0 0 Obstetric-Gynecology 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2036.97 0 0 0 0 0 0 2036.97 0 0 0 1101478798 1821283565 10 Physicians VOLETY SNIGDHA 611042315 109 Winnebago 0 1 Family Practice 0 5 0 0 7 0 0 0 0 0 0 38 0 164 0 0 0 0 0 0 32 0 0 22 0 0 0 0 0 0 47 0 441 0 0 0 0 0 0 32 0 0 22 0 0 0 0 0 0 47 0 441 0 0 0 0 0 0 75 0 0 875.63 0 0 0 0 0 0 243.15 0 6105.46 0 0 0 0 0 0 7299.24 0 0 0 1101478802 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 215 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 215 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11047.3 0 0 0 0 0 0 0 0 0 0 0 0 0 11047.3 0 0 0 1101478805 91 Waiver service provider--Adults (DHS/DDD) 57 Lake 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 0 145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24118.87 0 0 0 0 0 0 0 0 0 0 0 0 0 24118.87 0 0 0 1101478814 1568411072 16 Nurse Practitioners STIEB KATHERINE 622697287 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 113.54 0 0 0 0 0 0 113.54 0 0 0 1101478825 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 6244.48 0 0 0 0 0 0 0 0 0 0 0 0 0 6244.48 0 0 0 1101478853 1871601989 10 Physicians PATIL ROHI 625213832 63 Macon 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 519 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2997 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2997 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49667.2 0 0 0 0 0 0 49667.2 0 0 0 1101478860 1659349223 10 Physicians PATEL SHASHI A 610213116 60 Lee 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16316.55 0 0 0 0 0 0 16316.55 0 0 0 1101478896 1821007303 10 Physicians BEELER RODNEY 476701043 815 Indiana 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 1171 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1384 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1384 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43916.58 0 0 0 0 0 0 43916.58 0 0 0 1101478906 92 Waiver service provider--Disability (DHS/DRS) 63 Macon 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 16684.7 0 0 0 0 0 0 0 0 0 0 0 0 0 16684.7 0 0 0 1101478919 1619079688 10 Physicians EARVOLINO JENNIFER 606123228 200 Cook 0 1 Internal Medicine 0 7 0 0 0 0 0 0 0 0 0 3 0 96 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 7 0 252 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 7 0 252 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 24.47 0 2697.91 0 0 0 0 0 0 2776.38 0 0 0 1101478929 1780753269 33 Nursing Facilities MAYFIELD CARE CENTER INC 606442845 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1240 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25330 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3119785.24 0 0 0 0 0 0 0 3119785.24 0 0 0 1101478938 10 Physicians 30 DuPage 0 0 Radiation Oncology 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14.05 0 0 0 0 0 0 14.05 0 0 0 1101478950 1447315189 10 Physicians STOCKERL-GOLDSTEIN KEITH E 631600352 65 Madison 0 0 Oncology 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 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2825.65 0 0 0 0 0 0 2825.65 0 0 0 1101478955 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32888.2 0 0 0 0 0 0 0 0 0 0 0 0 0 32888.2 0 0 0 1101478959 1801898085 16 Nurse Practitioners STEWART JOYA 619511943 78 Moultrie 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 213 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 496 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 496 0 0 0 0 0 0 0 0 0 1476.49 0 0 0 0 0 0 0 0 9341.95 0 0 0 0 0 0 10818.44 0 0 0 1101478961 16 Nurse Practitioners 826 Missouri 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94.2 0 0 0 0 0 0 94.2 0 0 0 1101478966 1871672618 30 General Hospitals HOLLAND COMMUNITY HOSPITAL 494234946 823 Michigan NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 8 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 1964.98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1964.98 0 0 0 1101478967 1659348506 30 General Hospitals MERCY MEDICAL CENTER DUBUQUE 520017320 816 Iowa DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 0 0 0 0 0 170 0 0 0 0 55 0 0 0 53 0 0 0 0 0 0 0 0 0 255 0 0 0 0 66 0 0 0 68 0 0 0 0 0 0 0 0 0 255 0 0 0 0 252 0 0 0 76 0 0 0 0 0 0 0 0 0 31701.58 0 0 0 0 131420.5 0 0 0 11243.46 0 0 0 0 0 174365.54 0 0 0 1101478978 92 Waiver service provider--Disability (DHS/DRS) 91 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 20667.08 0 0 0 0 0 0 0 0 0 0 0 0 0 20667.08 0 0 0 1101478988 1235242496 10 Physicians PERRYMAN JOHN 611113107 109 Winnebago 0 1 Pediatrics 0 236 0 0 233 0 0 0 0 0 0 3 0 381 0 0 0 0 0 0 2088 0 0 823 0 0 0 0 0 0 3 0 812 0 0 0 0 0 0 2088 0 0 823 0 0 0 0 0 0 3 0 812 0 0 0 0 0 0 4176 0 0 26881.7 0 0 0 0 0 0 12 0 31548.7 0 0 0 0 0 0 62618.4 0 0 0 1101478994 30 General Hospitals 816 Iowa NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 0 130.01 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130.01 0 0 0 1101479009 1669586707 22 Physical Therapists IBRAHIM AMR 604675489 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 320 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1642 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1642 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 157020.29 157020.29 0 0 0 1101479015 30 General Hospitals 836 Ohio ARS-LS Long-term stay hospitals paid under an ARS 0 0 Children's Hospital 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 0 218.69 0 0 0 0 0 218.69 0 0 0 1101479023 1245244789 10 Physicians CRUTCHER DEANGELA 477140541 815 Indiana 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 3 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 173.73 0 1407.35 0 0 0 0 0 0 1581.08 0 0 0 1101479024 1154343861 60 Pharmacies TARGET STORE 1460 604302007 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 736 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18330 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26594.01 0 0 0 26594.01 0 0 0 1101479031 1245295187 10 Physicians SCAGGS THOMAS 618012529 19 Champaign 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 188 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 211 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 211 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6624.3 0 0 0 0 0 0 6624.3 0 0 0 1101479037 1750575700 55 Early Intervention Services LINDGREN VICTORIA 605407411 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97450.76 0 0 0 0 0 0 97450.76 0 0 0 1101479042 92 Waiver service provider--Disability (DHS/DRS) 107 Will 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 33228.4 0 0 0 0 0 0 0 0 0 0 0 0 0 33228.4 0 0 0 1101479058 92 Waiver service provider--Disability (DHS/DRS) 53 Kane 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 31033.78 0 0 0 0 0 0 0 0 0 0 0 0 0 31033.78 0 0 0 1101479081 10 Physicians 816 Iowa 0 0 Internal Medicine 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 27.3 0 0 0 0 0 0 27.3 0 0 0 1101479087 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18241.98 0 0 0 0 0 0 0 0 0 0 0 0 0 18241.98 0 0 0 1101479088 91 Waiver service provider--Adults (DHS/DDD) 53 Kane 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 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13750 0 0 0 0 0 0 0 0 0 0 0 0 0 13750 0 0 0 1101479093 1215913470 30 General Hospitals PRESBYTERIAN HOSPITAL 871064934 832 New Mexico NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1089.97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1089.97 0 0 0 1101479114 1972518413 70 Ambulance 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3 0 94 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 3 0 94 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 11.46 0 2566.48 0 0 0 0 0 0 2613.94 0 0 0 1101479136 1932223278 47 Local Education Agencies SOUTHERN WILL COUNTY COOP 604353436 107 Will 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 478 0 0 0 0 224 0 0 0 0 0 0 0 0 0 0 0 0 0 24759 0 0 0 0 224 0 0 0 0 0 0 0 0 0 0 0 0 0 24759 0 0 0 0 1110.3 0 0 0 0 0 0 0 0 0 0 0 0 0 342130.65 0 343240.95 0 0 0 1101479141 92 Waiver service provider--Disability (DHS/DRS) 30 DuPage 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 0 474.98 0 0 0 0 0 0 0 0 0 0 0 0 0 474.98 0 0 0 1101479155 10 Physicians 852 Wisconsin 0 0 Radiology 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 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 70.18 0 0 0 0 0 0 0 0 70.18 0 0 0 1101479160 92 Waiver service provider--Disability (DHS/DRS) 57 Lake 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 7161.82 0 0 0 1101479273 92 Waiver service provider--Disability (DHS/DRS) 56 Knox 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2820.17 0 0 0 0 0 0 0 0 0 0 0 0 0 2820.17 0 0 0 1101479305 1770590929 10 Physicians PRESS JOEL 606113015 200 Cook 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101479322 1710996715 10 Physicians SADOWSKI LAWRENCE 604356612 107 Will 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 4 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9.81 0 1697.62 0 0 0 0 0 0 1707.43 0 0 0 1101479328 1790723732 33 Nursing Facilities HEARTLAND OF CHAMPAIGN 618205405 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 442 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 80 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 0 0 0 0 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1413.37 0 0 0 0 0 0 0 0 1413.37 0 0 0 1101480675 1942472394 29 ICF/MR BRAUNS TERRACE 622462277 12 Bond 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 0 446 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8566 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 619816.07 0 0 0 0 0 0 0 0 0 0 619816.07 0 0 0 1101480682 1942362835 10 Physicians KURANI P V 606253547 200 Cook 0 0 Internal Medicine 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 0 225 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 225 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2153.2 0 0 0 0 0 0 2153.2 0 0 0 1101480686 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 1055 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1055 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52700.76 0 0 0 0 0 0 0 0 0 0 0 0 0 52700.76 0 0 0 1101480689 91 Waiver service provider--Adults (DHS/DDD) 96 St Clair 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 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2185.16 0 0 0 0 0 0 0 0 0 0 0 0 0 2185.16 0 0 0 1101480698 92 Waiver service provider--Disability (DHS/DRS) 30 DuPage 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 13861.25 0 0 0 0 0 0 0 0 0 0 0 0 0 13861.25 0 0 0 1101480699 1841239167 70 Ambulance Service Providers OSWEGO FIRE PROTECTION DIST 605439553 55 Kendall 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 314 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 800 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 800 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46156.18 0 0 0 0 0 0 46156.18 0 0 0 1101480702 1386858413 10 Physicians WYSOCKI NICOLE 606112654 200 Cook 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 763.19 0 0 0 0 0 0 763.19 0 0 0 1101480710 92 Waiver service provider--Disability (DHS/DRS) 89 Rock Island 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3195 0 0 0 0 0 0 0 0 0 0 0 0 0 3195 0 0 0 1101480716 92 Waiver service provider--Disability (DHS/DRS) 99 Union 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2455.07 0 0 0 0 0 0 0 0 0 0 0 0 0 2455.07 0 0 0 1101480717 1265477822 10 Physicians VARKEY ANITA 601533328 200 Cook 0 1 Internal Medicine 0 92 0 0 0 0 0 0 0 0 0 0 0 252 0 0 0 0 0 0 717 0 0 0 0 0 0 0 0 0 0 0 386 0 0 0 0 0 0 717 0 0 0 0 0 0 0 0 0 0 0 386 0 0 0 0 0 0 2136 0 0 0 0 0 0 0 0 0 0 0 12598.78 0 0 0 0 0 0 14734.78 0 0 0 1101480731 10 Physicians 852 Wisconsin 0 0 Internal Medicine 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24.45 0 0 0 0 0 0 24.45 0 0 0 1101480736 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 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 8949.35 0 0 0 0 0 0 0 0 0 0 0 0 0 8949.35 0 0 0 1101480742 1447266929 12 Optometrists AFRYL GLENN 605152323 30 DuPage 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 109 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 109 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2692.53 0 1073.44 0 0 0 0 3765.97 0 0 0 1101480753 92 Waiver service provider--Disability (DHS/DRS) 13 Boone 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10772.05 0 0 0 0 0 0 0 0 0 0 0 0 0 10772.05 0 0 0 1101480762 1104801190 10 Physicians DECKARD ALAN 627949639 91 Sangamon 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 37 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 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4407.49 0 0 0 0 0 0 4407.49 0 0 0 1101480778 1578674420 10 Physicians STOLTZ DAVID 619202522 24 Coles 0 1 Pediatrics 0 632 0 0 351 0 0 0 0 0 0 67 0 630 0 0 0 0 0 0 5873 0 0 1629 0 0 0 0 0 0 71 0 1466 0 0 0 0 0 0 5873 0 0 1629 0 0 0 0 0 0 71 0 1466 0 0 0 0 0 0 11762 0 0 49616.17 0 0 0 0 0 0 290.38 0 68217.23 0 0 0 0 0 0 129885.78 0 0 0 1101480782 1447258181 10 Physicians WRIGHT SCOTT 614019780 56 Knox 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 292 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1072 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1072 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17473.55 0 0 0 0 0 0 17473.55 0 0 0 1101480788 1093044471 16 Nurse Practitioners COLBERT MONIQUE 606173913 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 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 0 126.79 0 0 0 0 0 0 126.79 0 0 0 1101480790 1548448913 36 Community mental health provider LIFELINKS MENTAL HEALTH 619203615 24 Coles 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1730 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1730 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101480793 1801827126 10 Physicians DACHMAN CAREY 601932971 200 Cook 0 0 Rheumatology 0 0 0 0 0 0 0 0 0 0 0 19 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 712 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 712 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123.8 0 1914 0 0 0 0 0 0 2037.8 0 0 0 1101480799 1356639363 16 Nurse Practitioners LEVY BOURGEOIS JENNIFER 628642157 49 Jefferson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28563.76 0 0 0 0 0 0 28563.76 0 0 0 1101480801 10 Physicians 826 Missouri 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 143.8 0 41.6 0 0 0 0 0 0 185.4 0 0 0 1101480809 1447354709 10 Physicians MATHEW MATHEW C 610213175 60 Lee 0 0 Urology 0 0 0 0 0 0 0 0 0 0 0 4 0 254 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 552 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 552 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120.2 0 12028.27 0 0 0 0 0 0 12148.47 0 0 0 1101480820 1053648642 16 Nurse Practitioners AUTON JULIA K 625215579 63 Macon 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 132 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 210 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 210 0 0 0 0 0 0 0 0 0 868.05 0 0 0 0 0 0 0 0 4750.09 0 0 0 0 0 0 5618.14 0 0 0 1101480830 1336137546 10 Physicians KONTOS GEORGE 527226573 816 Iowa 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 14 0 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23.41 0 5142.57 0 0 0 0 0 0 5165.98 0 0 0 1101480869 92 Waiver service provider--Disability (DHS/DRS) 90 Saline 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11854.87 0 0 0 0 0 0 0 0 0 0 0 0 0 11854.87 0 0 0 1101480882 1275644551 10 Physicians KANNIN MICHELE 606064911 200 Cook 0 1 Internal Medicine 0 12 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 868.02 0 0 0 0 0 0 952.02 0 0 0 1101480883 92 Waiver service provider--Disability (DHS/DRS) 36 Franklin 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 12627.39 0 0 0 0 0 0 0 0 0 0 0 0 0 12627.39 0 0 0 1101480902 92 Waiver service provider--Disability (DHS/DRS) 88 Richland 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4296.28 0 0 0 0 0 0 0 0 0 0 0 0 0 4296.28 0 0 0 1101480909 1306871793 10 Physicians WIESEMANN RICHARD 604264267 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 68 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1633.78 0 30.78 0 0 0 0 0 0 1664.56 0 0 0 1101480917 1841460391 36 Community mental health provider METROPOLITAN FAMILY NORTH CTR 606344360 200 Cook 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 412 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 412 0 0 1816.72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34375.1 0 0 36191.82 0 0 0 1101480928 1760788376 10 Physicians IQBAL ROBINA 605151552 30 DuPage 0 0 Internal Medicine 0 12 0 0 0 0 0 0 0 0 0 4 0 33 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 7 0 51 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 7 0 51 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 15.7 0 1412.6 0 0 0 0 0 0 1469.3 0 0 0 1101480948 1952452195 22 Physical Therapists ATALLAH HISHAM 604152667 200 Cook 0 0 0 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 0 199 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 199 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 721.75 721.75 0 0 0 1101480955 1538114608 36 Community mental health provider FAMILY COUNSELING CENTER INC 629381136 84 Pope 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 250 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 250 0 0 890.43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19092.84 0 0 19983.27 0 0 0 1101480970 1306848858 10 Physicians DIANOVSKY MELISSA 600052381 200 Cook 0 1 Pediatrics 0 10 0 0 12 0 0 0 0 0 0 3 0 12 0 0 0 0 0 0 27 0 0 39 0 0 0 0 0 0 3 0 15 0 0 0 0 0 0 27 0 0 39 0 0 0 0 0 0 3 0 15 0 0 0 0 0 0 54 0 0 987.54 0 0 0 0 0 0 33.34 0 721.54 0 0 0 0 0 0 1796.42 0 0 0 1101480995 1164661393 10 Physicians MAGANA TATIANA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 196 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 214 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 214 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7551.51 0 0 0 0 0 0 7551.51 0 0 0 1101480997 1699761973 10 Physicians BADESCU VLAD 604428504 107 Will 0 0 Internal Medicine 0 106 0 0 1 0 0 0 0 0 0 1 0 96 0 0 0 0 0 0 582 0 0 1 0 0 0 0 0 0 1 0 290 0 0 0 0 0 0 582 0 0 1 0 0 0 0 0 0 1 0 290 0 0 0 0 0 0 1687 0 0 104.96 0 0 0 0 0 0 0 0 7603.84 0 0 0 0 0 0 9395.8 0 0 0 1101481000 1346310562 10 Physicians GUYON ANDREA 616157831 80 Peoria 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 153 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23105.12 0 0 0 0 0 0 23105.12 0 0 0 1101481014 1639487903 11 Dentists SEIDE ASHLEY 606234313 200 Cook 0 0 General Dentistry 0 0 0 128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 516 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 516 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13240.99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13240.99 0 0 0 1101481027 11 Dentists 53 Kane 0 0 General Dentistry 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 862.15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 862.15 0 0 0 1101481029 1306921887 30 General Hospitals DELTA MEDICAL CENTER 387033246 825 Mississippi ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2604.16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2604.16 0 0 0 1101481031 94 Waiver service provider--Children's support (DHS/DDD) 89 Rock Island 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 0 496.92 0 0 0 0 0 0 0 0 0 0 0 0 0 496.92 0 0 0 1101481034 30 General Hospitals 810 Florida NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 71.12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71.12 0 0 0 1101481051 1912171364 10 Physicians BIRNBAUM ANDREA 606118709 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 3 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74.7 0 1579.6 0 0 0 0 0 0 1654.3 0 0 0 1101481064 1841446770 16 Nurse Practitioners PATTERSON BLAIR 627810001 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 265 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 288 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 288 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9480.91 0 0 0 0 0 0 9480.91 0 0 0 1101481065 1720081805 39 Hospice HOSPICE OF SOUTHERN ILL INC 622202133 96 St Clair 0 0 0 0 0 0 0 0 0 0 273 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 703 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14035 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1514735.42 0 0 0 0 0 0 0 0 0 0 0 1514735.42 0 0 0 1101481078 1922114115 36 Community mental health provider SINNISSIPPI CENTERS INC 610212850 60 Lee 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 2580 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6238 0 0 2580 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6238 0 0 1575.61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 247390.46 0 0 248966.07 0 0 0 1101481084 1164477766 10 Physicians KAYEMBE TSHISWAKA 630442719 826 Missouri 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 0 0 7 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 0 185.65 0 0 0 0 0 0 185.65 0 0 0 1101481090 1548360449 63 Other Providers of Medical Equipment/Supplies (Non-registered) LINK MEDICAL EQUIPMENT INC 606455209 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 377 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3841 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3841 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 136569.11 0 717.72 0 0 0 0 137286.83 0 0 0 1101481105 1962485151 63 Other Providers of Medical Equipment/Supplies (Non-registered) HOME CARE PLUS INC 606454511 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 485 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1298 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1298 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99185.53 0 920.62 0 0 0 0 100106.15 0 0 0 1101481123 92 Waiver service provider--Disability (DHS/DRS) 98 Tazewell 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 173.81 0 0 0 0 0 0 0 0 0 0 0 0 0 173.81 0 0 0 1101481125 1922010362 75 Department of Alcohol and Substance Abuse Provider STEPPING STONES INC 604351958 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 228 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1849 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3497 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 244032.89 0 0 244032.89 0 0 0 1101481137 1467435461 70 Ambulance Service Providers AIR EVAC EMS INC 624732206 33 Effingham 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 176 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 207 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 207 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 181168.55 0 0 0 0 0 0 181168.55 0 0 0 1101481140 1073655825 16 Nurse Practitioners WAGNER MICHAEL 618324320 100 Vermilion 0 0 0 6 0 0 12 0 0 0 0 0 0 0 0 202 0 0 0 0 0 0 13 0 0 19 0 0 0 0 0 0 0 0 947 0 0 0 0 0 0 13 0 0 19 0 0 0 0 0 0 0 0 947 0 0 0 0 0 0 39 0 0 731.83 0 0 0 0 0 0 0 0 27652.23 0 0 0 0 0 0 28423.06 0 0 0 1101481156 24 Speech Therapists 200 Cook 0 0 0 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 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 1668.88 1668.88 0 0 0 1101481162 1558309856 10 Physicians AJMERE NIRAJ 601344205 53 Kane 0 0 Gastroenterology 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 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2103.6 0 0 0 0 0 0 2103.6 0 0 0 1101481166 10 Physicians 852 Wisconsin 0 0 Anesthesiology 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1539.46 0 0 0 0 0 0 1539.46 0 0 0 1101481170 1154534352 34 State-operated facility (DHS) UNIT 0451 HOME 51 LUDEMAN 604661200 200 Cook 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 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 897 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 547705.64 0 0 0 0 0 0 0 0 0 0 547705.64 0 0 0 1101481189 92 Waiver service provider--Disability (DHS/DRS) 79 Ogle 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 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10 0 333 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 333 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 119.76 0 30766.19 0 0 0 0 0 0 30885.95 0 0 0 1101483673 1891893525 10 Physicians CIANCIO SEBASTIAN J 618324360 100 Vermilion 0 0 Urological Surgery 0 0 0 0 0 0 0 0 0 0 0 16 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 246 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 246 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 608.73 0 2363.77 0 0 0 0 0 0 2972.5 0 0 0 1101483691 1538277504 10 Physicians SAVINO ANTHONY 600106812 57 Lake 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 18 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 414.07 0 2093.38 0 0 0 0 0 0 2507.45 0 0 0 1101483693 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11324.07 0 0 0 0 0 0 0 0 0 0 0 0 0 11324.07 0 0 0 1101483718 1376763227 10 Physicians MAENDER CHRISTOPHER W 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0 0 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 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9064 0 0 0 0 0 0 0 0 0 0 0 0 0 9064 0 0 0 1101483803 1073636072 55 Early Intervention Services WILSON DEBORAH L 604732512 200 Cook 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 0 479 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 479 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32614.66 0 0 0 0 0 0 32614.66 0 0 0 1101483816 1003920547 10 Physicians SHAH MANOJ 600681136 200 Cook 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 193 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 193 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11089.47 0 0 0 0 0 0 11089.47 0 0 0 1101483822 14 Chiropractors 89 Rock Island 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101483824 1568618544 10 Physicians BIAGINI TIMOTHY 614553369 70 McDonough 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 318 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 608 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 608 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61566.13 0 0 0 0 0 0 61566.13 0 0 0 1101483827 1447297817 10 Physicians MALALIS LEONARDO 605233808 200 Cook 0 0 Neonatal-Perinatal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 261 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 587 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 587 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57505.67 0 0 0 0 0 0 57505.67 0 0 0 1101483833 1194784819 36 Community mental health provider TRANSITIONS OF WESTERN IL 623057918 10 Adams 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 760 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 760 0 0 146.5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53947.49 0 0 54093.99 0 0 0 1101483844 1457514697 10 Physicians CAMREN GERALD P 606123714 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 751 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1125 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1125 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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Physicians 200 Cook 0 0 Cardiovascular Surgery 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 0 127.7 0 0 0 0 0 0 127.7 0 0 0 1101484174 1013179449 10 Physicians PRABHAKAR NAVEEN 606576624 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 495 0 244 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 682 0 354 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 682 0 354 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9397.02 0 9305.39 0 0 0 0 0 0 18702.41 0 0 0 1101484175 98 Waiver service provider--TBI (DHS/DRS) 64 Macoupin 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 20718.56 0 0 0 0 0 0 0 0 0 0 0 0 0 20718.56 0 0 0 1101484184 1295757011 10 Physicians LUU HUE 605276686 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 3 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63.95 0 23455.57 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23438.25 0 0 0 0 0 0 0 0 0 0 0 0 0 23438.25 0 0 0 1101484432 98 Waiver service provider--TBI (DHS/DRS) 57 Lake 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 74.87 0 0 0 0 0 0 0 0 0 0 0 0 0 74.87 0 0 0 1101484444 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 2393.2 0 0 0 0 0 0 0 0 0 0 0 0 0 2393.2 0 0 0 1101484470 91 Waiver service provider--Adults (DHS/DDD) 107 Will 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 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2155.74 0 0 0 0 0 0 0 0 0 0 0 0 0 2155.74 0 0 0 1101484476 1437325107 30 General Hospitals KEOKUK AREA HOSPITAL 526323456 816 Iowa NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 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BRADLEY 617043630 72 McLean 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3420.46 0 0 0 0 0 0 3420.46 0 0 0 1101484493 94 Waiver service provider--Children's support (DHS/DDD) 86 Putnam 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 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 6710.79 0 0 0 0 0 0 0 0 0 0 0 0 0 6710.79 0 0 0 1101484499 1427109743 10 Physicians ZADIKOFF CINDY 606118709 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2611.03 0 0 0 0 0 0 2611.03 0 0 0 1101484504 1851312979 10 Physicians ADEYEMI OLUWATOYIN 606123714 200 Cook 0 0 Infectious Diseases 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 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 140.82 0 0 0 0 0 0 140.82 0 0 0 1101484507 92 Waiver service provider--Disability (DHS/DRS) 97 Stephenson 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 0 384.71 0 0 0 0 0 0 0 0 0 0 0 0 0 384.71 0 0 0 1101484508 1801162151 16 Nurse Practitioners WALKER HAROLYN 618012530 19 Champaign 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 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 965.88 0 0 0 0 0 0 965.88 0 0 0 1101484509 1922047653 10 Physicians ATCHISON SEAN 609012901 54 Kankakee 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 1133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1467 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1467 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58585.76 0 0 0 0 0 0 58585.76 0 0 0 1101484515 1043425580 55 Early Intervention Services PINA MELISSA 617649774 61 Livingston 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 195 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 195 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9833.25 0 0 0 0 0 0 9833.25 0 0 0 1101484517 1982799961 10 Physicians SKJEI LEAH 601391405 30 DuPage 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 263 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 271 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 271 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8005.3 0 0 0 0 0 0 8005.3 0 0 0 1101484519 23 Occupational Therapists 200 Cook 0 0 0 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 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1696.8 1696.8 0 0 0 1101484520 1225092901 13 Podiatrists KALETA JENNIFER 606131011 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 280 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 280 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3099.12 0 0 0 0 0 0 3099.12 0 0 0 1101484553 1285669911 10 Physicians DAVIES CHARLES 619289388 78 Moultrie 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 176 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 324 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 324 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9803.31 0 0 0 0 0 0 9803.31 0 0 0 1101484555 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 10943.28 0 0 0 0 0 0 0 0 0 0 0 0 0 10943.28 0 0 0 1101484561 1598883076 10 Physicians TIPIRNENI SAMATHA 618012530 19 Champaign 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 0 0 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 223 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 223 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10738.2 0 0 0 0 0 0 10738.2 0 0 0 1101484567 1629148739 63 Other Providers of Medical Equipment/Supplies (Non-registered) PROSTHETIC AND ORTHOTIC CARE 622081842 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88 0 449 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88 0 449 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3155.8 0 66617.65 0 0 0 0 69773.45 0 0 0 1101484570 1700997301 10 Physicians 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13118.44 0 0 0 0 0 0 0 0 0 0 0 0 0 13118.44 0 0 0 1101485537 1649251364 10 Physicians HUSAYNI TAREK 604532699 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 298 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1205 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1205 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38203.94 0 0 0 0 0 0 38203.94 0 0 0 1101485538 1861417669 10 Physicians SVENDROWSKI MARION 631102515 826 Missouri 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26899.06 0 0 0 0 0 0 26899.06 0 0 0 1101485548 1982815478 36 Community mental health provider LSSI OF ILLINOIS 606411819 200 Cook 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 2558 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3228 0 0 2558 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3228 0 0 5450.62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137311.46 0 0 142762.08 0 0 0 1101485562 10 Physicians 81 Perry 0 0 Radiology Diagnosis 0 0 0 0 0 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 818.62 0 0 0 0 0 0 0 0 818.62 0 0 0 1101485564 1053481861 30 General Hospitals DEPAUL HEALTH CENTER 630442512 826 Missouri NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 13 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 282.97 0 0 0 0 0 0 0 0 282.97 0 0 0 1101485565 92 Waiver service provider--Disability (DHS/DRS) 69 Massac 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12597.73 0 0 0 0 0 0 0 0 0 0 0 0 0 12597.73 0 0 0 1101485575 1689761934 63 Other Providers of Medical Equipment/Supplies (Non-registered) GOODHEALTH MEDICAL PRODUCTS 604192222 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2538 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2538 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 188234.88 0 0 0 0 0 0 188234.88 0 0 0 1101485589 1306851605 60 Pharmacies BOND DRUG COMPANY OF IL 3946 604352866 107 Will 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 0 0 0 0 0 3354 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78700 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 216044.56 0 0 0 216044.56 0 0 0 1101485594 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 25226.2 0 0 0 0 0 0 0 0 0 0 0 0 0 25226.2 0 0 0 1101485599 1043345002 55 Early Intervention Services PITTS ANGELA 627125862 91 Sangamon 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 0 958 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 958 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56970.58 0 0 0 0 0 0 56970.58 0 0 0 1101485607 92 Waiver service provider--Disability (DHS/DRS) 94 Shelby 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 1557.32 0 0 0 0 0 0 0 0 0 0 0 0 0 1557.32 0 0 0 1101485613 1801801022 60 Pharmacies BOND DRUG COMPANY OF IL 04306 606431407 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3605 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13327 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 283761 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 599391.79 0 0 0 599391.79 0 0 0 1101485622 1366558215 10 Physicians LUTHER LORI 619380372 24 Coles 0 0 Affiliated with FQHC 0 0 0 0 0 0 0 0 0 0 0 0 0 969 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39524.22 0 0 0 0 0 0 39524.22 0 0 0 1101485628 91 Waiver service provider--Adults (DHS/DDD) 91 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 0 213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22514.25 0 0 0 0 0 0 0 0 0 0 0 0 0 22514.25 0 0 0 1101485633 1104058023 10 Physicians WITKOWSKI PIOTR 605276686 200 Cook 0 0 Surgery General 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 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1517.49 0 0 0 0 0 0 1517.49 0 0 0 1101485634 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 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 1452 0 0 0 0 0 0 0 0 0 0 0 0 0 1452 0 0 0 1101485655 1982632154 10 Physicians ULANSKI LAWRENCE 606743460 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 4 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 282 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 282 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65.35 0 46088.79 0 0 0 0 0 0 46154.14 0 0 0 1101485657 92 Waiver service provider--Disability (DHS/DRS) 68 Mason 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 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35438.71 0 0 0 0 0 0 0 0 0 0 0 0 0 35438.71 0 0 0 1101485665 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1982.2 0 0 0 0 0 0 0 0 0 0 0 0 0 1982.2 0 0 0 1101485671 1841226537 10 Physicians MUTLU GOKHAN 606118709 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3489.55 0 0 0 0 0 0 3489.55 0 0 0 1101485672 1598820268 10 Physicians KELLER CHRISTOPHER 637015230 801 Alabama 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11147.65 0 0 0 0 0 0 11147.65 0 0 0 1101485675 1770523219 10 Physicians WALSH RYAN 616151410 80 Peoria 0 1 Family Practice 0 63 0 0 4 0 0 0 0 0 0 7 0 74 0 0 0 0 0 0 436 0 0 4 0 0 0 0 0 0 12 0 89 0 0 0 0 0 0 436 0 0 4 0 0 0 0 0 0 12 0 89 0 0 0 0 0 0 1223 0 0 223.16 0 0 0 0 0 0 61.02 0 2641.21 0 0 0 0 0 0 4148.39 0 0 0 1101485687 1346455094 10 Physicians BUSSING DANA 606114264 200 Cook 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 316 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 316 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1398.12 0 0 0 0 0 0 1398.12 0 0 0 1101485689 92 Waiver service provider--Disability (DHS/DRS) 91 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 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8368.77 0 0 0 0 0 0 0 0 0 0 0 0 0 8368.77 0 0 0 1101485693 1174872550 16 Nurse Practitioners PODOLSKY NATALIE 60201 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 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 0 266.42 0 0 0 0 0 0 266.42 0 0 0 1101485704 1699774414 10 Physicians PORTER VERNA 620404701 65 Madison 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11247.42 0 0 0 0 0 0 11247.42 0 0 0 1101485717 1992907455 47 Local Education Agencies BLACKHAWK AREA SP ED DIST 865 612444428 89 Rock Island 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 601 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 11225 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 11225 0 0 0 0 191.31 0 0 0 0 0 0 0 0 0 0 0 0 0 116688.63 0 116879.94 0 0 0 1101485720 1285663328 40 Federally Qualified Health Centers NORTH SHORE HEALTH CENTER 600353110 57 Lake 0 1 0 2100 2055 0 1030 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16973 13328 0 3968 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16973 13328 0 3968 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39060 860074.87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 899134.87 0 0 0 1101485725 1255659587 10 Physicians RAJJOUB MOHANNAD 618324360 100 Vermilion 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 103 0 174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 879 0 591 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 879 0 591 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22266.2 0 61698.29 0 0 0 0 0 0 83964.49 0 0 0 1101485729 1891772778 10 Physicians GUPTA NISHEETH 463211769 815 Indiana 0 0 Oncology 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 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5811.22 0 0 0 0 0 0 5811.22 0 0 0 1101485740 1982727830 10 Physicians FERRERA DEAN 604536459 200 Cook 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 691 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17532.49 0 0 0 0 0 0 17532.49 0 0 0 1101485744 1306898960 30 General Hospitals ST VINCENT HOSPITAL 462601902 815 Indiana NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 35 0 0 0 0 13 0 0 0 13 0 0 0 0 0 0 0 0 0 38 0 0 0 0 13 0 0 0 17 0 0 0 0 0 0 0 0 0 38 0 0 0 0 160 0 0 0 17 0 0 0 0 0 0 0 0 0 5394.4 0 0 0 0 101559.1 0 0 0 10031.81 0 0 0 0 0 116985.31 0 0 0 1101485747 1801895784 12 Optometrists HUBBARD NED 614430146 45 Henry 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 103 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 210 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 210 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4412.18 0 2355.02 0 0 0 0 6767.2 0 0 0 1101485754 1295999183 10 Physicians BREUNIG ADAM 60012 71 McHenry 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3781.73 0 0 0 0 0 0 3781.73 0 0 0 1101485758 1063410868 10 Physicians CHANIN MATTHEW P 452132664 832 New Mexico 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 178.27 0 0 0 0 0 0 0 0 178.27 0 0 0 1101485760 91 Waiver service provider--Adults (DHS/DDD) 109 Winnebago 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 0 252 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 252 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24452.88 0 0 0 0 0 0 0 0 0 0 0 0 0 24452.88 0 0 0 1101485761 91 Waiver service provider--Adults (DHS/DDD) 109 Winnebago 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 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23760 0 0 0 0 0 0 0 0 0 0 0 0 0 23760 0 0 0 1101485777 1700992799 10 Physicians AMER EMAD 601375823 30 DuPage 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 207 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3435.07 0 0 0 0 0 0 3435.07 0 0 0 1101485778 1598794455 23 Occupational Therapists SALEFSKI WENDY 625264169 63 Macon 0 0 0 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 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 297.13 297.13 0 0 0 1101485785 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 17938.15 0 0 0 0 0 0 0 0 0 0 0 0 0 17938.15 0 0 0 1101485799 92 Waiver service provider--Disability (DHS/DRS) 57 Lake 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 0 196.77 0 0 0 0 0 0 0 0 0 0 0 0 0 196.77 0 0 0 1101485803 1821319450 11 Dentists BALANEY SAMIR 606233708 200 Cook 0 0 General Dentistry 0 0 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 378 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 378 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9196 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9196 0 0 0 1101485805 1568637189 10 Physicians LEE DANIEL 618203909 13 Boone 0 1 Family Practice 0 152 0 0 23 0 0 0 0 0 0 142 0 477 0 0 0 0 0 0 1137 0 0 71 0 0 0 0 0 0 308 0 724 0 0 0 0 0 0 1137 0 0 71 0 0 0 0 0 0 308 0 724 0 0 0 0 0 0 3067 0 0 2606.81 0 0 0 0 0 0 3081.91 0 30347.6 0 0 0 0 0 0 39103.32 0 0 0 1101485844 1487821468 10 Physicians SADIKOVIC AZRA 605061460 53 Kane 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 2 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2.58 0 7522.87 0 0 0 0 0 0 7525.45 0 0 0 1101485866 91 Waiver service provider--Adults (DHS/DDD) 64 Macoupin 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 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4637.36 0 0 0 0 0 0 0 0 0 0 0 0 0 4637.36 0 0 0 1101485876 1639123458 10 Physicians KAUR TANJEEV 606127232 30 DuPage 0 1 Geriatrics 0 34 0 0 0 0 0 0 0 0 0 0 0 158 0 0 0 0 0 0 64 0 0 0 0 0 0 0 0 0 0 0 374 0 0 0 0 0 0 64 0 0 0 0 0 0 0 0 0 0 0 374 0 0 0 0 0 0 191 0 0 0 0 0 0 0 0 0 0 0 2651.63 0 0 0 0 0 0 2842.63 0 0 0 1101485890 1265525737 10 Physicians DIETRICH YOCKEY SARAH 627032403 91 Sangamon 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2071.21 0 0 0 0 0 0 2071.21 0 0 0 1101485896 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16181.93 0 0 0 0 0 0 0 0 0 0 0 0 0 16181.93 0 0 0 1101485900 92 Waiver service provider--Disability (DHS/DRS) 63 Macon 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 10109.06 0 0 0 0 0 0 0 0 0 0 0 0 0 10109.06 0 0 0 1101485905 1346236569 10 Physicians MANLEY MICHAEL 611075075 109 Winnebago 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 263 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 263 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11124.04 0 0 0 0 0 0 11124.04 0 0 0 1101485910 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 0 288 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 288 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15153.6 0 0 0 0 0 0 0 0 0 0 0 0 0 15153.6 0 0 0 1101485915 1609820984 10 Physicians LIND JOHN 611033655 109 Winnebago 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 3735 0 321 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5881 0 666 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5881 0 666 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57920.89 0 10837.73 0 0 0 0 0 0 68758.62 0 0 0 1101485919 1760488142 10 Physicians ELLIOTT JOHN 620628500 65 Madison 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3191.22 0 0 0 0 0 0 3191.22 0 0 0 1101485922 16 Nurse Practitioners 65 Madison 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 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 173.08 0 0 0 0 0 0 173.08 0 0 0 1101485964 1205082526 36 Community mental health provider THRESHOLDS 606242738 200 Cook 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 598 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 598 0 0 2125.06 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40977.67 0 0 43102.73 0 0 0 1101486003 1417147174 10 Physicians FERNANDEZ KAREN S. 616052576 80 