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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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