Peoria 0 0 Pediatric Hematology Oncology 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 330 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 330 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53513.79 0 0 0 0 0 0 53513.79 0 0 0 1101486004 1124040399 16 Nurse Practitioners PANARESE MARK 606123723 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 322.59 0 0 0 0 0 0 322.59 0 0 0 1101486009 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5121.6 0 0 0 0 0 0 0 0 0 0 0 0 0 5121.6 0 0 0 1101486013 93 Waiver service provider--HIV/AIDS (DHS/DRS) 24 Coles 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 12477.17 0 0 0 0 0 0 0 0 0 0 0 0 0 12477.17 0 0 0 1101486016 10 Physicians 200 Cook 0 0 Obstetric-Gynecology 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 967.11 0 0 0 0 0 0 967.11 0 0 0 1101486017 1962441584 10 Physicians RAGHAVAN VATHSALA 602011718 200 Cook 0 0 Radiology Therapeutic 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7569.13 0 0 0 0 0 0 7569.13 0 0 0 1101486022 1932279742 16 Nurse Practitioners MURDOCH PATRICIA W 618012529 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2055.95 0 0 0 0 0 0 2055.95 0 0 0 1101486026 92 Waiver service provider--Disability (DHS/DRS) 93 Scott 0 0 0 0 0 0 0 0 1 0 0 0 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Cook 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 1 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3.82 0 191.03 0 0 0 0 0 0 194.85 0 0 0 1101486631 1831201698 10 Physicians SHARMA RASHMI 606118709 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 285.24 0 0 0 0 0 0 285.24 0 0 0 1101486638 1386649762 60 Pharmacies OSWALDS PHARMACY 605407563 30 DuPage 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 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2613 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4957.85 0 0 0 4957.85 0 0 0 1101486647 1417254871 16 Nurse Practitioners OCIEPKA ERIKA 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 306.89 0 0 0 0 0 0 306.89 0 0 0 1101486653 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 266 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17832.85 0 0 0 0 0 0 17832.85 0 0 0 1101486685 1114983798 10 Physicians GONA VASANTHA 601783199 27 Dekalb 0 1 Internal Medicine 0 22 0 0 0 0 0 0 0 0 0 0 0 109 0 0 0 0 0 0 209 0 0 0 0 0 0 0 0 0 0 0 415 0 0 0 0 0 0 209 0 0 0 0 0 0 0 0 0 0 0 415 0 0 0 0 0 0 696 0 0 0 0 0 0 0 0 0 0 0 6506.25 0 0 0 0 0 0 7202.25 0 0 0 1101486710 1750560009 10 Physicians SZANTO MARTIN J 606591219 200 Cook 0 0 Internal Medicine 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 0 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 454.75 0 0 0 0 0 0 454.75 0 0 0 1101486712 1104871797 10 Physicians HAMMING EDWARD 600315709 57 Lake 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 20 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 489.4 0 3330.51 0 0 0 0 0 0 3819.91 0 0 0 1101486717 1336127141 10 Physicians GUTGUTIA KANAN 532024815 852 Wisconsin 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5116.81 0 0 0 0 0 0 5116.81 0 0 0 1101486721 92 Waiver service provider--Disability (DHS/DRS) 91 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 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 2325.6 0 0 0 0 0 0 0 0 0 0 0 0 0 2325.6 0 0 0 1101486723 1043376536 55 Early Intervention Services CONTRERAS ROBIN 606083810 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 613 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 613 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54211.53 0 0 0 0 0 0 54211.53 0 0 0 1101486731 2100477149 71 Medicar Provider YOUR DESTINATION TRANSPORT 604221058 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9526 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9526 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81364.7 0 0 0 0 0 0 81364.7 0 0 0 1101486745 1891077988 23 Occupational Therapists GERVAIS AMY 604221928 200 Cook 0 0 0 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 0 0 0 820 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 820 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62863.8 62863.8 0 0 0 1101486746 1255339677 10 Physicians SYED MASOOD 606292082 200 Cook 0 1 Family Practice 0 428 0 0 31 0 0 0 0 0 0 52 0 222 0 0 0 0 0 0 1109 0 0 82 0 0 0 0 0 0 71 0 771 0 0 0 0 0 0 1109 0 0 82 0 0 0 0 0 0 71 0 771 0 0 0 0 0 0 2696 0 0 2820.06 0 0 0 0 0 0 167.13 0 23403.15 0 0 0 0 0 0 29086.34 0 0 0 1101486769 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 196 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 196 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8811.27 0 0 0 0 0 0 0 0 0 0 0 0 0 8811.27 0 0 0 1101486777 1316034010 10 Physicians ROSS MATTHEW 605552914 30 DuPage 0 0 Neurology Surgery 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 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2890.4 0 0 0 0 0 0 2890.4 0 0 0 1101486810 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 29426.66 0 0 0 0 0 0 0 0 0 0 0 0 0 29426.66 0 0 0 1101486815 1245492941 10 Physicians HARDWICK JENNIFER 627032312 91 Sangamon 0 0 Child Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22.51 0 0 0 0 0 0 22.51 0 0 0 1101486818 1558397802 60 Pharmacies SCHNUCKS PHARMACY 148 622062539 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 283 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1284 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33246 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44145.87 0 0 0 44145.87 0 0 0 1101486832 30 General Hospitals 810 Florida NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 0 338.7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 338.7 0 0 0 1101486835 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 14605.33 0 0 0 0 0 0 0 0 0 0 0 0 0 14605.33 0 0 0 1101486840 92 Waiver service provider--Disability (DHS/DRS) 19 Champaign 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 3584.99 0 0 0 0 0 0 0 0 0 0 0 0 0 3584.99 0 0 0 1101486846 1003802281 10 Physicians VISCARRA MERRIE 606123835 200 Cook 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 0 0 0 185 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 839 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 839 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15012.62 0 0 0 0 0 0 15012.62 0 0 0 1101486851 1518973072 60 Pharmacies WALGREEN CO 09253 420030501 818 Kentucky 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3086 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3811.76 0 0 0 3811.76 0 0 0 1101486857 1124084926 10 Physicians BARDELLA INIS 999999999 57 Lake 0 0 0 0 0 0 4 0 0 0 0 0 0 1 0 27 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 1 0 63 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 1 0 63 0 0 0 0 0 0 0 0 0 402.95 0 0 0 0 0 0 4 0 1172.5 0 0 0 0 0 0 1579.45 0 0 0 1101486866 91 Waiver service provider--Adults (DHS/DDD) 10 Adams 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 19 0 0 0 0 0 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 0 529.1 0 0 0 0 0 0 0 0 0 0 0 0 0 529.1 0 0 0 1101486870 1508093527 10 Physicians KALU UWA 600508419 71 McHenry 0 0 Internal Medicine 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 355.24 0 0 0 0 0 0 355.24 0 0 0 1101486873 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21771.29 0 0 0 0 0 0 0 0 0 0 0 0 0 21771.29 0 0 0 1101486884 1356357818 60 Pharmacies BOND DRUG COMPANY OF IL 02558 604261921 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1654 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6039 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 136060 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 216988.97 0 0 0 216988.97 0 0 0 1101486891 92 Waiver service provider--Disability (DHS/DRS) 62 Logan 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 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 10032.94 0 0 0 0 0 0 0 0 0 0 0 0 0 10032.94 0 0 0 1101486896 10 Physicians 816 Iowa 0 0 Internal Medicine 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102.83 0 0 0 0 0 0 102.83 0 0 0 1101486910 1033215868 10 Physicians ALI MOHAMMED 606441580 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 207 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 654 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 654 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15023.99 0 0 0 0 0 0 15023.99 0 0 0 1101486914 1619052776 63 Other Providers of Medical Equipment/Supplies (Non-registered) LINCARE INC 464107151 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 492 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 492 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7368.67 0 0 0 0 0 0 7368.67 0 0 0 1101486923 1164442505 10 Physicians OCONNOR CHRISTOPHER 606123833 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 6 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10298.22 0 0 0 0 0 0 10298.22 0 0 0 1101486932 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 23808 0 0 0 0 0 0 0 0 0 0 0 0 0 23808 0 0 0 1101486943 1124088828 11 Dentists KAHN ALLA 606186423 200 Cook 0 0 General Dentistry 0 0 0 488 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2754 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2754 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99720.21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99720.21 0 0 0 1101486962 1164498812 10 Physicians OYEDIJO DOTUN 609144796 54 Kankakee 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 953 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 953 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74385.76 0 0 0 0 0 0 74385.76 0 0 0 1101486963 92 Waiver service provider--Disability (DHS/DRS) 47 Jackson 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53.46 0 0 0 0 0 0 0 0 0 0 0 0 0 53.46 0 0 0 1101486967 1467464339 10 Physicians DUBAUSKAS OZLEM 601302529 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 877 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 877 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25527.57 0 0 0 0 0 0 25527.57 0 0 0 1101486972 36 Community mental health provider 71 McHenry 0 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104.14 0 0 104.14 0 0 0 1101486974 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4574.53 0 0 0 0 0 0 0 0 0 0 0 0 0 4574.53 0 0 0 1101486975 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 1312.4 0 0 0 0 0 0 0 0 0 0 0 0 0 1312.4 0 0 0 1101486981 1558460022 10 Physicians SASSO BRIAN 609141092 54 Kankakee 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 126 0 0 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11867 0 0 0 0 28431 0 0 35 44504 0 0 0 0 0 1365.77 84070.53 0 0 2346013.49 0 0 0 0 23602369.1 0 0 87125.52 5104078.47 0 0 0 0 0 31225022.88 0 0 0 1101486991 1538247762 40 Federally Qualified Health Centers BOOKER FAMILY HEALTH CENTER 606534224 200 Cook 0 1 0 2058 1311 0 377 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11942 5089 0 1175 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11942 5089 0 1175 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30926 313661.79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 344587.79 0 0 0 1101486995 1154343689 10 Physicians AMBLER DOUGLAS 601871039 30 DuPage 0 1 Internal Medicine 0 13 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 205 0 0 0 0 0 0 0 0 0 0 0 1562.74 0 0 0 0 0 0 1767.74 0 0 0 1101486999 1366599854 70 Ambulance Service Providers SHRADER AMBULANCE SERVICE 619101407 29 Douglas 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 341 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 341 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18119.16 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(Non-registered) LINCARE INC. 627044502 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 242 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2382 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2382 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81703.93 0 0 0 0 0 0 81703.93 0 0 0 1101487271 1518960483 10 Physicians EGGERS DAVID 477101680 815 Indiana 0 0 Neurology Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2826.08 0 0 0 0 0 0 2826.08 0 0 0 1101487289 1245499839 10 Physicians GOPIREDDY DHEERAJ 535381960 852 Wisconsin 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 437 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 597 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 597 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15950.23 0 0 0 0 0 0 0 0 15950.23 0 0 0 1101487290 1316151004 16 Nurse Practitioners ROLFSEN NORMA 606162477 200 Cook 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 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 281 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24112 0 0 0 0 0 0 0 0 0 0 0 0 0 24112 0 0 0 1101487485 92 Waiver service provider--Disability (DHS/DRS) 63 Macon 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97.96 0 0 0 0 0 0 0 0 0 0 0 0 0 97.96 0 0 0 1101487492 1447360631 10 Physicians SIDDIQUI NADEEM 601220021 109 Winnebago 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 267 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 305 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 305 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7417.22 0 0 0 0 0 0 7417.22 0 0 0 1101487493 1053512491 10 Physicians LYON MILENA 606127307 200 Cook 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8994.88 0 0 0 0 0 0 8994.88 0 0 0 1101487494 91 Waiver service provider--Adults (DHS/DDD) 30 DuPage 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 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0 0 0 0 6 0 26 0 0 0 0 0 0 81 0 0 37 0 0 0 0 0 0 8 0 82 0 0 0 0 0 0 81 0 0 37 0 0 0 0 0 0 8 0 82 0 0 0 0 0 0 182 0 0 972.29 0 0 0 0 0 0 25.75 0 2029.53 0 0 0 0 0 0 3209.57 0 0 0 1101487637 1164463535 10 Physicians BROOKFIELD LESLIE 600252425 200 Cook 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 0 0 218 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 378 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 378 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4054.63 0 0 0 0 0 0 4054.63 0 0 0 1101487650 2100478068 28 Waiver service provider--Supportive living facility (HFS) GRAND PRAIRIE ASSISTED LIVING 614557508 70 McDonough 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 713 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18510 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1008741.44 0 0 0 0 0 0 0 0 0 0 0 0 0 1008741.44 0 0 0 1101487657 1518983832 10 Physicians RIEW KIEHYUN 631568233 826 Missouri 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 6 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 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4 0 0 0 0 0 0 0 0 0 0 0 0 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 3444.75 0 0 0 0 0 0 0 0 0 0 0 0 0 3444.75 0 0 0 1101487718 1346392750 16 Nurse Practitioners RUSSELL TERRI 604358200 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 270 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 387 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 387 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23651.49 0 0 0 0 0 0 23651.49 0 0 0 1101487729 1003923459 10 Physicians LIU LARRY HANPING 606161536 200 Cook 0 0 General Practice 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1084.35 0 0 0 0 0 0 1084.35 0 0 0 1101487742 1700016417 60 Pharmacies WALGREENS 10205 622941336 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 363 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1903 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45215 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 150902.9 0 0 0 150902.9 0 0 0 1101487743 1205058799 10 Physicians ODONNELL SCOTT 601933553 200 Cook 0 1 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 155.57 0 5545.86 0 0 0 0 0 0 5701.43 0 0 0 1101487826 92 Waiver service provider--Disability (DHS/DRS) 25 Crawford 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 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 7684.97 0 0 0 0 0 0 0 0 0 0 0 0 0 7684.97 0 0 0 1101487834 1053535864 34 State-operated facility (DHS) UNIT 0111 HOME 11 LUDEMAN 604661200 200 Cook 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 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 862 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 531557.9 0 0 0 0 0 0 0 0 0 0 531557.9 0 0 0 1101487839 1124191846 12 Optometrists DYGOLA SHAWN 607141402 200 Cook 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 128 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 128 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2726.87 0 1610.28 0 0 0 0 4337.15 0 0 0 1101487844 1245493865 60 Pharmacies GOREVILLE PROFESSIONAL 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1831159748 10 Physicians SAULIS VYTAS 606941400 30 DuPage 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 522 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 576 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 576 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17381.25 0 0 0 0 0 0 17381.25 0 0 0 1101487956 40 Federally Qualified Health Centers 53 Kane 0 0 0 0 3 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 0 371.31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 371.31 0 0 0 1101487966 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8084.96 0 0 0 0 0 0 0 0 0 0 0 0 0 8084.96 0 0 0 1101487968 1790804144 70 Ambulance Service Providers NEW MILFORD FIRE PROT DIST 611094854 109 Winnebago 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 29 0 0 0 0 0 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 0 829.85 0 0 0 0 0 0 829.85 0 0 0 1101487969 91 Waiver service provider--Adults (DHS/DDD) 91 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 0 340 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 340 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16137 0 0 0 0 0 0 0 0 0 0 0 0 0 16137 0 0 0 1101487970 1891883773 10 Physicians DALY JEROME T 604232010 107 Will 0 1 General Practice 0 42 0 0 5 0 0 0 0 0 0 1 0 17 0 0 0 0 0 0 311 0 0 16 0 0 0 0 0 0 1 0 40 0 0 0 0 0 0 311 0 0 16 0 0 0 0 0 0 1 0 40 0 0 0 0 0 0 732 0 0 582.29 0 0 0 0 0 0 3.33 0 1323.9 0 0 0 0 0 0 2641.52 0 0 0 1101487972 22 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 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8308.12 8308.12 0 0 0 1101487982 1316947336 10 Physicians HAMILTON LINDA 605639791 30 DuPage 0 1 Pediatrics 0 170 0 0 88 0 0 0 0 0 0 39 0 165 0 0 0 0 0 0 1411 0 0 223 0 0 0 0 0 0 39 0 195 0 0 0 0 0 0 1411 0 0 223 0 0 0 0 0 0 39 0 195 0 0 0 0 0 0 2822 0 0 8167.21 0 0 0 0 0 0 340.74 0 8906.7 0 0 0 0 0 0 20236.65 0 0 0 1101487992 1942485735 10 Physicians ANSAR SAMEER 611082491 109 Winnebago 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 394 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 394 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7045.69 0 0 0 0 0 0 7045.69 0 0 0 1101487993 1255335188 10 Physicians ROHLFING AMY 622781105 87 Randolph 0 1 Internal Medicine 0 30 0 0 0 0 0 0 0 0 0 0 0 82 0 0 0 0 0 0 248 0 0 0 0 0 0 0 0 0 0 0 256 0 0 0 0 0 0 248 0 0 0 0 0 0 0 0 0 0 0 256 0 0 0 0 0 0 822 0 0 0 0 0 0 0 0 0 0 0 2279.81 0 0 0 0 0 0 3101.81 0 0 0 1101488004 1528123742 10 Physicians BACHMAN CATHERINE 605276686 30 DuPage 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18674.77 0 0 0 0 0 0 18674.77 0 0 0 1101488006 1174727267 10 Physicians RUSSELL HOLLY 604877725 200 Cook 0 1 Pediatrics 0 648 0 0 420 0 0 0 0 0 0 163 0 391 0 0 0 0 0 0 4353 0 0 1726 0 0 0 0 0 0 172 0 680 0 0 0 0 0 0 4353 0 0 1726 0 0 0 0 0 0 172 0 680 0 0 0 0 0 0 8706 0 0 52713.33 0 0 0 0 0 0 1200.39 0 24198.31 0 0 0 0 0 0 86818.03 0 0 0 1101488013 10 Physicians 57 Lake 0 0 Hematology 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38.6 0 0 0 0 0 0 38.6 0 0 0 1101488015 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16822.18 0 0 0 0 0 0 0 0 0 0 0 0 0 16822.18 0 0 0 1101488026 91 Waiver service provider--Adults (DHS/DDD) 64 Macoupin 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 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10375.71 0 0 0 0 0 0 0 0 0 0 0 0 0 10375.71 0 0 0 1101488032 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 14334.28 0 0 0 0 0 0 0 0 0 0 0 0 0 14334.28 0 0 0 1101488052 1215954839 10 Physicians RUFF RICHARD 604404906 107 Will 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 428 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 472 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 472 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14007.81 0 0 0 0 0 0 14007.81 0 0 0 1101488054 1861449605 70 Ambulance Service Providers MAYWOOD FIRE DEPT 601531372 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 465 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1306 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1306 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56449.03 0 0 0 0 0 0 56449.03 0 0 0 1101488060 1629229414 28 Waiver service provider--Supportive living facility (HFS) HERITAGE WOODS OF DEKALB 601151106 27 Dekalb 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 0 659 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17407 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 170 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 170 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9120.51 0 0 0 0 0 0 9120.51 0 0 0 1101488195 10 Physicians 200 Cook 0 0 Pediatrics 0 0 0 0 1 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 32.15 0 0 0 0 0 0 0 0 38.6 0 0 0 0 0 0 70.75 0 0 0 1101488196 1730392721 10 Physicians ATTAR SAMER 606112991 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 27 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 521.58 0 6625.36 0 0 0 0 0 0 7146.94 0 0 0 1101488207 1295810836 11 Dentists ENGEN PAUL 601232019 53 Kane 0 0 General Dentistry 0 0 0 8 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 0 594.37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 594.37 0 0 0 1101488209 1679693949 47 Local Education Agencies PINCKNEYVILLE SCH DIST 50 622741370 81 Perry 0 0 0 0 0 0 88 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 1182 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 1182 0 0 0 0 1012.48 0 0 0 0 0 0 0 0 0 0 0 0 0 22429.43 0 23441.91 0 0 0 1101488212 1912980863 10 Physicians VERA TRACY L 604332548 30 DuPage 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60312.84 0 0 0 0 0 0 60312.84 0 0 0 1101488221 92 Waiver service provider--Disability (DHS/DRS) 79 Ogle 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 25679.34 0 0 0 0 0 0 0 0 0 0 0 0 0 25679.34 0 0 0 1101488227 1245211366 10 Physicians KILEY PHILIP J 600051069 200 Cook 0 0 Internal Medicine 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 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 387.26 0 0 0 0 0 0 387.26 0 0 0 1101488232 1932214186 10 Physicians SEVERINO RONALD 601897813 30 DuPage 0 1 Family Practice 0 12 0 0 7 0 0 0 0 0 0 2 0 20 0 0 0 0 0 0 117 0 0 7 0 0 0 0 0 0 3 0 38 0 0 0 0 0 0 117 0 0 7 0 0 0 0 0 0 3 0 38 0 0 0 0 0 0 258 0 0 583.62 0 0 0 0 0 0 20.72 0 712.44 0 0 0 0 0 0 1574.78 0 0 0 1101488251 1083785075 10 Physicians BOYER JERREL 606253500 200 Cook 0 0 Neurology Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 309 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 309 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29125.35 0 0 0 0 0 0 29125.35 0 0 0 1101488258 1114013125 10 Physicians WILBUR ANDREW 606127232 57 Lake 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 749 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1022 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1022 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36634.11 0 7638.16 0 0 0 0 0 0 44272.27 0 0 0 1101488263 1427097104 10 Physicians SUSSMAN MITCHELL 618012500 19 Champaign 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 90 0 217 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 127.32 0 0 0 0 0 0 0 0 127.32 0 0 0 1101488336 1336136514 10 Physicians HOWARD DANIEL 420037941 818 Kentucky 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 1 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3.46 0 777.83 0 0 0 0 0 0 781.29 0 0 0 1101488347 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 2277.74 0 0 0 0 0 0 0 0 0 0 0 0 0 2277.74 0 0 0 1101488350 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2127.18 0 0 0 0 0 0 0 0 0 0 0 0 0 2127.18 0 0 0 1101488354 10 Physicians 30 DuPage 0 0 Dermatology 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 420.88 0 0 0 0 0 0 420.88 0 0 0 1101488357 1982692653 10 Physicians DOSHI HIMANSHU 463201931 815 Indiana 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 187 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 233 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 233 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2788.25 0 199.3 0 0 0 0 0 0 2987.55 0 0 0 1101488365 1427266279 10 Physicians WOLFMEYER MARK 616030001 80 Peoria 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 416 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 416 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8357.81 0 0 0 0 0 0 8357.81 0 0 0 1101488366 1679723548 10 Physicians ALLAMNENI SIREESHA 606493835 200 Cook 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 0 0 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 413 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 413 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 478.54 0 0 0 0 0 0 478.54 0 0 0 1101488369 1891707923 10 Physicians MALICK ALI 600147978 71 McHenry 0 0 Rheumatology 0 0 0 0 0 0 0 0 0 0 0 0 0 39 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 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 876.03 0 0 0 0 0 0 876.03 0 0 0 1101488374 1407166671 40 Federally Qualified Health Centers UIH-MILE SQUARE AT CICERO 608042508 200 Cook 0 1 0 9510 2131 0 1000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59079 7633 0 2852 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59079 7633 0 2852 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 148845 562610.7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 711455.7 0 0 0 1101488381 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 35249.46 0 0 0 0 0 0 0 0 0 0 0 0 0 35249.46 0 0 0 1101488386 10 Physicians 826 Missouri 0 0 Dermatology 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 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 94.54 0 0 0 0 0 0 94.54 0 0 0 1101488390 1497948301 10 Physicians SHAHRAWAT SONIA 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0 0 0 0 0 0 0 0 7491.8 0 0 0 0 0 0 0 0 0 0 0 0 0 7491.8 0 0 0 1101488405 1700960572 10 Physicians GREELING RODNEY 620628553 65 Madison 0 1 Plastic Surgery 0 1 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 1019.61 0 0 0 0 0 0 1055.61 0 0 0 1101488418 1447276662 10 Physicians SNIDER BARBARA 631123005 826 Missouri 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 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 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 275.18 0 0 0 0 0 0 275.18 0 0 0 1101488419 1538166236 10 Physicians MARMO FRANK 606291813 200 Cook 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 1257 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2111 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2111 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40086.31 0 2163.7 0 0 0 0 0 0 42250.01 0 0 0 1101488425 1124076419 36 Community mental health provider ASSOCIATION HOUSE OF CHICAGO 606473758 200 Cook 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 846 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 831 0 0 846 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 831 0 0 26048.99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38478.31 0 0 64527.3 0 0 0 1101488429 1205847688 10 Physicians SANTHANAM VIMALA 606431791 200 Cook 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2716.62 0 0 0 0 0 0 2716.62 0 0 0 1101488432 92 Waiver service provider--Disability (DHS/DRS) 72 McLean 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 7397.36 0 0 0 0 0 0 0 0 0 0 0 0 0 7397.36 0 0 0 1101488443 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 32926.84 0 0 0 0 0 0 0 0 0 0 0 0 0 32926.84 0 0 0 1101488446 1831220318 10 Physicians SADER SAMER 616033002 80 Peoria 0 0 Nephrology 0 0 0 0 0 0 0 0 0 0 0 27 0 221 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64 0 863 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64 0 863 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108.68 0 9991.77 0 0 0 0 0 0 10100.45 0 0 0 1101488469 1467507814 10 Physicians HEDAYATI TARLAN 606123714 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 347 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 358 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 358 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12812.45 0 0 0 0 0 0 12812.45 0 0 0 1101488497 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12797.57 0 0 0 0 0 0 0 0 0 0 0 0 0 12797.57 0 0 0 1101488501 11 Dentists 91 Sangamon 0 0 General Dentistry 0 0 0 2 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 0 213.45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 213.45 0 0 0 1101488504 1982831038 10 Physicians MACVENN MELISSA 999999999 55 Kendall 0 0 0 0 0 0 1 0 0 0 0 0 0 32 0 188 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 52 0 305 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 52 0 305 0 0 0 0 0 0 0 0 0 12.8 0 0 0 0 0 0 927.73 0 11847.99 0 0 0 0 0 0 12788.52 0 0 0 1101488505 1215040654 10 Physicians CAMPBELL MAIBRITT 606575147 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 1100 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1684 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1684 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32637.36 0 1244.27 0 0 0 0 0 0 33881.63 0 0 0 1101488515 1518065341 10 Physicians STANDAGE CHRISTOPHER 600986911 71 McHenry 0 0 Otorhinolaryngology 0 0 0 0 2 0 0 0 0 0 0 0 0 127 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 586 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 586 0 0 0 0 0 0 0 0 0 30.4 0 0 0 0 0 0 0 0 5196.63 0 0 0 0 0 0 5227.03 0 0 0 1101488521 1164624706 25 Audiologists ROCK ARICA 617017904 72 McLean 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 175.13 175.13 0 0 0 1101488522 1275620700 10 Physicians RAY KATHRYN 601695017 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 2 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 215.7 0 440.64 0 0 0 0 0 0 656.34 0 0 0 1101488526 1225216054 10 Physicians HARRISON ELIZABETH 631101010 826 Missouri 0 0 Pediatrics 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 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 0 880.53 0 0 0 0 0 0 880.53 0 0 0 1101488529 1366467755 16 Nurse Practitioners TOENNIES KRISTI 625265858 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 957 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 957 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12043.37 0 0 0 0 0 0 12043.37 0 0 0 1101488533 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 198 0 0 0 1101488549 1326091133 10 Physicians PETRI WALTER 601181416 53 Kane 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8736.75 0 0 0 0 0 0 8736.75 0 0 0 1101488550 1568463305 10 Physicians VEEDER MICHAEL 616157828 80 Peoria 0 0 Oncology 0 0 0 0 0 0 0 0 0 0 0 34 0 358 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 213 0 2663 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 213 0 2663 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2245.17 0 512296.87 0 0 0 0 0 0 514542.04 0 0 0 1101488563 2100478981 71 Medicar Provider AMERICARE USA INC 606165103 200 Cook 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 11313 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11313 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90128.46 0 0 0 0 0 0 90128.46 0 0 0 1101488565 1790770865 10 Physicians SANDHU HARCHARAN 604535200 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5947.05 0 0 0 0 0 0 5947.05 0 0 0 1101488570 94 Waiver service provider--Children's support (DHS/DDD) 63 Macon 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 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2326.7 0 0 0 0 0 0 0 0 0 0 0 0 0 2326.7 0 0 0 1101488582 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 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 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 24.9 0 0 0 0 0 0 24.9 0 0 0 1101488586 1336251982 10 Physicians BOROWIECKI TOMASZ 627023719 91 Sangamon 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 34 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 659.2 0 9365.57 0 0 0 0 0 0 10024.77 0 0 0 1101488595 1518179209 10 Physicians ALEXANDER TAMIKA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 291 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 386 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 386 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 793.9 0 110557.81 0 0 0 0 0 0 111351.71 0 0 0 1101488604 92 Waiver service provider--Disability (DHS/DRS) 96 St Clair 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10587 0 0 0 0 0 0 0 0 0 0 0 0 0 10587 0 0 0 1101488605 1952466179 10 Physicians SMALL STEPHEN 605276686 30 DuPage 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14530.96 0 0 0 0 0 0 14530.96 0 0 0 1101488639 1760426126 10 Physicians CRABB GEOFF 604404906 107 Will 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 385 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 436 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 436 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13702 0 0 0 0 0 0 13702 0 0 0 1101488644 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26666.8 0 0 0 0 0 0 0 0 0 0 0 0 0 26666.8 0 0 0 1101488649 91 Waiver service provider--Adults (DHS/DDD) 68 Mason 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 0 314 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 314 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9490.8 0 0 0 0 0 0 0 0 0 0 0 0 0 9490.8 0 0 0 1101488654 92 Waiver service provider--Disability (DHS/DRS) 70 McDonough 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 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10090.02 0 0 0 0 0 0 0 0 0 0 0 0 0 10090.02 0 0 0 1101488656 1396855821 63 Other Providers of Medical Equipment/Supplies (Non-registered) INTEGRATED HOMECARE SERVS INC 611088010 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 869 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8643 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8643 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 397821.46 0 1041.18 0 0 0 0 398862.64 0 0 0 1101488658 92 Waiver service provider--Disability (DHS/DRS) 47 Jackson 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 1681 0 0 0 0 0 0 0 0 0 0 0 0 0 1681 0 0 0 1101488661 1306849872 10 Physicians HAERR ROBERT 478042706 815 Indiana 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 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 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1749.48 0 0 0 0 0 0 1749.48 0 0 0 1101488663 1114167541 62 Opticians / Optical Companies ACCUVISION CENTER 600734906 57 Lake 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 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 248.82 0 0 0 0 248.82 0 0 0 1101488668 1326204090 91 Waiver service provider--Adults (DHS/DDD) STUBNAR HOLLY 606474153 200 Cook 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121342.62 0 0 0 0 0 0 0 0 0 0 0 0 0 121342.62 0 0 0 1101488679 91 Waiver service provider--Adults (DHS/DDD) 83 Pike 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 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13575.91 0 0 0 0 0 0 0 0 0 0 0 0 0 13575.91 0 0 0 1101488706 1639181605 10 Physicians STOTZ AIMEE 601533304 200 Cook 0 0 General Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1948.9 0 0 0 0 0 0 1948.9 0 0 0 1101488715 1205876893 10 Physicians ROSENBERG SHARON 607122234 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 4 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 163 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 163 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 586.76 0 0 0 0 0 0 590.76 0 0 0 1101488720 1376784769 10 Physicians SVANCAREK BRIDGETTE 631101010 826 Missouri 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 1 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31.35 0 1286.59 0 0 0 0 0 0 1317.94 0 0 0 1101488731 2100479149 91 Waiver service provider--Adults (DHS/DDD) SOLEDAD SOCIAL SERVICES CORP 60108 30 DuPage 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6467 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6467 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 882826.45 0 0 0 0 0 0 0 0 0 0 0 0 0 882826.45 0 0 0 1101488748 1083629208 60 Pharmacies WALGREEN CO 606502531 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5408 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20339 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 475741 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 907829.13 0 0 0 907829.13 0 0 0 1101488773 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6039 0 0 0 0 0 0 0 0 0 0 0 0 0 6039 0 0 0 1101488778 1922098748 11 Dentists KIM JOHN 606414730 200 Cook 0 0 General Dentistry 0 0 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 587 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 587 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18599.31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18599.31 0 0 0 1101488785 1356310882 10 Physicians DAVIS STEVEN 526412600 816 Iowa 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1948.72 0 0 0 0 0 0 0 0 1948.72 0 0 0 1101488786 94 Waiver service provider--Children's support (DHS/DDD) 109 Winnebago 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 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10588.94 0 0 0 0 0 0 0 0 0 0 0 0 0 10588.94 0 0 0 1101488793 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 18364.13 0 0 0 0 0 0 0 0 0 0 0 0 0 18364.13 0 0 0 1101488796 1265448443 10 Physicians HORWITZ STEVEN D. 602011718 200 Cook 0 0 Otolaryngology 0 0 0 0 0 0 0 0 0 0 0 0 0 338 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 0 0 0 0 0 673 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34247.12 0 0 0 0 0 0 34247.12 0 0 0 1101488802 1568472363 55 Early Intervention Services HARVEY JENNIFER 623053646 10 Adams 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 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6416.8 0 0 0 0 0 0 6416.8 0 0 0 1101488807 1306832829 10 Physicians RAHMANI BAHRAM 606118709 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 5 0 245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 428 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 428 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156.97 0 26438.93 0 0 0 0 0 0 26595.9 0 0 0 1101488810 1316954308 60 Pharmacies WALGREEN CO 606174712 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1574 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7207 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165745 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 345949.79 0 0 0 345949.79 0 0 0 1101488812 1144520156 11 Dentists GOVINDAIAH SIRISHA 606284215 200 Cook 0 0 General Dentistry 0 0 0 331 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1602 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1602 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53769.49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53769.49 0 0 0 1101488817 1487633566 10 Physicians NWACHUKWU DENNIS 601533328 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1262.22 0 0 0 0 0 0 1262.22 0 0 0 1101488826 91 Waiver service provider--Adults (DHS/DDD) 91 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 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 8299.5 0 0 0 0 0 0 0 0 0 0 0 0 0 8299.5 0 0 0 1101488834 93 Waiver service provider--HIV/AIDS (DHS/DRS) 65 Madison 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3485.7 0 0 0 0 0 0 0 0 0 0 0 0 0 3485.7 0 0 0 1101488835 1740295989 60 Pharmacies WALGREEN CO 3686 631184604 826 Missouri 0 0 0 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 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 552 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 464.14 0 0 0 464.14 0 0 0 1101488853 1497743488 10 Physicians CUMPA EDGARD 627949636 91 Sangamon 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18423.24 0 0 0 0 0 0 18423.24 0 0 0 1101488854 1922029362 60 Pharmacies PHARMAKON LONG TERM CARE PHARM 460325649 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 3248 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 78643 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 523.78 0 0 8840.26 0 0 0 9364.04 0 0 0 1101488863 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14871.55 0 0 0 0 0 0 0 0 0 0 0 0 0 14871.55 0 0 0 1101488866 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14318.32 0 0 0 0 0 0 0 0 0 0 0 0 0 14318.32 0 0 0 1101488867 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 349 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 349 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10626 0 0 0 0 0 0 0 0 0 0 0 0 0 10626 0 0 0 1101488872 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 2910.57 0 0 0 0 0 0 0 0 0 0 0 0 0 2910.57 0 0 0 1101488891 2100479309 91 Waiver service provider--Adults (DHS/DDD) DUBOIS DOUGLAS CENTRES 604191244 200 Cook 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2303966.32 0 0 0 0 0 0 0 0 0 0 0 0 0 2303966.32 0 0 0 1101488900 2100479318 90 Waiver service provider--Elderly (DOA) ADDUS HOMECARE 605151765 30 DuPage 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 2561 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2561 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88669.01 0 0 0 0 0 0 0 0 0 0 0 0 0 88669.01 0 0 0 1101488906 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 19 0 0 0 0 0 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 16496.03 0 0 0 0 0 0 0 0 0 0 0 0 0 16496.03 0 0 0 1101488908 1770671000 10 Physicians PAE SARAH 600077315 200 Cook 0 1 Pediatrics 0 17 0 0 19 0 0 0 0 0 0 10 0 32 0 0 0 0 0 0 69 0 0 53 0 0 0 0 0 0 12 0 43 0 0 0 0 0 0 69 0 0 53 0 0 0 0 0 0 12 0 43 0 0 0 0 0 0 138 0 0 1798.11 0 0 0 0 0 0 53.71 0 1500.8 0 0 0 0 0 0 3490.62 0 0 0 1101488915 10 Physicians 98 Tazewell 0 1 Family Practice 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4.62 0 0 0 0 0 0 4.62 0 0 0 1101488932 1164492708 10 Physicians KIM JERRY 604631256 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4857.11 0 0 0 0 0 0 4857.11 0 0 0 1101488933 1780694216 10 Physicians HOFFMAN MARK D 606751611 200 Cook 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1479.33 0 0 0 0 0 0 1479.33 0 0 0 1101488934 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 0 803.92 0 0 0 0 0 0 0 0 0 0 0 0 0 803.92 0 0 0 1101488946 1235341173 63 Other Providers of Medical Equipment/Supplies (Non-registered) MACK MOORE SHOES INC 619203020 24 Coles 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 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1407.33 0 0 0 0 0 0 1407.33 0 0 0 1101488956 1013904366 33 Nursing Facilities MANOR COURT OF MARYVILLE 620628531 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 808 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21301 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1865643 0 0 0 0 0 0 0 1865643 0 0 0 1101488963 1063534733 10 Physicians GOLBER INNA 606452814 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 201 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4019 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4019 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9160.1 0 0 0 0 0 0 9160.1 0 0 0 1101488970 1144471806 25 Audiologists MESSINA JILL 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 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 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 184.52 184.52 0 0 0 1101488976 1003803552 10 Physicians TOWNE WILLIAM 601344220 53 Kane 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 1 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15.54 0 4391.41 0 0 0 0 0 0 4406.95 0 0 0 1101488977 91 Waiver service provider--Adults (DHS/DDD) 823 Michigan 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 0 308 0 0 0 0 0 0 0 0 0 0 0 0 0 308 0 0 0 1101488980 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 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 1615.25 0 0 0 0 0 0 0 0 0 0 0 0 0 1615.25 0 0 0 1101488981 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13468.8 0 0 0 0 0 0 0 0 0 0 0 0 0 13468.8 0 0 0 1101488997 36 Community mental health provider 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 539.46 0 0 539.46 0 0 0 1101489063 1033102926 10 Physicians ROSALES RICHARD 463603301 815 Indiana 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 343 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2088 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2088 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9133.23 0 0 0 0 0 0 0 0 9133.23 0 0 0 1101489065 1871571661 10 Physicians NOWAK CANDACE 606411604 200 Cook 0 0 Family Practice 0 0 0 0 5 0 0 0 0 0 0 17 0 110 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 19 0 125 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 19 0 125 0 0 0 0 0 0 0 0 0 147.8 0 0 0 0 0 0 199.1 0 4010.92 0 0 0 0 0 0 4357.82 0 0 0 1101489066 1811085822 10 Physicians SHISHIR JAIN 608044163 200 Cook 0 1 Internal Medicine 0 165 0 0 7 0 0 0 0 0 0 30 0 294 0 0 0 0 0 0 286 0 0 7 0 0 0 0 0 0 74 0 1178 0 0 0 0 0 0 286 0 0 7 0 0 0 0 0 0 74 0 1178 0 0 0 0 0 0 788 0 0 587.09 0 0 0 0 0 0 173.73 0 16004.53 0 0 0 0 0 0 17553.35 0 0 0 1101489074 1033254347 24 Speech Therapists KUPPERMAN SUSAN 603022233 200 Cook 0 0 0 0 0 0 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 29 0 0 0 0 0 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 3399.58 3399.58 0 0 0 1101489076 1114923497 10 Physicians PHILLIPS BRYAN 604461673 107 Will 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 6 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 325 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 325 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6702.67 0 0 0 0 0 0 6702.67 0 0 0 1101489084 1609104041 71 Medicar Provider KREIDER SERVICES INCORPORATED 610210366 60 Lee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 195 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64759.92 0 0 0 0 0 0 64759.92 0 0 0 1101489093 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19462.59 0 0 0 0 0 0 0 0 0 0 0 0 0 19462.59 0 0 0 1101489119 1811922552 10 Physicians SKOMURSKI JAMES 604532380 200 Cook 0 0 Family Practice 0 0 0 0 59 0 0 0 0 0 0 0 0 208 0 0 0 0 0 0 0 0 0 170 0 0 0 0 0 0 0 0 253 0 0 0 0 0 0 0 0 0 170 0 0 0 0 0 0 0 0 253 0 0 0 0 0 0 0 0 0 4043.73 0 0 0 0 0 0 0 0 9002.95 0 0 0 0 0 0 13046.68 0 0 0 1101489128 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 30634.82 0 0 0 0 0 0 0 0 0 0 0 0 0 30634.82 0 0 0 1101489137 1083736177 30 General Hospitals CARLE FOUNDATION HOSPITAL 618012529 19 Champaign DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 0 0 0 0 2038 0 0 0 0 0 0 11065 0 0 2422 0 0 0 0 0 0 0 0 4192 0 0 0 0 0 0 52628 0 0 8584 0 0 0 0 0 0 0 0 4192 0 0 0 0 0 0 52628 0 0 8584 0 0 0 0 0 0 0 0 27902.72 0 0 0 0 0 0 559839.74 0 0 597592.63 0 0 0 0 0 1185335.09 0 0 0 1101489138 1740219567 10 Physicians BUSSELL JENNIFER 600302084 57 Lake 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1433.89 0 0 0 0 0 0 1433.89 0 0 0 1101489142 1164437349 60 Pharmacies BOND DRUG COMPANY OF IL 04519 606534508 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 1319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 4426 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 115029 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32.07 0 0 217916.11 0 0 0 217948.18 0 0 0 1101489178 1912927146 10 Physicians NOPARSTAK DAVID 606405255 200 Cook 0 1 Internal Medicine 0 13 0 0 0 0 0 0 0 0 0 21 0 59 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 25 0 131 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 25 0 131 0 0 0 0 0 0 243 0 0 0 0 0 0 0 0 0 127.79 0 4792.76 0 0 0 0 0 0 5163.55 0 0 0 1101489187 1346598406 11 Dentists RAJESH MYTHILI 999999999 200 Cook 0 0 0 0 0 216 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29390.15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29390.15 0 0 0 1101489188 1528201589 16 Nurse Practitioners CROPSEY JENNIFER 601232300 53 Kane 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 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 128.64 0 0 0 0 0 0 128.64 0 0 0 1101489189 1386959443 25 Audiologists RICE MARY 999999999 826 Missouri 0 0 0 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 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7366.09 7366.09 0 0 0 1101489202 1134224934 10 Physicians BROOKER ROBERT 631102515 826 Missouri 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 326 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 326 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37445.6 0 0 0 0 0 0 37445.6 0 0 0 1101489218 1972806784 29 ICF/MR PETERMAN HOUSE 606601017 200 Cook 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 0 282 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6777 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 861399.69 0 0 0 0 0 0 0 0 0 0 861399.69 0 0 0 1101489219 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 14845.86 0 0 0 0 0 0 0 0 0 0 0 0 0 14845.86 0 0 0 1101489224 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 21583.44 0 0 0 0 0 0 0 0 0 0 0 0 0 21583.44 0 0 0 1101489232 1386659886 10 Physicians PERROS DIMITRI 602023439 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 14 0 240 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 448 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 448 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 249 0 15457.47 0 0 0 0 0 0 15706.47 0 0 0 1101489245 1851320238 10 Physicians ROSSI THOMAS 615202608 37 Fulton 0 0 General Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 295 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 594 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 594 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40736.46 0 0 0 0 0 0 40736.46 0 0 0 1101489251 92 Waiver service provider--Disability (DHS/DRS) 96 St Clair 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 30894.4 0 0 0 0 0 0 0 0 0 0 0 0 0 30894.4 0 0 0 1101489253 1457367526 10 Physicians HARGAN PAUL 631102515 826 Missouri 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 76 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1815.51 0 455.99 0 0 0 0 0 0 2271.5 0 0 0 1101489259 1891700084 60 Pharmacies BOND DRUG COMPANY OF IL 600 611092206 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1335 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 6630 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 155245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3.93 0 0 372406.96 0 0 0 372410.89 0 0 0 1101489261 10 Physicians 30 DuPage 0 0 Internal Medicine 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 0 1101489274 1841399821 11 Dentists CARDENAS CYNTHIA 604361243 107 Will 0 0 General Dentistry 0 0 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 236 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 236 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7523.97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7523.97 0 0 0 1101489276 1871653972 30 General Hospitals FMC TERRE HAUTE NORTH 478042743 815 Indiana NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 920 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9551.95 0 0 0 0 0 9551.95 0 0 0 1101489309 1972609022 10 Physicians SALGIA RAKESH 606284247 200 Cook 0 1 Internal Medicine 0 206 0 0 0 0 0 0 0 0 0 0 0 204 0 0 0 0 0 0 1243 0 0 0 0 0 0 0 0 0 0 0 1006 0 0 0 0 0 0 1243 0 0 0 0 0 0 0 0 0 0 0 1006 0 0 0 0 0 0 3600 0 0 0 0 0 0 0 0 0 0 0 14971.07 0 0 0 0 0 0 18571.07 0 0 0 1101489313 1609835461 36 Community mental health provider YOUTH SERVICE BUREAU 613568826 15 Bureau 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2746.78 0 0 2746.78 0 0 0 1101489318 1942244645 30 General Hospitals THE BOARD OF TRUSTEES OF THE U 606127232 200 Cook ARS-U.I. 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89829.72 0 0 0 1101489924 92 Waiver service provider--Disability (DHS/DRS) 97 Stephenson 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 2892.95 0 0 0 0 0 0 0 0 0 0 0 0 0 2892.95 0 0 0 1101489934 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 0 220.56 0 0 0 0 0 0 0 0 0 0 0 0 0 220.56 0 0 0 1101489948 1609125186 16 Nurse Practitioners MOONEY LAURIE 619538037 29 Douglas 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 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 0 583.65 0 0 0 0 0 0 583.65 0 0 0 1101489949 92 Waiver service provider--Disability (DHS/DRS) 108 Williamson 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 17529.35 0 0 0 0 0 0 0 0 0 0 0 0 0 17529.35 0 0 0 1101489954 92 Waiver service provider--Disability (DHS/DRS) 56 Knox 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 2098.76 0 0 0 0 0 0 0 0 0 0 0 0 0 2098.76 0 0 0 1101489969 1710917836 10 Physicians MCGIVNEY RANDALL 604023429 200 Cook 0 0 Pathology 0 0 0 0 4 0 0 0 0 0 0 6368 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 55742 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 55742 0 0 0 0 0 0 0 0 0 0 0 21.74 0 0 0 0 0 0 226417.75 0 0 0 0 0 0 0 0 226439.49 0 0 0 1101489971 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 61 0 0 0 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 4418.7 0 0 0 0 0 0 0 0 0 0 0 0 0 4418.7 0 0 0 1101489976 2100480394 91 Waiver service provider--Adults (DHS/DDD) "NEIGHBORHOOD SERVICES,INC" 606311900 200 Cook 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7951 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7951 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 966333.49 0 0 0 0 0 0 0 0 0 0 0 0 0 966333.49 0 0 0 1101490000 91 Waiver service provider--Adults (DHS/DDD) 30 DuPage 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 0 262 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 262 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13476.36 0 0 0 0 0 0 0 0 0 0 0 0 0 13476.36 0 0 0 1101490003 1679757397 47 Local Education Agencies CENTRAL A AND M CU DIST 21 625100140 20 Christian 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2775.2 0 2775.2 0 0 0 1101490020 1417202607 11 Dentists PATEL JITENDRAKUMAR 627026309 91 Sangamon 0 0 General Dentistry 0 0 0 936 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 6855 0 0 0 0 0 0 0 0 0 0 0 70 0 0 0 0 0 0 6855 0 0 0 0 0 0 0 0 0 0 0 70 0 0 0 0 0 0 184683.94 0 0 0 0 0 0 0 0 0 0 0 26344.5 0 0 0 0 211028.44 0 0 0 1101490039 92 Waiver service provider--Disability (DHS/DRS) 53 Kane 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 3010.77 0 0 0 0 0 0 0 0 0 0 0 0 0 3010.77 0 0 0 1101490043 63 Other Providers of Medical Equipment/Supplies (Non-registered) 53 Kane 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 92.06 0 0 0 0 0 0 92.06 0 0 0 1101490059 1013980101 10 Physicians RAMSEY TARA 627810001 91 Sangamon 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 1202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1443 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1443 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56876.21 0 0 0 0 0 0 56876.21 0 0 0 1101490060 91 Waiver service provider--Adults (DHS/DDD) 53 Kane 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 0 297 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 297 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12782 0 0 0 0 0 0 0 0 0 0 0 0 0 12782 0 0 0 1101490073 1174526511 10 Physicians HSIEH MATTHEW 604023441 200 Cook 0 1 Family Practice 0 51 0 0 9 0 0 0 0 0 0 10 0 53 0 0 0 0 0 0 138 0 0 26 0 0 0 0 0 0 13 0 86 0 0 0 0 0 0 138 0 0 26 0 0 0 0 0 0 13 0 86 0 0 0 0 0 0 321 0 0 752.83 0 0 0 0 0 0 98.54 0 1732.33 0 0 0 0 0 0 2904.7 0 0 0 1101490081 92 Waiver service provider--Disability (DHS/DRS) 55 Kendall 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 14349.44 0 0 0 0 0 0 0 0 0 0 0 0 0 14349.44 0 0 0 1101490103 1255534483 10 Physicians CHAWLA SHALINI 605591514 30 DuPage 0 0 Psychiatry 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 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 2462.68 0 0 0 0 0 0 2462.68 0 0 0 1101490120 1477507226 11 Dentists MACLEOD STEPHEN 999999999 200 Cook 0 0 0 0 0 599 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2601 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2601 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133927.66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133927.66 0 0 0 1101490152 1972507705 10 Physicians COATS RICHARD 622265363 96 St Clair 0 0 Vascular Surgery 0 0 0 0 0 0 0 0 0 0 0 21 0 183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 486 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 486 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 226.7 0 11018.32 0 0 0 0 0 0 11245.02 0 0 0 1101490163 1861467755 10 Physicians ZAK STEVEN 600625100 200 Cook 0 0 Neurology 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 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 387.75 0 0 0 0 0 0 387.75 0 0 0 1101490167 92 Waiver service provider--Disability (DHS/DRS) 96 St Clair 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 17201.9 0 0 0 0 0 0 0 0 0 0 0 0 0 17201.9 0 0 0 1101490179 91 Waiver service provider--Adults (DHS/DDD) 30 DuPage 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 0 350 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 350 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21417 0 0 0 0 0 0 0 0 0 0 0 0 0 21417 0 0 0 1101490186 94 Waiver service provider--Children's support (DHS/DDD) 96 St Clair 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 1344.42 0 0 0 0 0 0 0 0 0 0 0 0 0 1344.42 0 0 0 1101490187 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2935.73 0 0 0 0 0 0 0 0 0 0 0 0 0 2935.73 0 0 0 1101490192 1316244817 10 Physicians SANDOVAL HERRERA CARLOS 606233824 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 96 0 325 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117 0 727 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117 0 727 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3345.6 0 68080.15 0 0 0 0 0 0 71425.75 0 0 0 1101490197 91 Waiver service provider--Adults (DHS/DDD) 24 Coles 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 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10257 0 0 0 0 0 0 0 0 0 0 0 0 0 10257 0 0 0 1101490208 30 General Hospitals 850 Washington NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 0 697.92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 697.92 0 0 0 1101490211 1093834301 30 General Hospitals OSF HOLY FAMILY PART B 614621007 102 Warren DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 1 0 General Hospital - Adult and Child 0 0 0 0 115 0 0 0 0 0 0 1319 0 0 246 0 0 0 0 0 0 0 0 221 0 0 0 0 0 0 5094 0 0 751 0 0 0 0 0 0 0 0 221 0 0 0 0 0 0 5094 0 0 751 0 0 0 0 0 0 0 0 1093.61 0 0 0 0 0 0 27136.65 0 0 160594.64 0 0 0 0 0 188824.9 0 0 0 1101490214 1245256551 10 Physicians UPPALURI RAVINDRA 631101010 826 Missouri 0 0 Otolaryngology 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 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2444.91 0 0 0 0 0 0 2444.91 0 0 0 1101490229 1790892842 14 Chiropractors RICE DONALD 610210312 60 Lee 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 0 263 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 263 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2022.91 0 0 0 0 0 0 2022.91 0 0 0 1101490233 1891726956 60 Pharmacies KMART STORES OF IL LLC 7185 615501545 98 Tazewell 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 677 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17627 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30710.14 0 0 0 30710.14 0 0 0 1101490245 1639109879 10 Physicians BEITEL JOYCE 618215923 19 Champaign 0 0 Family Practice 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 1101490246 1740228857 10 Physicians UNDEVIA SAMIR 606576708 200 Cook 0 0 Hematology 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2677.44 0 0 0 0 0 0 2677.44 0 0 0 1101490262 1245202068 10 Physicians BAHU AMIRA 600101919 57 Lake 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 179 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 218 0 238 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 218 0 238 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3759.29 0 4227.55 0 0 0 0 0 0 7986.84 0 0 0 1101490270 1073599775 10 Physicians KOSTIC JASMINKA 606601344 200 Cook 0 1 General Practice 0 100 0 0 0 0 0 0 0 0 0 0 0 184 0 0 0 0 0 0 168 0 0 0 0 0 0 0 0 0 0 0 495 0 0 0 0 0 0 168 0 0 0 0 0 0 0 0 0 0 0 495 0 0 0 0 0 0 422 0 0 0 0 0 0 0 0 0 0 0 10703.05 0 0 0 0 0 0 11125.05 0 0 0 1101490278 1336490333 16 Nurse Practitioners COPP SUSAN 616360001 98 Tazewell 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 187 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 187 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4070.1 0 0 0 0 0 0 4070.1 0 0 0 1101490288 1871593236 10 Physicians STOCKMAL PETER 604358200 107 Will 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 627 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 699 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 699 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21924.78 0 0 0 0 0 0 21924.78 0 0 0 1101490293 91 Waiver service provider--Adults (DHS/DDD) 69 Massac 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 0 240 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 240 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17910.2 0 0 0 0 0 0 0 0 0 0 0 0 0 17910.2 0 0 0 1101490303 1528073541 60 Pharmacies WALGREEN CO 4834 631131519 826 Missouri 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 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 849 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 774.36 0 0 0 774.36 0 0 0 1101490313 92 Waiver service provider--Disability (DHS/DRS) 37 Fulton 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 14511.46 0 0 0 0 0 0 0 0 0 0 0 0 0 14511.46 0 0 0 1101490328 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 3668.8 0 0 0 0 0 0 0 0 0 0 0 0 0 3668.8 0 0 0 1101490329 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10736 0 0 0 0 0 0 0 0 0 0 0 0 0 10736 0 0 0 1101490330 92 Waiver service provider--Disability (DHS/DRS) 40 Grundy 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 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 1314.23 0 0 0 0 0 0 0 0 0 0 0 0 0 1314.23 0 0 0 1101490332 1619003126 63 Other Providers of Medical Equipment/Supplies (Non-registered) SIGMA SURGICAL SUPPLY CORP 606225681 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 397 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4994 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4994 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 277069.04 0 1943.37 0 0 0 0 279012.41 0 0 0 1101490345 1316962798 10 Physicians EILBERT WESLEY 606127232 30 DuPage 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 10 0 725 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 866 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 866 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 289.15 0 90954.02 0 0 0 0 0 0 91243.17 0 0 0 1101490348 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 1567.39 0 0 0 0 0 0 0 0 0 0 0 0 0 1567.39 0 0 0 1101490353 1831258391 10 Physicians PRETE CAROLE 602015910 200 Cook 0 1 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4209.24 0 0 0 0 0 0 4209.24 0 0 0 1101490373 1841251451 10 Physicians HARKER JAMES 611033655 109 Winnebago 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 316 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 486 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 486 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8284.41 0 0 0 0 0 0 0 0 8284.41 0 0 0 1101490376 1639281926 10 Physicians LEWIS TAMRA 600102540 57 Lake 0 0 Urology 0 0 0 0 0 0 0 0 0 0 0 12 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25.73 0 892.2 0 0 0 0 0 0 917.93 0 0 0 1101490381 1578765426 36 Community mental health provider STICKNEY PUBLIC HEALTH DIST 604592051 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12758.16 0 0 12758.16 0 0 0 1101490401 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 25449.81 0 0 0 0 0 0 0 0 0 0 0 0 0 25449.81 0 0 0 1101490414 1295826675 10 Physicians MUSTARD MICHAEL 606313222 72 McLean 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 114 0 223 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 256 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 256 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1209.56 0 12466.28 0 0 0 0 0 0 13675.84 0 0 0 1101490419 1265410989 10 Physicians ROUSONELOS GUS A 605408928 30 DuPage 0 1 Pediatrics 0 1 0 0 5 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 7 0 0 18 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 7 0 0 18 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 14 0 0 561.42 0 0 0 0 0 0 0 0 158.08 0 0 0 0 0 0 733.5 0 0 0 1101490420 1902972003 60 Pharmacies ROSENBLUM DRUGS 606492103 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 442 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 2538 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 73583 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89.5 0 0 97679.21 0 0 0 97768.71 0 0 0 1101490438 91 Waiver service provider--Adults (DHS/DDD) 62 Logan 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 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11008.8 0 0 0 0 0 0 0 0 0 0 0 0 0 11008.8 0 0 0 1101490442 1639375496 10 Physicians RAKIC ANDREI 601181464 53 Kane 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 228 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 228 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 776.82 0 0 0 0 0 0 776.82 0 0 0 1101490443 10 Physicians 19 Champaign 0 0 Pediatrics 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1667.15 0 0 0 0 0 0 1667.15 0 0 0 1101490463 1154397545 10 Physicians REDDY SRIDEVI 606118700 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 11 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 341.44 0 700.53 0 0 0 0 0 0 1041.97 0 0 0 1101490474 1083699722 10 Physicians BLENDONOHY PETER 600745551 200 Cook 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 0 0 0 159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1451 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1451 0 0 0 0 0 0 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606314200 200 Cook 0 0 General Dentistry 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1014.3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1014.3 0 0 0 1101490778 1194923060 10 Physicians HASEEB ATEEQ 481089649 836 Ohio 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 931.62 0 0 0 0 0 0 931.62 0 0 0 1101490818 1124088489 10 Physicians HOOBERMAN ARTHUR 600681270 200 Cook 0 0 Internal Medicine 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 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9903.19 0 0 0 0 0 0 9903.19 0 0 0 1101490819 1770625311 10 Physicians GIACAMAN MIKE 631102515 826 Missouri 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 15 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 2688.13 0 0 0 0 0 0 2688.13 0 0 0 1101490820 1801818240 30 General Hospitals SPARTA COMMUNITY HOSPITAL 622861820 87 Randolph ARS-PD Hospitals paid a Per Diem rate. 1 0 Government Owned 0 0 0 0 0 2155 0 0 0 0 66 2 0 4 980 0 0 0 0 0 0 0 0 0 4300 0 0 0 0 71 2 0 4 2205 0 0 0 0 0 0 0 0 0 4300 0 0 0 0 181 2 0 4 2205 0 0 0 0 0 0 0 0 0 772042.46 0 0 0 0 128050.43 845.66 0 8272.73 728085.44 0 0 0 0 0 1637296.72 0 0 0 1101490829 98 Waiver service provider--TBI (DHS/DRS) 91 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 7461.73 0 0 0 0 0 0 0 0 0 0 0 0 0 7461.73 0 0 0 1101490838 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 7515.58 0 0 0 0 0 0 0 0 0 0 0 0 0 7515.58 0 0 0 1101490841 10 Physicians 815 Indiana 0 0 Radiology 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 99.72 0 0 0 0 0 0 0 0 99.72 0 0 0 1101490842 1164534707 23 Occupational Therapists STOLZENBURG CARRIE 601812877 30 DuPage 0 0 0 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 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1801.72 1801.72 0 0 0 1101490849 1861410011 10 Physicians KARINATTU JOSEPH 618337423 100 Vermilion 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 209 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 209 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1063.76 0 0 0 0 0 0 1063.76 0 0 0 1101490852 1710076237 10 Physicians BERGER DANIEL 606744271 200 Cook 0 1 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 2 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 1018 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 1018 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23.54 0 2169.46 0 0 0 0 0 0 2193 0 0 0 1101490857 92 Waiver service provider--Disability (DHS/DRS) 91 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 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 4674.44 0 0 0 0 0 0 0 0 0 0 0 0 0 4674.44 0 0 0 1101490871 91 Waiver service provider--Adults (DHS/DDD) 96 St Clair 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 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3363.8 0 0 0 0 0 0 0 0 0 0 0 0 0 3363.8 0 0 0 1101490879 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20765.59 0 0 0 0 0 0 0 0 0 0 0 0 0 20765.59 0 0 0 1101490882 1417903139 12 Optometrists STELMACK JOAN 606081288 200 Cook 0 0 Therapeutic Pharmaceutical Agents 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 933.37 0 0 0 0 0 0 933.37 0 0 0 1101490890 93 Waiver service 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0 0 0 0 0 8 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182.62 0 884.92 0 0 0 0 1067.54 0 0 0 1101491391 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4126.67 0 0 0 0 0 0 0 0 0 0 0 0 0 4126.67 0 0 0 1101491394 90 Waiver service provider--Elderly (DOA) 65 Madison 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 0 278 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 278 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11641.38 0 0 0 0 0 0 0 0 0 0 0 0 0 11641.38 0 0 0 1101491399 94 Waiver service provider--Children's support (DHS/DDD) 30 DuPage 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 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5443.9 0 0 0 0 0 0 0 0 0 0 0 0 0 5443.9 0 0 0 1101491406 10 Physicians 815 Indiana 0 0 Pathology 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177.42 0 0 0 0 0 0 0 0 177.42 0 0 0 1101491413 91 Waiver service provider--Adults (DHS/DDD) 14 Brown 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 0 219 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 219 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15593.26 0 0 0 0 0 0 0 0 0 0 0 0 0 15593.26 0 0 0 1101491416 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 276 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 276 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22959.75 0 0 0 0 0 0 0 0 0 0 0 0 0 22959.75 0 0 0 1101491419 1538133350 10 Physicians SUCHOMSKI GERALD 626298047 91 Sangamon 0 1 Family Practice 0 55 0 0 1 0 0 0 0 0 0 3 0 23 0 0 0 0 0 0 429 0 0 1 0 0 0 0 0 0 3 0 33 0 0 0 0 0 0 429 0 0 1 0 0 0 0 0 0 3 0 33 0 0 0 0 0 0 1061 0 0 76.84 0 0 0 0 0 0 10.75 0 1075.64 0 0 0 0 0 0 2224.23 0 0 0 1101491421 1043402035 10 Physicians BUTNARIU DANIEL 627949636 91 Sangamon 0 0 Pulmonary Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 193 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 633 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 633 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81063.51 0 0 0 0 0 0 81063.51 0 0 0 1101491440 94 Waiver service provider--Children's support (DHS/DDD) 107 Will 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 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8250 0 0 0 0 0 0 0 0 0 0 0 0 0 8250 0 0 0 1101491449 1528031846 10 Physicians JOHN SAYONA 606123845 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 178 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 178 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7809.07 0 0 0 0 0 0 7809.07 0 0 0 1101491452 10 Physicians 200 Cook 0 0 Internal Medicine 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33.9 0 0 0 0 0 0 33.9 0 0 0 1101491461 92 Waiver service provider--Disability (DHS/DRS) 13 Boone 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 11003.04 0 0 0 0 0 0 0 0 0 0 0 0 0 11003.04 0 0 0 1101491464 1477622298 36 Community mental health provider RESURRECTION BEHAVIORAL HLTH 601603635 200 Cook 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 1626 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 375 0 0 1626 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 375 0 0 19130.07 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35747.08 0 0 54877.15 0 0 0 1101491468 1750391843 10 Physicians THAKRAR HARISH V 606405265 200 Cook 0 0 Radiology Therapeutic 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 283.1 0 0 0 0 0 0 283.1 0 0 0 1101491477 1720034408 60 Pharmacies OSCO DRUG 3260 601743433 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 721 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17876 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43764.71 0 0 0 43764.71 0 0 0 1101491485 1811248651 16 Nurse Practitioners PEMBLE JENNIFER 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3635.31 0 0 0 0 0 0 3635.31 0 0 0 1101491507 1558377069 10 Physicians SZYMKE THOMAS 616025021 80 Peoria 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 376 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 376 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9391.84 0 0 0 0 0 0 9391.84 0 0 0 1101491509 30 General Hospitals 819 Louisiana NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 192.76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 192.76 0 0 0 1101491515 1568451490 10 Physicians DHOLAKIA ASHOK G 604062426 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 1 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 303 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 303 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13.41 0 2508.27 0 0 0 0 0 0 2521.68 0 0 0 1101491520 1376563742 10 Physicians GLOVER JENNIFER 604023429 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 420 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 420 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24054.16 0 0 0 0 0 0 24054.16 0 0 0 1101491524 1497720411 10 Physicians PATTERSON JANET 616033201 80 Peoria 0 0 Pediatrics 0 0 0 0 43 0 0 0 0 0 0 0 0 111 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 143 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 143 0 0 0 0 0 0 0 0 0 677.56 0 0 0 0 0 0 0 0 20999.28 0 0 0 0 0 0 21676.84 0 0 0 1101491533 1336396860 36 Community mental health provider THRESHOLDS 606442157 200 Cook 0 0 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 562 0 0 825 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6131 0 0 825 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6131 0 0 29313.07 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 560670.77 0 0 589983.84 0 0 0 1101491535 1629026208 10 Physicians TALSKY JOSEPH 620026751 65 Madison 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 83 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 144 0 432 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 144 0 432 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6659.3 0 45361.12 0 0 0 0 0 0 52020.42 0 0 0 1101491537 1376576181 70 Ambulance Service Providers MERCY AMBULANCE SERVICE 477115645 815 Indiana 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 0 109 0 0 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 17771.36 0 0 0 0 0 0 17771.36 0 0 0 1101491544 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 258 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 258 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9099.2 0 0 0 0 0 0 0 0 0 0 0 0 0 9099.2 0 0 0 1101491548 1215985528 10 Physicians PINNEY RICHARD 601082152 30 DuPage 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 2 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31.4 0 111.73 0 0 0 0 0 0 143.13 0 0 0 1101491553 1700166139 16 Nurse Practitioners WISLANDER ALYSSA 612822904 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 282.06 0 0 0 0 0 0 282.06 0 0 0 1101491558 1114183951 28 Waiver service provider--Supportive living facility (HFS) HERITAGE WOODS OF CHICAGO 606121737 200 Cook 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 0 744 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17578 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1284603.04 0 0 0 0 0 0 0 0 0 0 0 0 0 1284603.04 0 0 0 1101491568 10 Physicians 826 Missouri 0 0 Gynecology 0 0 0 0 0 0 0 0 0 0 0 2 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 143.8 0 71.65 0 0 0 0 0 0 215.45 0 0 0 1101491569 10 Physicians 815 Indiana 0 0 Internal Medicine 0 0 0 0 0 0 0 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 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 0 188.9 0 0 0 0 0 0 188.9 0 0 0 1101491570 93 Waiver service provider--HIV/AIDS (DHS/DRS) 91 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 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 90 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 1101491574 1265552400 10 Physicians VERGARA ROBERT C 629023988 810 Florida 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 0 0 275 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 293 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 293 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9692.99 0 0 0 0 0 0 9692.99 0 0 0 1101491580 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 13821.09 0 0 0 0 0 0 0 0 0 0 0 0 0 13821.09 0 0 0 1101491581 1457447443 10 Physicians ODEH YASEEN 606226134 200 Cook 0 1 Clinical Pharmacology 0 145 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 173 0 0 0 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 173 0 0 0 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 485 0 0 0 0 0 0 0 0 0 0 0 1781.66 0 0 0 0 0 0 2266.66 0 0 0 1101491586 1669445052 10 Physicians MERO TANYA 623014038 10 Adams 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 7 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 280 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 280 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 227.26 0 27728.09 0 0 0 0 0 0 27955.35 0 0 0 1101491591 30 General Hospitals 816 Iowa NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 175.31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 175.31 0 0 0 1101491592 1235103581 10 Physicians ALTIMARI ANTHONY 601871038 30 DuPage 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14699.47 0 0 0 0 0 0 14699.47 0 0 0 1101491601 1023175536 12 Optometrists TORRE GUSTAVO 600253236 200 Cook 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 594 0 626 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 992 0 661 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 992 0 661 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16653.74 0 18655.97 0 0 0 0 35309.71 0 0 0 1101491612 36 Community mental health provider 200 Cook 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 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 0 133.2 0 0 133.2 0 0 0 1101491614 1659385722 16 Nurse Practitioners ONEILL SUSAN 605652463 30 DuPage 0 1 0 18 0 0 5 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 96 0 0 11 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 96 0 0 11 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 269 0 0 592.77 0 0 0 0 0 0 0 0 522.93 0 0 0 0 0 0 1384.7 0 0 0 1101491627 1568593663 60 Pharmacies COUNTY MARKET PHARMACY 083 627046405 91 Sangamon 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 0 487 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13699 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19097.22 0 0 0 19097.22 0 0 0 1101491651 94 Waiver service provider--Children's support (DHS/DDD) 73 Menard 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 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 1493.25 0 0 0 0 0 0 0 0 0 0 0 0 0 1493.25 0 0 0 1101491656 1447453691 10 Physicians CRUZ OLIVER DULCE 631102515 826 Missouri 0 0 Geriatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 923.61 0 0 0 0 0 0 923.61 0 0 0 1101491662 1093706137 33 Nursing Facilities HERITAGE HEALTH EL PASO 617381508 110 Woodford 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 514 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12997 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1017672.04 0 0 0 0 0 0 0 1017672.04 0 0 0 1101491685 1841281979 33 Nursing Facilities HERITAGE HEALTH NORMAL 617612422 72 McLean 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 397 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10259 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 907857.69 0 0 0 0 0 0 0 907857.69 0 0 0 1101491687 1568473122 10 Physicians STEELE ANDREW 631102515 826 Missouri 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 1 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1210.97 0 0 0 0 0 0 1210.97 0 0 0 1101491690 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 10551.68 0 0 0 0 0 0 0 0 0 0 0 0 0 10551.68 0 0 0 1101491701 1033135991 10 Physicians GROSSBERG GEORGE 631102515 826 Missouri 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76.4 0 0 0 0 0 0 76.4 0 0 0 1101491716 92 Waiver service provider--Disability (DHS/DRS) 47 Jackson 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11273.41 0 0 0 0 0 0 0 0 0 0 0 0 0 11273.41 0 0 0 1101491718 1063514800 39 Hospice COMMUNITY HOSPICES OF AM NW IL 614012515 56 Knox 0 0 0 0 0 0 0 0 0 0 193 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 729 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19236 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1685236.19 0 0 0 0 0 0 0 0 0 0 0 1685236.19 0 0 0 1101491722 1679779045 28 Waiver service provider--Supportive living facility (HFS) PRAIRIE LIVING AT CHAUTAUQUA 629016001 47 Jackson 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1022 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24734 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1169866.71 0 0 0 0 0 0 0 0 0 0 0 0 0 1169866.71 0 0 0 1101491740 91 Waiver service provider--Adults (DHS/DDD) 91 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 47 0 0 0 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 3669.3 0 0 0 0 0 0 0 0 0 0 0 0 0 3669.3 0 0 0 1101491753 92 Waiver 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 172.9 0 0 0 0 0 0 172.9 0 0 0 1101492557 1558648865 16 Nurse Practitioners NAGLE KATHLEEN 999999999 30 DuPage 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 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115.03 0 0 0 0 0 0 115.03 0 0 0 1101492569 91 Waiver service provider--Adults (DHS/DDD) 57 Lake 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 0 209 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 209 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16783.39 0 0 0 0 0 0 0 0 0 0 0 0 0 16783.39 0 0 0 1101492579 1770604456 55 Early Intervention Services MCCORMICK JOANNE 606146005 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 0 314 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 314 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17934.65 0 0 0 0 0 0 17934.65 0 0 0 1101492585 1174794028 11 Dentists SCHAFER 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0 0 0 0 0 0 0 0 0 0 1 0 0 123989 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2.19 0 0 233788.84 0 0 0 233791.03 0 0 0 1101492677 1184640302 10 Physicians HASSAN ANJUM 631101093 826 Missouri 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 277 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 277 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4569.34 0 0 0 0 0 0 0 0 4569.34 0 0 0 1101492689 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 643.5 0 0 0 0 0 0 0 0 0 0 0 0 0 643.5 0 0 0 1101492704 1154462224 10 Physicians RAJESH ALLA 612656898 89 Rock Island 0 0 Nephrology 0 0 0 0 0 0 0 0 0 0 0 0 0 211 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 725 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 725 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14078.58 0 0 0 0 0 0 14078.58 0 0 0 1101492706 92 Waiver service provider--Disability (DHS/DRS) 49 Jefferson 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 14308.2 0 0 0 0 0 0 0 0 0 0 0 0 0 14308.2 0 0 0 1101492715 92 Waiver service provider--Disability (DHS/DRS) 66 Marion 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 13079.38 0 0 0 0 0 0 0 0 0 0 0 0 0 13079.38 0 0 0 1101492729 1740349695 10 Physicians BROCKSTEIN BRUCE 604402100 107 Will 0 0 Hematology 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 170 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 170 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2745.75 0 0 0 0 0 0 2745.75 0 0 0 1101492732 1770640880 10 Physicians MATHEW ABRAHAM 604771847 200 Cook 0 1 Internal Medicine 0 231 0 0 3 0 0 0 0 0 0 0 0 122 0 0 0 0 0 0 1144 0 0 3 0 0 0 0 0 0 0 0 334 0 0 0 0 0 0 1144 0 0 3 0 0 0 0 0 0 0 0 334 0 0 0 0 0 0 3274 0 0 216.32 0 0 0 0 0 0 0 0 7575.62 0 0 0 0 0 0 11065.94 0 0 0 1101492743 91 Waiver service provider--Adults (DHS/DDD) 40 Grundy 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 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24908.4 0 0 0 0 0 0 0 0 0 0 0 0 0 24908.4 0 0 0 1101492747 1134310113 60 Pharmacies WALGREENS 10908 637751267 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 307 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7071 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26557.69 0 0 0 26557.69 0 0 0 1101492749 1013134402 10 Physicians KANG JASON 602011718 200 Cook 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88.5 0 0 0 0 0 0 0 0 88.5 0 0 0 1101492755 1134368707 16 Nurse Practitioners CRAFT JUSTIN 629037647 47 Jackson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7913.43 0 0 0 0 0 0 7913.43 0 0 0 1101492763 91 Waiver 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2216.73 0 0 0 0 0 0 0 0 0 0 0 0 0 2216.73 0 0 0 1101492833 1417021882 10 Physicians HAMEL TIM 610249590 109 Winnebago 0 1 Family Practice 0 154 0 0 18 0 0 0 0 0 0 9 0 88 0 0 0 0 0 0 1152 0 0 67 0 0 0 0 0 0 14 0 233 0 0 0 0 0 0 1152 0 0 67 0 0 0 0 0 0 14 0 233 0 0 0 0 0 0 2962 0 0 1659.26 0 0 0 0 0 0 104.65 0 6427.67 0 0 0 0 0 0 11153.58 0 0 0 1101492839 1407869779 10 Physicians BERTOLOZZI JOHN 601181416 53 Kane 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 4 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22597.05 0 0 0 0 0 0 22597.05 0 0 0 1101492846 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 279.89 0 0 0 0 0 0 0 0 0 0 0 0 0 279.89 0 0 0 1101492850 98 Waiver 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0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 248.95 0 0 0 0 0 0 248.95 0 0 0 1101493053 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 33938.03 0 0 0 0 0 0 0 0 0 0 0 0 0 33938.03 0 0 0 1101493060 1730194846 60 Pharmacies WALGREENS 04241 463191461 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 201 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4477.69 0 0 0 4477.69 0 0 0 1101493064 1104872753 60 Pharmacies OSCO DRUG 3308 601934071 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 269 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1217 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30663 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63061.03 0 0 0 63061.03 0 0 0 1101493079 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 3834.49 0 0 0 0 0 0 0 0 0 0 0 0 0 3834.49 0 0 0 1101493080 92 Waiver service provider--Disability (DHS/DRS) 87 Randolph 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 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9968.45 0 0 0 0 0 0 0 0 0 0 0 0 0 9968.45 0 0 0 1101493084 10 Physicians 852 Wisconsin 0 0 Cardiovascular Diseases 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 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 88.73 0 0 0 0 0 0 88.73 0 0 0 1101493097 1952680712 36 Community mental health provider CHILDRENS HOME AND AID SOCIETY 61702 72 McLean 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 404 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 404 0 0 3261.33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24924.31 0 0 28185.64 0 0 0 1101493099 2100483517 90 Waiver service 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0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 1196 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18.42 0 12894.38 0 0 0 0 0 0 12912.8 0 0 0 1101493177 60 Pharmacies 826 Missouri 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5915.13 0 0 0 5915.13 0 0 0 1101493186 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 11919.24 0 0 0 0 0 0 0 0 0 0 0 0 0 11919.24 0 0 0 1101493199 1255333415 10 Physicians RUSTUM AMER 606222851 200 Cook 0 1 Internal Medicine 0 294 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 357 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 357 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1100 0 0 0 1101493204 1659483204 10 Physicians CRADOCK KIMBERLY 609421801 100 Vermilion 0 0 Traumatic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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service provider--Disability (DHS/DRS) 19 Champaign 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7190.23 0 0 0 0 0 0 0 0 0 0 0 0 0 7190.23 0 0 0 1101493274 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 7439.79 0 0 0 0 0 0 0 0 0 0 0 0 0 7439.79 0 0 0 1101493277 30 General Hospitals 810 Florida NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 458.76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 458.76 0 0 0 1101493282 10 Physicians 200 Cook 0 0 Family Practice 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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1695 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63788.88 0 0 0 0 0 0 0 0 0 0 0 0 0 63788.88 0 0 0 1101493781 92 Waiver service provider--Disability (DHS/DRS) 57 Lake 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 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29166.25 0 0 0 0 0 0 0 0 0 0 0 0 0 29166.25 0 0 0 1101493790 1134326770 10 Physicians SCHWARTZ EDRIC 611042315 109 Winnebago 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 124 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 273 0 380 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 273 0 380 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3385.61 0 18648 0 0 0 0 0 0 22033.61 0 0 0 1101493794 1194758706 70 Ambulance Service Providers MANHATTAN VOLUNTEER FPD 604429832 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1943.26 0 0 0 0 0 0 1943.26 0 0 0 1101493800 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 1 0 0 0 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1578673778 63 Other Providers of Medical Equipment/Supplies (Non-registered) APRIA HEALTHCARE LLC 478044011 839 Pennsylvania 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10221.35 0 0 0 0 0 0 10221.35 0 0 0 1101493887 1093790347 22 Physical Therapists SCHULTZ SCOTT 600506933 71 McHenry 0 0 0 0 0 0 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 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1946.73 1946.73 0 0 0 1101493888 1831371756 55 Early Intervention Services TYRRELL DIANE 601781495 27 Dekalb 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 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 0 323.73 0 0 0 0 0 0 323.73 0 0 0 1101493893 1003818451 10 Physicians BRAASTAD FRED E 616142017 80 Peoria 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 340 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 340 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29021.7 0 0 0 0 0 0 29021.7 0 0 0 1101493896 1568487460 25 Audiologists DAVIA KRISTEN 601484932 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 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 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102.71 102.71 0 0 0 1101493898 92 Waiver service provider--Disability (DHS/DRS) 85 Pulaski 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20772.31 0 0 0 0 0 0 0 0 0 0 0 0 0 20772.31 0 0 0 1101493906 1679543151 10 Physicians DLUGOPOLSKI-GACH JOSEPHINE 606910263 30 DuPage 0 1 Pediatrics 0 860 0 0 207 0 0 0 0 0 0 0 0 333 0 0 0 0 0 0 6438 0 0 292 0 0 0 0 0 0 0 0 568 0 0 0 0 0 0 6438 0 0 292 0 0 0 0 0 0 0 0 568 0 0 0 0 0 0 14999 0 0 24259.82 0 0 0 0 0 0 0 0 28669.14 0 0 0 0 0 0 67927.96 0 0 0 1101493909 1063672137 10 Physicians YEE DANA 637015230 826 Missouri 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1391.83 0 0 0 0 0 0 1391.83 0 0 0 1101493913 92 Waiver service provider--Disability (DHS/DRS) 55 Kendall 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 37859.18 0 0 0 0 0 0 0 0 0 0 0 0 0 37859.18 0 0 0 1101493917 1336145036 10 Physicians WOLIN PRESTON 606141454 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 11 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 145.84 0 2353.69 0 0 0 0 0 0 2499.53 0 0 0 1101493926 1982654331 16 Nurse Practitioners PAGE GAYE 610811252 106 Whiteside 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 145 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 428 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 428 0 0 0 0 0 0 0 0 0 1221.68 0 0 0 0 0 0 0 0 3843.51 0 0 0 0 0 0 5065.19 0 0 0 1101493929 1043366370 70 Ambulance Service Providers ASSUMPTION FIRE PROTECTION 625101071 20 Christian 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 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2516.18 0 0 0 0 0 0 2516.18 0 0 0 1101493932 1417023102 10 Physicians LEE JEFFREY 300852161 57 Lake 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 432 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 469 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 469 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13955.89 0 0 0 0 0 0 13955.89 0 0 0 1101493935 1518123108 10 Physicians KERMEN RACHEL 600261339 200 Cook 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2385.55 0 0 0 0 0 0 2385.55 0 0 0 1101493939 1174699854 10 Physicians LYMAN JEFFREY 602011718 200 Cook 0 0 Admitting Privileges 0 0 0 0 0 0 0 0 0 0 0 0 0 362 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 387 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 387 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14162.2 0 0 0 0 0 0 14162.2 0 0 0 1101493944 1033163720 10 Physicians BUTLER MARTIN 605238723 53 Kane 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 1412 0 173 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2117 0 248 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2117 0 248 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36027.05 0 2656 0 0 0 0 0 0 38683.05 0 0 0 1101493945 1336243815 10 Physicians REDLICH KRISTI 60142 53 Kane 0 1 General Practice 0 199 0 0 184 0 0 0 0 0 0 110 0 154 0 0 0 0 0 0 964 0 0 563 0 0 0 0 0 0 132 0 226 0 0 0 0 0 0 964 0 0 563 0 0 0 0 0 0 132 0 226 0 0 0 0 0 0 2214 0 0 14318.83 0 0 0 0 0 0 662.05 0 9134.03 0 0 0 0 0 0 26328.91 0 0 0 1101493948 1548441207 10 Physicians TURLEY KENNETH 610811278 106 Whiteside 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 415 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 446 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 446 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64467.63 0 0 0 0 0 0 64467.63 0 0 0 1101493958 1336152628 10 Physicians JENNINGS LAWRENCE 606112991 200 Cook 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 765 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1691 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1691 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38409.85 0 0 0 0 0 0 0 0 38409.85 0 0 0 1101493965 1578898441 24 Speech Therapists SANDERS MEGAN 616141290 80 Peoria 0 0 0 0 0 0 0 0 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 0 205 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 205 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14135.03 14135.03 0 0 0 1101493966 1588682017 10 Physicians MCCORMICK MOLLY 631101010 826 Missouri 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1314.12 0 0 0 0 0 0 1314.12 0 0 0 1101493979 94 Waiver service provider--Children's support (DHS/DDD) 107 Will 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 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4174.31 0 0 0 0 0 0 0 0 0 0 0 0 0 4174.31 0 0 0 1101494026 1376679472 10 Physicians MURRAY BARBARA 627047401 91 Sangamon 0 1 Pediatrics 0 118 0 0 102 0 0 0 0 0 0 36 0 134 0 0 0 0 0 0 1047 0 0 296 0 0 0 0 0 0 40 0 247 0 0 0 0 0 0 1047 0 0 296 0 0 0 0 0 0 40 0 247 0 0 0 0 0 0 2094 0 0 11720.52 0 0 0 0 0 0 258.12 0 10887.29 0 0 0 0 0 0 24959.93 0 0 0 1101494030 1457533739 10 Physicians PANT PUROHIT MUKTA 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118.24 0 22877.84 0 0 0 0 0 0 22996.08 0 0 0 1101494058 1447257258 30 General Hospitals HAMILTON MEMORIAL HOSPITAL 628591213 41 Hamilton DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 1 0 Government Owned 0 2 0 0 0 1560 0 0 0 0 121 0 0 0 535 0 0 0 0 0 4 0 0 0 2734 0 0 0 0 138 0 0 0 1135 0 0 0 0 0 4 0 0 0 2734 0 0 0 0 358 0 0 0 1162 0 0 0 0 0 214.27 0 0 0 776478.77 0 0 0 0 130001.77 0 0 0 292284.08 0 0 0 0 0 1198978.89 0 0 0 1101494074 92 Waiver service provider--Disability (DHS/DRS) 26 Cumberland 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 17900.9 0 0 0 0 0 0 0 0 0 0 0 0 0 17900.9 0 0 0 1101494103 92 Waiver service provider--Disability (DHS/DRS) 98 Tazewell 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 7764.45 0 0 0 0 0 0 0 0 0 0 0 0 0 7764.45 0 0 0 1101494105 1689984304 11 Dentists ANTONY SOTY 999999999 200 Cook 0 0 0 0 0 743 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4375 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4375 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111272.18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111272.18 0 0 0 1101494108 47 Local Education Agencies 103 Washington 0 0 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 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1416.2 0 1416.2 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3410 0 0 0 0 0 0 0 0 0 0 0 0 0 3410 0 0 0 1101495190 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 3040.59 0 0 0 0 0 0 0 0 0 0 0 0 0 3040.59 0 0 0 1101495191 1992710032 60 Pharmacies BOND DRUG COMPANY OF ILLINOIS 602013026 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 793 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4472 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114820 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 262795.93 0 0 0 262795.93 0 0 0 1101495198 1831131101 10 Physicians CHIA S WAK 620951898 65 Madison 0 1 Pediatrics 0 126 0 0 170 0 0 0 0 0 0 0 0 197 0 0 0 0 0 0 946 0 0 318 0 0 0 0 0 0 0 0 483 0 0 0 0 0 0 946 0 0 318 0 0 0 0 0 0 0 0 483 0 0 0 0 0 0 1904 0 0 17491.09 0 0 0 0 0 0 0 0 22240.45 0 0 0 0 0 0 41635.54 0 0 0 1101495205 94 Waiver service provider--Children's support (DHS/DDD) 89 Rock Island 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 0 290 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 290 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7611.02 0 0 0 0 0 0 0 0 0 0 0 0 0 7611.02 0 0 0 1101495224 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 120 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 0 0 0 0 0 0 0 0 0 0 0 0 12924.67 0 0 0 0 0 0 0 0 0 0 0 0 0 12924.67 0 0 0 1101495226 1730200791 10 Physicians NAALLAH RAHMAT 616021076 80 Peoria 0 1 Family Practice 0 12 0 0 16 0 0 0 0 0 0 36 0 116 0 0 0 0 0 0 63 0 0 21 0 0 0 0 0 0 54 0 183 0 0 0 0 0 0 63 0 0 21 0 0 0 0 0 0 54 0 183 0 0 0 0 0 0 174 0 0 1307.61 0 0 0 0 0 0 331.14 0 17428.97 0 0 0 0 0 0 19241.72 0 0 0 1101495227 92 Waiver service provider--Disability (DHS/DRS) 107 Will 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15223.35 0 0 0 0 0 0 0 0 0 0 0 0 0 15223.35 0 0 0 1101495232 92 Waiver service provider--Disability (DHS/DRS) 90 Saline 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 16799.98 0 0 0 0 0 0 0 0 0 0 0 0 0 16799.98 0 0 0 1101495234 1306113667 33 Nursing Facilities SYMPHONY OF LINCOLN 626561306 62 Logan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 626 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16354 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2170209.4 0 0 0 0 0 0 0 2170209.4 0 0 0 1101495248 1497802730 11 Dentists JUSUFI LULJETA 606573119 200 Cook 0 0 General Dentistry 0 0 0 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 465 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 465 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18060.35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18060.35 0 0 0 1101495259 1093720633 60 Pharmacies BASINGER PHARMACY INC 604356622 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 889 0 0 1021 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3726 0 0 7977 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3726 0 0 178572 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 276620.9 0 0 245629.62 0 0 0 522250.52 0 0 0 1101495284 1417025735 10 Physicians PAVLOVIC CHRISTOPHER 600681168 200 Cook 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 1 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 1056 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 1056 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12.71 0 1479.81 0 0 0 0 0 0 1492.52 0 0 0 1101495292 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 18384.15 0 0 0 0 0 0 0 0 0 0 0 0 0 18384.15 0 0 0 1101495293 1881655140 10 Physicians DIACONESCU ELIZA 601181416 53 Kane 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 7 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 252 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 252 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7.06 0 476.78 0 0 0 0 0 0 483.84 0 0 0 1101495301 1427036011 10 Physicians RUBINSTEIN WAYNE 600161687 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 285 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 285 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12807.76 0 0 0 0 0 0 12807.76 0 0 0 1101495323 1275858466 10 Physicians KORNFELD BENJAMIN 999999999 200 Cook 0 0 0 0 0 0 39 0 0 0 0 0 0 2 0 40 0 0 0 0 0 0 0 0 0 109 0 0 0 0 0 0 2 0 45 0 0 0 0 0 0 0 0 0 109 0 0 0 0 0 0 2 0 45 0 0 0 0 0 0 0 0 0 1398.78 0 0 0 0 0 0 7.33 0 1143.56 0 0 0 0 0 0 2549.67 0 0 0 1101495336 1689682304 10 Physicians KIANG CHUANG 608052701 200 Cook 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 366 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 775 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 775 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4706.09 0 0 0 0 0 0 0 0 4706.09 0 0 0 1101495344 1164449419 60 Pharmacies WALMART PHARMACY 10-0196 629013140 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1444 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11226 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 284017 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 501992.58 0 0 0 501992.58 0 0 0 1101495347 1578781977 10 Physicians BERI ROHINEE 604641200 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9228.1 0 0 0 0 0 0 9228.1 0 0 0 1101495352 1386750685 10 Physicians GREEN CURTIS 619389258 24 Coles 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 349 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 979 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 979 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87844.4 0 0 0 0 0 0 87844.4 0 0 0 1101495360 1932295177 10 Physicians HARTMAN MARY 631101002 826 Missouri 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14842.49 0 0 0 0 0 0 14842.49 0 0 0 1101495361 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 31217.22 0 0 0 0 0 0 0 0 0 0 0 0 0 31217.22 0 0 0 1101495364 1508068065 47 Local Education Agencies EAST PEORIA COMM HIGH SCH 309 616112863 98 Tazewell 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 66 0 0 0 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 2603 0 0 0 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 2603 0 0 0 0 1235.73 0 0 0 0 0 0 0 0 0 0 0 0 0 39164.69 0 40400.42 0 0 0 1101495373 1912014564 36 Community mental health provider ADVOCATE IL MASONIC MED CTR 606576704 200 Cook 0 0 0 836 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1367 0 0 2746 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4623 0 0 2746 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4623 0 0 112028.24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 436284.87 0 0 548313.11 0 0 0 1101495385 1366541369 10 Physicians NETZEL MICHAEL 535661546 852 Wisconsin 0 0 Allergy 0 0 0 0 0 0 0 0 0 0 0 4 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 283 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 283 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39.4 0 8482.81 0 0 0 0 0 0 8522.21 0 0 0 1101495387 1013180090 10 Physicians FIELD BRIAN 606223086 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 310 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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 0 0 0 0 0 0 0 0 0 0 0 1101495438 1972607497 10 Physicians MONACO MARY 604355134 107 Will 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 437 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 437 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2156.96 0 0 0 0 0 0 2156.96 0 0 0 1101495459 1477549590 10 Physicians GILDNER JAMES 627026700 91 Sangamon 0 0 Obstetric-Gynecology 0 0 0 0 1 0 0 0 0 0 0 37 0 77 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 69 0 163 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 69 0 163 0 0 0 0 0 0 0 0 0 14.6 0 0 0 0 0 0 1768.41 0 15173.8 0 0 0 0 0 0 16956.81 0 0 0 1101495471 1184614711 10 Physicians MIKATI ISSAM 606118709 200 Cook 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 714 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 993 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 993 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13361.88 0 0 0 0 0 0 13361.88 0 0 0 1101495475 1255430120 10 Physicians FLACCO VALERIE 614889517 56 Knox 0 1 Family Practice 0 361 0 0 26 0 0 0 0 0 0 30 0 338 0 0 0 0 0 0 2986 0 0 51 0 0 0 0 0 0 59 0 1166 0 0 0 0 0 0 2986 0 0 51 0 0 0 0 0 0 59 0 1166 0 0 0 0 0 0 7928 0 0 1540.41 0 0 0 0 0 0 224.9 0 29051.53 0 0 0 0 0 0 38744.84 0 0 0 1101495479 1780659748 10 Physicians KALAPURAKAL JOHN 606118709 200 Cook 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 421 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 421 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11570.85 0 0 0 0 0 0 11570.85 0 0 0 1101495482 1679632129 10 Physicians PODOKSIK INNA 600611365 57 Lake 0 1 Internal Medicine 0 72 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 519 0 0 0 0 0 0 0 0 0 0 0 211 0 0 0 0 0 0 519 0 0 0 0 0 0 0 0 0 0 0 211 0 0 0 0 0 0 1528 0 0 0 0 0 0 0 0 0 0 0 7705.85 0 0 0 0 0 0 9233.85 0 0 0 1101495484 1851677629 60 Pharmacies COUNTY MARKET PHARMACY 185 615202608 37 Fulton 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1088 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10690 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 259577 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 567489.93 0 0 0 567489.93 0 0 0 1101495496 30 General Hospitals 816 Iowa ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 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 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 529.11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 529.11 0 0 0 1101495516 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 17041.09 0 0 0 0 0 0 0 0 0 0 0 0 0 17041.09 0 0 0 1101495517 1831214154 33 Nursing Facilities TRI STATE NURSING REHAB CENTER 604381801 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 748 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16701 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1806196.38 0 0 0 0 0 0 0 1806196.38 0 0 0 1101495526 1780698712 10 Physicians THOMAS SONYA 606234316 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 51 0 0 0 0 0 0 277 0 484 0 0 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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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 402.47 0 0 0 0 0 0 402.47 0 0 0 1101499482 92 Waiver service provider--Disability (DHS/DRS) 30 DuPage 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 24782.05 0 0 0 0 0 0 0 0 0 0 0 0 0 24782.05 0 0 0 1101499487 1962454983 10 Physicians MITZELFELT DONALD 615543903 98 Tazewell 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 39 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 278 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 278 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 753.01 0 16653.79 0 0 0 0 0 0 17406.8 0 0 0 1101499501 1477549483 10 Physicians SHIELDS RUSSEL 420033813 818 Kentucky 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 231 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 326 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 326 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7521.73 0 803.78 0 0 0 0 0 0 8325.51 0 0 0 1101499519 1538294483 36 Community mental health provider HEARTLAND HEALTH OUTREACH 606407528 200 Cook 0 0 0 386 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 363 0 0 5871 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11547 0 0 5871 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11547 0 0 242864.69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 646096.81 0 0 888961.5 0 0 0 1101499535 1124076419 94 Waiver service provider--Children's support (DHS/DDD) ASSOCIATION HOUSE 606472159 200 Cook 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10203.79 0 0 0 0 0 0 0 0 0 0 0 0 0 10203.79 0 0 0 1101499544 92 Waiver service provider--Disability (DHS/DRS) 27 Dekalb 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 29809.68 0 0 0 0 0 0 0 0 0 0 0 0 0 29809.68 0 0 0 1101499564 1548231293 60 Pharmacies PCA PHARMACY 402996395 818 Kentucky 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3640 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4339.66 0 0 0 4339.66 0 0 0 1101499574 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 24321.61 0 0 0 0 0 0 0 0 0 0 0 0 0 24321.61 0 0 0 1101499590 55 Early Intervention Services 200 Cook 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 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3011.24 0 0 0 0 0 0 3011.24 0 0 0 1101499607 92 Waiver service provider--Disability (DHS/DRS) 30 DuPage 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 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 10934.32 0 0 0 0 0 0 0 0 0 0 0 0 0 10934.32 0 0 0 1101499624 1518128636 11 Dentists OGBARA TAJUDEEN 606392070 200 Cook 0 0 General Dentistry 0 0 0 244 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1580 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1580 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52687.02 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52687.02 0 0 0 1101499628 1912002148 10 Physicians KELLS AMY 631101010 826 Missouri 0 0 Plastic Surgery 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 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10487.54 0 0 0 0 0 0 10487.54 0 0 0 1101499632 55 Early Intervention Services 47 Jackson 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 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 0 200.01 0 0 0 0 0 0 200.01 0 0 0 1101499637 1528143971 10 Physicians OHALLORAN RICHARD 623012727 10 Adams 0 0 Urology 0 0 0 0 0 0 0 0 0 0 0 6 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14.9 0 5445.53 0 0 0 0 0 0 5460.43 0 0 0 1101499641 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 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 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5418.82 0 0 0 0 0 0 0 0 0 0 0 0 0 5418.82 0 0 0 1101499646 1821398678 16 Nurse Practitioners GARNER ANDREW 637014556 826 Missouri 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 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2891.44 0 0 0 0 0 0 2891.44 0 0 0 1101499656 1003096496 60 Pharmacies WALGREENS 10971 600428450 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 526 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2827 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68446 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 270461 0 0 0 270461 0 0 0 1101499662 10 Physicians 852 Wisconsin 0 0 Urological Surgery 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 5.29 0 0 0 0 0 0 5.29 0 0 0 1101499664 1639158777 10 Physicians QADIR KHURRAM 611033655 109 Winnebago 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 374 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 374 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32764.89 0 0 0 0 0 0 32764.89 0 0 0 1101499673 1336136803 63 Other Providers of Medical Equipment/Supplies (Non-registered) ALDEN LINCOLN PARK REHAB 606575421 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 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6673.8 0 0 0 0 0 0 6673.8 0 0 0 1101499683 1548280605 10 Physicians KIM GEORGE 600261314 200 Cook 0 0 Nephrology 0 0 0 0 0 0 0 0 0 0 0 0 0 170 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 532 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 532 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8597.02 0 0 0 0 0 0 8597.02 0 0 0 1101499685 1972628006 30 General Hospitals AURORA LAKELAND MED CTR 531214337 852 Wisconsin ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 0 0 0 0 0 30 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 9302.34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9302.34 0 0 0 1101499699 98 Waiver service provider--TBI (DHS/DRS) 53 Kane 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 1134.14 0 0 0 0 0 0 0 0 0 0 0 0 0 1134.14 0 0 0 1101499700 98 Waiver service provider--TBI (DHS/DRS) 67 Marshall 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7614.14 0 0 0 0 0 0 0 0 0 0 0 0 0 7614.14 0 0 0 1101499701 1750311031 16 Nurse Practitioners POPPE JANE E 609361477 35 Ford 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 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 388.22 0 0 0 0 0 0 388.22 0 0 0 1101499706 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 4340.29 0 0 0 0 0 0 0 0 0 0 0 0 0 4340.29 0 0 0 1101499717 92 Waiver service provider--Disability (DHS/DRS) 19 Champaign 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 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 1704.95 0 0 0 0 0 0 0 0 0 0 0 0 0 1704.95 0 0 0 1101499719 91 Waiver service provider--Adults (DHS/DDD) 80 Peoria 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 0 263 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 263 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8149.16 0 0 0 0 0 0 0 0 0 0 0 0 0 8149.16 0 0 0 1101499723 1033110721 10 Physicians PIOTROWSKI AGNIESZKA 605213829 30 DuPage 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 175 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 258 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 258 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1833.21 0 0 0 0 0 0 0 0 1833.21 0 0 0 1101499724 1972672640 22 Physical Therapists SALAMA ATEF 606295148 200 Cook 0 0 0 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 0 258 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 258 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2169.6 2169.6 0 0 0 1101499729 1770500209 10 Physicians WRIGHT NEILL 631101010 826 Missouri 0 0 Neurology Surgery 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 412.9 0 0 0 0 0 0 412.9 0 0 0 1101499741 1447277397 70 Ambulance Service Providers DIXON RURAL FIRE PROT DIST 610211964 60 Lee 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 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6410.23 0 0 0 0 0 0 6410.23 0 0 0 1101499742 91 Waiver service provider--Adults (DHS/DDD) 30 DuPage 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 0 287 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 287 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24772 0 0 0 0 0 0 0 0 0 0 0 0 0 24772 0 0 0 1101499755 1770522500 10 Physicians VERMA ANUPAM 617013534 72 McLean 0 0 Infectious Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8203.51 0 0 0 0 0 0 8203.51 0 0 0 1101499760 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 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 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 4263.57 0 0 0 0 0 0 0 0 0 0 0 0 0 4263.57 0 0 0 1101499762 1972640134 10 Physicians GOMEZ PATRICK 616157822 80 Peoria 0 0 Oncology 0 0 0 0 0 0 0 0 0 0 0 24 0 153 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 1589 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 1589 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1322.25 0 178104.1 0 0 0 0 0 0 179426.35 0 0 0 1101499774 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 283 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 283 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9045.68 0 0 0 0 0 0 0 0 0 0 0 0 0 9045.68 0 0 0 1101499789 1093961468 10 Physicians HIBBERT PAUL 623014038 10 Adams 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 99 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 128 0 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 128 0 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1388.63 0 1770.8 0 0 0 0 0 0 3159.43 0 0 0 1101499792 47 Local Education Agencies 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2416.36 0 2416.36 0 0 0 1101499811 1497748040 30 General Hospitals HOOPESTON COMM MEMORIAL HOSP 609421801 100 Vermilion DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 1 0 General Hospital - Adult and Child 0 0 0 0 0 1118 0 0 0 0 27 0 0 0 325 0 0 0 0 0 0 0 0 0 1981 0 0 0 0 32 0 0 0 566 0 0 0 0 0 0 0 0 0 1991 0 0 0 0 84 0 0 0 651 0 0 0 0 0 0 0 0 0 775546.72 0 0 0 0 34033.45 0 0 0 287763.22 0 0 0 0 0 1097343.39 0 0 0 1101499813 1275512154 10 Physicians SHARIS PETER 612656899 89 Rock Island 0 0 Cardiology 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 0 130.08 0 0 0 0 0 0 130.08 0 0 0 1101499815 1780699926 60 Pharmacies BOND DRUG COMPANY OF IL 02720 605161638 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 299 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27031 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 96796.77 0 0 0 96796.77 0 0 0 1101499818 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 314 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 314 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12618.65 0 0 0 0 0 0 0 0 0 0 0 0 0 12618.65 0 0 0 1101499832 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 12598.8 0 0 0 0 0 0 0 0 0 0 0 0 0 12598.8 0 0 0 1101499834 1083604185 10 Physicians GAONKAR TUSHAR 605401105 30 DuPage 0 0 Family Practice 0 0 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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 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 27812.44 0 0 0 0 0 0 0 0 0 0 0 0 0 27812.44 0 0 0 1101499868 30 General Hospitals 845 Texas ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 148.92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 148.92 0 0 0 1101499870 1831103092 10 Physicians SCHWARTZ IRVING 623012748 10 Adams 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 0 0 1026 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1563 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1563 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19161.4 0 0 0 0 0 0 19161.4 0 0 0 1101499874 1174509442 10 Physicians BRIAN JOHNNY 527221647 816 Iowa 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1094.5 0 0 0 0 0 0 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0 0 152 0 0 0 0 0 0 0 0 0 0 0 0 0 23803.58 0 30694.01 0 0 10944 0 0 0 0 0 0 0 0 0 0 0 0 65441.59 0 0 0 1101499903 91 Waiver service provider--Adults (DHS/DDD) 107 Will 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 0 354 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 354 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14959.5 0 0 0 0 0 0 0 0 0 0 0 0 0 14959.5 0 0 0 1101499932 1851332514 10 Physicians ROBERTSON THESSA 464026099 815 Indiana 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 492 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 515 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 515 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18111.99 0 0 0 0 0 0 18111.99 0 0 0 1101499939 1598912735 10 Physicians OLSEN JEFFREY 999999999 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3548.38 0 0 0 0 0 0 3548.38 0 0 0 1101499945 1023097151 33 Nursing Facilities FOUNTAIN VIEW INC 629301399 90 Saline 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 259 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6511 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 455239.71 0 0 0 0 0 0 0 455239.71 0 0 0 1101499948 1538326426 13 Podiatrists DUKAREVICH IGOR 601602040 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 454 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 454 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8332.82 0 0 0 0 0 0 8332.82 0 0 0 1101499951 1093868283 10 Physicians WANG FERGUSON LISA 478042706 815 Indiana 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2496.74 0 0 0 0 0 0 2496.74 0 0 0 1101499956 1730225384 47 Local Education Agencies CARMI WHITE CUS DIST 5 628211474 105 White 0 0 0 0 0 0 293 0 0 0 0 0 0 0 0 0 0 0 0 0 201 0 0 0 0 554 0 0 0 0 0 0 0 0 0 0 0 0 0 17100 0 0 0 0 554 0 0 0 0 0 0 0 0 0 0 0 0 0 17100 0 0 0 0 3495.8 0 0 0 0 0 0 0 0 0 0 0 0 0 235446.56 0 238942.36 0 0 0 1101499962 1972716017 10 Physicians TAORMINA MIA 601484932 30 DuPage 0 0 Infectious Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2178.17 0 0 0 0 0 0 2178.17 0 0 0 1101499985 1205905197 10 Physicians NGO KHAI 622265366 96 St Clair 0 1 Pediatrics 0 32 0 0 143 0 0 0 0 0 0 76 0 190 0 0 0 0 0 0 259 0 0 699 0 0 0 0 0 0 93 0 328 0 0 0 0 0 0 259 0 0 699 0 0 0 0 0 0 93 0 328 0 0 0 0 0 0 518 0 0 19238.6 0 0 0 0 0 0 372.91 0 10154.04 0 0 0 0 0 0 30283.55 0 0 0 1101499990 1386877504 25 Audiologists BORN STEPHANIE 627032403 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 157 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 157 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3189.75 3189.75 0 0 0 1101499992 1386699114 10 Physicians ZARIF ADIL 601202125 53 Kane 0 0 Pathology 0 0 0 0 10 0 0 0 0 0 0 4433 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 43154 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 386.95 0 0 0 0 0 0 0 0 0 0 0 0 0 386.95 0 0 0 1101500012 1023279643 10 Physicians MERCHANT DELWIN 627025324 91 Sangamon 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 633 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 683 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 683 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17330.55 0 0 0 0 0 0 17330.55 0 0 0 1101500014 1518913904 60 Pharmacies OSCO DRUG 3192 604675412 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 419 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10597 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19663.82 0 0 0 19663.82 0 0 0 1101500018 92 Waiver service provider--Disability (DHS/DRS) 13 Boone 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 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 2345.34 0 0 0 0 0 0 0 0 0 0 0 0 0 2345.34 0 0 0 1101500027 1194896068 10 Physicians PALMER LOWELL 626501136 77 Morgan 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 210.02 0 0 0 0 0 0 210.02 0 0 0 1101500029 1205023611 10 Physicians KAVITT ROBERT 605277594 30 DuPage 0 0 Internal Medicine 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 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2530.2 0 0 0 0 0 0 2530.2 0 0 0 1101500032 1508885229 16 Nurse Practitioners WU JOSEPHINE 600442203 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1033.43 0 0 0 0 0 0 1033.43 0 0 0 1101500036 1447237425 10 Physicians LUTFI RAMI 606162333 200 Cook 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 185 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 185 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13126.8 0 0 0 0 0 0 13126.8 0 0 0 1101500049 1205004405 47 Local Education Agencies LOMBARD SCHOOL DISTRICT 44 601483317 30 DuPage 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 201 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 7805 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 7805 0 0 0 0 161.54 0 0 0 0 0 0 0 0 0 0 0 0 0 198433.97 0 198595.51 0 0 0 1101500053 1154634145 10 Physicians SAAD MAGED 999999999 200 Cook 0 0 0 305 0 0 3 0 0 0 0 0 0 0 0 206 0 0 0 0 0 0 1877 0 0 4 0 0 0 0 0 0 0 0 522 0 0 0 0 0 0 1877 0 0 4 0 0 0 0 0 0 0 0 522 0 0 0 0 0 0 5444 0 0 321.28 0 0 0 0 0 0 0 0 9186.18 0 0 0 0 0 0 14951.46 0 0 0 1101500054 1487742409 10 Physicians HUH RICHARD 606123806 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 418 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 418 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3953.69 0 0 0 0 0 0 3953.69 0 0 0 1101500056 1487817409 62 Opticians / Optical Companies GUILES EYEWEAR BOUTIQUE INC 606414818 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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626.26 0 0 0 1101500132 2100490550 90 Waiver service provider--Elderly (DOA) COMMUNITY HOME ENVIRONMENTAL 625264936 63 Macon 0 0 0 0 0 0 0 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9923 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9923 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 434177.78 0 0 0 0 0 0 0 0 0 0 0 0 0 434177.78 0 0 0 1101500147 1457576993 47 Local Education Agencies LAGRANGE SCHOOL DISTRICT 102 605261802 200 Cook 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 114 0 0 0 0 194 0 0 0 0 0 0 0 0 0 0 0 0 0 6970 0 0 0 0 194 0 0 0 0 0 0 0 0 0 0 0 0 0 6970 0 0 0 0 998.69 0 0 0 0 0 0 0 0 0 0 0 0 0 105036.42 0 106035.11 0 0 0 1101500166 1992704332 10 Physicians PATEL SAMIR 625213882 63 Macon 0 1 Pediatrics 0 42 0 0 34 0 0 0 0 0 0 0 0 168 0 0 0 0 0 0 332 0 0 52 0 0 0 0 0 0 0 0 272 0 0 0 0 0 0 332 0 0 52 0 0 0 0 0 0 0 0 272 0 0 0 0 0 0 664 0 0 2933.56 0 0 0 0 0 0 0 0 9087.12 0 0 0 0 0 0 12684.68 0 0 0 1101500175 1770648917 40 Federally Qualified Health Centers SIHF FAIRMONT CITY HEALTH CTR 622012204 96 St 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0 0 0 1101500230 1760582316 10 Physicians JONAS ROY 604689590 107 Will 0 1 Pediatrics 0 155 0 0 150 0 0 0 0 0 0 68 0 258 0 0 0 0 0 0 1213 0 0 610 0 0 0 0 0 0 102 0 675 0 0 0 0 0 0 1213 0 0 610 0 0 0 0 0 0 102 0 675 0 0 0 0 0 0 2426 0 0 18690.98 0 0 0 0 0 0 1146.76 0 25874.62 0 0 0 0 0 0 48138.36 0 0 0 1101500231 1336285444 10 Physicians BOSE RON 631101010 826 Missouri 0 0 Oncology 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 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7589.63 0 0 0 0 0 0 7589.63 0 0 0 1101500240 1083891402 55 Early Intervention Services STEPHENSON CHRISTINE 601422345 71 McHenry 0 0 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 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9598.21 0 0 0 0 0 0 9598.21 0 0 0 1101500244 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 484 0 0 0 0 0 0 0 0 0 0 0 0 0 484 0 0 0 1101500249 92 Waiver service provider--Disability (DHS/DRS) 53 Kane 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 36649.64 0 0 0 0 0 0 0 0 0 0 0 0 0 36649.64 0 0 0 1101500279 1871596817 10 Physicians ABIAD HOMER 606123723 200 Cook 0 0 Infectious Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 280.58 0 0 0 0 0 0 280.58 0 0 0 1101500282 1750307963 16 Nurse Practitioners KWIATKOWSKI MARIANNE 605212962 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 188 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 671 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 671 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1520.33 0 0 0 0 0 0 1520.33 0 0 0 1101500291 50 Home Health Agencies - In Home 56 Knox 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 19 0 0 0 0 0 0 0 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Adams 0 0 0 336 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2204 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2204 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230168.44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230168.44 0 0 0 1101500874 1124070263 70 Ambulance Service Providers THE 1033 AMBULANCE SERVICE LTD 613629601 15 Bureau 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 244 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 834 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 834 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50328.25 0 0 0 0 0 0 50328.25 0 0 0 1101500882 1861547515 11 Dentists KARICH JOHN 618539200 19 Champaign 0 0 General Practice 0 0 0 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1753 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1753 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48345.45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48345.45 0 0 0 1101500890 55 Early Intervention Services 200 Cook 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 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2917.18 0 0 0 0 0 0 2917.18 0 0 0 1101500892 1619979671 10 Physicians PUCCIA VINCENT 478044021 200 Cook 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2844.97 0 0 0 0 0 0 2844.97 0 0 0 1101500895 1649228990 10 Physicians RABEN STEPHEN 622581424 96 St Clair 0 1 Family Practice 0 8 0 0 4 0 0 0 0 0 0 3 0 38 0 0 0 0 0 0 43 0 0 11 0 0 0 0 0 0 4 0 132 0 0 0 0 0 0 43 0 0 11 0 0 0 0 0 0 4 0 132 0 0 0 0 0 0 101 0 0 802.77 0 0 0 0 0 0 9.03 0 2037 0 0 0 0 0 0 2949.8 0 0 0 1101500904 94 Waiver service provider--Children's support (DHS/DDD) 57 Lake 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 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 1540 0 0 0 0 0 0 0 0 0 0 0 0 0 1540 0 0 0 1101500919 1023370657 11 Dentists YOON CHEON 619538020 29 Douglas 0 0 General Dentistry 0 0 0 1130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4003 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4003 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130394.39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130394.39 0 0 0 1101500925 92 Waiver service provider--Disability (DHS/DRS) 39 Greene 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7255.25 0 0 0 0 0 0 0 0 0 0 0 0 0 7255.25 0 0 0 1101500933 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17837.14 0 0 0 0 0 0 0 0 0 0 0 0 0 17837.14 0 0 0 1101500945 1154599751 16 Nurse Practitioners FIORE KAITLIN 606035606 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 988.53 0 0 0 0 0 0 988.53 0 0 0 1101500946 10 Physicians 826 Missouri 0 0 Pathology 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 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 20.55 0 0 0 0 0 0 0 0 20.55 0 0 0 1101500949 25 Audiologists 852 Wisconsin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131.91 131.91 0 0 0 1101500956 92 Waiver service provider--Disability (DHS/DRS) 100 Vermilion 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 2316.65 0 0 0 0 0 0 0 0 0 0 0 0 0 2316.65 0 0 0 1101500968 1427232412 10 Physicians DIETHELM JESSICA 606123844 200 Cook 0 1 Internal Medicine 0 38 0 0 0 0 0 0 0 0 0 4 0 148 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 5 0 349 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 5 0 349 0 0 0 0 0 0 297 0 0 0 0 0 0 0 0 0 23.66 0 4948.96 0 0 0 0 0 0 5269.62 0 0 0 1101500980 1568599470 55 Early Intervention Services RODIN BONNIE 602031824 200 Cook 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 0 438 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 438 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32264.11 0 0 0 0 0 0 32264.11 0 0 0 1101500982 1134164486 16 Nurse Practitioners LOCKART BARBARA 606143363 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 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1542.64 0 0 0 0 0 0 1542.64 0 0 0 1101500985 1760782650 16 Nurse Practitioners WHITLATCH TERESA 606731258 200 Cook 0 1 0 210 0 0 3 0 0 0 0 0 0 0 0 153 0 0 0 0 0 0 1646 0 0 3 0 0 0 0 0 0 0 0 418 0 0 0 0 0 0 1646 0 0 3 0 0 0 0 0 0 0 0 418 0 0 0 0 0 0 4826 0 0 203.46 0 0 0 0 0 0 0 0 12461.58 0 0 0 0 0 0 17491.04 0 0 0 1101500998 92 Waiver service provider--Disability (DHS/DRS) 100 Vermilion 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2597.81 0 0 0 0 0 0 0 0 0 0 0 0 0 2597.81 0 0 0 1101500999 14 Chiropractors 19 Champaign 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 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 0 143.38 0 0 0 0 0 0 143.38 0 0 0 1101501009 1649355660 60 Pharmacies DOCS DRUGS OF WILMINGTON 604811671 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 553 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3265 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80721 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 192859.15 0 0 0 192859.15 0 0 0 1101501012 1104824457 10 Physicians STONE MULHERN KRISTEN 600052407 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 4 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 287.6 0 1985.63 0 0 0 0 0 0 2273.23 0 0 0 1101501015 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11954.25 0 0 0 0 0 0 0 0 0 0 0 0 0 11954.25 0 0 0 1101501021 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 1541.49 0 0 0 0 0 0 0 0 0 0 0 0 0 1541.49 0 0 0 1101501029 1932497922 16 Nurse Practitioners WEAVER REBECCA J. 616151941 80 Peoria 0 0 General Psychiatry Residency 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 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2986.42 0 0 0 0 0 0 2986.42 0 0 0 1101501034 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 15729.65 0 0 0 0 0 0 0 0 0 0 0 0 0 15729.65 0 0 0 1101501035 1548200298 60 Pharmacies REA CLINIC PHARMACY 628220155 36 Franklin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1217 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13653 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 378410 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 278137.23 0 0 0 278137.23 0 0 0 1101501042 1306089479 10 Physicians SIVASUBRAMANIAN GEETHA 618012530 19 Champaign 0 0 Infectious Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 263 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 737 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 737 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10388.24 0 0 0 0 0 0 10388.24 0 0 0 1101501047 93 Waiver service provider--HIV/AIDS (DHS/DRS) 80 Peoria 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 22191.35 0 0 0 0 0 0 0 0 0 0 0 0 0 22191.35 0 0 0 1101501049 10 Physicians 852 Wisconsin 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 1 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88.05 0 315.48 0 0 0 0 0 0 403.53 0 0 0 1101501057 1386726255 10 Physicians CARLSON SCOTT 615712200 98 Tazewell 0 1 Pediatrics 0 450 0 0 301 0 0 0 0 0 0 118 0 320 0 0 0 0 0 0 3958 0 0 1254 0 0 0 0 0 0 134 0 593 0 0 0 0 0 0 3958 0 0 1254 0 0 0 0 0 0 134 0 593 0 0 0 0 0 0 7928 0 0 37743.06 0 0 0 0 0 0 1096.65 0 23329.65 0 0 0 0 0 0 70097.36 0 0 0 1101501073 1205863370 10 Physicians KAMBOL JAMES 532024809 852 Wisconsin 0 0 Emergency Medicine 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 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1437.85 0 0 0 0 0 0 1437.85 0 0 0 1101501078 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12244.48 0 0 0 0 0 0 0 0 0 0 0 0 0 12244.48 0 0 0 1101501087 92 Waiver service provider--Disability (DHS/DRS) 59 Lawrence 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 32149.27 0 0 0 0 0 0 0 0 0 0 0 0 0 32149.27 0 0 0 1101501119 1477655686 10 Physicians BOXLEY GILLESPIE KIA 601814822 30 DuPage 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 0 1019 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1087 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1087 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34354.29 0 0 0 0 0 0 34354.29 0 0 0 1101501121 1922368729 30 General Hospitals RENAL CENTER NEW LENOX 604519528 844 Tennessee DIALYSIS Outpatient dialysis centers. 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 196 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1542 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23008.66 0 0 0 0 0 23008.66 0 0 0 1101501125 1467617126 10 Physicians NICHOLAS JENNIFER 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 1475 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2008 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2008 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45388.38 0 3009.33 0 0 0 0 0 0 48397.71 0 0 0 1101501126 92 Waiver service provider--Disability (DHS/DRS) 107 Will 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 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 10626.49 0 0 0 0 0 0 0 0 0 0 0 0 0 10626.49 0 0 0 1101501127 1528067865 33 Nursing Facilities FREEBURG CARE CENTER INC 622431905 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 496 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1010245.99 0 0 0 0 0 0 0 1010245.99 0 0 0 1101501146 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 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 1772.26 0 0 0 0 0 0 0 0 0 0 0 0 0 1772.26 0 0 0 1101501147 16 Nurse Practitioners 826 Missouri 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 0 767.5 0 0 0 0 0 0 767.5 0 0 0 1101501148 1093714719 63 Other Providers of Medical Equipment/Supplies (Non-registered) WHABA MEDICAL INC 601722883 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2862.63 0 0 0 0 0 0 2862.63 0 0 0 1101501161 1912969528 25 Audiologists ERICKSON KRISTINE 600622802 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 275 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 275 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8016.5 8016.5 0 0 0 1101501166 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 324 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 324 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14586 0 0 0 0 0 0 0 0 0 0 0 0 0 14586 0 0 0 1101501167 1437217460 12 Optometrists OBERREITER ANGELA 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 271 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 271 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4805.42 0 0 0 0 0 0 4805.42 0 0 0 1101501170 1639386790 10 Physicians LUU MINH 606123863 200 Cook 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 264 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 264 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26642.98 0 0 0 0 0 0 26642.98 0 0 0 1101501176 92 Waiver service provider--Disability (DHS/DRS) 42 Hancock 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 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16143.18 0 0 0 0 0 0 0 0 0 0 0 0 0 16143.18 0 0 0 1101501187 2100491605 72 Taxicabs and Livery Companies SOUTHERN ILLINOIS TRANSPORT 629061536 99 Union 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1429 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 957213.81 0 0 0 0 0 0 957213.81 0 0 0 1101501189 1295739548 30 General Hospitals SALEM TOWNSHIP HOSPITAL 628814263 66 Marion DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 1 0 General Hospital - Adult and Child 0 0 0 0 6 0 0 0 0 0 0 1456 0 0 282 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 6816 0 0 1071 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 6816 0 0 1071 0 0 0 0 0 0 0 0 35.51 0 0 0 0 0 0 42818.07 0 0 182985.53 0 0 0 0 0 225839.11 0 0 0 1101501195 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 31925.72 0 0 0 0 0 0 0 0 0 0 0 0 0 31925.72 0 0 0 1101501213 92 Waiver service provider--Disability (DHS/DRS) 96 St Clair 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 14524.2 0 0 0 0 0 0 0 0 0 0 0 0 0 14524.2 0 0 0 1101501222 1982631537 10 Physicians GIBBONS VINCENT 535625531 10 Adams 0 0 Child Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 226 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14256.7 0 0 0 0 0 0 14256.7 0 0 0 1101501236 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 7657.23 0 0 0 0 0 0 0 0 0 0 0 0 0 7657.23 0 0 0 1101501240 30 General Hospitals 836 Ohio NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101501252 1982662920 22 Physical Therapists BURNETT LISK JILL 628962402 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 503 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 503 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12452.39 12452.39 0 0 0 1101501256 1104824887 10 Physicians VICTOR JEFF 601344205 53 Kane 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1167.25 0 0 0 0 0 0 1167.25 0 0 0 1101501263 1962424838 10 Physicians LONG JEREMIAH 631101016 826 Missouri 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 101 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2244.43 0 959.62 0 0 0 0 0 0 3204.05 0 0 0 1101501278 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 18561.32 0 0 0 0 0 0 0 0 0 0 0 0 0 18561.32 0 0 0 1101501284 94 Waiver service provider--Children's support (DHS/DDD) 65 Madison 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 78 0 0 0 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 16236 0 0 0 0 0 0 0 0 0 0 0 0 0 16236 0 0 0 1101501286 1760542732 30 General Hospitals SWEDISHAMERICAN HOSPITAL 611042315 109 Winnebago DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 Breast Cancer Screening 0 0 0 0 737 0 0 0 0 0 0 8638 0 0 727 0 0 0 0 0 0 0 0 762 0 0 0 0 0 0 53016 0 0 4868 0 0 0 0 0 0 0 0 762 0 0 0 0 0 0 53016 0 0 4868 0 0 0 0 0 0 0 0 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Peoria 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 40592.58 0 0 0 0 0 0 0 0 0 0 0 0 0 40592.58 0 0 0 1101504056 1245291962 70 Ambulance Service Providers CISSNA PARK FIRE PROTECT DIST 609246155 46 Iroquois 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 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 1690.42 0 0 0 0 0 0 1690.42 0 0 0 1101504065 1164756094 28 Waiver service provider--Supportive living facility (HFS) BROOKSTONE ESTATES FAIRFIELD 628372611 104 Wayne 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 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2712 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137858.61 0 0 0 0 0 0 0 0 0 0 0 0 0 137858.61 0 0 0 1101504068 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 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0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3764.89 0 0 0 0 0 0 3764.89 0 0 0 1101504220 92 Waiver service provider--Disability (DHS/DRS) 30 DuPage 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 28192.08 0 0 0 0 0 0 0 0 0 0 0 0 0 28192.08 0 0 0 1101504238 1003832304 10 Physicians RANGANATHAN PRABHA 631081606 826 Missouri 0 0 Rheumatology 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3605.72 0 0 0 0 0 0 3605.72 0 0 0 1101504244 10 Physicians 816 Iowa 0 0 Anesthesiology 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 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 315.66 0 0 0 0 0 0 315.66 0 0 0 1101504245 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 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1101505319 1891740288 60 Pharmacies SINGER PHARMACY INC 606344019 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 110 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 374 0 0 605 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 374 0 0 16097 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28182.37 0 0 40358.51 0 0 0 68540.88 0 0 0 1101505329 1033291182 10 Physicians HABIBY REEMA 606112991 200 Cook 0 0 Pediatrics 0 0 0 0 5 0 0 0 0 0 0 11 0 257 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 13 0 401 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 13 0 401 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 79.8 0 26407.5 0 0 0 0 0 0 26519.3 0 0 0 1101505334 1962469734 10 Physicians KRAUS ROBERT 625261592 63 Macon 0 0 Neurology Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12628.93 0 0 0 0 0 0 12628.93 0 0 0 1101505337 1851412662 55 Early Intervention Services VARNER SANDRA 605107620 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 149.66 0 0 0 0 0 0 149.66 0 0 0 1101505378 1811002660 55 Early Intervention Services NEFF CHRISTINA 601357520 27 Dekalb 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 0 247 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 247 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26596.11 0 0 0 0 0 0 26596.11 0 0 0 1101505387 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 28739.95 0 0 0 0 0 0 0 0 0 0 0 0 0 28739.95 0 0 0 1101505397 1447235783 10 Physicians REINER BRUCE H 982399633 850 Washington 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 143 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 179 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 179 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3798.85 0 123.86 0 0 0 0 0 0 3922.71 0 0 0 1101505400 1265418933 16 Nurse Practitioners CUNNINGHAM DEBRA 620026751 65 Madison 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 118 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 217 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 217 0 0 0 0 0 0 0 0 0 970.3 0 0 0 0 0 0 0 0 16667.25 0 0 0 0 0 0 17637.55 0 0 0 1101505414 10 Physicians 816 Iowa 0 0 Pediatric Hematology Oncology 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 147.24 0 0 0 0 0 0 147.24 0 0 0 1101505419 1750369419 10 Physicians CONNOLLY EDWARD 612656133 89 Rock Island 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 80 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166 0 417 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166 0 417 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2088.59 0 17587.41 0 0 0 0 0 0 19676 0 0 0 1101505421 1750515367 10 Physicians AKBAR SAMREEN 601692048 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 21 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 173 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 173 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1821.12 0 12862.23 0 0 0 0 0 0 14683.35 0 0 0 1101505427 98 Waiver service provider--TBI (DHS/DRS) 91 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8701.87 0 0 0 0 0 0 0 0 0 0 0 0 0 8701.87 0 0 0 1101505433 22 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 4 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 1995.4 1995.4 0 0 0 1101505440 1740274661 11 Dentists VERGOTINE RODNEY 606127210 200 Cook 0 0 General Dentistry 0 0 0 269 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1041 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1041 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33940.78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33940.78 0 0 0 1101505442 92 Waiver service provider--Disability (DHS/DRS) 36 Franklin 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 15137.86 0 0 0 0 0 0 0 0 0 0 0 0 0 15137.86 0 0 0 1101505458 1174694343 12 Optometrists MLSNA REID 610681867 79 Ogle 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 628 0 541 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1768 0 564 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1768 0 564 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35419.13 0 16033.72 0 0 0 0 51452.85 0 0 0 1101505460 10 Physicians 57 Lake 0 0 Anesthesiology 0 0 0 0 0 0 0 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 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 4.52 0 0 0 0 0 0 4.52 0 0 0 1101505461 92 Waiver service provider--Disability (DHS/DRS) 91 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 10619.99 0 0 0 0 0 0 0 0 0 0 0 0 0 10619.99 0 0 0 1101505462 1144488750 60 Pharmacies CVS PHARMACY 00484 612654504 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 335 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2496 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67823 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103178.72 0 0 0 103178.72 0 0 0 1101505466 1609911536 60 Pharmacies MORSE L DRUGS 606263481 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 998 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 12026 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 343313 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 257.41 0 0 972924.84 0 0 0 973182.25 0 0 0 1101505478 1548264914 14 Chiropractors PRICE CHARLES 624542027 25 Crawford 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 0 172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 374.11 0 0 0 0 0 0 374.11 0 0 0 1101505484 2100495902 91 Waiver service provider--Adults (DHS/DDD) SHOTSBERGER SARA 999999999 200 Cook 0 0 0 0 0 0 0 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 555 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 555 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14616.45 0 0 0 0 0 0 0 0 0 0 0 0 0 14616.45 0 0 0 1101505486 1225094881 12 Optometrists NIX LISA 527539236 816 Iowa 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1147.46 0 593.47 0 0 0 0 1740.93 0 0 0 1101505493 2100495911 90 Waiver service provider--Elderly (DOA) HENRY COUNTY HEALTH DEPT 614438319 45 Henry 0 0 0 0 0 0 0 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12581 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12581 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 529381.27 0 0 0 0 0 0 0 0 0 0 0 0 0 529381.27 0 0 0 1101505504 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 260 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 0 0 0 0 0 0 0 0 0 0 0 22881.84 0 0 0 0 0 0 0 0 0 0 0 0 0 22881.84 0 0 0 1101505508 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 21447.09 0 0 0 0 0 0 0 0 0 0 0 0 0 21447.09 0 0 0 1101505521 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 6643.63 0 0 0 0 0 0 0 0 0 0 0 0 0 6643.63 0 0 0 1101505524 1073508172 10 Physicians ATASSI MOHAMAD 606162477 200 Cook 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 2 0 694 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 2972 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 2972 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22.92 0 27671.78 0 0 0 0 0 0 27694.7 0 0 0 1101505533 91 Waiver service provider--Adults (DHS/DDD) 26 Cumberland 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 0 327 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 327 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11735.34 0 0 0 0 0 0 0 0 0 0 0 0 0 11735.34 0 0 0 1101505538 1922100742 10 Physicians PLATTNER PAUL 618321735 100 Vermilion 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 265 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 265 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14844.99 0 0 0 0 0 0 14844.99 0 0 0 1101505562 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 12248.59 0 0 0 0 0 0 0 0 0 0 0 0 0 12248.59 0 0 0 1101505565 10 Physicians 200 Cook 0 0 Internal Medicine 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 84.85 0 0 0 0 0 0 84.85 0 0 0 1101505578 1972508398 10 Physicians SAFI MALAZ 622062822 96 St Clair 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 21 0 296 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 551 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 551 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55.35 0 10331.94 0 0 0 0 0 0 10387.29 0 0 0 1101505579 1316243751 63 Other Providers of Medical Equipment/Supplies (Non-registered) FAIRMEADOWS HOMEHEALTH CTR 463750789 815 Indiana 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 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3469.85 0 0 0 0 0 0 3469.85 0 0 0 1101505605 92 Waiver service provider--Disability (DHS/DRS) 34 Fayette 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2021.07 0 0 0 0 0 0 0 0 0 0 0 0 0 2021.07 0 0 0 1101505618 91 Waiver service provider--Adults (DHS/DDD) 89 Rock Island 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 0 363 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 363 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15375.3 0 0 0 0 0 0 0 0 0 0 0 0 0 15375.3 0 0 0 1101505636 10 Physicians 815 Indiana 0 0 Internal Medicine 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51.4 0 0 0 0 0 0 51.4 0 0 0 1101505638 92 Waiver service provider--Disability (DHS/DRS) 47 Jackson 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 1769.61 0 0 0 0 0 0 0 0 0 0 0 0 0 1769.61 0 0 0 1101505655 1982775631 30 General Hospitals CENTER FOR RENAL REPLACEMENT 607121735 200 Cook DIALYSIS Outpatient dialysis centers. 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 196 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2458 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38066.02 0 0 0 0 0 38066.02 0 0 0 1101505659 1730282393 10 Physicians ABDELMEGUID ALAA 609012942 54 Kankakee 0 0 Cardiovascular Diseases 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 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71.52 0 0 0 0 0 0 71.52 0 0 0 1101505663 1790703916 10 Physicians PATEL PARAG 600681130 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 3 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 346 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 346 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22.92 0 10052.8 0 0 0 0 0 0 10075.72 0 0 0 1101505667 94 Waiver service provider--Children's support (DHS/DDD) 82 Piatt 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 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5761.16 0 0 0 0 0 0 0 0 0 0 0 0 0 5761.16 0 0 0 1101505670 1033153325 70 Ambulance Service Providers VILLAGE OF SOUTH CHICAGO HTS 604114815 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7938.49 0 0 0 0 0 0 7938.49 0 0 0 1101505672 1417944109 10 Physicians KATZ ARTHUR 604611862 200 Cook 0 0 Otorhinolaryngology 0 0 0 0 1 0 0 0 0 0 0 5 0 212 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 5 0 1638 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 5 0 1638 0 0 0 0 0 0 0 0 0 15.2 0 0 0 0 0 0 188.1 0 38964.86 0 0 0 0 0 0 39168.16 0 0 0 1101505704 1245227842 16 Nurse Practitioners JULIAN STIEGEL EDITHA E 600478444 57 Lake 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 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1049.31 0 0 0 0 0 0 1049.31 0 0 0 1101505705 1366487969 10 Physicians GANJU ARUNA 606118702 200 Cook 0 0 Neurology Surgery 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 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3838.16 0 0 0 0 0 0 3838.16 0 0 0 1101505710 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 11950.2 0 0 0 0 0 0 0 0 0 0 0 0 0 11950.2 0 0 0 1101505712 1962721696 11 Dentists DHAWAN SUNDEEP 604591583 200 Cook 0 0 General Dentistry 0 0 0 250 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1409 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1409 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38433.28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38433.28 0 0 0 1101505713 92 Waiver service provider--Disability (DHS/DRS) 26 Cumberland 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 2029.9 0 0 0 0 0 0 0 0 0 0 0 0 0 2029.9 0 0 0 1101505715 30 General Hospitals 803 Arizona NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 453.35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 453.35 0 0 0 1101505718 1497735385 63 Other Providers of Medical Equipment/Supplies (Non-registered) NEUMANNS HOME MEDICAL 605062831 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 940 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 940 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23432.74 0 0 0 0 0 0 23432.74 0 0 0 1101505728 1134259781 10 Physicians SPARROW ROBERT 616033143 80 Peoria 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 493 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 493 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8028.03 0 0 0 0 0 0 8028.03 0 0 0 1101505745 10 Physicians 852 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76.7 0 1085.01 0 0 0 0 0 0 1161.71 0 0 0 1101506223 93 Waiver service provider--HIV/AIDS (DHS/DRS) 37 Fulton 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21694.85 0 0 0 0 0 0 0 0 0 0 0 0 0 21694.85 0 0 0 1101506236 1649578337 39 Hospice SAFE HAVEN HOSPICE LLC 626562777 62 Logan 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3531 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 285679.7 0 0 0 0 0 0 0 0 0 0 0 285679.7 0 0 0 1101506248 1780726273 10 Physicians SILVER DENNIS 625651838 94 Shelby 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7477.38 0 0 0 0 0 0 7477.38 0 0 0 1101506251 1851470769 10 Physicians NEWELL JOHN D 522421009 816 Iowa 0 0 Radiology Diagnosis 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 23 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 0 0 0 0 0 0 0 0 402.47 0 0 0 0 0 0 0 0 402.47 0 0 0 1101506252 1386771046 16 Nurse Practitioners MOORE TRACY 631102515 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7680.01 0 0 0 0 0 0 7680.01 0 0 0 1101506254 1770786667 10 Physicians BLACK JUDY 606112991 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2793.43 0 0 0 0 0 0 2793.43 0 0 0 1101506259 1326094954 60 Pharmacies OSCO DRUG 3003 605141615 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 477 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10852 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18953.98 0 0 0 18953.98 0 0 0 1101506268 30 General Hospitals 845 Texas NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1187.5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1187.5 0 0 0 1101506280 1114906294 10 Physicians SCHWARTZ JEFFREY 601533328 200 Cook 0 0 Cardiovascular Surgery 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 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31447.89 0 0 0 0 0 0 31447.89 0 0 0 1101506289 92 Waiver service provider--Disability (DHS/DRS) 22 Clay 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 14 0 0 0 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 4315.33 0 0 0 0 0 0 0 0 0 0 0 0 0 4315.33 0 0 0 1101506290 92 Waiver service provider--Disability (DHS/DRS) 24 Coles 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 1689.91 0 0 0 0 0 0 0 0 0 0 0 0 0 1689.91 0 0 0 1101506303 1700889227 63 Other Providers of Medical Equipment/Supplies (Non-registered) UNITED STATES MEDICAL SUPPLY 331221903 810 Florida 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1790 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14535 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14535 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40501 0 87.4 0 0 0 0 40588.4 0 0 0 1101506304 94 Waiver service provider--Children's support (DHS/DDD) 53 Kane 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63.52 0 0 0 0 0 0 0 0 0 0 0 0 0 63.52 0 0 0 1101506308 1831116367 10 Physicians SWARM ROBERT A 631600352 53 Kane 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 301 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 301 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4069.35 0 0 0 0 0 0 4069.35 0 0 0 1101506317 92 Waiver service provider--Disability (DHS/DRS) 15 Bureau 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 40432.04 0 0 0 0 0 0 0 0 0 0 0 0 0 40432.04 0 0 0 1101506319 2100496737 92 Waiver service provider--Disability (DHS/DRS) MJM HEALTH AGENCY INC 604358113 107 Will 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 265860.7 0 0 0 0 0 0 0 0 0 0 0 0 0 265860.7 0 0 0 1101506322 1891843652 12 Optometrists KHOURI MARLIN 604356429 107 Will 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 434 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 874 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 874 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26524.9 0 0 0 0 0 0 26524.9 0 0 0 1101506324 91 Waiver service provider--Adults (DHS/DDD) 65 Madison 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 3168 0 0 0 0 0 0 0 0 0 0 0 0 0 3168 0 0 0 1101506326 1306847702 10 Physicians SALTI GEORGE 606127317 200 Cook 0 0 Oncology 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 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6287.47 0 0 0 0 0 0 6287.47 0 0 0 1101506332 1639273576 60 Pharmacies CVS PHARMACY 2809 606188018 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 327 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1793 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45170 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83711.81 0 0 0 83711.81 0 0 0 1101506338 30 General Hospitals 836 Ohio NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 418.49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 418.49 0 0 0 1101506339 1609945922 10 Physicians DESILVA MARK 601545716 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 406 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 427 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 427 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12007.53 0 0 0 0 0 0 12007.53 0 0 0 1101506340 92 Waiver service provider--Disability (DHS/DRS) 816 Iowa 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5467.66 0 0 0 0 0 0 0 0 0 0 0 0 0 5467.66 0 0 0 1101506342 10 Physicians 107 Will 0 0 Family Practice 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 14 0 0 0 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 0 0 0 0 0 0 0 0 0 0 0 1101506344 1639348808 10 Physicians JONES KATHERINE 631101002 826 Missouri 0 0 Pediatrics 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 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1377.29 0 0 0 0 0 0 1377.29 0 0 0 1101506366 1518985043 10 Physicians THEODORO DANIEL 631101010 826 Missouri 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 4 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 134.6 0 2113.43 0 0 0 0 0 0 2248.03 0 0 0 1101506382 1265548986 16 Nurse Practitioners HERNDON ANGELA 622581447 96 St Clair 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 14 0 0 0 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 0 207.57 0 0 0 0 0 0 207.57 0 0 0 1101506392 1851449060 10 Physicians GUNARATNAM LETTRICIA 606455276 200 Cook 0 1 General Practice 0 663 0 0 61 0 0 0 0 0 0 1 0 439 0 0 0 0 0 0 1103 0 0 117 0 0 0 0 0 0 1 0 988 0 0 0 0 0 0 1103 0 0 117 0 0 0 0 0 0 1 0 988 0 0 0 0 0 0 2663 0 0 5733.52 0 0 0 0 0 0 4 0 27587.89 0 0 0 0 0 0 35988.41 0 0 0 1101506398 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 3835.34 0 0 0 0 0 0 0 0 0 0 0 0 0 3835.34 0 0 0 1101506403 1205934395 10 Physicians DARWEESH MUTAZZ 605231804 30 DuPage 0 1 Internal Medicine 0 175 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 559 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 559 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 1153 0 0 0 0 0 0 0 0 0 0 0 1727.44 0 0 0 0 0 0 2880.44 0 0 0 1101506408 1073786612 29 ICF/MR TORRENCE PLACE 604115125 200 Cook 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 0 425 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8255 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 858728.82 0 0 0 0 0 0 0 0 0 0 858728.82 0 0 0 1101506414 2100496832 90 Waiver service provider--Elderly (DOA) JAPANESE AMERICAN SERVICE COMM 606405403 200 Cook 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 744 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 744 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47622.62 0 0 0 0 0 0 0 0 0 0 0 0 0 47622.62 0 0 0 1101506416 1699119644 60 Pharmacies SAV MOR PHARMACY 999999999 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 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 0 0 0 0 0 19977 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28143.48 0 0 0 28143.48 0 0 0 1101506421 1083635874 10 Physicians OPERCHAL JUDITH 605213635 30 DuPage 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 462 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 655 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 655 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9396.31 0 457.02 0 0 0 0 0 0 9853.33 0 0 0 1101506425 1972530285 10 Physicians FISH KAREN 606123714 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 0 8 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 0 187.23 0 0 0 0 0 0 187.23 0 0 0 1101506434 1689857021 10 Physicians ZABALETA JUAN 606472017 200 Cook 0 0 General Practice 0 0 0 0 0 0 0 0 0 0 0 1 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36.39 0 58.44 0 0 0 0 0 0 94.83 0 0 0 1101506435 1700815123 10 Physicians LAZARUS MARTIN 600257657 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 526 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 652 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 652 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24177.58 0 957.83 0 0 0 0 0 0 25135.41 0 0 0 1101506442 1104829886 10 Physicians TURGUT TANSEL 625264163 63 Macon 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 0 0 395 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 646 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 646 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11071.03 0 0 0 0 0 0 11071.03 0 0 0 1101506446 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 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 24641.93 0 0 0 0 0 0 0 0 0 0 0 0 0 24641.93 0 0 0 1101506453 1093722860 10 Physicians LARSON JOHN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 290 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 397 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 397 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6592.4 0 0 0 0 0 0 0 0 6592.4 0 0 0 1101506454 1649269580 10 Physicians MEHAFFEY MARY 601873152 30 DuPage 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 3 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 533.17 0 0 0 0 0 0 533.17 0 0 0 1101506459 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17900.5 0 0 0 0 0 0 0 0 0 0 0 0 0 17900.5 0 0 0 1101506463 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 19 0 0 0 0 0 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 6512.82 0 0 0 0 0 0 0 0 0 0 0 0 0 6512.82 0 0 0 1101506469 91 Waiver service provider--Adults (DHS/DDD) 30 DuPage 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 0 364 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 364 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15669.5 0 0 0 0 0 0 0 0 0 0 0 0 0 15669.5 0 0 0 1101506470 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 4762.32 0 0 0 0 0 0 0 0 0 0 0 0 0 4762.32 0 0 0 1101506472 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12977.07 0 0 0 0 0 0 0 0 0 0 0 0 0 12977.07 0 0 0 1101506485 92 Waiver service provider--Disability (DHS/DRS) 106 Whiteside 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 5222.47 0 0 0 0 0 0 0 0 0 0 0 0 0 5222.47 0 0 0 1101506490 1104058379 10 Physicians DUQUE KRISTIN 606313715 200 Cook 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 635 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 635 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12107.8 0 0 0 0 0 0 12107.8 0 0 0 1101506493 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 19 0 0 0 0 0 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 1557.6 0 0 0 0 0 0 0 0 0 0 0 0 0 1557.6 0 0 0 1101506506 1548297252 10 Physicians REID CHURPHENA A 61610 98 Tazewell 0 0 Urology 0 0 0 0 0 0 0 0 0 0 0 317 0 628 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 413 0 1164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 413 0 1164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 865.91 0 105826.92 0 0 0 0 0 0 106692.83 0 0 0 1101506514 1558316802 10 Physicians FRANKLIN ROBERT 477500001 815 Indiana 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1179.29 0 0 0 0 0 0 0 0 1179.29 0 0 0 1101506530 1053522540 10 Physicians AREF AHMAD 606163878 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 42 0 402 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 933 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 933 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 415.75 0 71379.66 0 0 0 0 0 0 71795.41 0 0 0 1101506536 10 Physicians 80 Peoria 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52.16 0 62.5 0 0 0 0 0 0 114.66 0 0 0 1101506538 1174702948 10 Physicians RAI KARISHMA 604532658 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 2 0 0 0 0 0 0 509 0 265 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 1011 0 677 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 1011 0 677 0 0 0 0 0 0 0 0 0 53.95 0 0 0 0 0 0 48006.87 0 19621.68 0 0 0 0 0 0 67682.5 0 0 0 1101506542 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11324.19 0 0 0 0 0 0 0 0 0 0 0 0 0 11324.19 0 0 0 1101506544 92 Waiver service provider--Disability (DHS/DRS) 88 Richland 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 12226.57 0 0 0 0 0 0 0 0 0 0 0 0 0 12226.57 0 0 0 1101506548 1851343123 16 Nurse Practitioners FERNAU STEPHEN P. 605638669 33 Effingham 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1897.92 0 0 0 0 0 0 1897.92 0 0 0 1101506553 1083664106 10 Physicians SENESE MARIANNE 606751253 30 DuPage 0 1 Pediatrics 0 83 0 0 109 0 0 0 0 0 0 22 0 123 0 0 0 0 0 0 285 0 0 274 0 0 0 0 0 0 25 0 173 0 0 0 0 0 0 285 0 0 274 0 0 0 0 0 0 25 0 173 0 0 0 0 0 0 570 0 0 10148.17 0 0 0 0 0 0 260.75 0 6535.7 0 0 0 0 0 0 17514.62 0 0 0 1101506566 92 Waiver service provider--Disability (DHS/DRS) 77 Morgan 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10352.2 0 0 0 0 0 0 0 0 0 0 0 0 0 10352.2 0 0 0 1101506586 1538173265 10 Physicians SMITH CHRISTOPHER 535661569 852 Wisconsin 0 1 Family Practice 0 25 0 0 0 0 0 0 0 0 0 3 0 40 0 0 0 0 0 0 213 0 0 0 0 0 0 0 0 0 5 0 143 0 0 0 0 0 0 213 0 0 0 0 0 0 0 0 0 5 0 143 0 0 0 0 0 0 630 0 0 0 0 0 0 0 0 0 64.14 0 4167.34 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 17361.42 0 0 0 0 0 0 0 0 0 0 0 0 0 17361.42 0 0 0 1101507901 92 Waiver service provider--Disability (DHS/DRS) 54 Kankakee 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 4329.74 0 0 0 0 0 0 0 0 0 0 0 0 0 4329.74 0 0 0 1101507911 98 Waiver service provider--TBI (DHS/DRS) 45 Henry 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 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 10229.7 0 0 0 0 0 0 0 0 0 0 0 0 0 10229.7 0 0 0 1101507912 1922085729 10 Physicians EPSTEIN AARON 606118709 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 316 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 326 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 326 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12352.81 0 0 0 0 0 0 12352.81 0 0 0 1101507944 10 Physicians 852 Wisconsin 0 0 Thoracic Surgery 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 2253.49 0 0 0 1101508141 1346257961 10 Physicians COHEN LEEBER 606115966 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 347 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 601 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 601 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15761.75 0 0 0 0 0 0 0 0 15761.75 0 0 0 1101508145 30 General Hospitals 850 Washington ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 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 99.51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99.51 0 0 0 1101508180 30 General Hospitals 852 Wisconsin NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 649.83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 649.83 0 0 0 1101508182 1700880309 10 Physicians LEBUHN CARL 420033827 818 Kentucky 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25995.19 0 0 0 0 0 0 0 0 0 0 0 0 0 25995.19 0 0 0 1101510297 1982867446 10 Physicians SHUPE CASEY 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14692.63 0 0 0 0 0 0 14692.63 0 0 0 1101510304 1023082328 10 Physicians MARRA GUIDO 605152725 30 DuPage 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 4 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8495.42 0 0 0 0 0 0 8495.42 0 0 0 1101510305 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18017.21 0 0 0 0 0 0 0 0 0 0 0 0 0 18017.21 0 0 0 1101510307 91 Waiver service provider--Adults (DHS/DDD) 80 Peoria 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 0 313 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 313 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17430.6 0 0 0 0 0 0 0 0 0 0 0 0 0 17430.6 0 0 0 1101510320 92 Waiver service provider--Disability (DHS/DRS) 42 Hancock 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 7846.45 0 0 0 0 0 0 0 0 0 0 0 0 0 7846.45 0 0 0 1101510321 1821057324 10 Physicians KUCHIPUDI SANDESH 605131236 200 Cook 0 1 Internal Medicine 0 17 0 0 0 0 0 0 0 0 0 0 0 550 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 3425 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 3425 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 41474.85 0 0 0 0 0 0 41546.85 0 0 0 1101510334 1588633192 10 Physicians MALANI BRIJ 606575147 200 Cook 0 1 Internal Medicine 0 23 0 0 0 0 0 0 0 0 0 5 0 156 0 0 0 0 0 0 181 0 0 0 0 0 0 0 0 0 10 0 577 0 0 0 0 0 0 181 0 0 0 0 0 0 0 0 0 10 0 577 0 0 0 0 0 0 531 0 0 0 0 0 0 0 0 0 26.42 0 6017.84 0 0 0 0 0 0 6575.26 0 0 0 1101510336 92 Waiver service provider--Disability (DHS/DRS) 87 Randolph 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8559.6 0 0 0 0 0 0 0 0 0 0 0 0 0 8559.6 0 0 0 1101510337 1992768402 10 Physicians KEELE KEVIN 604264260 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 414 0 194 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 612 0 499 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 612 0 499 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4336.2 0 9885.03 0 0 0 0 0 0 14221.23 0 0 0 1101510353 1902875628 10 Physicians SIKAND PARAMJIT 604363172 107 Will 0 1 Internal Medicine 0 137 0 0 0 0 0 0 0 0 0 43 0 242 0 0 0 0 0 0 1054 0 0 0 0 0 0 0 0 0 82 0 816 0 0 0 0 0 0 1054 0 0 0 0 0 0 0 0 0 82 0 816 0 0 0 0 0 0 2948 0 0 0 0 0 0 0 0 0 750.94 0 10947.54 0 0 0 0 0 0 14646.48 0 0 0 1101510357 92 Waiver service provider--Disability (DHS/DRS) 104 Wayne 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11524.59 0 0 0 0 0 0 0 0 0 0 0 0 0 11524.59 0 0 0 1101510358 91 Waiver service provider--Adults (DHS/DDD) 65 Madison 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 19 0 0 0 0 0 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 2780.25 0 0 0 0 0 0 0 0 0 0 0 0 0 2780.25 0 0 0 1101510363 2100500781 94 Waiver service provider--Children's support (DHS/DDD) INDIVIDUALIZED SERVICES INC 617011939 72 McLean 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 974 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 974 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50188.63 0 0 0 0 0 0 0 0 0 0 0 0 0 50188.63 0 0 0 1101510367 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 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 0 219.58 0 0 0 0 0 0 0 0 0 0 0 0 0 219.58 0 0 0 1101510368 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 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 9013.29 0 0 0 0 0 0 0 0 0 0 0 0 0 9013.29 0 0 0 1101510376 1487841649 28 Waiver service provider--Supportive living facility (HFS) VICTORY CENTRE OF PARK FOREST 999999999 200 Cook 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 358 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9923 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 624580.08 0 0 0 0 0 0 0 0 0 0 0 0 0 624580.08 0 0 0 1101510384 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 45222.04 0 0 0 0 0 0 0 0 0 0 0 0 0 45222.04 0 0 0 1101510394 1114288628 60 Pharmacies MORTON ALWAN PHARMACY 999999999 98 Tazewell 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 999 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27686 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88317.96 0 0 0 88317.96 0 0 0 1101510408 1407828940 10 Physicians REYES CHRISTOPHER 622741034 81 Perry 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2373.38 0 0 0 0 0 0 2373.38 0 0 0 1101510414 1629153135 10 Physicians JOHNSON RICHARD 604502131 40 Grundy 0 1 Pediatrics 0 551 0 0 328 0 0 0 0 0 0 259 0 412 0 0 0 0 0 0 5410 0 0 1597 0 0 0 0 0 0 364 0 1258 0 0 0 0 0 0 5410 0 0 1597 0 0 0 0 0 0 364 0 1258 0 0 0 0 0 0 10831 0 0 45014.12 0 0 0 0 0 0 1775.15 0 52982.11 0 0 0 0 0 0 110602.38 0 0 0 1101510418 91 Waiver service provider--Adults (DHS/DDD) 30 DuPage 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 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11059.29 0 0 0 0 0 0 0 0 0 0 0 0 0 11059.29 0 0 0 1101510419 63 Other Providers of Medical Equipment/Supplies (Non-registered) 200 Cook 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 11.04 0 0 0 0 0 0 11.04 0 0 0 1101510427 98 Waiver service provider--TBI (DHS/DRS) 69 Massac 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26469.05 0 0 0 0 0 0 0 0 0 0 0 0 0 26469.05 0 0 0 1101510433 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17683.17 0 0 0 0 0 0 0 0 0 0 0 0 0 17683.17 0 0 0 1101510437 10 Physicians 200 Cook 0 0 Pediatrics 0 1 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 1101510440 92 Waiver service provider--Disability (DHS/DRS) 62 Logan 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 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 5356.09 0 0 0 0 0 0 0 0 0 0 0 0 0 5356.09 0 0 0 1101510442 1932372984 10 Physicians GOLDSMITH SUSAN 606118709 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 3 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15.11 0 15469.01 0 0 0 0 0 0 15484.12 0 0 0 1101510451 1891799565 10 Physicians BAUMER KEVIN 622265366 96 St Clair 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 33 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64 0 263 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64 0 263 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 315.79 0 3040.54 0 0 0 0 0 0 3356.33 0 0 0 1101510454 1922247790 10 Physicians PILLAI NISHANT 622461154 12 Bond 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5535.53 0 0 0 0 0 0 5535.53 0 0 0 1101510462 1558517870 36 Community mental health provider THRESHOLDS 606593080 200 Cook 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 337 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1526 0 0 337 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1526 0 0 8076.27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121091.46 0 0 129167.73 0 0 0 1101510465 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 5016.76 0 0 0 0 0 0 0 0 0 0 0 0 0 5016.76 0 0 0 1101510488 30 General Hospitals 846 Utah ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 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 0 245.41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 245.41 0 0 0 1101510504 1790059632 16 Nurse Practitioners DURBIN BRANDON 604489360 107 Will 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 19 0 0 0 0 0 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 0 422.95 0 0 0 0 0 0 422.95 0 0 0 1101510519 1487901096 23 Occupational Therapists NICHOL LAUREN 601545745 200 Cook 0 0 0 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 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 300.13 300.13 0 0 0 1101510538 91 Waiver service provider--Adults (DHS/DDD) 107 Will 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 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 1025.74 0 0 0 0 0 0 0 0 0 0 0 0 0 1025.74 0 0 0 1101510542 92 Waiver service provider--Disability (DHS/DRS) 58 La Salle 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 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 11209.47 0 0 0 0 0 0 0 0 0 0 0 0 0 11209.47 0 0 0 1101510550 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 3099.36 0 0 0 0 0 0 0 0 0 0 0 0 0 3099.36 0 0 0 1101510564 1750532412 55 Early Intervention Services WECHSLER AMY 606572076 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9741.99 0 0 0 0 0 0 9741.99 0 0 0 1101510572 1710050331 60 Pharmacies KROGER PHARMACY J 942 616041800 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 358 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1872 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45347 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87875.52 0 0 0 87875.52 0 0 0 1101510587 1194706747 10 Physicians MURPHY EILEEN 528011014 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6207.13 0 0 0 0 0 0 6207.13 0 0 0 1101510596 92 Waiver service provider--Disability (DHS/DRS) 90 Saline 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 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 4254.58 0 0 0 0 0 0 0 0 0 0 0 0 0 4254.58 0 0 0 1101510603 1508956509 30 General Hospitals UNIVERSITY OF CHICAGO HOSPITAL 605615314 30 DuPage DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adults Section 0 0 0 0 9 0 0 0 0 0 0 2997 0 0 1939 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 23157 0 0 5282 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 23157 0 0 5282 0 0 0 0 0 0 0 0 113.56 0 0 0 0 0 0 140367.15 0 0 694144.97 0 0 0 0 0 834625.68 0 0 0 1101510620 1275539009 10 Physicians YASSIN AMIN 606313222 107 Will 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 1141 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 0 0 0 0 0 0 0 0 0 0 0 0 1258 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38194.3 0 0 0 0 0 0 38194.3 0 0 0 1101510630 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50389.69 0 0 0 0 0 0 0 0 0 0 0 0 0 50389.69 0 0 0 1101510638 50 Home Health Agencies - In Home 200 Cook 0 0 0 0 0 0 0 0 0 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 23 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 0 0 0 0 0 0 0 0 1487.16 0 0 0 0 0 0 1487.16 0 0 0 1101510639 1124129309 16 Nurse Practitioners BEYER DIANNE 622265360 96 St Clair 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 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5220.79 0 0 0 0 0 0 5220.79 0 0 0 1101510645 2100501063 90 Waiver service provider--Elderly (DOA) MEDICAL GEAR LLC 999999999 200 Cook 0 0 0 0 0 0 0 0 889 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89885 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89885 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6426537.03 0 0 0 0 0 0 0 0 0 0 0 0 0 6426537.03 0 0 0 1101510653 92 Waiver service provider--Disability (DHS/DRS) 98 Tazewell 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 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 3064.75 0 0 0 0 0 0 0 0 0 0 0 0 0 3064.75 0 0 0 1101510659 1700998366 10 Physicians NOONE MICHAEL 605238723 30 DuPage 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3187.85 0 0 0 0 0 0 3187.85 0 0 0 1101510661 1093753287 10 Physicians GRUBER CHRIS 601234912 53 Kane 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 451 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 526 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 526 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13896.35 0 0 0 0 0 0 13896.35 0 0 0 1101510664 16 Nurse Practitioners 200 Cook 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 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71.69 0 0 0 0 0 0 71.69 0 0 0 1101510670 92 Waiver service provider--Disability (DHS/DRS) 66 Marion 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 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14616.15 0 0 0 0 0 0 0 0 0 0 0 0 0 14616.15 0 0 0 1101510675 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 15545.1 0 0 0 0 0 0 0 0 0 0 0 0 0 15545.1 0 0 0 1101510677 1386681377 70 Ambulance Service Providers NEW LENOX FIRE PROT DIST 604511835 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 268 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 268 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14622.64 0 0 0 0 0 0 14622.64 0 0 0 1101510678 1659481562 10 Physicians KOTA SRINIVAS 605984335 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 496 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 496 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1000.28 0 0 0 0 0 0 1000.28 0 0 0 1101510711 91 Waiver service provider--Adults (DHS/DDD) 55 Kendall 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 0 186 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 186 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11629.3 0 0 0 0 0 0 0 0 0 0 0 0 0 11629.3 0 0 0 1101510713 1255488441 63 Other Providers of Medical Equipment/Supplies (Non-registered) BLI MEDICAL SUPPLY LTD 606205821 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 458 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5737 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5737 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 399125.43 0 713.87 0 0 0 0 399839.3 0 0 0 1101510749 1134174931 10 Physicians ALI SYLVEENA 605595573 30 DuPage 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 593 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 602 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 602 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18589.01 0 0 0 0 0 0 18589.01 0 0 0 1101510760 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 7571.21 0 0 0 0 0 0 0 0 0 0 0 0 0 7571.21 0 0 0 1101510773 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 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 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 1101510787 1457310062 16 Nurse Practitioners NOELKE WAYNE 627810001 91 Sangamon 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 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 176.4 0 0 0 0 0 0 176.4 0 0 0 1101510790 1295705275 10 Physicians SCHLAIS RUDOLPH 604631256 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 2 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2204.08 0 0 0 0 0 0 2204.08 0 0 0 1101510800 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 19582.92 0 0 0 0 0 0 0 0 0 0 0 0 0 19582.92 0 0 0 1101510811 1760688592 10 Physicians YUCEBAY ELIF 606123833 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 515 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 699 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 699 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15472.05 0 0 0 0 0 0 15472.05 0 0 0 1101510812 1538314166 10 Physicians SRINIVASAN SUDHA 601901295 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2201.91 0 0 0 0 0 0 2201.91 0 0 0 1101510816 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 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 4802.5 0 0 0 0 0 0 0 0 0 0 0 0 0 4802.5 0 0 0 1101510819 10 Physicians 200 Cook 0 0 Internal Medicine 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 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 45.43 0 0 0 0 0 0 45.43 0 0 0 1101510825 92 Waiver service provider--Disability (DHS/DRS) 91 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 11028.22 0 0 0 0 0 0 0 0 0 0 0 0 0 11028.22 0 0 0 1101510827 1073703583 10 Physicians SILVERSTEIN JULIE 631101010 826 Missouri 0 0 Endocrinology 0 0 0 0 0 0 0 0 0 0 0 3 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7.98 0 1328.01 0 0 0 0 0 0 1335.99 0 0 0 1101510843 1316905607 10 Physicians ROCCO CARMEN A 605270826 30 DuPage 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6048.73 0 0 0 0 0 0 6048.73 0 0 0 1101510852 92 Waiver service provider--Disability (DHS/DRS) 37 Fulton 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 37915.58 0 0 0 0 0 0 0 0 0 0 0 0 0 37915.58 0 0 0 1101510860 1396702056 10 Physicians RASHEED QAISER 527325067 816 Iowa 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 4 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 296 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 296 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55.61 0 4132.47 0 0 0 0 0 0 4188.08 0 0 0 1101510863 1457334591 10 Physicians MCKENNEY EDWARD F 623411135 42 Hancock 0 1 Family Practice 0 68 0 0 11 0 0 0 0 0 0 16 0 179 0 0 0 0 0 0 564 0 0 15 0 0 0 0 0 0 38 0 454 0 0 0 0 0 0 564 0 0 15 0 0 0 0 0 0 38 0 454 0 0 0 0 0 0 1471 0 0 923.4 0 0 0 0 0 0 148.69 0 6234.14 0 0 0 0 0 0 8777.23 0 0 0 1101510865 1588866032 47 Local Education Agencies ROBEIN SCHOOL DIST 85 616111601 98 Tazewell 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 397 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 397 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3983.94 0 3983.94 0 0 0 1101510866 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 15707.26 0 0 0 0 0 0 0 0 0 0 0 0 0 15707.26 0 0 0 1101510876 1629112503 34 State-operated facility (DHS) UNIT 8175 3A FOX 604201322 61 Livingston 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 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1404 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 983012.26 0 0 0 0 0 0 0 0 0 0 983012.26 0 0 0 1101510884 1992842793 11 Dentists KOLOKYTHAS ANTONIA 606127210 200 Cook 0 0 General Dentistry 0 0 0 271 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 466 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 466 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55889.4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55889.4 0 0 0 1101510888 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 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 0 562.58 0 0 0 0 0 0 0 0 0 0 0 0 0 562.58 0 0 0 1101510898 2100501316 91 Waiver service provider--Adults (DHS/DDD) WABASH AREA. VOC. ENTERPRISES 628630487 101 Wabash 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8297 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8297 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 760987.94 0 0 0 0 0 0 0 0 0 0 0 0 0 760987.94 0 0 0 1101510904 1851397780 10 Physicians YATES LEROY 528073864 816 Iowa 0 0 Obstetric-Gynecology 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 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 2369.83 0 0 0 0 0 0 2369.83 0 0 0 1101510917 1992854566 14 Chiropractors DOWELL MARK 600987530 71 McHenry 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 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 958.63 0 0 0 0 0 0 958.63 0 0 0 1101510944 1811947930 10 Physicians ZEITLER KIRSTEN 601265626 30 DuPage 0 1 Pediatrics 0 36 0 0 54 0 0 0 0 0 0 16 0 88 0 0 0 0 0 0 141 0 0 144 0 0 0 0 0 0 17 0 122 0 0 0 0 0 0 141 0 0 144 0 0 0 0 0 0 17 0 122 0 0 0 0 0 0 282 0 0 4812.46 0 0 0 0 0 0 184.99 0 4596.08 0 0 0 0 0 0 9875.53 0 0 0 1101510947 30 General Hospitals 833 New York ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 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 83.7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83.7 0 0 0 1101511002 1215959176 10 Physicians EDOSOMWAN MAGNUS 606432116 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 45 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 1028.86 0 0 0 0 0 0 1028.86 0 0 0 1101511011 1871529560 60 Pharmacies ENLOE PCI PRESCRIPTION CTR 625221156 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7941 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 242814.38 0 0 0 242814.38 0 0 0 1101511017 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 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Pharmacies CVS PHARMACY 08698 606102702 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 216 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1295 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37474 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94462.9 0 0 0 94462.9 0 0 0 1101513527 1407864077 13 Podiatrists SUFFERN JENNIFER 606123723 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 548.05 0 0 0 0 0 0 548.05 0 0 0 1101513544 1063425296 10 Physicians BATISH NAINA 609145193 54 Kankakee 0 1 Pediatrics 0 120 0 0 106 0 0 0 0 0 0 68 0 253 0 0 0 0 0 0 1108 0 0 460 0 0 0 0 0 0 89 0 450 0 0 0 0 0 0 1108 0 0 460 0 0 0 0 0 0 89 0 450 0 0 0 0 0 0 2216 0 0 13489.26 0 0 0 0 0 0 687.55 0 17671.97 0 0 0 0 0 0 34064.78 0 0 0 1101513548 1477792406 10 Physicians LASKIEWICZ STEPHEN 531051828 852 Wisconsin 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1256.87 0 0 0 0 0 0 1256.87 0 0 0 1101513558 91 Waiver service provider--Adults (DHS/DDD) 40 Grundy 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 0 247 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 247 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23044.59 0 0 0 0 0 0 0 0 0 0 0 0 0 23044.59 0 0 0 1101513569 1144209339 10 Physicians NAAZ IKRAMUDDIN PARVEEN 601734761 200 Cook 0 0 Nephrology 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 854.8 0 0 0 0 0 0 854.8 0 0 0 1101513576 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14461.91 0 0 0 0 0 0 0 0 0 0 0 0 0 14461.91 0 0 0 1101513578 1922329507 10 Physicians CHICKRIS NICOLE 616151410 80 Peoria 0 0 Family Practice 0 0 0 0 30 0 0 0 0 0 0 14 0 213 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 16 0 463 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 16 0 463 0 0 0 0 0 0 0 0 0 2739.5 0 0 0 0 0 0 169.2 0 15844.39 0 0 0 0 0 0 18753.09 0 0 0 1101513598 1891861407 16 Nurse Practitioners GREENE CHRISTINE 61615 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 316 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 316 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 175.06 0 0 0 0 0 0 175.06 0 0 0 1101513607 92 Waiver service provider--Disability (DHS/DRS) 96 St Clair 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 19769.46 0 0 0 0 0 0 0 0 0 0 0 0 0 19769.46 0 0 0 1101513617 1780735688 12 Optometrists MARINO ANGELO 604501209 40 Grundy 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 395 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 825 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 825 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20274.68 0 336.66 0 0 0 0 20611.34 0 0 0 1101513619 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 20465.58 0 0 0 0 0 0 0 0 0 0 0 0 0 20465.58 0 0 0 1101513622 1811054935 40 Federally Qualified Health Centers SIHF STATE STREET CTR 622051803 96 St Clair 0 1 0 55 940 0 222 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 284 2746 0 700 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 284 2746 0 700 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 763 161660.83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 162423.83 0 0 0 1101513627 1891749701 10 Physicians PIERCE ROBERT H 600987401 71 McHenry 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 2379 0 157 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3807 0 229 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3807 0 229 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107001.57 0 2813.41 0 0 0 0 0 0 109814.98 0 0 0 1101513628 1952494932 10 Physicians NYAZEE M 620404661 65 Madison 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 337 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 337 0 0 0 0 0 0 0 0 0 0 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1003875147 12 Optometrists DIEHL JASON 622362560 75 Monroe 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 99 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5170.32 0 1815.24 0 0 0 0 6985.56 0 0 0 1101513861 1700995347 10 Physicians BARTOLONE ROBERT 600442203 57 Lake 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 3 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1203.69 0 0 0 0 0 0 1203.69 0 0 0 1101513870 1164786554 60 Pharmacies XPRESS PHARMACY INC 604532280 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 564 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3733 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100989 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 186651.99 0 0 0 186651.99 0 0 0 1101513883 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 362 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 362 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14041.5 0 0 0 0 0 0 0 0 0 0 0 0 0 14041.5 0 0 0 1101513909 1114947926 10 Physicians KOWALSKI DANUTA T 606313222 200 Cook 0 1 Internal Medicine 0 50 0 0 1 0 0 0 0 0 0 26 0 130 0 0 0 0 0 0 315 0 0 1 0 0 0 0 0 0 37 0 255 0 0 0 0 0 0 315 0 0 1 0 0 0 0 0 0 37 0 255 0 0 0 0 0 0 936 0 0 104.96 0 0 0 0 0 0 144.49 0 8496.12 0 0 0 0 0 0 9681.57 0 0 0 1101513921 1962481630 10 Physicians BUBOLZ JUSTIN 634010311 826 Missouri 0 0 Pediatrics 0 0 0 0 5 0 0 0 0 0 0 2 0 10 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 4 0 14 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 4 0 14 0 0 0 0 0 0 0 0 0 229.71 0 0 0 0 0 0 51.6 0 577.31 0 0 0 0 0 0 858.62 0 0 0 1101513932 1730260233 60 Pharmacies CHARTWELL MIDWEST WISCONSIN 535622540 852 Wisconsin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 238 0 0 402 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 238 0 0 2301 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5308.16 0 0 30880.97 0 0 0 36189.13 0 0 0 1101513952 92 Waiver service provider--Disability (DHS/DRS) 45 Henry 0 0 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 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1430.25 0 0 0 0 0 0 0 0 0 0 0 0 0 1430.25 0 0 0 1101513964 1316066087 24 Speech Therapists PEEL ELIZABETH 620253221 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 523 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 523 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38091.66 38091.66 0 0 0 1101513967 1023137528 60 Pharmacies JOHN H STROGER JR PHARMACY 606123714 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3505 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9259 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 351541 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2061759.99 0 0 0 2061759.99 0 0 0 1101513972 1518055524 30 General Hospitals LA RABIDA CHILDRENS HOSP 606491003 200 Cook CHILDRENS Hospital designated as childrens hospitals and paid a Per Diem rate. 0 0 0 0 0 0 578 0 0 0 0 0 0 1176 0 0 1743 0 0 0 0 0 0 0 0 1109 0 0 0 0 0 0 7265 0 0 19655 0 0 0 0 0 0 0 0 1109 0 0 0 0 0 0 7265 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Minnesota NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 0 246.84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 246.84 0 0 0 1101514916 1083622963 10 Physicians BACON BRUCE 631102515 826 Missouri 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 13 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 0 579.68 0 0 0 0 0 0 579.68 0 0 0 1101514920 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 194 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 194 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11968 0 0 0 0 0 0 0 0 0 0 0 0 0 11968 0 0 0 1101514923 1730110834 10 Physicians PURI LALIT 602011718 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 195 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 195 0 0 0 0 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provider--Disability (DHS/DRS) 96 St Clair 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 12541.76 0 0 0 0 0 0 0 0 0 0 0 0 0 12541.76 0 0 0 1101515314 1720046618 10 Physicians HEIDENRY VALERIE 605046065 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 640 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 640 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11583.35 0 0 0 0 0 0 11583.35 0 0 0 1101515319 10 Physicians 826 Missouri 0 0 Internal Medicine 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 14 0 0 0 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 0 463.37 0 0 0 0 0 0 463.37 0 0 0 1101515322 1083653927 10 Physicians CONSALTER MAURICIO 606071147 200 Cook 0 1 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 168 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 580 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 580 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5417.2 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4538.87 0 0 0 0 0 0 4538.87 0 0 0 1101515637 1780868521 13 Podiatrists COMMITO RICHARD 604631145 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 927 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 927 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 826.49 0 0 0 0 0 0 826.49 0 0 0 1101515642 1679685630 10 Physicians RAKSIN PATRICIA 606123714 200 Cook 0 0 Neurology Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1742.84 0 0 0 0 0 0 1742.84 0 0 0 1101515646 1215079553 23 Occupational Therapists KRISCHER DRU 606124861 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 593.23 593.23 0 0 0 1101515647 1194752998 29 ICF/MR POLK HOUSE 606601017 200 Cook 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 355 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6971 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 890682.51 0 0 0 0 0 0 0 0 0 0 890682.51 0 0 0 1101515667 91 Waiver service provider--Adults (DHS/DDD) 96 St Clair 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 0 317 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 317 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22084.48 0 0 0 0 0 0 0 0 0 0 0 0 0 22084.48 0 0 0 1101515672 2100506090 91 Waiver service provider--Adults (DHS/DDD) LEEDA SERVICE OF ILLINOIS INC 606261675 200 Cook 0 0 0 0 0 0 0 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50730 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50730 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6145864.26 0 0 0 0 0 0 0 0 0 0 0 0 0 6145864.26 0 0 0 1101515674 1962647149 16 Nurse Practitioners WILLIAMS LESLIE A 761165707 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 369 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 403 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 403 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13034.53 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 863 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9941.45 0 0 0 0 0 0 9941.45 0 0 0 1101515728 1831243831 10 Physicians VERGARA RODRIGUEZ PAMELA 606123723 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 254.7 0 0 0 0 0 0 254.7 0 0 0 1101515729 1689764920 10 Physicians FIROOZI TARANEH 606344401 200 Cook 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 0 61 0 413 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79 0 723 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79 0 723 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2672.42 0 32975.4 0 0 0 0 0 0 35647.82 0 0 0 1101515750 10 Physicians 826 Missouri 0 0 Anesthesiology 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101515760 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 12835.72 0 0 0 0 0 0 0 0 0 0 0 0 0 12835.72 0 0 0 1101515762 1225074495 16 Nurse Practitioners ELY MARY 627025324 91 Sangamon 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 351 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 351 0 0 0 0 0 0 0 0 0 64.3 0 0 0 0 0 0 0 0 4796.68 0 0 0 0 0 0 4860.98 0 0 0 1101515768 91 Waiver service provider--Adults (DHS/DDD) 107 Will 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 0 343 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 343 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16926.8 0 0 0 0 0 0 0 0 0 0 0 0 0 16926.8 0 0 0 1101515769 91 Waiver service provider--Adults (DHS/DDD) 107 Will 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 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12115 0 0 0 0 0 0 0 0 0 0 0 0 0 12115 0 0 0 1101515788 98 Waiver service provider--TBI (DHS/DRS) 109 Winnebago 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 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5545.33 0 0 0 0 0 0 0 0 0 0 0 0 0 5545.33 0 0 0 1101515819 1003919101 50 Home Health Agencies - In Home LOYOLA CENTER FOR HOME CARE 601545716 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 185 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1652 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1652 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 112510.26 0 0 0 0 0 0 112510.26 0 0 0 1101515844 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25017.69 0 0 0 0 0 0 0 0 0 0 0 0 0 25017.69 0 0 0 1101515846 1114289428 22 Physical Therapists PETERSON CASSANDRA 605066222 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 617.29 617.29 0 0 0 1101515849 1902823420 11 Dentists KNEEDLER CHARLES 620241708 65 Madison 0 0 General Dentistry 0 0 0 238 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 891 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 891 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18337.45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18337.45 0 0 0 1101515870 12 Optometrists 100 Vermilion 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 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 48.9 0 0 0 0 0 0 48.9 0 0 0 1101515873 1396796389 10 Physicians PYKA MANFRED 605545109 53 Kane 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2146 0 0 0 0 0 0 2146 0 0 0 1101515882 1083682421 10 Physicians FIELD AARON 535625531 852 Wisconsin 0 0 Radiology 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 14 0 0 0 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 1315.17 0 0 0 0 0 0 0 0 1315.17 0 0 0 1101515885 92 Waiver service provider--Disability (DHS/DRS) 30 DuPage 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 31385.58 0 0 0 0 0 0 0 0 0 0 0 0 0 31385.58 0 0 0 1101515892 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 865.42 0 0 0 0 0 0 0 0 0 0 0 0 0 865.42 0 0 0 1101515896 1891813440 34 State-operated facility (DHS) UNIT 4890 BLDG 805A SHAPIRO 609015018 54 Kankakee 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 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1440 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 966243.12 0 0 0 0 0 0 0 0 0 0 966243.12 0 0 0 1101515926 1154539260 55 Early Intervention Services LINDEE MICHELLE 615711726 98 Tazewell 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 313 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 313 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26486.33 0 0 0 0 0 0 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1101515944 1598828006 10 Physicians SHILLING REBECCA 462025149 815 Indiana 0 0 Pulmonary Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 386 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 386 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26811.67 0 0 0 0 0 0 26811.67 0 0 0 1101515945 1184679235 10 Physicians DERMAN GORDON 606123863 200 Cook 0 0 Plastic Surgery 0 0 0 0 0 0 0 0 0 0 0 2 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 92.63 0 5584.35 0 0 0 0 0 0 5676.98 0 0 0 1101515951 1952529109 55 Early Intervention Services NEELEY LORRI 604401667 107 Will 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 0 551 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 551 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31113.18 0 0 0 0 0 0 31113.18 0 0 0 1101515961 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 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WECHTER DAVID T 606313222 27 Dekalb 0 1 Internal Medicine 0 20 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 372 0 0 0 0 0 0 0 0 0 0 0 1012.24 0 0 0 0 0 0 1384.24 0 0 0 1101517226 1407082316 24 Speech Therapists FRISCH KELLY 600052410 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12771.92 12771.92 0 0 0 1101517233 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 361 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 361 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23650 0 0 0 0 0 0 0 0 0 0 0 0 0 23650 0 0 0 1101517259 1003864331 10 Physicians DONGAS JOHN 604322065 107 Will 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 1208 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1904 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1904 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12228.4 0 0 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0 0 0 0 0 0 0 0 0 0 0 15891 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 783375.96 0 0 0 0 0 0 0 0 0 0 0 0 0 783375.96 0 0 0 1101517320 47 Local Education Agencies 81 Perry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1987.2 0 1987.2 0 0 0 1101517325 10 Physicians 826 Missouri 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71.9 0 93.4 0 0 0 0 0 0 165.3 0 0 0 1101517336 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 455 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 455 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44710.6 0 0 0 0 0 0 0 0 0 0 0 0 0 44710.6 0 0 0 1101517345 92 Waiver service provider--Disability (DHS/DRS) 53 Kane 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 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 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0 0 0 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12060.57 12060.57 0 0 0 1101517417 1942492301 63 Other Providers of Medical Equipment/Supplies (Non-registered) MILLA MEDICAL SUPPLY LTD 601484535 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 537 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11372 0 347 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11372 0 347 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 579153.54 0 20553.6 0 0 0 0 599707.14 0 0 0 1101517421 1184651085 10 Physicians HELWIG JEFFREY 619442460 31 Edgar 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 632 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 713 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 713 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28251.12 0 0 0 0 0 0 28251.12 0 0 0 1101517426 1932259827 10 Physicians AGARWAL AMAL 606233596 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 245 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 0 0 0 0 0 0 0 0 0 0 0 260 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8671.7 0 0 0 0 0 0 8671.7 0 0 0 1101517429 1528138310 11 Dentists KROL MICHAEL 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0 0 1101517476 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 18353.49 0 0 0 0 0 0 0 0 0 0 0 0 0 18353.49 0 0 0 1101517482 1740418227 10 Physicians KAPIL NEHA 605604728 55 Kendall 0 1 Family Practice 0 155 0 0 61 0 0 0 0 0 0 39 0 159 0 0 0 0 0 0 1510 0 0 184 0 0 0 0 0 0 59 0 449 0 0 0 0 0 0 1510 0 0 184 0 0 0 0 0 0 59 0 449 0 0 0 0 0 0 3686 0 0 6696.5 0 0 0 0 0 0 521.64 0 17990.93 0 0 0 0 0 0 28895.07 0 0 0 1101517498 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 33130.83 0 0 0 0 0 0 0 0 0 0 0 0 0 33130.83 0 0 0 1101517500 10 Physicians 852 Wisconsin 0 0 Pediatric Endocrinology 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 2 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 208 0 0 0 0 0 0 0 0 0 0.01 0 0 0 0 0 0 0 0 10207.65 0 0 0 0 0 0 10207.66 0 0 0 1101517529 1407019524 10 Physicians HARE KATHERINE 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 739 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1379 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1379 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77718.46 0 0 0 0 0 0 77718.46 0 0 0 1101517548 1033198221 10 Physicians SUBBAIAH KOSURI 631282106 826 Missouri 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 431.41 0 0 0 0 0 0 431.41 0 0 0 1101517560 10 Physicians 200 Cook 0 0 Urological Surgery 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83.92 0 0 0 0 0 0 83.92 0 0 0 1101517563 40 Federally Qualified Health Centers 200 Cook 0 1 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 0 133.66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133.66 0 0 0 1101517569 1023031770 10 Physicians RHEE JUNG 600504035 71 McHenry 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 15 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 378 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 378 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 141.28 0 8623.77 0 0 0 0 0 0 8765.05 0 0 0 1101517572 92 Waiver service provider--Disability (DHS/DRS) 33 Effingham 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 0 740.73 0 0 0 0 0 0 0 0 0 0 0 0 0 740.73 0 0 0 1101517574 13 Podiatrists 200 Cook 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101517602 92 Waiver service provider--Disability (DHS/DRS) 24 Coles 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13585.72 0 0 0 0 0 0 0 0 0 0 0 0 0 13585.72 0 0 0 1101517605 94 Waiver service provider--Children's support (DHS/DDD) 23 Clinton 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 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6942.57 0 0 0 0 0 0 0 0 0 0 0 0 0 6942.57 0 0 0 1101517606 1205007648 47 Local Education Agencies GRASS LAKE SCHOOL DIST NO 36 600029613 57 Lake 0 0 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 0 411 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 411 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8206.32 0 8206.32 0 0 0 1101517608 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 10153.17 0 0 0 0 0 0 0 0 0 0 0 0 0 10153.17 0 0 0 1101517614 1184775744 10 Physicians LIVINGSTON GARY 600390619 71 McHenry 0 0 Otorhinolaryngology 0 0 0 0 0 0 0 0 0 0 0 3 0 87 0 0 0 0 0 0 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Waiver service provider--Adults (DHS/DDD) CASS CO. 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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 28547.38 0 0 0 0 0 0 0 0 0 0 0 0 0 28547.38 0 0 0 1101521218 1437367166 30 General Hospitals ROCKFORD MEMORIAL HOSPITAL 611033655 109 Winnebago DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 0 1 7 0 0 5644 0 0 0 0 2390 0 0 11 3446 0 0 0 0 0 4 7 0 0 9093 0 0 0 0 3084 0 0 11 6950 0 0 0 0 0 21 7 0 0 9093 0 0 0 0 16976 0 0 11 7163 0 0 0 0 0 667.56 554.79 0 0 1661307.44 0 0 0 0 21097056.23 0 0 19258.06 2496848.16 0 0 0 0 0 25275692.24 0 0 0 1101521223 1598759078 10 Physicians MORROW CHARLES 606143363 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 13 0 181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 215 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 215 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130.5 0 8861.25 0 0 0 0 0 0 8991.75 0 0 0 1101521227 1528139292 28 Waiver service provider--Supportive living facility (HFS) IVY APARTMENTS AT THE IMPERIAL 606142060 200 Cook 0 0 0 0 0 0 0 0 113 0 0 0 0 0 0 0 0 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1720152317 10 Physicians ALLEGRETTI PETER 600482670 57 Lake 0 0 General Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71.45 0 0 0 0 0 0 71.45 0 0 0 1101523653 1346313251 60 Pharmacies CVS PHARMACY 01773 604876109 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 466 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48480 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103798 0 0 0 103798 0 0 0 1101523661 1063674711 30 General Hospitals FRESENIUS MEDCL CARE SANDWICH 605481394 27 Dekalb DIALYSIS Outpatient dialysis centers. 0 0 General Hospital - Adult and Child 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 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 552 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22123.21 0 0 0 0 0 22123.21 0 0 0 1101523680 1194860395 10 Physicians SCHMIDT MATTHEW 604631001 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 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1101523837 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 25850.77 0 0 0 0 0 0 0 0 0 0 0 0 0 25850.77 0 0 0 1101523839 1992780050 10 Physicians FULK DOUGLAS 629015334 47 Jackson 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 1482 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3014 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3014 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 188017.01 0 6842.08 0 0 0 0 0 0 194859.09 0 0 0 1101523842 94 Waiver service provider--Children's support (DHS/DDD) 91 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 0 225 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 225 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14256 0 0 0 0 0 0 0 0 0 0 0 0 0 14256 0 0 0 1101523852 1427155837 10 Physicians NOVAK RICHARD 606743462 200 Cook 0 1 Pathology 0 14 0 0 0 0 0 0 0 0 0 0 0 140 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 302 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 302 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 16665.09 0 0 0 0 0 0 16739.09 0 0 0 1101523853 1861475121 10 Physicians ARRINGTON DEXTER 606081732 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19636.53 0 0 0 0 0 0 19636.53 0 0 0 1101523855 24 Speech Therapists 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6084.75 6084.75 0 0 0 1101523859 1295814556 33 Nursing Facilities PIATT COUNTY NURSING HOME 618560410 82 Piatt 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 266 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6739 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 510655.06 0 0 0 0 0 0 0 510655.06 0 0 0 1101523873 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 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 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 0 951.63 0 0 0 0 0 0 0 0 0 0 0 0 0 951.63 0 0 0 1101523876 1942224068 16 Nurse Practitioners LEE MYUNG 601262100 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 388.69 0 0 0 0 0 0 388.69 0 0 0 1101523882 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2665.53 0 0 0 0 0 0 0 0 0 0 0 0 0 2665.53 0 0 0 1101523910 1376789313 16 Nurse Practitioners VAJDA TIFFANY 600155234 57 Lake 0 0 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 0 483.3 0 0 0 0 0 0 483.3 0 0 0 1101523911 1750428967 10 Physicians BERMAN VALENTIN 608052666 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159 0 0 0 0 0 0 0 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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 25019.34 0 0 0 0 0 0 0 0 0 0 0 0 0 25019.34 0 0 0 1101525670 92 Waiver service provider--Disability (DHS/DRS) 71 McHenry 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 1829.79 0 0 0 0 0 0 0 0 0 0 0 0 0 1829.79 0 0 0 1101525672 1598720468 63 Other Providers of Medical Equipment/Supplies (Non-registered) SCHECK AND SIRESS PROSTHETICS 605630137 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 406 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 406 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5843.17 0 68873.1 0 0 0 0 74716.27 0 0 0 1101525677 1629007067 10 Physicians TAWFIK ATEF 611145731 109 Winnebago 0 1 Family Practice 0 2 0 0 14 0 0 0 0 0 0 5 0 81 0 0 0 0 0 0 20 0 0 25 0 0 0 0 0 0 5 0 210 0 0 0 0 0 0 20 0 0 25 0 0 0 0 0 0 5 0 210 0 0 0 0 0 0 60 0 0 1128.59 0 0 0 0 0 0 25.99 0 3872.13 0 0 0 0 0 0 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600315712 57 Lake 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 3 0 737 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 1740 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 1740 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28.08 0 14715.47 0 0 0 0 0 0 14743.55 0 0 0 1101525807 10 Physicians 826 Missouri 0 0 Emergency Medicine 0 0 0 0 0 0 0 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47.42 0 0 0 0 0 0 47.42 0 0 0 1101525825 1598887283 55 Early Intervention Services SMITH BONNIE 604512796 107 Will 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 0 280 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 280 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15554.09 0 0 0 0 0 0 15554.09 0 0 0 1101525826 1851577373 10 Physicians NEGA TODD 600261314 200 Cook 0 0 Infectious Diseases 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 0 295 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 0 0 0 0 0 0 0 0 0 0 0 0 3525.37 0 0 0 0 0 0 3525.37 0 0 0 1101525838 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13167 0 0 0 0 0 0 0 0 0 0 0 0 0 13167 0 0 0 1101525842 1780692319 23 Occupational Therapists ZARLEY KRISTY 606571500 200 Cook 0 0 0 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 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4190.34 4190.34 0 0 0 1101525848 1275528440 10 Physicians VOGT ROBERT 476309225 815 Indiana 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 23 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 450.17 0 686.76 0 0 0 0 0 0 1136.93 0 0 0 1101525853 1639145311 10 Physicians BIGIO EILEEN 606118702 200 Cook 0 0 Neuropathology 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 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 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0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1038.48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1038.48 0 0 0 1101525870 1922148360 29 ICF/MR ALDEN SPRINGS 601082105 30 DuPage 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 0 475 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8439 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1345006.25 0 0 0 0 0 0 0 0 0 0 1345006.25 0 0 0 1101525875 1053450601 75 Department of Alcohol and Substance Abuse Provider CENTRAL EAST ALCOHOL AND DRUG 619200532 24 Coles 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 248 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1357 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1359 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 217113.84 0 0 217113.84 0 0 0 1101525882 1124005517 60 Pharmacies GOTTLIEB PROF BLD PHARMACY 601601634 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 375 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9363 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21913.53 0 0 0 21913.53 0 0 0 1101525905 1073787164 60 Pharmacies WALGREENS #10938 610681533 79 Ogle 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 2084 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 14388 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 347105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7.86 0 0 760078.85 0 0 0 760086.71 0 0 0 1101525906 10 Physicians 53 Kane 0 0 Family Practice 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 1132.9 0 0 0 0 0 0 1132.9 0 0 0 1101525940 30 General Hospitals 851 West Virginia NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 57.3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57.3 0 0 0 1101525955 1811107956 36 Community mental health provider LSSI OF ILLINOIS 606181258 200 Cook 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 3513 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2212 0 0 3513 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1289 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 143385.06 0 0 0 0 0 0 0 143385.06 0 0 0 1101526184 1285787226 60 Pharmacies GLASH DRUG STORE INC 614221353 70 McDonough 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 385 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 0 0 0 0 0 111888 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 143596.9 0 0 0 143596.9 0 0 0 1101526185 1457359697 10 Physicians BERKELHAMMER CHARLES 604533767 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 3 0 183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 395 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 395 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29.36 0 26045.43 0 0 0 0 0 0 26074.79 0 0 0 1101526186 1548258197 10 Physicians LIN ANTHONY 601812650 30 DuPage 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 8 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 0 137.5 0 0 0 0 0 0 137.5 0 0 0 1101526198 1215981956 10 Physicians KWON OH HOON 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0 0 0 44 0 163 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 163 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114.85 0 1491.33 0 0 0 0 0 0 1606.18 0 0 0 1101526324 1518054121 10 Physicians DOWNER MERRY 627032403 91 Sangamon 0 0 Nephrology 0 0 0 0 0 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 262 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 262 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3749.32 0 0 0 0 0 0 3749.32 0 0 0 1101526328 1962459537 63 Other Providers of Medical Equipment/Supplies (Non-registered) RESPIRTECH 551131134 824 Minnesota 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 0 367 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 367 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 236583.43 0 0 0 0 0 0 236583.43 0 0 0 1101526331 10 Physicians 852 Wisconsin 0 0 Surgery General 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 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 3323.75 0 0 0 0 0 0 3323.75 0 0 0 1101526336 1659558666 10 Physicians MEKHAIEL ESSAM 620404701 65 Madison 0 0 Pulmonary Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 318 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 927 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 927 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31056.01 0 0 0 0 0 0 31056.01 0 0 0 1101526343 1851564470 10 Physicians BROOKS BENJAMIN A 625266311 63 Macon 0 1 Pediatrics 0 24 0 0 19 0 0 0 0 0 0 2 0 24 0 0 0 0 0 0 158 0 0 21 0 0 0 0 0 0 3 0 77 0 0 0 0 0 0 158 0 0 21 0 0 0 0 0 0 3 0 77 0 0 0 0 0 0 316 0 0 1638.47 0 0 0 0 0 0 44.48 0 3763 0 0 0 0 0 0 5761.95 0 0 0 1101526348 1639284946 10 Physicians GARCIA PATRICIA 606118702 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 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 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13348.03 0 0 0 0 0 0 13348.03 0 0 0 1101526360 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 13703.76 0 0 0 0 0 0 0 0 0 0 0 0 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BERNAL CARLOS 631101010 826 Missouri 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 12 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37.24 0 792.95 0 0 0 0 0 0 830.19 0 0 0 1101526848 1851474753 10 Physicians CARVER THOMAS 605859507 107 Will 0 0 Gynecology 0 0 0 0 0 0 0 0 0 0 0 10 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 459.68 0 8238.94 0 0 0 0 0 0 8698.62 0 0 0 1101526854 1265548192 30 General Hospitals RCGCI SPRING VALLEY 613629702 15 Bureau DIALYSIS Outpatient dialysis centers. 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 157 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1845 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10804.6 0 0 0 0 0 10804.6 0 0 0 1101526883 92 Waiver service provider--Disability (DHS/DRS) 27 Dekalb 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 37730.86 0 0 0 0 0 0 0 0 0 0 0 0 0 37730.86 0 0 0 1101526886 1073578944 63 Other Providers of Medical Equipment/Supplies (Non-registered) SCHECK AND SIRESS PROSTHETICS 606123841 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 92 0 360 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 1259 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 1259 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15685.91 0 272665.25 0 0 0 0 288351.16 0 0 0 1101526895 1548468200 10 Physicians ABLORDEPPEY ENYO 631101010 826 Missouri 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1732.12 0 0 0 0 0 0 1732.12 0 0 0 1101526902 10 Physicians 816 Iowa 0 0 Neurology Surgery 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1203.77 0 0 0 0 0 0 1203.77 0 0 0 1101526908 98 Waiver service provider--TBI (DHS/DRS) 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0 0 0 1101527030 1205156916 60 Pharmacies WALGREENS #13966 604023429 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 871 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 2206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 42823 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10221.47 0 0 140978.47 0 0 0 151199.94 0 0 0 1101527041 1538214101 11 Dentists AQEL FADI 606294515 200 Cook 0 0 General Dentistry 0 0 0 7678 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52873 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52873 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1449602.37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1449602.37 0 0 0 1101527049 1497022743 33 Nursing Facilities COUNTRYSIDE CARE CENTRE 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1138 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30849 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3393900.87 0 0 0 0 0 0 0 3393900.87 0 0 0 1101527058 1629149356 10 Physicians YEUNG JAMES 607121735 200 Cook 0 0 Nephrology 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 391.19 0 0 0 0 0 0 391.19 0 0 0 1101527065 1689623803 10 Physicians PERRY ANTHONY 606123849 200 Cook 0 0 Geriatrics 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72.53 0 0 0 0 0 0 72.53 0 0 0 1101527070 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9276.9 0 0 0 0 0 0 0 0 0 0 0 0 0 9276.9 0 0 0 1101527072 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13241.25 0 0 0 0 0 0 0 0 0 0 0 0 0 13241.25 0 0 0 1101527095 2100517513 91 Waiver service provider--Adults (DHS/DDD) EPILEPSY FOUNDATION OF GREATER 622265944 96 St Clair 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8620 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8620 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 976191.72 0 0 0 0 0 0 0 0 0 0 0 0 0 976191.72 0 0 0 1101527105 1306048871 47 Local Education Agencies INDIAN CREEK CUSD 425 605509784 27 Dekalb 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2072 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2072 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41153.69 0 41153.69 0 0 0 1101527118 92 Waiver service provider--Disability (DHS/DRS) 10 Adams 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 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 11318.87 0 0 0 0 0 0 0 0 0 0 0 0 0 11318.87 0 0 0 1101527121 1508906025 11 Dentists MAURER JOANNE 627042628 91 Sangamon 0 0 General Dentistry 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 309 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 309 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8496.68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8496.68 0 0 0 1101527131 1922008333 10 Physicians ALLEGRETTI JOSEPH 606123837 200 Cook 0 0 Otolaryngology 0 0 0 0 0 0 0 0 0 0 0 1 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 199 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 199 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62.7 0 3100.26 0 0 0 0 0 0 3162.96 0 0 0 1101527138 1093731770 10 Physicians ESHBACH JULIANNA E 605064356 53 Kane 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1200.18 0 0 0 0 0 0 1200.18 0 0 0 1101527143 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 21017.47 0 0 0 0 0 0 0 0 0 0 0 0 0 21017.47 0 0 0 1101527165 1225247760 10 Physicians SCOTT SARAH 611075421 109 Winnebago 0 0 Obstetric-Gynecology 0 0 0 0 3 0 0 0 0 0 0 28 0 122 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 43 0 246 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 43 0 246 0 0 0 0 0 0 0 0 0 216.32 0 0 0 0 0 0 1749.71 0 14159.87 0 0 0 0 0 0 16125.9 0 0 0 1101527169 92 Waiver service provider--Disability (DHS/DRS) 77 Morgan 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 23963.35 0 0 0 0 0 0 0 0 0 0 0 0 0 23963.35 0 0 0 1101527174 92 Waiver service provider--Disability (DHS/DRS) 85 Pulaski 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 22140.68 0 0 0 0 0 0 0 0 0 0 0 0 0 22140.68 0 0 0 1101527177 1679547079 10 Physicians CHARUK GEORGE 601533328 200 Cook 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 0 3 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 219 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 219 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 334.89 0 0 0 0 0 0 334.89 0 0 0 1101527182 1699059279 91 Waiver service provider--Adults (DHS/DDD) SANDROLINI JAMES 600562183 200 Cook 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 0 167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5178.57 0 0 0 0 0 0 0 0 0 0 0 0 0 5178.57 0 0 0 1101527184 1649257163 10 Physicians JACKSON GREGORY 600761214 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 753 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 936 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 936 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19328.67 0 1339.69 0 0 0 0 0 0 20668.36 0 0 0 1101527185 16 Nurse Practitioners 826 Missouri 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 86 0 0 0 1101527198 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 221 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 221 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14612 0 0 0 0 0 0 0 0 0 0 0 0 0 14612 0 0 0 1101527203 1548214216 10 Physicians MCGINTY FRANK 637034928 826 Missouri 0 0 Surgery General 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 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1565.43 0 0 0 0 0 0 1565.43 0 0 0 1101527207 1730132945 10 Physicians HELLER WILLIAM 606163230 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 21 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66.4 0 1430.53 0 0 0 0 0 0 1496.93 0 0 0 1101527222 1699777813 10 Physicians MALIEKEL KOCHURANI 627047450 91 Sangamon 0 0 Oncology 0 0 0 0 0 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 456 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 456 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4831.46 0 0 0 0 0 0 4831.46 0 0 0 1101527243 30 General Hospitals 845 Texas ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 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 99.26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99.26 0 0 0 1101527254 1487698213 16 Nurse Practitioners YRANELA JULITO 604611010 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 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 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 283.54 0 0 0 0 0 0 283.54 0 0 0 1101527273 1790824993 22 Physical Therapists KIRCHGESSNER SUSAN 614011883 56 Knox 0 0 0 0 0 0 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 0 554 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 554 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40506.21 40506.21 0 0 0 1101527276 14 Chiropractors 96 St Clair 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8.58 0 0 0 0 0 0 8.58 0 0 0 1101527279 1730184086 10 Physicians HIZON MIGUEL 609013642 54 Kankakee 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 2 0 262 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 1030 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 1030 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22.4 0 9483.46 0 0 0 0 0 0 9505.86 0 0 0 1101527283 1619950888 10 Physicians BOURSIER CHARLES 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 303 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 358 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 358 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11010.49 0 0 0 0 0 0 11010.49 0 0 0 1101527286 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 2324.63 0 0 0 0 0 0 0 0 0 0 0 0 0 2324.63 0 0 0 1101527296 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15149.2 0 0 0 0 0 0 0 0 0 0 0 0 0 15149.2 0 0 0 1101527297 1891900932 10 Physicians ENCINAS ALVARO 604111696 200 Cook 0 0 Internal Medicine 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 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 867.77 0 0 0 0 0 0 867.77 0 0 0 1101527321 92 Waiver service provider--Disability (DHS/DRS) 63 Macon 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 46558.96 0 0 0 0 0 0 0 0 0 0 0 0 0 46558.96 0 0 0 1101527322 23 Occupational Therapists 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 23 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 0 0 0 0 0 0 0 0 164.23 164.23 0 0 0 1101527323 1467470005 10 Physicians DUBBERKE ERIK 631101010 826 Missouri 0 0 Infectious Diseases 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 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 363.6 0 0 0 0 0 0 363.6 0 0 0 1101527344 1891877817 10 Physicians MONTEAGUDO JORGE 610811252 106 Whiteside 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 693 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1631 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1631 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117349.34 0 0 0 0 0 0 117349.34 0 0 0 1101527345 1528198884 10 Physicians RONDELLI DAMIANO 606127232 200 Cook 0 0 Hematology 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 263 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 263 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20228.08 0 0 0 0 0 0 20228.08 0 0 0 1101527350 1871606863 63 Other Providers of Medical Equipment/Supplies (Non-registered) NATIONWIDE HOME MEDICAL SUPPLY 629622947 11 Alexander 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 163 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 828 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 828 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10810.16 0 0 0 0 0 0 10810.16 0 0 0 1101527353 1548249113 10 Physicians MARCUS WENDI 600902979 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 6 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 0 328.04 0 0 0 0 0 0 328.04 0 0 0 1101527357 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9856 0 0 0 0 0 0 0 0 0 0 0 0 0 9856 0 0 0 1101527362 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 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 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 0 122.7 0 0 0 0 0 0 122.7 0 0 0 1101527394 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 16721.32 0 0 0 0 0 0 0 0 0 0 0 0 0 16721.32 0 0 0 1101527395 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3316.7 0 0 0 0 0 0 0 0 0 0 0 0 0 3316.7 0 0 0 1101527402 1497977888 10 Physicians WIETFELDT JOEL 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 185 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 185 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9539.74 0 0 0 0 0 0 9539.74 0 0 0 1101527417 1659349850 10 Physicians THOMPSON DAVID 611033655 109 Winnebago 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 498 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 611 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 611 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15771.32 0 0 0 0 0 0 15771.32 0 0 0 1101527420 1780638353 63 Other Providers of Medical Equipment/Supplies (Non-registered) LAVA SUPPLY INC 600255633 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 926 0 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22521 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22521 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1453143.81 0 14177.19 0 0 0 0 1467321 0 0 0 1101527422 2100517840 90 Waiver service provider--Elderly (DOA) COMMUNITY CARE SYSTEMS INC 627022312 91 Sangamon 0 0 0 0 0 0 0 0 383 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24224 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24224 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1250126.29 0 0 0 0 0 0 0 0 0 0 0 0 0 1250126.29 0 0 0 1101527425 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 1445.77 0 0 0 0 0 0 0 0 0 0 0 0 0 1445.77 0 0 0 1101527426 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 19 0 0 0 0 0 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 17147.76 0 0 0 0 0 0 0 0 0 0 0 0 0 17147.76 0 0 0 1101527428 1679514335 10 Physicians BAJO JAMES 606800618 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 633 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 759 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 759 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22110.35 0 0 0 0 0 0 22110.35 0 0 0 1101527430 10 Physicians 30 DuPage 0 0 Otorhinolaryngology 0 0 0 0 0 0 0 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151.47 0 0 0 0 0 0 151.47 0 0 0 1101527441 92 Waiver service provider--Disability (DHS/DRS) 54 Kankakee 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 25805 0 0 0 0 0 0 0 0 0 0 0 0 0 25805 0 0 0 1101527454 1346551702 16 Nurse Practitioners STARNES MARY 600442203 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18.89 0 0 0 0 0 0 18.89 0 0 0 1101527458 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 10240.91 0 0 0 0 0 0 0 0 0 0 0 0 0 10240.91 0 0 0 1101527465 1891740650 10 Physicians WARRAICH JAMSHED 477140541 815 Indiana 0 0 Internal Medicine 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 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1277.83 0 0 0 0 0 0 1277.83 0 0 0 1101527475 1407887938 10 Physicians BONE RICHARD 606431790 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93.18 0 0 0 0 0 0 93.18 0 0 0 1101527480 91 Waiver service provider--Adults (DHS/DDD) 40 Grundy 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 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5999.61 0 0 0 0 0 0 0 0 0 0 0 0 0 5999.61 0 0 0 1101527485 1962577676 10 Physicians FELDMAN JERRY 606123723 200 Cook 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74.92 0 0 0 0 0 0 74.92 0 0 0 1101527500 10 Physicians 826 Missouri 0 0 Anesthesiology 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 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0 0 0 5236.48 0 0 0 1101527586 1780753939 12 Optometrists KEFALAS CHARLES 606295037 200 Cook 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 331 0 281 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 708 0 289 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 708 0 289 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17762.31 0 8285.52 0 0 0 0 26047.83 0 0 0 1101527600 92 Waiver service provider--Disability (DHS/DRS) 33 Effingham 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 3823.73 0 0 0 0 0 0 0 0 0 0 0 0 0 3823.73 0 0 0 1101527601 92 Waiver service provider--Disability (DHS/DRS) 97 Stephenson 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 4121.74 0 0 0 0 0 0 0 0 0 0 0 0 0 4121.74 0 0 0 1101527626 1699881367 10 Physicians BAUER-COHEN HILLARY 606118709 53 Kane 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 331 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 468 0 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3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 639 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 639 0 0 1724.1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50871.8 0 0 52595.9 0 0 0 1101527657 2100518075 10 Physicians NAJJAR EMAD 627690001 91 Sangamon 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 541.65 0 0 0 0 0 0 541.65 0 0 0 1101527660 1386670941 10 Physicians ALZALAM NAZEM 604551775 200 Cook 0 1 Pediatrics 0 927 0 0 515 0 0 0 0 0 0 90 0 479 0 0 0 0 0 0 4911 0 0 2096 0 0 0 0 0 0 101 0 1225 0 0 0 0 0 0 4911 0 0 2096 0 0 0 0 0 0 101 0 1225 0 0 0 0 0 0 9822 0 0 63857.55 0 0 0 0 0 0 1022.84 0 49086.57 0 0 0 0 0 0 123788.96 0 0 0 1101527675 2100518093 90 Waiver service provider--Elderly (DOA) LARLIN HOMECARE SERVICES 605163447 30 DuPage 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 2277 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2277 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29425.6 0 0 0 0 0 0 0 0 0 0 0 0 0 29425.6 0 0 0 1101527697 1285737957 60 Pharmacies CVS PHARMACY 6935 618537039 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 211 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1709 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57210.14 0 0 0 57210.14 0 0 0 1101527702 92 Waiver service provider--Disability (DHS/DRS) 25 Crawford 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 17008.49 0 0 0 0 0 0 0 0 0 0 0 0 0 17008.49 0 0 0 1101527708 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14956.01 0 0 0 0 0 0 0 0 0 0 0 0 0 14956.01 0 0 0 1101527713 1144209719 10 Physicians CHUNDURI KRISHNA 631282106 826 Missouri 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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16 Nurse Practitioners TITONE JESSECCA 999999999 91 Sangamon 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 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 601.23 0 0 0 0 0 0 601.23 0 0 0 1101527790 1861476111 13 Podiatrists KURTZ ELIZABETH 606225512 200 Cook 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 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1479.97 0 0 0 0 0 0 1479.97 0 0 0 1101527801 30 General Hospitals 812 Hawaii NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 401.19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 401.19 0 0 0 1101527804 1073530606 10 Physicians ROTHSCHILD JULIE 604023429 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 276 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 297 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 297 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8538.51 0 0 0 0 0 0 8538.51 0 0 0 1101527805 1639183171 23 Occupational Therapists LONG MEGAN 522412837 816 Iowa 0 0 0 0 0 0 0 0 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 0 281 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 281 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20566.75 20566.75 0 0 0 1101527822 1528214715 10 Physicians KASSIR JENNIFER 606740018 30 DuPage 0 0 Internal Medicine 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 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 0 242.04 0 0 0 0 0 0 242.04 0 0 0 1101527826 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11682 0 0 0 0 0 0 0 0 0 0 0 0 0 11682 0 0 0 1101527858 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 257 0 0 0 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0 0 0 0 0 0 0 8 0 0 0 0 0 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 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2428.92 0 0 0 0 0 0 0 0 0 0 0 0 0 2428.92 0 0 0 1101527880 92 Waiver service provider--Disability (DHS/DRS) 79 Ogle 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 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 2338.9 0 0 0 0 0 0 0 0 0 0 0 0 0 2338.9 0 0 0 1101527889 2100518307 90 Waiver service provider--Elderly (DOA) COVENANT HEALTHCARE SERVICES 606196248 200 Cook 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 0 870 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 870 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53286.22 0 0 0 0 0 0 0 0 0 0 0 0 0 53286.22 0 0 0 1101527921 1144325051 10 Physicians KHAN ALI 600313376 57 Lake 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 7 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 0 285.46 0 0 0 0 0 0 285.46 0 0 0 1101527925 92 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0 0 369 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 369 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13946.29 0 0 0 0 0 0 13946.29 0 0 0 1101528652 1316138704 10 Physicians CHICOS ALEXANDRU 606118709 200 Cook 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 1 0 481 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 655 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 655 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7.84 0 10519.16 0 0 0 0 0 0 10527 0 0 0 1101528658 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 20179.37 0 0 0 0 0 0 0 0 0 0 0 0 0 20179.37 0 0 0 1101528685 1649433442 62 Opticians / Optical Companies INTERNATIONAL MISSIONS ALLIANC 606187413 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2103.02 0 0 0 0 2103.02 0 0 0 1101528688 1881647675 10 Physicians GARDNER GLENN 605151500 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0 0 0 0 0 0 0 0 0 0 0 8823.4 0 8285.12 0 0 0 0 17108.52 0 0 0 1101528761 1568647196 10 Physicians FISHKIN SHERRY 604222125 200 Cook 0 0 Otolaryngology 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1031.43 0 0 0 0 0 0 1031.43 0 0 0 1101528792 1740304948 16 Nurse Practitioners DOWNEY ELIZABETH 630433411 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 178 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 178 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3598.74 0 0 0 0 0 0 3598.74 0 0 0 1101528795 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 0 208 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 208 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13781.98 0 0 0 0 0 0 0 0 0 0 0 0 0 13781.98 0 0 0 1101528797 2100519215 71 Medicar Provider PALM TERRACE OF MATTOON 619386031 24 Coles 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 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Equipment/Supplies (Non-registered) BALLERT ORTHOPEDIC 600894356 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8001.28 0 10302.5 0 0 0 0 18303.78 0 0 0 1101528818 98 Waiver service provider--TBI (DHS/DRS) 80 Peoria 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 37204.58 0 0 0 0 0 0 0 0 0 0 0 0 0 37204.58 0 0 0 1101528824 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 24976.55 0 0 0 0 0 0 0 0 0 0 0 0 0 24976.55 0 0 0 1101528830 1679673354 10 Physicians RADEMACHER DENNIS 625213800 63 Macon 0 1 Family Practice 0 31 0 0 19 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 293 0 0 30 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 293 0 0 30 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 662 0 0 1475.28 0 0 0 0 0 0 0 0 6534.43 0 0 0 0 0 0 8671.71 0 0 0 1101528838 1568425692 10 Physicians KUMBAR CHANDRASHEKAR 477101656 815 Indiana 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3913.34 0 0 0 0 0 0 3913.34 0 0 0 1101528839 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1138.5 0 0 0 0 0 0 0 0 0 0 0 0 0 1138.5 0 0 0 1101528848 92 Waiver service provider--Disability (DHS/DRS) 95 Stark 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 13989 0 0 0 0 0 0 0 0 0 0 0 0 0 13989 0 0 0 1101528849 1700055308 22 Physical Therapists OLIVERI PHIL 611076801 109 Winnebago 0 0 0 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 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 932.59 932.59 0 0 0 1101528852 10 Physicians 826 Missouri 0 0 Gastroenterology 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24.45 0 0 0 0 0 0 24.45 0 0 0 1101528855 1902177496 16 Nurse Practitioners HARRIS JENNIFER 420037914 818 Kentucky 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 291.26 0 0 0 0 0 0 291.26 0 0 0 1101528860 16 Nurse Practitioners 826 Missouri 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101528874 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 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 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 2366.19 0 0 0 0 0 0 0 0 0 0 0 0 0 2366.19 0 0 0 1101528883 1740279934 10 Physicians KIM JOY 601882402 30 DuPage 0 1 Family Practice 0 2 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 274.08 0 0 0 0 0 0 298.08 0 0 0 1101528885 1801107537 10 Physicians SYED MAHMOODA T 379321983 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 1249 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1398 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1398 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50812.83 0 0 0 0 0 0 50812.83 0 0 0 1101528892 1417972597 10 Physicians HUANG MEI 631418573 63 Macon 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 217 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 541 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 541 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 142264.1 0 0 0 0 0 0 142264.1 0 0 0 1101528894 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 13144.34 0 0 0 0 0 0 0 0 0 0 0 0 0 13144.34 0 0 0 1101528897 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 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 1953.6 0 0 0 0 0 0 0 0 0 0 0 0 0 1953.6 0 0 0 1101528904 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 317.4 0 0 0 0 0 0 0 0 0 0 0 0 0 317.4 0 0 0 1101528909 1184870545 10 Physicians RUSINAK DAVID 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 375 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 522 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 522 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21845.42 0 0 0 0 0 0 0 0 21845.42 0 0 0 1101528913 1366475113 63 Other Providers of Medical Equipment/Supplies (Non-registered) WILLIAMS BROS HEALTH CARE 475916329 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 728 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 728 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36768.85 0 0 0 0 0 0 36768.85 0 0 0 1101528914 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18062 0 0 0 0 0 0 0 0 0 0 0 0 0 18062 0 0 0 1101528915 1598765901 10 Physicians KIMBALL VALERIE 602023784 200 Cook 0 1 Pediatrics 0 151 0 0 96 0 0 0 0 0 0 60 0 90 0 0 0 0 0 0 714 0 0 401 0 0 0 0 0 0 96 0 156 0 0 0 0 0 0 714 0 0 401 0 0 0 0 0 0 96 0 156 0 0 0 0 0 0 1428 0 0 11081.58 0 0 0 0 0 0 572.78 0 7412.57 0 0 0 0 0 0 20494.93 0 0 0 1101528941 1992914352 10 Physicians LICIS AMY 631101010 826 Missouri 0 0 Child Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2853.74 0 0 0 0 0 0 2853.74 0 0 0 1101528954 1891763082 10 Physicians SLAGLE DAVID 616033136 80 Peoria 0 1 Infectious Diseases 0 4 0 0 0 0 0 0 0 0 0 0 0 134 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 406 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 406 0 0 0 0 0 0 150 0 0 0 0 0 0 0 0 0 0 0 15125.18 0 0 0 0 0 0 15275.18 0 0 0 1101528980 1679580807 10 Physicians MALIK MASUD 611145603 109 Winnebago 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 0 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 240 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 240 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6002.8 0 0 0 0 0 0 6002.8 0 0 0 1101528983 1700845104 14 Chiropractors SCHOAF DANIEL 610300307 79 Ogle 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 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 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 179.61 0 0 0 0 0 0 179.61 0 0 0 1101528986 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 49649.96 0 0 0 0 0 0 0 0 0 0 0 0 0 49649.96 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14.68 0 2563.3 0 0 0 0 0 0 2577.98 0 0 0 1101530046 1841210457 10 Physicians JACOBSON DANIEL 606074013 200 Cook 0 0 General Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2438.1 0 0 0 0 0 0 2438.1 0 0 0 1101530086 1912933938 10 Physicians KINSINGER PAUL 615712181 98 Tazewell 0 1 Family Practice 0 9 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 199 0 0 0 0 0 0 0 0 0 0 0 183.6 0 0 0 0 0 0 382.6 0 0 0 1101530087 14 Chiropractors 23 Clinton 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 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41.4 0 0 0 0 0 0 41.4 0 0 0 1101530103 1629286067 10 Physicians YADLA SANJAY 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 0 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Physicians DANGLES CHRIS 609362004 81 Perry 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 12 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 157 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 157 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 291.97 0 9695.17 0 0 0 0 0 0 9987.14 0 0 0 1101530156 1194933846 10 Physicians PEART RENEE 604532600 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17639.82 0 0 0 0 0 0 17639.82 0 0 0 1101530164 1740493352 10 Physicians RICE JOHN 535625531 852 Wisconsin 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 212.09 0 0 0 0 0 0 212.09 0 0 0 1101530166 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 97.26 0 0 0 0 0 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0 0 0 8577.64 0 0 0 0 0 0 0 0 0 0 0 0 0 8577.64 0 0 0 1101530177 1528004777 10 Physicians HANSON THOMAS 622631534 103 Washington 0 0 Emergency Medicine 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 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1947.21 0 0 0 0 0 0 1947.21 0 0 0 1101530200 1174713648 10 Physicians KHAN ATIKA 606253500 200 Cook 0 1 Internal Medicine 0 52 0 0 0 0 0 0 0 0 0 0 0 240 0 0 0 0 0 0 130 0 0 0 0 0 0 0 0 0 0 0 555 0 0 0 0 0 0 130 0 0 0 0 0 0 0 0 0 0 0 555 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 7913.98 0 0 0 0 0 0 8278.98 0 0 0 1101530222 1427128909 10 Physicians ALFORD RODNEY 60958 54 Kankakee 0 1 Pediatrics 0 30 0 0 14 0 0 0 0 0 0 5 0 176 0 0 0 0 0 0 113 0 0 28 0 0 0 0 0 0 5 0 452 0 0 0 0 0 0 113 0 0 28 0 0 0 0 0 0 5 0 452 0 0 0 0 0 0 287 0 0 1049.27 0 0 0 0 0 0 5.04 0 7888.92 0 0 0 0 0 0 9230.23 0 0 0 1101530224 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 9296.25 0 0 0 0 0 0 0 0 0 0 0 0 0 9296.25 0 0 0 1101530249 1225010911 40 Federally Qualified Health Centers PRIMECARE WEST TOWN 606221797 200 Cook 0 1 0 1208 1088 0 438 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7232 4595 0 1467 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7232 4595 0 1467 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16846 264248.74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 281094.74 0 0 0 1101530253 1053393108 10 Physicians ROLLO JOHN 631366119 826 Missouri 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 0 50 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 0 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 885.35 0 0 0 0 0 0 0 0 885.35 0 0 0 1101530276 1285608976 10 Physicians KURIEN SHAUN 616151941 200 Cook 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 1 0 589 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1044 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1044 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3.82 0 7745.02 0 0 0 0 0 0 7748.84 0 0 0 1101530285 91 Waiver service provider--Adults (DHS/DDD) 107 Will 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 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1980 0 0 0 0 0 0 0 0 0 0 0 0 0 1980 0 0 0 1101530299 1922261130 10 Physicians MAGILL MEGHAN 601533328 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 246 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 246 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 546.1 0 0 0 0 0 0 546.1 0 0 0 1101530301 1467785782 40 Federally Qualified Health Centers ACCESS LOCATED AT HOLY CROSS 606291839 200 Cook 0 1 0 3885 1823 0 830 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20226 7604 0 2704 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20226 7604 0 2704 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50570 507187.52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 557757.52 0 0 0 1101530303 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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1285767244 47 Local Education Agencies WALTONVILLE CU 1 628942812 49 Jefferson 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 88 0 0 0 0 0 0 0 0 0 0 0 0 0 533 0 0 0 0 88 0 0 0 0 0 0 0 0 0 0 0 0 0 533 0 0 0 0 530.68 0 0 0 0 0 0 0 0 0 0 0 0 0 10159.72 0 10690.4 0 0 0 1101530414 1518991066 10 Physicians SANTORINEOS DIANE 616370001 200 Cook 0 1 Dermatology 0 279 0 0 221 0 0 0 0 0 0 153 0 228 0 0 0 0 0 0 2390 0 0 718 0 0 0 0 0 0 225 0 385 0 0 0 0 0 0 2390 0 0 718 0 0 0 0 0 0 225 0 385 0 0 0 0 0 0 4780 0 0 23275.64 0 0 0 0 0 0 2072.14 0 16149.66 0 0 0 0 0 0 46277.44 0 0 0 1101530437 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14509.09 0 0 0 0 0 0 0 0 0 0 0 0 0 14509.09 0 0 0 1101530440 1982749263 10 Physicians COHAN ADAM 600451681 57 Lake 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 2 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74.5 0 100.69 0 0 0 0 0 0 175.19 0 0 0 1101530443 10 Physicians 816 Iowa 0 0 Pathology 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20.55 0 0 0 0 0 0 0 0 20.55 0 0 0 1101530449 1417035817 10 Physicians VERHEY PETER 999999999 829 Nevada 0 0 0 0 0 0 0 0 0 0 0 0 0 82 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3179.4 0 21.54 0 0 0 0 0 0 3200.94 0 0 0 1101530450 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 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 7257.7 0 0 0 0 0 0 0 0 0 0 0 0 0 7257.7 0 0 0 1101530452 1316935828 11 Dentists DAVIS WILLIAM 600166460 200 Cook 0 0 General Dentistry 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4628.57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4628.57 0 0 0 1101530465 92 Waiver service provider--Disability (DHS/DRS) 57 Lake 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 0 481.97 0 0 0 0 0 0 0 0 0 0 0 0 0 481.97 0 0 0 1101530467 1649365529 10 Physicians ALUL RUSHDI 604404707 107 Will 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 679 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 990 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 990 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22850.39 0 0 0 0 0 0 22850.39 0 0 0 1101530470 1114086766 10 Physicians PRZEZDZIAK TOMASZ 600442203 57 Lake 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 1 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6022.84 0 0 0 0 0 0 6022.84 0 0 0 1101530473 1417935800 10 Physicians OSTRANDER DALE 625264163 63 Macon 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16890.08 0 0 0 0 0 0 16890.08 0 0 0 1101530480 1508942921 10 Physicians TWYMAN KIMBERLY 631102515 826 Missouri 0 0 Pediatrics 0 0 0 0 1 0 0 0 0 0 0 0 0 149 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 173 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 173 0 0 0 0 0 0 0 0 0 16.07 0 0 0 0 0 0 0 0 24710.36 0 0 0 0 0 0 24726.43 0 0 0 1101530481 92 Waiver service provider--Disability (DHS/DRS) 96 St Clair 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 14330.88 0 0 0 0 0 0 0 0 0 0 0 0 0 14330.88 0 0 0 1101530485 16 Nurse Practitioners 826 Missouri 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 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 0 280.2 0 0 0 0 0 0 280.2 0 0 0 1101530488 1629255377 10 Physicians MAXEY SMARTT MECCA 600313336 57 Lake 0 0 Family Practice 0 0 0 0 27 0 0 0 0 0 0 20 0 115 0 0 0 0 0 0 0 0 0 122 0 0 0 0 0 0 25 0 228 0 0 0 0 0 0 0 0 0 122 0 0 0 0 0 0 25 0 228 0 0 0 0 0 0 0 0 0 3843.26 0 0 0 0 0 0 240.03 0 9003.29 0 0 0 0 0 0 13086.58 0 0 0 1101530494 91 Waiver service provider--Adults (DHS/DDD) 96 St Clair 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 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10885.8 0 0 0 0 0 0 0 0 0 0 0 0 0 10885.8 0 0 0 1101530502 1629083944 60 Pharmacies BOND DRUG COMPANY OF ILLINOIS 600602207 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1045 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5262 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123933 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 227370.78 0 0 0 227370.78 0 0 0 1101530503 1932167327 10 Physicians HUANG CHING CHONG 604358200 107 Will 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1423.32 0 0 0 0 0 0 1423.32 0 0 0 1101530505 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 15620.67 0 0 0 0 0 0 0 0 0 0 0 0 0 15620.67 0 0 0 1101530509 14 Chiropractors 109 Winnebago 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 9.63 0 0 0 0 0 0 9.63 0 0 0 1101530514 30 General Hospitals 843 South Dakota NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 579.84 0 0 0 0 1289.62 0 0 0 0 0 0 0 0 0 1869.46 0 0 0 1101530519 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22797.89 0 0 0 0 0 0 0 0 0 0 0 0 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11576.67 0 0 0 1101530546 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 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 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 11973.28 0 0 0 0 0 0 0 0 0 0 0 0 0 11973.28 0 0 0 1101530552 10 Physicians 200 Cook 0 0 Pediatrics 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365.64 0 0 0 0 0 0 365.64 0 0 0 1101530554 10 Physicians 816 Iowa 0 0 Anesthesiology 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 414.22 0 0 0 0 0 0 414.22 0 0 0 1101530559 92 Waiver service provider--Disability (DHS/DRS) 67 Marshall 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1366.85 0 0 0 0 0 0 0 0 0 0 0 0 0 1366.85 0 0 0 1101530573 1538262431 10 Physicians BARKMEIER 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1538476593 10 Physicians NOVEY WALDO 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 303 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 821 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 821 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17242.1 0 0 0 0 0 0 17242.1 0 0 0 1101530778 1659400539 47 Local Education Agencies NO SUB SPEC EDU DIST SEJA 804 600353816 57 Lake 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 175 0 0 0 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 9551 0 0 0 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 9551 0 0 0 0 596.33 0 0 0 0 0 0 0 0 0 0 0 0 0 594609.18 0 595205.51 0 0 0 1101530780 91 Waiver service provider--Adults (DHS/DDD) 108 Williamson 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 0 241 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 241 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21722.25 0 0 0 0 0 0 0 0 0 0 0 0 0 21722.25 0 0 0 1101530785 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 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 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0 44 0 0 0 0 0 0 15 0 178 0 0 0 0 0 0 1917 0 0 108 0 0 0 0 0 0 20 0 259 0 0 0 0 0 0 1917 0 0 108 0 0 0 0 0 0 20 0 259 0 0 0 0 0 0 4701 0 0 3943.32 0 0 0 0 0 0 47.81 0 11463.51 0 0 0 0 0 0 20155.64 0 0 0 1101532376 1669476560 10 Physicians BLINDER KEVIN 631441317 826 Missouri 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 7 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 934 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 934 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 196.05 0 28225.23 0 0 0 0 0 0 28421.28 0 0 0 1101532381 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5953.2 0 0 0 0 0 0 0 0 0 0 0 0 0 5953.2 0 0 0 1101532382 1518160704 47 Local Education Agencies GARDNER S WILMINGTON THS 73 604240257 40 Grundy 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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631101010 826 Missouri 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 157 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 157 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6093.24 0 0 0 0 0 0 6093.24 0 0 0 1101532497 1518046390 10 Physicians DIXON GERALD 616147300 80 Peoria 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 0 1118 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1454 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1454 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20947.01 0 771.26 0 0 0 0 0 0 21718.27 0 0 0 1101532513 1801850045 10 Physicians IZHAR FARZANA 606212616 200 Cook 0 1 Neonatology 0 908 0 0 461 0 0 0 0 0 0 0 0 273 0 0 0 0 0 0 6729 0 0 1502 0 0 0 0 0 0 0 0 380 0 0 0 0 0 0 6729 0 0 1502 0 0 0 0 0 0 0 0 380 0 0 0 0 0 0 14945 0 0 54107.23 0 0 0 0 0 0 0 0 14332.98 0 0 0 0 0 0 83385.21 0 0 0 1101532514 1669616611 16 Nurse Practitioners STOUT KATHERINE 618215923 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 227 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 227 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5188.55 0 0 0 0 0 0 5188.55 0 0 0 1101532520 2100522938 71 Medicar Provider NEWMAN JOSEPH 606496104 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 5989 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5989 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53634.84 0 0 0 0 0 0 53634.84 0 0 0 1101532524 1194824953 10 Physicians AGANAD JANET 601011836 30 DuPage 0 1 Internal Medicine 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 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1260.42 0 0 0 0 0 0 1260.42 0 0 0 1101532530 2100522948 11 Dentists BUERK BETHEL 620402300 65 Madison 0 0 General Practice 0 0 0 1326 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6016 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6016 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 162739.84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 162739.84 0 0 0 1101532538 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 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 18862.86 0 0 0 0 0 0 0 0 0 0 0 0 0 18862.86 0 0 0 1101532552 1568407641 10 Physicians BARAN EMILY 606118702 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 350 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 384 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 384 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11399.29 0 0 0 0 0 0 11399.29 0 0 0 1101532554 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2125.19 0 0 0 0 0 0 0 0 0 0 0 0 0 2125.19 0 0 0 1101532579 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11932.47 0 0 0 0 0 0 0 0 0 0 0 0 0 11932.47 0 0 0 1101532582 92 Waiver service provider--Disability (DHS/DRS) 22 Clay 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 610.02 0 0 0 0 0 0 0 0 0 0 0 0 0 610.02 0 0 0 1101532585 1811148786 10 Physicians PARK DANNY 606253611 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 445 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17895.37 0 0 0 0 0 0 17895.37 0 0 0 1101532588 1639200314 60 Pharmacies OSCO PHARMACY 435 627032128 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 692 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17042 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27769.97 0 0 0 27769.97 0 0 0 1101532606 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 35865.95 0 0 0 0 0 0 0 0 0 0 0 0 0 35865.95 0 0 0 1101532623 92 Waiver service provider--Disability (DHS/DRS) 100 Vermilion 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 0 146.57 0 0 0 0 0 0 0 0 0 0 0 0 0 146.57 0 0 0 1101532634 1750507133 10 Physicians CONRAD EDWARD 601893878 30 DuPage 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 0 7 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82.2 0 420.03 0 0 0 0 0 0 502.23 0 0 0 1101532647 92 Waiver service provider--Disability (DHS/DRS) 72 McLean 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28393.88 0 0 0 0 0 0 0 0 0 0 0 0 0 28393.88 0 0 0 1101532651 1558441808 10 Physicians GAVAGAN THOMAS 606127248 200 Cook 0 0 Family Practice 0 140 0 0 11 0 0 0 0 0 0 11 0 92 0 0 0 0 0 0 981 0 0 16 0 0 0 0 0 0 14 0 119 0 0 0 0 0 0 981 0 0 16 0 0 0 0 0 0 14 0 119 0 0 0 0 0 0 2464 0 0 947.26 0 0 0 0 0 0 54.62 0 10874.95 0 0 0 0 0 0 14340.83 0 0 0 1101532653 1467702878 16 Nurse Practitioners JASIENIECKI KRISTIN 602011718 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 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 0 461.93 0 0 0 0 0 0 461.93 0 0 0 1101532655 92 Waiver service provider--Disability (DHS/DRS) 96 St Clair 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 0 520.59 0 0 0 0 0 0 0 0 0 0 0 0 0 520.59 0 0 0 1101532656 1851466635 63 Other Providers of Medical Equipment/Supplies (Non-registered) HANGER PROSTHETICS & ORTHOTICS 618011552 845 Texas 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66 0 243 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66 0 243 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14871.8 0 86446.42 0 0 0 0 101318.22 0 0 0 1101532657 1912277708 60 Pharmacies MEIJER PHARMACY 182 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 722 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16798 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30809.83 0 0 0 30809.83 0 0 0 1101532665 98 Waiver service provider--TBI (DHS/DRS) 56 Knox 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 11410.64 0 0 0 0 0 0 0 0 0 0 0 0 0 11410.64 0 0 0 1101532667 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 31795.78 0 0 0 0 0 0 0 0 0 0 0 0 0 31795.78 0 0 0 1101532668 1861623365 10 Physicians BARZSO THEODORE 613501604 58 La Salle 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 394 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 410 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 410 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10486.99 0 0 0 0 0 0 10486.99 0 0 0 1101532674 1275564940 10 Physicians GRUMET KENNETH 602023453 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 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 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18.65 0 0 0 0 0 0 18.65 0 0 0 1101532687 98 Waiver service provider--TBI (DHS/DRS) 30 DuPage 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2700.1 0 0 0 0 0 0 0 0 0 0 0 0 0 2700.1 0 0 0 1101532690 1518985027 60 Pharmacies WAL MART 10 1418 622691657 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 399 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1649 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42056 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57673.15 0 0 0 57673.15 0 0 0 1101532692 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2064 0 0 0 0 0 0 0 0 0 0 0 0 0 2064 0 0 0 1101532694 1518251149 16 Nurse Practitioners HOLLIN TALLY 601082218 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 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 90.56 0 0 0 0 0 0 90.56 0 0 0 1101532709 92 Waiver service provider--Disability (DHS/DRS) 79 Ogle 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 705.32 0 0 0 0 0 0 0 0 0 0 0 0 0 705.32 0 0 0 1101532710 30 General Hospitals 818 Kentucky DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48.85 0 0 25.98 0 0 0 0 0 74.83 0 0 0 1101532714 92 Waiver service provider--Disability (DHS/DRS) 58 La Salle 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 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24787.68 0 0 0 0 0 0 0 0 0 0 0 0 0 24787.68 0 0 0 1101532715 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12297.93 0 0 0 0 0 0 0 0 0 0 0 0 0 12297.93 0 0 0 1101532741 24 Speech Therapists 200 Cook 0 0 0 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 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3881.01 3881.01 0 0 0 1101532743 1578656682 40 Federally Qualified Health Centers SHAWNEE WOMENS HEALTH AND FAM 629011409 47 Jackson 0 0 0 0 946 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8459 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8459 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 517452.4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 517452.4 0 0 0 1101532744 1326337783 63 Other Providers of Medical Equipment/Supplies (Non-registered) KELLER ORTHOTICS INC 606124861 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24009.41 0 0 0 0 24009.41 0 0 0 1101532745 1255353603 10 Physicians MARSHALL KIMBERLY 617613551 72 McLean 0 1 Pediatrics 0 92 0 0 141 0 0 0 0 0 0 61 0 217 0 0 0 0 0 0 800 0 0 356 0 0 0 0 0 0 130 0 385 0 0 0 0 0 0 800 0 0 356 0 0 0 0 0 0 130 0 385 0 0 0 0 0 0 1600 0 0 17779.74 0 0 0 0 0 0 1196.72 0 17176.16 0 0 0 0 0 0 37752.62 0 0 0 1101532746 1326042870 60 Pharmacies PHARMACY SOLUTIONS 600641802 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 374 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15486 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1008512.71 0 0 0 1008512.71 0 0 0 1101532751 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 3038.34 0 0 0 0 0 0 0 0 0 0 0 0 0 3038.34 0 0 0 1101532752 1063449296 10 Physicians COLEMAN GLENNETTA 611250764 109 Winnebago 0 0 Internal Medicine 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 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 582.47 0 0 0 0 0 0 582.47 0 0 0 1101532754 30 General Hospitals 852 Wisconsin NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 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 0 290.62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 290.62 0 0 0 1101532761 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21035.84 0 0 0 0 0 0 0 0 0 0 0 0 0 21035.84 0 0 0 1101532766 1114063963 10 Physicians WILENSKY JACOB 606743460 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 4 0 159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 426 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 426 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15.07 0 17171.76 0 0 0 0 0 0 17186.83 0 0 0 1101532774 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 10327.66 0 0 0 0 0 0 0 0 0 0 0 0 0 10327.66 0 0 0 1101532780 1831421593 10 Physicians SERAPHIN SALLY P 605638669 30 DuPage 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4149.09 0 0 0 0 0 0 4149.09 0 0 0 1101532789 1043203862 10 Physicians KAMIN MATTHEW 604611185 200 Cook 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 740 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1295 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1295 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8864.43 0 0 0 0 0 0 8864.43 0 0 0 1101532793 1538241591 10 Physicians BEATY SHAD 615502498 98 Tazewell 0 1 Pediatrics 0 386 0 0 231 0 0 0 0 0 0 68 0 248 0 0 0 0 0 0 3325 0 0 742 0 0 0 0 0 0 82 0 386 0 0 0 0 0 0 3325 0 0 742 0 0 0 0 0 0 82 0 386 0 0 0 0 0 0 6674 0 0 22554.39 0 0 0 0 0 0 568.42 0 15528.69 0 0 0 0 0 0 45325.5 0 0 0 1101532794 1225208549 10 Physicians CAPPELLO MICHAEL 600101919 57 Lake 0 0 Neonatal-Perinatal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 715 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 715 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99202.3 0 0 0 0 0 0 99202.3 0 0 0 1101532809 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 17382.99 0 0 0 0 0 0 0 0 0 0 0 0 0 17382.99 0 0 0 1101532810 24 Speech Therapists 96 St Clair 0 0 0 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 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 2042.3 2042.3 0 0 0 1101532819 92 Waiver service provider--Disability (DHS/DRS) 106 Whiteside 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 23739.28 0 0 0 0 0 0 0 0 0 0 0 0 0 23739.28 0 0 0 1101532824 1073615076 10 Physicians DIMOU CATHERINE 606123828 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 157.09 0 0 0 0 0 0 157.09 0 0 0 1101532828 1316977556 10 Physicians SCHULWOLF ELIZABETH 601533328 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 286 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 286 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4186.61 0 0 0 0 0 0 4186.61 0 0 0 1101532839 92 Waiver service provider--Disability (DHS/DRS) 107 Will 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 24114.46 0 0 0 0 0 0 0 0 0 0 0 0 0 24114.46 0 0 0 1101532841 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 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 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17097.86 0 0 0 0 0 0 0 0 0 0 0 0 0 17097.86 0 0 0 1101532849 1114949211 10 Physicians KANASHIRO MARY 604772273 200 Cook 0 1 Internal Medicine 0 2 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 515 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 515 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 2616.28 0 0 0 0 0 0 2625.28 0 0 0 1101532852 91 Waiver service provider--Adults (DHS/DDD) 55 Kendall 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 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12661 0 0 0 0 0 0 0 0 0 0 0 0 0 12661 0 0 0 1101532865 1114033669 10 Physicians MARTIN ALLISON 604675561 200 Cook 0 1 Family Practice 0 72 0 0 36 0 0 0 0 0 0 58 0 219 0 0 0 0 0 0 350 0 0 66 0 0 0 0 0 0 77 0 316 0 0 0 0 0 0 350 0 0 66 0 0 0 0 0 0 77 0 316 0 0 0 0 0 0 967 0 0 2937.34 0 0 0 0 0 0 356.05 0 9765.89 0 0 0 0 0 0 14026.28 0 0 0 1101532873 1013065556 10 Physicians SORUCO FERNANDO 600054197 200 Cook 0 0 Endocrinology 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8494.96 0 0 0 0 0 0 0 0 0 0 0 0 0 8494.96 0 0 0 1101534776 1609878420 10 Physicians SAMMARCO M 615202608 37 Fulton 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 4 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 195 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 195 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29.69 0 64147.31 0 0 0 0 0 0 64177 0 0 0 1101534781 1881842979 11 Dentists BAJAJ JASPREET 601813529 200 Cook 0 0 General Dentistry 0 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 939 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 939 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24473.62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24473.62 0 0 0 1101534782 1962529016 23 Occupational Therapists YOUNG STACIE 618012529 19 Champaign 0 0 0 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 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11653.53 11653.53 0 0 0 1101534785 1033281506 10 Physicians WU JOHN 606493306 200 Cook 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1101534830 1982732566 47 Local Education Agencies CHAMPAIGN CU SCHOOL DISTRICT 4 618205818 19 Champaign 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 847 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 33297 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 33297 0 0 0 0 170.52 0 0 0 0 0 0 0 0 0 0 0 0 0 327387.2 0 327557.72 0 0 0 1101534842 1891854345 10 Physicians FARRELL ELAINE 602011718 200 Cook 0 0 Neonatology 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 384 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 384 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31110.13 0 0 0 0 0 0 31110.13 0 0 0 1101534845 1568467306 33 Nursing Facilities "MERCY REHAB AND CARE CENTER, I" 622262301 96 St Clair 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 0 436 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10675 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 933583.77 0 0 0 0 0 0 0 933583.77 0 0 0 1101534846 1992781934 10 Physicians BERNHARDT THOMAS 625250557 40 Grundy 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 0 212 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 235 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 235 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30063.2 0 0 0 0 0 0 30063.2 0 0 0 1101534848 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17377.14 0 0 0 0 0 0 0 0 0 0 0 0 0 17377.14 0 0 0 1101534851 10 Physicians 815 Indiana 0 0 Ophthalmology 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 4 0 0 0 0 0 0 0 0 0 0 0 0 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 1320.39 0 0 0 0 0 0 1320.39 0 0 0 1101534857 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 15364.64 0 0 0 0 0 0 0 0 0 0 0 0 0 15364.64 0 0 0 1101534859 1982681458 10 Physicians WONG ALTON 606162477 200 Cook 0 0 Hematology 0 0 0 0 0 0 0 0 0 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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10184.43 0 0 0 1101534936 1841247236 10 Physicians MANGANELLI PAUL 605406558 30 DuPage 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2140.53 0 0 0 0 0 0 2140.53 0 0 0 1101534952 92 Waiver service provider--Disability (DHS/DRS) 46 Iroquois 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 18232.18 0 0 0 0 0 0 0 0 0 0 0 0 0 18232.18 0 0 0 1101534960 1255400255 63 Other Providers of Medical Equipment/Supplies (Non-registered) CHICAGOLAND EARLY INTERVENTION 604397741 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18354.16 0 2464.82 0 0 0 0 20818.98 0 0 0 1101534969 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 228 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 228 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18682.4 0 0 0 0 0 0 0 0 0 0 0 0 0 18682.4 0 0 0 1101534994 91 Waiver service provider--Adults (DHS/DDD) 96 St Clair 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 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25146 0 0 0 0 0 0 0 0 0 0 0 0 0 25146 0 0 0 1101534995 1912934670 10 Physicians VOIRIN TERRY 605859509 98 Tazewell 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 1 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 262 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 262 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4.77 0 7757.8 0 0 0 0 0 0 7762.57 0 0 0 1101534998 1972699452 16 Nurse Practitioners EVANS MOLLY K. 623631350 10 Adams 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 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122.7 0 0 0 0 0 0 122.7 0 0 0 1101535001 92 Waiver service provider--Disability (DHS/DRS) 91 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 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 2561.7 0 0 0 0 0 0 0 0 0 0 0 0 0 2561.7 0 0 0 1101535006 24 Speech Therapists 200 Cook 0 0 0 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 23 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 0 0 0 0 0 0 0 0 1549.39 1549.39 0 0 0 1101535018 1861672677 63 Other Providers of Medical Equipment/Supplies (Non-registered) GRANITE CITY ORTHOPEDICS 620341904 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4.06 0 4372.98 0 0 0 0 4377.04 0 0 0 1101535022 1659322535 10 Physicians BAXAMUSA TAIZOON 600531272 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 61 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 725.31 0 3134.86 0 0 0 0 0 0 3860.17 0 0 0 1101535033 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20872.5 0 0 0 0 0 0 0 0 0 0 0 0 0 20872.5 0 0 0 1101535046 1255578118 60 Pharmacies KANKAKEE AREA PHARMACY INC 609013673 54 Kankakee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 226 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2321 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66468 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120729.13 0 0 0 120729.13 0 0 0 1101535055 1053306597 10 Physicians REDDY LALITHA 604355487 107 Will 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 1 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5.16 0 2371.36 0 0 0 0 0 0 2376.52 0 0 0 1101535072 39 Hospice 65 Madison 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 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2681.75 0 0 0 0 0 0 0 0 0 0 0 2681.75 0 0 0 1101535080 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 368.62 0 0 0 0 0 0 0 0 0 0 0 0 0 368.62 0 0 0 1101535082 16 Nurse Practitioners 19 Champaign 0 0 0 0 0 0 0 0 0 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 249.87 0 0 0 0 0 0 249.87 0 0 0 1101535084 1215965660 10 Physicians SHAH ATUL 622861867 87 Randolph 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 8 0 326 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 625 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 625 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71.32 0 11672.94 0 0 0 0 0 0 11744.26 0 0 0 1101535098 1174515035 10 Physicians IYER ANITA 600892085 57 Lake 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 144 0 171 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 313 0 306 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 313 0 306 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9348.44 0 28540.11 0 0 0 0 0 0 37888.55 0 0 0 1101535101 1497859649 30 General Hospitals NORTHWESTERN MEMORIAL HOSP 606112908 200 Cook DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 Perinatal Level II Center 0 5 265 0 0 5337 0 0 0 0 3592 1 0 4 7314 0 0 0 0 0 6 1047 0 0 8087 0 0 0 0 4218 1 0 4 14639 0 0 0 0 0 12 2939 0 0 8087 0 0 0 0 23639 1 0 10 15574 0 0 0 0 0 172.6 54698.25 0 0 1641978.05 0 0 0 0 24517263.74 0 0 7279.16 2738288.85 0 0 0 0 0 28959680.65 0 0 0 1101535102 1053339499 10 Physicians NORA MARYANNETTE 607122527 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 350 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 350 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1129.07 0 0 0 0 0 0 1129.07 0 0 0 1101535113 1689794489 43 Encounter rate clinic LOGAN SQUARE HLTH CTR COOK CO 606472938 200 Cook ARS-C.O.P. "JH Stroger, Oak Forest and Provident Hospitals, paid under an alternate reimbursement system" 0 1 Direct Access 0 753 496 0 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1710 1577 0 432 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1710 1577 0 432 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3821 307318.66 0 70840.47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 381980.13 0 0 0 1101535115 1427052885 16 Nurse Practitioners DUBAY MCDERMIT JEANETTE 607142828 200 Cook 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 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 97.49 0 0 0 0 0 0 97.49 0 0 0 1101535138 1447254255 10 Physicians PATEL PIUSHKUMAR 601429545 71 McHenry 0 1 Internal Medicine 0 4 0 0 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 149 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 149 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 2077.19 0 0 0 0 0 0 2123.19 0 0 0 1101535139 1326045089 10 Physicians KOHN NORMAN V 606181537 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 236 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 236 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3666.2 0 0 0 0 0 0 3666.2 0 0 0 1101535141 1780602250 16 Nurse Practitioners MCGLAUGHLIN ALICIA 631102515 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 223 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 283 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 283 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11464.94 0 0 0 0 0 0 11464.94 0 0 0 1101535145 1649458753 10 Physicians HALANDRAS PEGGE 601533328 200 Cook 0 0 Vascular Surgery 0 0 0 0 0 0 0 0 0 0 0 17 0 249 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 446 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 446 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 380.27 0 12138.18 0 0 0 0 0 0 12518.45 0 0 0 1101535149 1538316062 36 Community mental health provider THRESHOLDS 606324335 200 Cook 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 522 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 522 0 0 924.91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46510.88 0 0 47435.79 0 0 0 1101535150 1366496028 10 Physicians TAFT NANCY 601342542 53 Kane 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1128.3 0 0 0 0 0 0 1128.3 0 0 0 1101535158 92 Waiver service provider--Disability (DHS/DRS) 48 Jasper 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 76.27 0 0 0 0 0 0 0 0 0 0 0 0 0 76.27 0 0 0 1101535163 1255322038 11 Dentists KANELLOS JAMES 606174508 200 Cook 0 0 General Dentistry 0 0 0 494 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58777.29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58777.29 0 0 0 1101535203 1326031436 10 Physicians JORDAN ASHBY 600102379 57 Lake 0 0 Pulmonary Diseases 0 0 0 0 0 0 0 0 0 0 0 0 0 348 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 742 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 742 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10911.64 0 0 0 0 0 0 10911.64 0 0 0 1101535215 30 General Hospitals 833 New York ARS-LS Long-term stay hospitals paid under an ARS 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1934.43 0 0 0 0 0 0 0 0 0 1934.43 0 0 0 1101535219 1891958880 10 Physicians AHMED SARAH 605047222 30 DuPage 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 240 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 327 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 327 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8880.95 0 0 0 0 0 0 8880.95 0 0 0 1101535220 92 Waiver service provider--Disability (DHS/DRS) 42 Hancock 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 24798.49 0 0 0 0 0 0 0 0 0 0 0 0 0 24798.49 0 0 0 1101535224 91 Waiver service provider--Adults (DHS/DDD) 107 Will 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 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 0 963.6 0 0 0 0 0 0 0 0 0 0 0 0 0 963.6 0 0 0 1101535226 10 Physicians 36 Franklin 0 0 Family Practice 0 0 0 0 0 0 0 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 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 0 0 0 0 0 0 0 0 0 0 0 1101535246 91 Waiver service provider--Adults (DHS/DDD) 37 Fulton 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 0 320 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 320 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16044.6 0 0 0 0 0 0 0 0 0 0 0 0 0 16044.6 0 0 0 1101535248 1720236284 16 Nurse Practitioners REESE CATHERINE 631041003 826 Missouri 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 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 422.51 0 0 0 0 0 0 422.51 0 0 0 1101535249 1811150725 10 Physicians ROSENBERG JONATHAN 600315711 57 Lake 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 0 278 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 561 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 561 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28962.96 0 0 0 0 0 0 28962.96 0 0 0 1101535254 1104065911 70 Ambulance Service Providers GRAND RIDGE VOLUNTEER FIRE DEP 613250687 58 La Salle 0 0 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 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 5470.98 0 0 0 0 0 0 5470.98 0 0 0 1101535275 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13083.2 0 0 0 0 0 0 0 0 0 0 0 0 0 13083.2 0 0 0 1101535280 1467582338 10 Physicians WAUGH DARCY 616151941 200 Cook 0 0 Family Practice 0 0 0 0 1 0 0 0 0 0 0 168 0 483 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 217 0 558 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 217 0 558 0 0 0 0 0 0 0 0 0 6.4 0 0 0 0 0 0 1918.18 0 15265.98 0 0 0 0 0 0 17190.56 0 0 0 1101535287 10 Physicians 97 Stephenson 0 0 Oncology 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 96.69 0 0 0 0 0 0 96.69 0 0 0 1101535288 1689689705 60 Pharmacies BOND DRUG COMPANY OF IL 4409 618213011 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 2325 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 9953 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 211422 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27.56 0 0 478756.44 0 0 0 478784 0 0 0 1101535293 1891778080 61 Independent Laboratories LABORATORY CORP OF AMERICA 402293126 818 Kentucky 0 0 0 0 0 0 0 0 0 0 0 0 0 1463 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1525 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1525 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83064.8 0 0 0 0 0 0 0 0 83064.8 0 0 0 1101535294 1801889340 12 Optometrists STONE WENDY 606163878 200 Cook 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 237 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 237 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4333.04 0 0 0 0 0 0 4333.04 0 0 0 1101535301 1033184247 10 Physicians HAMPTON SIMONE 618202101 19 Champaign 0 1 Family Practice 0 294 0 0 2 0 0 0 0 0 0 0 0 136 0 0 0 0 0 0 1304 0 0 2 0 0 0 0 0 0 0 0 219 0 0 0 0 0 0 1304 0 0 2 0 0 0 0 0 0 0 0 219 0 0 0 0 0 0 3547 0 0 29.45 0 0 0 0 0 0 0 0 24956.61 0 0 0 0 0 0 28533.06 0 0 0 1101535314 1770615320 22 Physical Therapists MORGAN CATHERINE 603021317 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 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 1741.44 1741.44 0 0 0 1101535346 92 Waiver service provider--Disability (DHS/DRS) 10 Adams 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 11215.74 0 0 0 0 0 0 0 0 0 0 0 0 0 11215.74 0 0 0 1101535347 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 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 0 250 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 250 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15598.8 0 0 0 0 0 0 0 0 0 0 0 0 0 15598.8 0 0 0 1101535348 91 Waiver service provider--Adults (DHS/DDD) 53 Kane 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 0 286 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 286 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24106.5 0 0 0 0 0 0 0 0 0 0 0 0 0 24106.5 0 0 0 1101535357 1740593268 16 Nurse Practitioners JIPPING VICTORIA 600681005 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83.01 0 0 0 0 0 0 83.01 0 0 0 1101535361 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 19 0 0 0 0 0 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 19086.32 0 0 0 0 0 0 0 0 0 0 0 0 0 19086.32 0 0 0 1101535372 10 Physicians 852 Wisconsin 0 0 Cardiology 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33.15 0 0 0 0 0 0 33.15 0 0 0 1101535390 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 301 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 301 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7055.77 0 0 0 0 0 0 0 0 0 0 0 0 0 7055.77 0 0 0 1101535393 1447565353 16 Nurse Practitioners BENSON MICHELLE 616360001 80 Peoria 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 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 0 177.85 0 0 0 0 0 0 177.85 0 0 0 1101535404 1689762452 10 Physicians DWORSKY BRADLEY 605213186 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 17 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 196.98 0 3163.83 0 0 0 0 0 0 3360.81 0 0 0 1101535406 1063682086 10 Physicians KUMAR MUNISH 80433520 53 Kane 0 0 Neonatology 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4584.05 0 0 0 0 0 0 4584.05 0 0 0 1101535410 1881687390 10 Physicians KHAMIS MOHAMMAD 606252316 200 Cook 0 1 Internal Medicine 0 124 0 0 20 0 0 0 0 0 0 0 0 190 0 0 0 0 0 0 916 0 0 38 0 0 0 0 0 0 0 0 897 0 0 0 0 0 0 916 0 0 38 0 0 0 0 0 0 0 0 897 0 0 0 0 0 0 2417 0 0 1744.9 0 0 0 0 0 0 0 0 30545.98 0 0 0 0 0 0 34707.88 0 0 0 1101535411 1689684557 10 Physicians JOHNSON REMA 605595574 30 DuPage 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 0 351 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 386 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 386 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14381.11 0 0 0 0 0 0 14381.11 0 0 0 1101535419 1730301524 10 Physicians MACCOTTA LUIGI 631101010 826 Missouri 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1080.51 0 0 0 0 0 0 1080.51 0 0 0 1101535423 1881785079 10 Physicians THEO CURT 602023328 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 1 0 113 0 0 0 0 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Physicians SPIEWAK MATTHEW 601262885 30 DuPage 0 1 Family Practice 0 23 0 0 11 0 0 0 0 0 0 5 0 100 0 0 0 0 0 0 80 0 0 17 0 0 0 0 0 0 5 0 175 0 0 0 0 0 0 80 0 0 17 0 0 0 0 0 0 5 0 175 0 0 0 0 0 0 212 0 0 939.09 0 0 0 0 0 0 51.38 0 4814.38 0 0 0 0 0 0 6016.85 0 0 0 1101535473 1306806682 10 Physicians RANTIS PETER 600052452 200 Cook 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 3 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62.7 0 2728.23 0 0 0 0 0 0 2790.93 0 0 0 1101535479 1437227592 10 Physicians HAN THWAN H 620403330 65 Madison 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 0 328 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7247.25 0 0 0 0 0 0 7247.25 0 0 0 1101535485 1467424473 10 Physicians TUMACDER ROBERT 600442203 57 Lake 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 5 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 82 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 240 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2882 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2882 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 150151.5 0 0 150151.5 0 0 0 1101535807 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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 0 176 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 176 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10219 0 0 0 0 0 0 0 0 0 0 0 0 0 10219 0 0 0 1101535810 92 Waiver service provider--Disability (DHS/DRS) 60 Lee 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 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11391.8 0 0 0 0 0 0 0 0 0 0 0 0 0 11391.8 0 0 0 1101535816 10 Physicians 826 Missouri 0 0 Orthopedic Surgery 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62.15 0 0 0 0 0 0 62.15 0 0 0 1101535820 1982658217 10 Physicians STEFFEN EDWARD 611042200 109 Winnebago 0 0 Radiology 0 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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 3424.84 0 0 0 0 0 0 0 0 0 0 0 0 0 3424.84 0 0 0 1101536271 1215975578 10 Physicians LARKIN TIMOTHY 605407430 30 DuPage 0 0 Cardiovascular Diseases 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 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4279.09 0 0 0 0 0 0 4279.09 0 0 0 1101536291 1033474051 29 ICF/MR TRAFFORD ESTATES 999999999 104 Wayne 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3296 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 279467.31 0 0 0 0 0 0 0 0 0 0 279467.31 0 0 0 1101536313 92 Waiver service provider--Disability (DHS/DRS) 63 Macon 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 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 9554.61 0 0 0 0 0 0 0 0 0 0 0 0 0 9554.61 0 0 0 1101536318 16 Nurse Practitioners 826 Missouri 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 1 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15061.31 0 0 0 0 0 0 15061.31 0 0 0 1101536861 91 Waiver service provider--Adults (DHS/DDD) 96 St Clair 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 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 0 686.4 0 0 0 0 0 0 0 0 0 0 0 0 0 686.4 0 0 0 1101536866 1437188224 10 Physicians KELLS KENNETH 600261610 200 Cook 0 1 Family Practice 0 111 0 0 2 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 618 0 0 2 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 618 0 0 2 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 1641 0 0 105.05 0 0 0 0 0 0 0 0 502.87 0 0 0 0 0 0 2248.92 0 0 0 1101536873 1679580062 10 Physicians OAKEY JEROME 617043738 72 McLean 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 31 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 925.11 0 5363.4 0 0 0 0 0 0 6288.51 0 0 0 1101536877 92 Waiver service provider--Disability (DHS/DRS) 55 Kendall 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 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 6688.66 0 0 0 0 0 0 0 0 0 0 0 0 0 6688.66 0 0 0 1101536888 1659386951 60 Pharmacies WALGREEN CO 318 605163809 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 454 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 12019 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21.87 0 0 46899.58 0 0 0 46921.45 0 0 0 1101536895 1174560528 33 Nursing Facilities MANORCARE OF OAK LAWN EAST 604532697 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 548 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9430 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 606654.63 0 0 0 0 0 0 0 606654.63 0 0 0 1101536896 1124170535 11 Dentists MAJZOUB ABDUL 606465713 200 Cook 0 0 General Dentistry 0 0 0 360 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1517 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1517 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43517.2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43517.2 0 0 0 1101536903 1073776134 10 Physicians MORELL WATTON AIMEE 611082425 109 Winnebago 0 0 Internal Medicine 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 0 231 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 231 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 251.51 0 0 0 0 0 0 251.51 0 0 0 1101536907 1972577013 10 Physicians SANKARY EDWARD 601533304 200 Cook 0 1 Internal Medicine 0 261 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 1784 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 1784 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 5295 0 0 0 0 0 0 0 0 0 0 0 1864.74 0 0 0 0 0 0 7159.74 0 0 0 1101536909 1669468674 10 Physicians ADAMS WILLIAM 420033813 818 Kentucky 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 197 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 293 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 293 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6746.72 0 440.2 0 0 0 0 0 0 7186.92 0 0 0 1101536914 1295798742 10 Physicians ZAVERDAS GEORGE A 616151941 80 Peoria 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 0 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1774.38 0 0 0 0 0 0 1774.38 0 0 0 1101536916 1992859789 10 Physicians THOMAS SAJJINI 606313745 200 Cook 0 1 Family Practice 0 774 0 0 97 0 0 0 0 0 0 15 0 254 0 0 0 0 0 0 4668 0 0 191 0 0 0 0 0 0 29 0 442 0 0 0 0 0 0 4668 0 0 191 0 0 0 0 0 0 29 0 442 0 0 0 0 0 0 11384 0 0 7780.44 0 0 0 0 0 0 162.12 0 19845.07 0 0 0 0 0 0 39171.63 0 0 0 1101536959 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 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 17132.65 0 0 0 0 0 0 0 0 0 0 0 0 0 17132.65 0 0 0 1101536961 1881640597 60 Pharmacies OSCO DRUG 3349 606391041 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 754 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 3744 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 90334 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34.59 0 0 198412.17 0 0 0 198446.76 0 0 0 1101536964 1780629485 10 Physicians DAVISON DONALD 618012530 19 Champaign 0 1 Pediatrics 0 9 0 0 1 0 0 0 0 0 0 0 0 314 0 0 0 0 0 0 103 0 0 1 0 0 0 0 0 0 0 0 654 0 0 0 0 0 0 103 0 0 1 0 0 0 0 0 0 0 0 654 0 0 0 0 0 0 218 0 0 6.4 0 0 0 0 0 0 0 0 36818.2 0 0 0 0 0 0 37042.6 0 0 0 1101536978 1801924196 24 Speech Therapists DAVIS STACEY 629011138 47 Jackson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 999 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 999 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73190.7 73190.7 0 0 0 1101536984 1629035845 10 Physicians MURRAY ROBERT 611033655 109 Winnebago 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 685 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 867 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 867 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24906.35 0 1113.19 0 0 0 0 0 0 26019.54 0 0 0 1101536992 1285665661 10 Physicians SHAFFER TROY 611033655 109 Winnebago 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 668 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 790 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 790 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21239.91 0 0 0 0 0 0 21239.91 0 0 0 1101536998 10 Physicians 852 Wisconsin 0 0 Pediatrics 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 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 85 0 0 0 0 0 0 85 0 0 0 1101286993 1942343447 30 General Hospitals SHRINERS HOSPITAL FOR CHILDREN 631313597 826 Missouri NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 Children's Hospital 0 0 0 0 0 0 0 0 0 0 21 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 163350.63 0 0 0 82407.94 0 0 0 0 0 245758.57 0 0 14.47 1101207245 1659364206 31 Psychiatric Hospitals CENTERPOINTE HOSPITAL 633049101 826 Missouri PSYCH Psychiatric hospitals paid a Per Diem rate. 0 0 Hospital childrens mental health 0 0 0 0 0 0 0 0 0 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 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 0 0 0 0 0 0 0 0 0 0 0 0 553444.65 0 0 0 0 0 0 0 0 0 553444.65 0 0 28.94 1101165464 1770610073 30 General Hospitals RICHLAND MEMORIAL HOSPITAL 624502553 88 Richland DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 0 0 0 0 0 2719 0 0 0 0 850 0 0 17 1918 0 0 0 0 0 0 0 0 0 4566 0 0 0 0 940 0 0 17 4011 0 0 0 0 0 0 0 0 0 4566 0 0 0 0 2806 0 0 17 4011 0 0 0 0 0 0 0 0 0 588251.23 0 0 0 0 1381307.58 0 0 29517.02 782594.84 0 0 0 0 0 2781670.67 0 0 101.31 1101151042 1528143088 30 General Hospitals KINDRED CHICAGO CENTRAL HOSP 606414799 200 Cook ARS-LS Long-term stay hospitals paid under an ARS 0 0 LTAC Special Qualification 0 0 0 0 0 0 0 0 0 0 316 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 402 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11357 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8807999.16 0 0 0 0 0 0 0 0 0 8807999.16 0 0 1947.04 1101213921 1255391611 30 General Hospitals SSM HEALTH ST. MARYS HOSPITAL 628013056 66 Marion DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 0 0 228 0 0 5747 0 0 0 0 1783 0 0 0 3109 0 0 0 0 0 0 672 0 0 11910 0 0 0 0 2222 0 0 0 6058 0 0 0 0 0 0 672 0 0 11921 0 0 0 0 7339 0 0 0 6204 0 0 0 0 0 0 38861.88 0 0 2514405.39 0 0 0 0 4526647.69 0 0 0 2100415.46 0 0 0 0 0 9180330.42 0 0 2219.35 1101263754 1235117532 30 General Hospitals RANKEN JORDAN A PED REHAB CTR 630433411 826 Missouri CHILDRENS Hospital designated as childrens hospitals and paid a Per Diem rate. 0 0 Children's Hospital 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1588 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2607037.34 0 0 0 0 0 0 0 0 0 2607037.34 0 0 2393.3 1101270233 1750482022 30 General Hospitals CHILDRENS HOSP OF WISCONSIN 532011997 852 Wisconsin CHILDRENS Hospital designated as childrens hospitals and paid a Per Diem rate. 0 0 Children's Hospital 0 0 0 0 0 22 0 0 0 0 16 0 0 0 42 0 0 0 0 0 0 0 0 0 26 0 0 0 0 14 0 0 0 63 0 0 0 0 0 0 0 0 0 26 0 0 0 0 52 0 0 0 63 0 0 0 0 0 0 0 0 0 5123.41 0 0 0 0 92534.85 0 0 0 20604.84 0 0 0 0 0 118263.1 0 0 2543.54 1101161718 1093801797 30 General Hospitals MEMORIAL HOSP CARBONDALE 629011462 47 Jackson DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 0 5 0 0 0 8138 0 0 0 0 4129 0 0 56 6648 0 0 0 0 0 6 0 0 0 14272 0 0 0 0 4782 0 0 56 12660 0 0 0 0 0 8 0 0 0 14282 0 0 0 0 13500 0 0 56 14190 0 0 0 0 0 244.45 0 0 0 3545109.36 0 0 0 0 11469006.95 0 0 129726.92 5930977.28 0 0 0 0 0 21075064.96 0 0 2568.13 1001257839 1427000884 30 General Hospitals PRESENCE UNITED SAMARITANS MC 618323752 100 Vermilion DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 0 3 0 0 0 4504 0 0 0 0 1564 0 0 0 936 0 0 0 0 0 6 0 0 0 7754 0 0 0 0 1101 0 0 0 1609 0 0 0 0 0 12 0 0 0 7759 0 0 0 0 3085 0 0 0 1858 0 0 0 0 0 0 0 0 0 1066853.38 0 0 0 0 1380847.68 0 0 0 279241.73 0 0 0 0 0 2726942.79 0 0 5309.83 1101302962 1427146430 30 General Hospitals LA RABIDA CHILDRENS HOSP 606491003 200 Cook CHILDRENS Hospital designated as childrens hospitals and paid a Per Diem rate. 0 0 Children's Hospital 0 0 0 0 0 1437 0 0 0 0 237 0 0 0 97 0 0 0 0 0 0 0 0 0 2005 0 0 0 0 315 0 0 0 278 0 0 0 0 0 0 0 0 0 2005 0 0 0 0 5599 0 0 0 278 0 0 0 0 0 0 0 0 0 289681.24 0 0 0 0 11795641.68 0 0 0 146472.37 0 0 0 0 0 12231795.29 0 0 6989.14 1101415296 1164539730 30 General Hospitals LUTHERAN GENERAL CHILDRENS HOS 600681174 200 Cook CHILDRENS Hospital designated as childrens hospitals and paid a Per Diem rate. 0 0 Perinatal Level II Center 0 0 0 0 0 4331 0 0 0 0 1019 0 0 0 2304 0 0 0 0 0 0 0 0 0 5819 0 0 0 0 918 0 0 0 3034 0 0 0 0 0 0 0 0 0 5848 0 0 0 0 7325 0 0 0 3052 0 0 0 0 0 0 0 0 0 953369.57 0 0 0 0 19276746.34 0 0 0 1576218.41 0 0 0 0 0 21806334.32 0 0 8604.7 1101146050 1033132220 30 General Hospitals BARNES JEWISH HOSPITAL 631101621 826 Missouri DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 0 0 4 0 0 1318 0 0 0 0 1947 6 0 4 3168 0 0 0 0 0 0 7 0 0 1725 0 0 0 0 1968 7 0 4 7940 0 0 0 0 0 0 7 0 0 1725 0 0 0 0 12677 7 0 67 7940 0 0 0 0 0 0 464.64 0 0 230424.75 0 0 0 0 17125282.25 0 0 141681.82 1720840.95 0 0 0 0 0 19218694.41 0 0 14263.08 1101266657 1619034659 30 General Hospitals CARLE FOUNDATION HOSPITAL 618012529 19 Champaign DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 Perinatal Level II Center 0 6 0 0 0 8053 0 0 0 0 4648 0 0 5 7079 0 0 0 0 0 17 0 0 0 13665 0 0 0 0 3648 0 0 5 15806 0 0 0 0 0 21 0 0 0 13669 0 0 0 0 19501 0 0 5 15877 0 0 0 0 0 2088.98 0 0 0 2766973.14 0 0 0 0 22860063.18 0 0 11319.89 5171903.69 0 0 0 0 0 30812348.88 0 0 23614.44 1101282699 1144549775 30 General Hospitals WEST SUBURBAN MEDICAL CNTR 603022519 200 Cook DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 0 2 0 0 0 8991 0 0 0 0 3120 0 0 6 2740 0 0 0 0 0 2 0 0 0 13054 0 0 0 0 2140 0 0 6 6031 0 0 0 0 0 2 0 0 0 13054 0 0 0 0 7937 0 0 9 6073 0 0 0 0 0 101.31 0 0 0 1947361.88 0 0 0 0 5830191.09 0 0 16255.18 924171.31 0 0 0 0 0 8718080.77 0 0 26697.08 1101256561 1871678334 30 General Hospitals KINDRED HOSPITAL CHICAGO 601642628 200 Cook ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 858 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1061 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23602 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19018803.22 0 0 0 0 0 0 0 0 0 19018803.22 0 0 26952.01 1101074153 1629328604 31 Psychiatric Hospitals GARFIELD PARK HOSPITAL 999999999 200 Cook 0 0 0 0 238 0 0 0 0 0 0 0 416 0 0 0 0 0 0 0 0 0 0 350 0 0 0 0 0 0 0 442 0 0 0 0 0 0 0 0 0 0 2361 0 0 0 0 0 0 0 4701 0 0 0 0 0 0 0 0 0 0 355034.62 0 0 0 0 0 0 0 5675723.11 0 0 0 0 0 0 0 0 0 6030757.73 0 0 38010.15 1101292884 1306921911 30 General Hospitals SAINT MARGARET MERCY NO 463201931 815 Indiana DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 0 2 0 0 0 3735 0 0 0 0 932 0 0 0 412 0 0 0 0 0 3 0 0 0 5275 0 0 0 0 771 0 0 0 822 0 0 0 0 0 3 0 0 0 5275 0 0 0 0 3876 0 0 0 847 0 0 0 0 0 0 0 0 0 844628.38 0 0 0 0 2883403.62 0 0 0 126805.46 0 0 0 0 0 3854837.46 0 0 68879.56 1101408586 1992727663 30 General Hospitals ST LOUIS CHILDRENS HOSPITAL 631101077 826 Missouri CHILDRENS Hospital designated as childrens hospitals and paid a Per Diem rate. 0 0 Perinatal Level II Center 0 0 0 0 0 1334 0 0 0 0 962 0 0 0 1706 0 0 0 0 0 0 0 0 0 1628 0 0 0 0 893 0 0 0 2546 0 0 0 0 0 0 0 0 0 1628 0 0 0 0 6718 0 0 0 2851 0 0 0 0 0 0 0 0 0 278932.69 0 0 0 0 17649627.47 0 0 0 1318158.21 0 0 0 0 0 19246718.37 0 0 83068.91 1101386116 1962572396 30 General Hospitals ST MARYS HEALTH CENTER 631171811 826 Missouri DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 Perinatal Level II Center 0 0 0 0 0 195 0 0 0 0 832 0 0 0 381 0 0 0 0 0 0 0 0 0 257 0 0 0 0 426 0 0 0 846 0 0 0 0 0 0 0 0 0 257 0 0 0 0 2606 0 0 0 854 0 0 0 0 0 0 0 0 0 32347.5 0 0 0 0 2530749.78 0 0 0 203992.38 0 0 0 0 0 2767089.66 0 0 86693.06 1101489395 1093894990 30 General Hospitals COMER CHILDRENS HOSPITAL 605615314 30 DuPage CHILDRENS Hospital designated as childrens hospitals and paid a Per Diem rate. 0 0 General Hospital - Children Section 0 0 0 0 0 7260 0 0 0 0 1765 0 0 0 2035 0 0 0 0 0 0 0 0 0 10073 0 0 0 0 1535 0 0 0 2995 0 0 0 0 0 0 0 0 0 10075 0 0 0 0 13670 0 0 0 3000 0 0 0 0 0 0 0 0 0 1628571.4 0 0 0 0 38338500.87 0 0 0 2486522.77 0 0 0 0 0 42453595.04 0 0 118246.35 1101214589 1790734127 30 General Hospitals CHILDRENS HOSPITAL OF ILLINOIS 616370001 80 Peoria CHILDRENS Hospital designated as childrens hospitals and paid a Per Diem rate. 0 0 PERINATAL LEVEL III CENTER 0 0 0 0 0 3133 0 0 0 0 1789 0 0 0 2722 0 0 0 0 0 0 0 0 0 4146 0 0 0 0 1474 0 0 0 4153 0 0 0 0 0 0 0 0 0 4149 0 0 0 0 12436 0 0 0 4226 0 0 0 0 0 0 0 0 0 763811.04 0 0 0 0 26102384.48 0 0 0 2578666.64 0 0 0 0 0 29444862.16 0 0 141771.28 1101011787 1235234535 30 General Hospitals LURIE CHILDRENS HOSPITAL 606112991 200 Cook CHILDRENS Hospital designated as childrens hospitals and paid a Per Diem rate. 0 0 PERINATAL LEVEL III CENTER 0 0 1101 0 0 12388 0 0 0 0 4017 0 0 0 7697 0 0 0 0 0 0 7471 0 0 17837 0 0 0 0 3890 0 0 0 12767 0 0 0 0 0 0 7471 0 0 17837 0 0 0 0 26361 0 0 0 12767 0 0 0 0 0 0 504721.37 0 0 4097322.17 0 0 0 0 90901353.56 0 0 0 10055895.17 0 0 0 0 0 105559292.3 0 0 303190.79 1101170905 1518057769 30 General Hospitals MT SINAI HOSP MED CTR CHICAGO 606081704 200 Cook DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 0 3 1040 0 0 6040 0 0 0 0 6440 0 0 12 5357 0 0 0 0 0 17 2998 0 0 8633 0 0 0 0 4760 0 0 12 9272 0 0 0 0 0 17 6780 0 0 8637 0 0 0 0 20428 0 0 17 10071 0 0 0 0 0 986.7 409309.05 0 0 1950383.57 0 0 0 0 27134460.28 0 0 37847.98 2034668.05 0 0 0 0 0 31567655.63 0 0 378465.53 1101157997 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101158001 98 Waiver service provider--TBI (DHS/DRS) 98 Tazewell 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101158003 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101158038 40 Federally Qualified Health Centers 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101158048 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101158075 93 Waiver service provider--HIV/AIDS (DHS/DRS) 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101158077 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101158095 92 Waiver service provider--Disability (DHS/DRS) 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101158112 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101158121 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101158123 92 Waiver service provider--Disability (DHS/DRS) 816 Iowa 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101158138 33 Nursing Facilities 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101158174 92 Waiver service provider--Disability (DHS/DRS) 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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Coordination Entities (CCEs). 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HEALTHCARE CONSORTIUM OF IL 60419 200 Cook 0 0 2476 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1825345.17 0 1101537890 78 Accountable Care Act Entities (ACEs) HEALTHCURA 60661 200 Cook 0 0 34612 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4060489.2 0 1101537891 80 Prepaid health plan--Health maintenance organization HEALTHSPRING OF ILLINOIS MMP 60604 200 Cook 0 0 12455 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 149425277.5 0 1101537892 80 Prepaid health plan--Health maintenance organization HUMANA HEALTH PLAN INC MMP 60661 200 Cook 0 0 12046 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 149783094.6 0 1101537893 80 Prepaid health plan--Health maintenance organization ILLINICARE HEALTH PLAN INC FHP 60559 30 DuPage 0 0 165776 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 464945827.8 0 1101537896 80 Prepaid health plan--Health maintenance organization ILLINICARE HEALTH PLAN INC ICP 60559 30 DuPage 0 0 28904 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 566431949.1 0 1101537899 78 Accountable Care Act Entities (ACEs) ILLINOIS PRTNRSHP FOR HLTH INC 61801 19 Champaign County 0 0 29893 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3966035.8 0 1101537902 79 Care Coordination Entities (CCEs). LARABIDA CLINIC 60649 200 Cook 0 0 638 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 904256.13 0 1101537905 78 Accountable Care Act Entities (ACEs) LOYOLA PHYSICIAN PARTNERS LLC 60153 200 Cook 0 0 23603 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2469979.5 0 1101537908 78 Accountable Care Act Entities (ACEs) LOYOLA UNIVERSITY HLTH SYSTEM 60153 200 Cook 0 0 17029 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 153261 0 1101537911 79 Care Coordination Entities (CCEs). LURIE CHILDREN'S HEALTH LLC 60611 200 Cook 0 0 1772 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2456063.78 0 1101537914 79 Care Coordination Entities (CCEs). MACON CO MENTAL HEALTH BOARD 62523 63 Macon 0 0 931 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 618221.64 0 1101537917 80 Prepaid health plan--Health maintenance organization MERIDIAN HEALTH PLAN INC MMP 60604 200 Cook 0 0 234930 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 766937806 0 1101537920 80 Prepaid health plan--Health maintenance organization MOLINA HEALTHCARE OF ILL FHP 60523 30 DuPage 0 0 94484 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 267771738.9 0 1101537923 80 Prepaid health plan--Health maintenance organization MOLINA HEALTHCARE OF ILLINOIS 60523 30 DuPage 0 0 5569 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75880910.47 0 1101537926 78 Accountable Care Act Entities (ACEs) MYCARE CHICAGO LLC 60625 200 Cook 0 0 51408 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6811245.25 0 1101537929 79 Care Coordination Entities (CCEs). NEXT LEVEL HEALTH PARTNERS 60612 200 Cook 0 0 4005 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6339782.36 0 1101537932 78 Accountable Care Act Entities (ACEs) NEXT LEVEL HEALTH PARTNERS LLC 60612 200 Cook 0 0 11539 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2807976.95 0 1101537935 79 Care Coordination Entities (CCEs). PRECEDENCE CARE COORDINATION 61265 89 Kane County 0 0 739 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1008172.62 0 1101537938 78 Accountable Care Act Entities (ACEs) SMARTPLAN CHOICE 60016 200 Cook 0 0 69850 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8630035.15 0 1101537941 79 Care Coordination Entities (CCEs). TOGETHER4HEALTH LLC 60602 200 Cook 0 0 2026 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3132226 0 1101537944 78 Accountable Care Act Entities (ACEs) UI HEALTH PLUS 60677 200 Cook 0 0 30144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4372738.4 0